Displaying publications 21 - 40 of 69 in total

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  1. Chew KS, van Merrienboer JJG, Durning SJ
    BMC Med Educ, 2017 Nov 29;17(1):234.
    PMID: 29187172 DOI: 10.1186/s12909-017-1078-x
    BACKGROUND: A key challenge clinicians face when considering differential diagnoses is whether the patient data have been adequately collected. Insufficient data may inadvertently lead to premature closure of the diagnostic process. This study aimed to test the hypothesis that the application of a mnemonic checklist helps to stimulate more patient data collection, thus leading to better diagnostic consideration.

    METHODS: A total of 88 final year medical students were assigned to either an educational intervention group or a control group in a non-equivalent group post-test only design. Participants in the intervention group received a tutorial on the use of a mnemonic checklist aimed to minimize cognitive errors in clinical decision-making. Two weeks later, the participants in both groups were given a script concordance test consisting of 10 cases, with 3 items per case, to assess their clinical decisions when additional data are given in the case scenarios.

    RESULTS: The Mann-Whitney U-test performed on the total scores from both groups showed no statistical significance (U = 792, z = -1.408, p = 0.159). When comparisons were made for the first half and the second half of the SCT, it was found that participants in the intervention group performed significantly better than participants in the control group in the first half of the test, with median scores of 9.15 (IQR 8.00-10.28) vs. 8.18 (IQR 7.16-9.24) respectively, U = 642.5, z = -2.661, p = 0.008. No significant difference was found in the second half of the test, with the median score of 9.58 (IQR 8.90-10.56) vs. 9.81 (IQR 8.83-11.12) for the intervention group and control group respectively (U = 897.5, z = -0.524, p = 0.60).

    CONCLUSION: Checklist use in differential diagnoses consideration did show some benefit. However, this benefit seems to have been traded off by the time and effort in using it. More research is needed to determine whether this benefit could be translated into clinical practice after repetitive use.

  2. Tiong JJL, Kho HL, Mai CW, Lau HL, Hasan SS
    BMC Med Educ, 2018 Jul 17;18(1):168.
    PMID: 30016945 DOI: 10.1186/s12909-018-1274-3
    BACKGROUND: This study was carried out to gauge the prevalence of academic dishonesty among academics in Malaysian universities. A direct comparison was made between academics of healthcare and non-healthcare courses to note the difference in the level of academic integrity between the two groups. In addition, the predisposing factors and implications of academic dishonesty, as well as the different measures perceived to be effective at curbing this problem were also investigated.

    METHODS: A cross-sectional study design with mixed qualitative and quantitative approaches was employed and data collection was carried out primarily using self-administered questionnaire.

    RESULTS: Approximately half (52.5%, n = 74) of all respondents (n = 141) reported having personally encountered at least one case of academic dishonesty involving their peers. The results also revealed the significantly higher prevalence of various forms of academic misconduct among healthcare academics compared to their non-healthcare counterparts. Although respondents were generally conscious of the negative implications associated with academic dishonesty, more than half of all cases of misconduct were not reported due to the indifferent attitude among academics. Low levels of self-discipline and integrity were found to be the major factors leading to academic misdeeds and respondents opined that university managements should be more proactive in addressing this issue.

    CONCLUSIONS: The outcome of this study should serve as a clarion call for all relevant stakeholders to start making immediate amends in order to improve the current state of affairs in academia.

  3. Salari M, Roozbehi A, Zarifi A, Tarmizi RA
    BMC Med Educ, 2018 Aug 10;18(1):195.
    PMID: 30097035 DOI: 10.1186/s12909-018-1305-0
    BACKGROUND: Nursing education in Iran has conventionally focused on lecture-based strategies. Improvements in teaching and learning over the years have led to an expansion of the pedagogies available to educators. Likewise, there has been a suggestion for a move toward more learner-centered teaching strategies and pedagogies that can result in improvement in learning. This study was undertaken to investigate the effects of Problem-Based Learning in developing cognitive skills in learning Pediatric Nursing among university students.

