Recurrent respiratory papillomatosis (RRP) is a rare cause of childhood stridor which typically presents before the age of five years and results from the vertical transmission of the human papilloma virus. Genotypes 11 and 6 are commonly implicated in RRP. Following vertical transmission, the human papilloma virus (HPV) causes overgrowth of the airway epithelium which causes partial airway obstruction and the symptoms of stridor. The mainstay management is surgical debridement of the papillomata but the recurrence rate subsequent to surgery is high, such that most children will require repeated surgical procedures at regular interval. Medical adjuvant therapy can be used, but data is limited and the medications are used on an off-label basis. This case highlights the ethical considerations that need to be made when using off-label medications in paediatric patients.
Objectives: This investigation focused on finding the changes in learning approaches of students’ while experiencing physiology curriculum and to explore the reflection of changes if any, on their critical thinking skills.
Methods: In this longitudinal study, information on students’ learning approaches was obtained using the revised two factor study process questionnaire (R-SPQ-2F) at the commencement (pre-test) and completion (post-test) of first year MBBS course. The total score and the scores obtained in the critical thinking questions in four physiology assessments were analysed. Pre and post-tests scores in R-SPQ-2F and assessment scores were compared using independent samples t-test and one way repeated measure ANOVA respectively. Correlation of scores between assessments was done using Pearson correlation. A p value < 0.05 was taken as significant.
Results: A significant increase in students’ deep learning approach at the completion of the physiology curriculum when compared to commencement (p < 0.001) was observed. A progressive improvement in their scores as they experienced the curriculum was also noticed. A moderate correlation among critical thinking questions scores and a strong correlation between critical thinking questions and total essay scores were also recorded.
Conclusion: The study revealed improvement in students’ deep approach to learning in physiology which was reflected in their performance in critical thinking questions.
Study site: Melaka Manipal Medical College, Manipal University, India
Introduction: Nurses are generally trained on the procedures of blood transfusion during their years of service. However, the level of knowledge varies among individuals and healthcare centres. Thus, this study addresses a knowledge gap regarding nurses’ knowledge and transfusion safety in the local clinical setting. Objectives: This study aimed to determine nurses’ level of knowledge of various phases of blood transfusion and associate this knowledge with their socio-professional details. Methods: This was a cross-sectional, quantitative study. The target population was in-patient ward nurses at Hospital Pulau Pinang. The systematic random sampling method was used to select 185 nurses to participate in this study. Data were collected using a validated research questionnaire that consisted of 31 items (9 items related to socio-professional factors and 22 knowledge items). Data were analysed using descriptive and inferential analyses. Results: The overall knowledge score was moderate (mean = 70.44%, SD = 11.35). None of the nurses was able to answer all of the knowledge questions correctly. Of the participants, 72.29%, 71.75%, and 67.14% exhibited knowledge of blood bag collection and patient preparation; pre-transfusion nursing activities; and during and post-transfusion nursing responsibilities and management of transfusion reactions, respectively. Factors such as age, years of service, department, and availability of the transfusion policy in the ward significantly affected the mean knowledge scores. Conclusion: Nurses’ knowledge of blood transfusion at Hospital Pulau Pinang was moderate. More training and courses should be provided to improve their knowledge.
Mastering the art of conducting a research along with the competitive era of publishing papers showed the importance of undergraduate research. The purpose of this research was to study the impact of undergraduate research “Special Study Module (SSM)” on Universiti Kebangsaan Malaysia (UKM) medical students and alumni.
Methodology: This was a cross-sectional study whereby 64 fifth year UKM medical students of academic-session 2014/2015 and 49 alumni of year 2010 were participated on their SSM research activities. The questionnaire administered online which enquired on participants’ level of interest, confidence and SSM research experiences. Frequency and percentage distribution were used for descriptive analysis.
Result: Out of 119 participants,113 responded giving a response rate of 95%. More than 90% respondents in both group felt that SSM experience was enriching and 80%–90% felt SSM experience was pleasant. In both groups 47%–50% respondents believed, SSM experience contributed their high level of interest on research. The most influencing factors on their level of interest were supervisor guidance as reported by73%–80% respondents. It was said that SSM supervisor was academically stimulating, impressive as role model and supportive. The most confidence skill was the ability to function within a group and least confidence skill was manuscript writing.