    METHODS: In this quasi-experimental, posttest-only nonequivalent control group design, the subjects were undergraduate students who had enrolled in Pediatric Nursing II at Islamic Azad University in Iran. The experiment was conducted over a period of eight weeks, one two-hour session and two two-hour sessions. Two experimental groups, Pure Problem-Based Learning (PPBL) and the Hybrid Problem- Based Learning (HPBL), and one Lecturing or Conventional Teaching and Learning (COTL) group were involved. In the PPBL group, PBL method with guided questions and a tutor, and in the HPBL group, problem-based learning method, some guided questions, minimal lecturing and a tutor were used. The COTL group, however, underwent learning using conventional instruction utilizing full lecture. The three groups were compared on cognitive performances, namely, test performance, mental effort, and instructional efficiency. Two instruments, i.e., Pediatric Nursing Performance Test (PNPT) and Paas Mental Effort Rating Scale (PMER) were used. In addition, the two-Dimensional Instructional Efficiency Index (IEI) formula was utilized. The statistical analyses used were ANOVA, ANCOVA, and mixed between-within subjects ANOVA.

    RESULTS: Results showed that the PPBL and HPBL instructional methods, in comparison with COTL, enhanced the students' overall and higher-order performances in Pediatric Nursing, and induced higher level of instructional efficiency with less mental effort (p 

  4. Salim H, Lee PY, Ghazali SS, Ching SM, Ali H, Shamsuddin NH, et al.
    BMC Med Educ, 2018 Aug 29;18(1):206.
    PMID: 30157829 DOI: 10.1186/s12909-018-1315-y
    BACKGROUND: Blended learning (BL) is a learning innovation that applies the concept of face-to-face learning and online learning. However, examples of these innovations are still limited in the teaching of postgraduate education within the field of family medicine. Malaysian postgraduate clinical training, is an in-service training experience and face-to-face teaching with the faculty members can be challenging. Given this, we took the opportunity to apply BL in their training. This study provides an exploration of the perceptions of the educators and students toward the implementation of BL.

    METHODS: A qualitative approach was employed using focus group discussions (FGD) and in-depth interviews (IDI) at an academic centre that trains family physicians. Twelve trainees, all of whom were in their hospital specialty's rotations and five faculty members were purposively selected. Three FGDs among the trainees, one FGD and two IDIs among the faculty members were conducted using a semi-structured topic guide. Data were collected through audio-recorded interviews, transcribed verbatim and checked for accuracy. A thematic approach was used to analyse the data.

    RESULTS: There were four main themes that emerged from the analysis. Both educators and trainees bill the perspective that BL encouraged continuity in learning. They agreed that BL bridges the gap in student-teacher interactions. Although educators perceived that BL is in concordance with trainees learning style, trainees felt differently about this. Some educators and trainees perceived BL to be an extra burden in teaching and learning.

    CONCLUSION: This study highlights a mix positive and negative perceptions of BL by educators and trainees. BL were perceived positively for continuity in learning and student-teacher interaction. However, educator and learner have mismatched perception of learning style. BL was also perceived to cause extra burden to both educators and learners. Integrating BL to a traditional learning curriculum is still a challenge. By knowing the strengths of BL in this setting, family medicine trainees in Malaysia can use it to enhance their current learning experience. Future study can investigate different pedagogical designs that suit family medicine trainees and educators in promoting independent learning in postgraduate training.

  5. Alrashdan MS, Alazzam M, Alkhader M, Phillips C
    BMC Med Educ, 2018 Nov 26;18(1):283.
    PMID: 30477562 DOI: 10.1186/s12909-018-1386-9
    BACKGROUND: Differences between dental students in terms of social, economic and cultural backgrounds are likely to impact their professional career plans. The aim of this study was to explore the professional career plans among final year dental students from different backgrounds at a single Middle Eastern institution (Jordan university of Science and Technology-JUST).

    METHODS: Fifth year dental students at JUST were invited to fill out a paper based self-administered questionnaire. Data was collected on students` demographics, their future career plans and the impact of social and economic changes on such plans, their interest in postgraduate studies and the specialty of choice in addition to the influence of a group of factors on that choice. Data was also collected on the value of non-academic workshops, guidance regarding career plans, participants` preferred pattern of work (full-time versus part-time) and retirement plans. Students were categorized according to their nationalities. Pearson's chi squared test, one way ANOVA and post hoc tests were used to measure statistical significance between measured variables and backgrounds of participants. The level of significance was set at P ≤ 0.05.

    RESULTS: A total of 227 students completed the survey (response rate = 84%). 47% of the participants were Jordanians, 27% were Malaysians, 11% were from Gulf States (Saudi Arabia, Bahrain, Kuwait and Qatar), 10% were from conflict zones in the Middle East (Syria, Iraq, Palestine and Yemen) and 5% comprised students from other nationalities. Significant differences were found between students from different backgrounds in their funding sources (Chi square = 132, P 

  6. Chew KS, van Merrienboer JJG, Durning SJ
    BMC Med Educ, 2019 Jan 10;19(1):18.
    PMID: 30630472 DOI: 10.1186/s12909-018-1451-4
    BACKGROUND: Establishing a diagnosis is a complex, iterative process involving patient data gathering, integration and interpretation. Premature closure is a fallacious cognitive tendency of closing the diagnostic process before sufficient data have been gathered. A proposed strategy to minimize premature closure is the use of a checklist to trigger metacognition (the process of monitoring one's own thinking). A number of studies have suggested the effectiveness of this strategy in classroom settings. This qualitative study examined the perception of usability of a metacognitive mnemonic checklist called TWED checklist (where the letter "T = Threat", "W = What if I am wrong? What else?", "E = Evidence" and "D = Dispositional influence") in a real clinical setting.

    METHOD: Two categories of participants, i.e., medical doctors (n = 11) and final year medical students (Group 1, n = 5; Group 2, n = 10) participated in four separate focus group discussions. Nielsen's 5 dimensions of usability (i.e. learnability, effectiveness, memorability, errors, and satisfaction) and Pentland's narrative network were adapted as the framework to study the usability and the implementation of the checklist in a real clinical setting respectively.

    RESULTS: Both categories (medical doctors and medical students) of participants found that the TWED checklist was easy to learn and effective in promoting metacognition. For medical student participants, items "T" and "W" were believed to be the two most useful aspects of the checklist, whereas for the doctor participants, it was item "D". Regarding its implementation, item "T" was applied iteratively, items "W" and "E" were applied when the outcomes did not turn out as expected, and item "D" was applied infrequently. The one checkpoint where all four items were applied was after the initial history taking and physical examination had been performed to generate the initial clinical impression.

    CONCLUSION: A metacognitive checklist aimed to check cognitive errors may be a useful tool that can be implemented in the real clinical setting.

  7. Chua SS, Lai PSM, Sim SM, Tan CH, Foong CC
    BMC Med Educ, 2019 Apr 05;19(1):101.
    PMID: 30953493 DOI: 10.1186/s12909-019-1525-y
    BACKGROUND: The success of interprofessional collaboration in healthcare services requires a paradigm shift in the training of future health profession practitioners. This study aimed to develop and validate an instrument to measure Student Acceptance of Interprofessional Learning (SAIL) in Malaysia, and to assess this attribute among medical and pharmacy students using a prescribing skills training workshop.

    METHODS: The study consisted of two phases. In Phase 1, a 10-item instrument (SAIL-10) was developed and tested on a cohort of medical and pharmacy students who attended the workshop. In Phase 2, different cohorts of medical and pharmacy students completed SAIL-10 before and after participating in the workshop.

    RESULTS: Factor analysis showed that SAIL-10 has two domains: "facilitators of interprofessional learning" and "acceptance to learning in groups". The overall SAIL-10 and the two domains have adequate internal consistency and stable reliability. The total score and scores for the two domains were significantly higher after students attended the prescribing skills workshop.

    CONCLUSIONS: This study produced a valid and reliable instrument, SAIL-10 which was used to demonstrate that the prescribing skills workshop, where medical and pharmacy students were placed in an authentic context, was a promising activity to promote interprofessional learning among future healthcare professionals.

  8. Yadav H, Jegasothy R, Ramakrishnappa S, Mohanraj J, Senan P
    BMC Med Educ, 2019 Jun 18;19(1):218.
    PMID: 31215454 DOI: 10.1186/s12909-019-1662-3
    BACKGROUND: Ethical behavior and professionalism is an ideal characteristic required of medical students and included as 'must achieve' and critical aspect of medical students' curriculum. This study proposes to determine the perceived unethical and unprofessional behavior among medical students in a private medical university from year 1 to year 5 of the medical curriculum.

    METHODS: A cross-sectional study was conducted among year 1 to year 5 medical students in a private medical university. A self-administered questionnaire was used with the 3 major domains of professionalism and ethics i.e. discipline plagiarism and cheating.

    RESULTS: A total of 464 respondents responded to the survey and they included medical students from year 1 and year 2 (pre-clinical) and years 3-5 (clinical years). Majority of the students, 275 (59.2%) answered that they had not seen any form of unethical behavior among other students. The females seem to have a larger number 172(63%) among the same gender compared to the males. Majority 352 (75%) of them had not heard of the 'Code of Professional Conduct by the Malaysian Medical Council'. About fifty three (53.1%) of the students answered that the training was sufficient.

    CONCLUSIONS: This study showed that the perception of unethical behavior was 58.8% in the 1st year (pre-clinical) and it increased to 65.2% in the 5th year (clinical). The 3 main discipline issues were students do not show interest in class (mean 2.9/4), they are rude to other students (mean 2.8/4) and talking during class (mean 2.6/4). Despite the existence of unethical behavior among the students majority of them (71.7%) claimed that they had adequate training in ethics and professionalism. It is proposed that not only the teaching of ethics and professionalism be reviewed but an assessment strategy be introduced to strengthen the importance of professionalism and ethics.

  9. Ismail MA, Ahmad A, Mohammad JA, Fakri NMRM, Nor MZM, Pa MNM
    BMC Med Educ, 2019 Jun 25;19(1):230.
    PMID: 31238926 DOI: 10.1186/s12909-019-1658-z
    BACKGROUND: Gamification is an increasingly common phenomenon in education. It is a technique to facilitate formative assessment and to promote student learning. It has been shown to be more effective than traditional methods. This phenomenological study was conducted to explore the advantages of gamification through the use of the Kahoot! platform for formative assessment in medical education.

    METHODS: This study employed a phenomenological design. Five focus groups were conducted with medical students who had participated in several Kahoot! sessions.

    RESULTS: Thirty-six categories and nine sub-themes emerged from the focus group discussions. They were grouped into three themes: attractive learning tool, learning guidance and source of motivation.

    CONCLUSIONS: The results suggest that Kahoot! sessions motivate students to study, to determine the subject matter that needs to be studied and to be aware of what they have learned. Thus, the platform is a promising tool for formative assessment in medical education.

  10. Mohd S, Yusof N, Lai LL, Hossain MG, Ramalingam S, Hamid SSA, et al.
    BMC Med Educ, 2019 Jul 01;19(1):238.
    PMID: 31262281 DOI: 10.1186/s12909-019-1685-9
    BACKGROUND: Procurement of bone allograft must be performed by trained personnel. Improper handling and lack of knowledge during bone procurement will lead to contamination hence jeopardizing quality of the procured bones and expose bone recipients to risks of infection in post-operative phase. Bone procurement workshop is the fundamental training programme to enhance skill among personnel who has been or will be involved in bone procurement. This study evaluated the effectiveness of the workshop contents including teaching materials by assessing the knowledge on bone procurement among the participants before and after the workshop.

    METHODS: Bone procurement workshop was held for 2 days for doctors and paramedics. The knowledge on bone procurement was evaluated in pre- and post-assessments by answering self administration questionnaire before and after the workshop, respectively.

    RESULTS: A total of 50 participants comprised of doctors and paramedics attended the workshop however only 15 (55.6%) doctors and 12 (44.4%) paramedics completed the assessments. Overall, the mean total score for the post-assessment (61.4%) was significantly higher (p 

  11. Griffiths AW, Cheong WL, Saw PS, Parveen S
    BMC Med Educ, 2020 Mar 20;20(1):82.
    PMID: 32192471 DOI: 10.1186/s12909-020-1972-5
    BACKGROUND: One of the major challenges worldwide is the stigma associated with dementia. There is limited dementia awareness within Malaysian communities, including levels of confusion regarding the differences between dementia and the usual ageing progress, which can lead to delays in support seeking. The need for additional training and education for healthcare professionals has been highlighted. The present study aimed to evaluate the benefits of a one-hour dementia education session (Dementia Detectives workshop) for pharmacy and medicine undergraduate students at a Malaysian university.

    METHODS: Participants attended the workshop and completed pre- (Time 1) and post-workshop (Time 2) questionnaires consisting of validated measures exploring attitudes towards dementia and older people more broadly.

    RESULTS: A total of 97 students were recruited. Attitudes towards people with dementia showed significant positive changes between Time 1 and Time 2, whereas no differences were found for attitudes towards older people.

    CONCLUSIONS: As medical and pharmacy students develop theoretical knowledge, practical skills and professional attitudes during their undergraduate studies, it is important for students to also learn about the humanistic side of diseases and conditions through workshops such as the one presented here. Further research should now be conducted to consider how Dementia Detectives can be delivered to non-healthcare students and what the barriers and facilitators to wider delivery are.

  12. Puthiaparampil T, Rahman MM
    BMC Med Educ, 2020 May 06;20(1):141.
    PMID: 32375739 DOI: 10.1186/s12909-020-02057-w
    BACKGROUND: Multiple choice questions, used in medical school assessments for decades, have many drawbacks such as hard to construct, allow guessing, encourage test-wiseness, promote rote learning, provide no opportunity for examinees to express ideas, and do not provide information about strengths and weakness of candidates. Directly asked, directly answered questions like Very Short Answer Questions (VSAQ) are considered a better alternative with several advantages.

    OBJECTIVES: This study aims to compare student performance in MCQ and VSAQ and obtain feedback. from the stakeholders.

    METHODS: Conduct multiple true-false, one best answer, and VSAQ tests in two batches of medical students, compare their scores and psychometric indices of the tests and seek opinion from students and academics regarding these assessment methods.

    RESULTS: Multiple true-false and best answer test scores showed skewed results and low psychometric performance compared to better psychometrics and more balanced student performance in VSAQ tests. The stakeholders' opinions were significantly in favour of VSAQ.

    CONCLUSION AND RECOMMENDATION: This study concludes that VSAQ is a viable alternative to multiple-choice question tests, and it is widely accepted by medical students and academics in the medical faculty.

  13. Lai AKH, Noor Azhar AMB, Bustam AB, Tiong XT, Chan HC, Ahmad RB, et al.
    BMC Med Educ, 2020 Aug 12;20(1):263.
    PMID: 32787921 DOI: 10.1186/s12909-020-02173-7
    BACKGROUND: Although gamification increases user engagement, its effectiveness in point-of-care ultrasonographic training has yet to be fully established. This study was conducted with the primary outcome of evaluating its effectiveness in point-of-care ultrasonographic training as compared to conventional approach.

    METHODS: Participants consisting of junior doctors were randomized into either the (1) gamified or the (2) conventional educational approach for ultrasonographic training.

    RESULTS: A total of 31 junior doctors participated in this study (16 participants in gamified arm, 15 in the conventional arm after one participant from the conventional arm dropped out due to work commitment). Two-way mixed ANOVA test showed that there was no statistically significant interaction between the types of educational approach and time of testing (pre-test, post-test, 2 months post-training) for both theoretical knowledge score and practical skills score, with F(2, 58) = 39.6, p 

  14. Melson E, Davitadze M, Aftab M, Ng CY, Ooi E, Blaggan P, et al.
    BMC Med Educ, 2020 Aug 18;20(1):274.
    PMID: 32811488 DOI: 10.1186/s12909-020-02190-6
    BACKGROUND: Simulation-based learning (SBL) has been increasingly used in both undergraduate and postgraduate medical training curricula. The aim of Simulation via Instant Messaging-Birmingham Advance (SIMBA) is to create a simple virtual learning environment to improve trainees' self-reported confidence in diabetes and Endocrinology.

    METHODS: This study was done as part of the continuous professional development for Health Education England West Midlands speciality trainees in diabetes and Endocrinology. Standardized transcripts of anonymized real-life endocrinology (endocrine session) and diabetes cases (diabetes session) were used in the simulation model. Trainees interacted with moderators through WhatsApp® in this model. All cases were then discussed in detail by a consultant endocrinologist with reference to local, national and international guidelines. Trainee acceptance rate and improvement in their self-reported confidence levels post-simulation were assessed.

    RESULTS: 70.8% (n = 17/24) and 75% (n = 18/24) strongly agreed the simulation session accommodated their personal learning style and the session was engaging. 66.7% (n = 16/24) strongly felt that the simulation was worth their time. In the endocrine session, there was a significant improvement in trainees' confidence in the management of craniopharyngioma (p = 0.0179) and acromegaly (p = 0.0025). There was a trend towards improved confidence levels to manage Cushing's disease and macroprolactinoma. In diabetes session, there was a significant improvement in trainees' confidence to interpret continuous glucose monitor readings (p = 0.01). There was a trend towards improvement for managing monogenic diabetes, hypoglycaemic unawareness and interpreting Libre readings. Overall, there was a significant improvement in trainees' confidence in managing cases that were discussed post-simulation.

    CONCLUSION: SIMBA is an effective learning model to improve trainees' confidence to manage various diabetes and endocrine case scenarios. More sessions with a variety of other speciality case scenarios are needed to further assess SIMBA's effectiveness and application in other areas of medical training.

  15. Dash NR, Guraya SY, Al Bataineh MT, Abdalla ME, Yusoff MSB, Al-Qahtani MF, et al.
    BMC Med Educ, 2020 Nov 30;20(1):480.
    PMID: 33256705 DOI: 10.1186/s12909-020-02358-0
    BACKGROUND: In the current wave of educational reforms, understanding teaching styles of medical faculty can help modify instructional strategies for effective teaching. Few studies have probed distinctive teaching styles of medical faculty. We compared preferred teaching styles of faculty from seven medical schools in United Arab Emirates, the Netherlands, Saudi Arabia, Malaysia, Pakistan, and Sudan.

    METHODS: The validated Grasha-Riechmann teaching style inventory was administered online for data collection and used SPSS version 20.0 for statistical analysis.

    RESULTS: Of the 460 invitees, 248 responded (response rate; 54%). Delegator teaching style was most common with a highest median and mean of 2.38 and 2.45, respectively. There was a significant correlation between expert and authority teaching styles, correlation coefficient 0.62. Similarly, we found a significant correlation between authority teaching style and nature of curriculum, correlation coefficient 0.30. Multiple regression analysis showed that only authority teaching style and male gender had significant correlation. Interestingly, 117 (47%) teachers disagreed with the teaching philosophy of delivering course contents by strictly following learning outcomes. Female teachers (114/248) were more willing to negotiate with their students regarding how and what to teach in their course, while male teachers tended to allow more autonomy by allowing students to set their learning agenda.

    CONCLUSIONS: This study showed that the medical teachers preferred delegator teacher style that promotes students' collaboration and peer-to-peer learning. Most teachers are conscious of their teaching styles to motivate students for scientific curiosity. These findings can help medical educators to modify their teaching styles for effective learning.

  16. Mohd Shafiaai MSF, Kadirvelu A, Pamidi N
    BMC Med Educ, 2020 Dec 07;20(1):494.
    PMID: 33287807 DOI: 10.1186/s12909-020-02408-7
    BACKGROUND: PASS is a peer-led structured academic mentoring program designed to provide academic assistance for new students in their transition from college to university studies and also for students struggling in certain units. This study aims to establish acquired skills by peer leaders associated with peer-led mentoring via the PASS program, and to explore the role played by these acquired skills in their journey to become a successful doctor.

    METHODS: Study participants were forty selected second-year undergraduate medical students at Monash University Malaysia with commendable examination results. Validated pre-test and post-test questionnaires were administered to explore changes in the level of communication, leadership, professional, and pedagogical skills before and after participation in peer mentoring program. Qualitative analysis of focused group interviews was performed by an independent investigator to identify how the skills developed as a peer mentor may help with becoming a good doctor. Major themes were identified with the thematic-analysis approach.

    RESULTS: Thirty-eight students completed the pre-test and post-test questionnaires. Peer leaders reported improvement in oral and written skills for teaching; increased confidence to give constructive feedback; better stress management; efficient time management; improved interpersonal skills; and enhanced problem-solving and critical thinking capabilities. Eight major themes were identified from the interview and peer leaders reported positive experience of working in diverse environments and shouldering of responsibilities.

    CONCLUSIONS: Peer-led mentoring provides a good opportunity for medical students to shoulder responsibilities as a leader and offers an experience of managing a team of their peers and juniors which in turn may enhance their communication, interpersonal, and leadership skills.

  17. Puthiaparampil T, Rahman M
    BMC Med Educ, 2021 Jan 07;21(1):29.
    PMID: 33413332 DOI: 10.1186/s12909-020-02463-0
    BACKGROUND: Distractor efficiency and the optimum number of functional distractors per item in One Best Answer Questions have been debated. The prevalence of non-functional distractors has led to a reduction in the number of distractors per item with the advantage of adding more items in the test. The existing literature eludes a definite answer to the question of what distractor efficiency best matches excellent psychometric indices. We examined the relationship between distractor efficiency and the psychometric indices of One Best Answer Questions in search of an answer.

    METHODS: We analysed 350 items used in 7 professional examinations and determined their distractor efficiency and the number of functional distractors per item. The items were sorted into five groups - excellent, good, fair, remediable and discarded based on their discrimination index. We studied how the distractor efficiency and functional distractors per item correlated with these five groups.

    RESULTS: Correlation of distractor efficiency with psychometric indices was significant but far from perfect. The excellent group topped in distractor efficiency in 3 tests, the good group in one test, the remediable group equalled excellent group in one test, and the discarded group topped in 2 tests.

    CONCLUSIONS: The distractor efficiency did not correlate in a consistent pattern with the discrimination index. Fifty per cent or higher distractor efficiency, not hundred percent, was found to be the optimum.

  18. Hadie SNH, Yusoff MSB, Arifin WN, Kasim F, Ismail ZIM, Asari MA, et al.
    BMC Med Educ, 2021 Jan 14;21(1):50.
    PMID: 33446203 DOI: 10.1186/s12909-020-02467-w
    BACKGROUND: The Anatomy Education Environment Measurement Inventory (AEEMI) evaluates the perception of medical students of educational climates with regard to teaching and learning anatomy. The study aimed to cross-validate the AEEMI, which was previously studied in a public medical school, and proposed a valid universal model of AEEMI across public and private medical schools in Malaysia.

    METHODS: The initial 11-factor and 132-item AEEMI was distributed to 1930 pre-clinical and clinical year medical students from 11 medical schools in Malaysia. The study examined the construct validity of the AEEMI using exploratory and confirmatory factor analyses.

    RESULTS: The best-fit model of AEEMI was achieved using 5 factors and 26 items (χ 2 = 3300.71 (df = 1680), P

  19. Ngim CF, Fullerton PD, Ratnasingam V, Arasoo VJT, Dominic NA, Niap CPS, et al.
    BMC Med Educ, 2021 Mar 24;21(1):180.
    PMID: 33761946 DOI: 10.1186/s12909-021-02585-z
    BACKGROUND: The Objective Structured Clinical Exam (OSCE) is a useful means of generating meaningful feedback. OSCE feedback may be in various forms (written, face to face and audio or video recordings). Studies on OSCE feedback are uncommon, especially involving Asian medical students.

    METHODS: We compared two methods of OSCE feedback delivered to fourth year medical students in Malaysia: (i) Face to face (FTF) immediate feedback (semester one) (ii) Individualised enhanced written (EW) feedback containing detailed scores in each domain, examiners' free text comments and the marking rubric (semester two). Both methods were evaluated by students and staff examiners, and students' responses were compared against their OSCE performance.

    RESULTS: Of the 116 students who sat for both formative OSCEs, 82.8% (n=96) and 86.2% (n=100) responded to the first and second survey respectively. Most students were comfortable to receive feedback (91.3% in FTF, 96% in EW) with EW feedback associated with higher comfort levels (p=0.022). Distress affected a small number with no differences between either method (13.5% in FTF, 10% in EW, p=0.316). Most students perceived both types of feedback improved their performance (89.6% in FTF, 95% in EW); this perception was significantly stronger for EW feedback (p=0.008). Students who preferred EW feedback had lower OSCE scores compared to those preferring FTF feedback (mean scores ± SD: 43.8 ± 5.3 in EW, 47.2 ± 6.5 in FTF, p=0.049). Students ranked the "marking rubric" to be the most valuable aspect of the EW feedback. Tutors felt both methods of feedback were equally beneficial. Few examiners felt they needed training (21.4% in FTF, 15% in EW) but students perceived this need for tutors' training differently (53.1% in FTF, 46% in EW) CONCLUSION: Whilst both methods of OSCE feedback were highly valued, students preferred to receive EW feedback and felt it was more beneficial. Learning cultures of Malaysian students may have influenced this view. Information provided in EW feedback should be tailored accordingly to provide meaningful feedback in OSCE exams.

  20. Albarrak AI, Zakaria N, Almulhem J, Khan SA, Karim NA
    BMC Med Educ, 2021 Apr 08;21(1):199.
    PMID: 33832479 DOI: 10.1186/s12909-021-02639-2
    BACKGROUND & OBJECTIVE: Medical schools have evolved toward competency-based education and active learner-centered strategies. Medical informatics course was introduced in 2011 in the 3rd year at the College of Medicine (CoM), King Saud University (KSU), to enhance future medical graduates with technological and information competencies. Modified team-based learning and blended learning were emphasized using face-to-face lectures, various e-learning technologies, workshop and seminars. The current study's main objective was to assess students' perceptions towards blended and modified team-based learning at the CoM in KSU.

    METHODS: A survey was distributed to medical students in three consecutive years: 2017-2019. The survey contains items regarding student perception of various types of blended learning techniques applied in the course. The survey was administered using i-Clicker; an interactive device that enables students to answer survey questions. Descriptive statistics were used to examine the perception of students on these blended learning dimensions investigated.

    RESULTS: Seven-hundred and one student responded to the questionnaire (male; 69.5%, female 30.5%). Out of which, 59.1% of students found team interactions positively supported discussions and asked questions freely, and 48.1% expressed that working in groups facilitated their learning process. However, 56.0% of students chose face-to-face lectures as the most preferred class activities followed by discussion 23.8%. More than 78% of participants agree that online quizzes are good experience and enjoyable. Grade center where students can check for marks and attendance also received high perception (66.3%).

    CONCLUSION: Introducing modified team-based and blended-learning are considered challenging, and therefore, investigating their perceptions can provide useful insights into how these methods could be used more effectively. The blended-learning technique is highly essential in teaching medical informatics to overcome challenges faced due to a large number of students and the need for various exposures to reach the course's learning goals. Moreover, it is noticed that students were engaged in face-to-face and online activities, furthermore, modified team-based learning reported facilitating learning and asking questions without embarrassment.

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