Conclusion: Undergraduate SSM research showed positive impact on participants’ research activities. More in-depth analysis should be considered especially on manuscript writing as the students were least confident in this skill.
Introduction: Investigation on spiritual issue in healthcare practice received less attention. Muslims valued pray activity or known as salat as one of the important daily activity. However, negligible study is available on salat as the end goal of occupational therapy intervention. This study aims to investigate the awareness and the impact of Muslim-culture on occupational therapists in Malaysia. Methods: A cross-sectional survey study was conducted via internet-based and manual paper-and-pencil survey throughout occupational therapists in Malaysia. Descriptive and inferential statistics using percentage, Cronbach’s alpha and Chi-square was implemented on the findings. Results: In total, 119 occupational therapists responded. The questionnaire has overall internal consistency ofα = 0.74. Occupational therapists have positive perceptions on spiritual activity but poorly translated into service implementation and faced challenges. Factors such as level of education, years of experience, religion, working location and work setting were significant on the awareness, perception, practice and challenges. Cultural-based practice is challenging for occupational therapy even in the majority-practice context. Occupational therapists should differentiate between belief and activity in spiritual issue to provide a better assistance for the clients. Conclusion: This study showed continuing education is desired to drive the occupational therapy profession for a better cultural-sensitivity service delivery.
ntroduction: In the marking of objective structured clinical examination (OSCE), checklist scoring and global rating are two commonly used scoring systems. Objective: The purpose of this study was to examine correlations between checklist scores and global ratings for four OSCE stations of different station type. Method: Data for this study was obtained from the Final Year OSCE (n=185). Each station’s score sheet consisted of a detailed checklist of items examined. A global rating scale was also included for the examiner to indicate the global assessment for the station. Spearman’s rho correlation coefficients between checklist scores and global ratings were computed for four stations of different station type. For each station, correlations between checklist scores and global ratings were also checked across the three parallel circuits running concurrently and throughout the four rounds. Result: Spearman’s rho correlation coefficients (ρ) between checklist scores and global ratings for the four stations ranged between 0.62 to 0.88, at p
Introduction: Medical school expected to be a time of personal development, achievement, and well-being. However, research shows that there are many negative effects on students’ mental health due to the current educational process. Objective: This research aimed to determine the prevalence and risk factors of depression, anxiety, and stress among medical students of a private medical university in Malaysia. Method: Cross sectional study was conducted using self-administered questionnaires including socio-demographic factors, DASS-21 and MSSQ-40 questionnaires. Result: Prevalence of stress, anxiety, and depression were 46.9%, 76.2% and 60.2% respectively. Multiple logistic regression analysis showed that academic related stressors were only associated with stress [adjusted OR 1.78, 95% CI (1.23, 2.58), p=0.002]. Group activities related stressors were significantly associated with stress [adjusted OR=1.45, 95%CI (1.20, 1.75), p
Students-t test is the most popular statistical test. The test compares two mean values to judge if they are different or not. For small data it is possible to conduct it using manual calculation – however that is not the case. Researchers would need to use statistical software and packages to conduct their analysis. This guide will help the junior researchers to conduct independent- and paired-t test using STATA software.
The paper discusses on the complexity of the issues surrounding a patient with subluxation of cervical spine in a Down syndrome child. Several relevant issues are discussed including consent in a minor, conflicting decision making between parents and doctors, end-of-life issues, supporting handicapped child with minimal co-morbidities, community ethics, neglect of care by the caregiver and decision making after allowing zonal of parental discretion. Despite the difficulties surrounding parental actions, there are still ethical priorities which have to be considered individually to alleviate the suffering of the patients and the family members. Dealing with patients with chronic illnesses is a challenge for any medical doctors. The case warrants sensitive approach to allow appropriate respect for parental decision despite in disagreement with the clinical team. The term ‘zone of parental discretion’ refers to a controversial area of decision making; and has still many potential conflicts on day to day clinical cases, especially among the conservative society in the East Coast of Peninsular Malaysia.
Objective: The objectives of this study were to determine the effect of a one and a half year educational intervention on the job dissatisfaction of teachers in 30 Community Based Rehabilitation (CBR) centres in Kelantan, Malaysia, and to identify the factors influencing changes in job dissatisfaction following the intervention. Method: Ten educational modules were administered to the teachers. A validated Malay version of Job Content Questionnaire (JCQ) was used pre intervention, mid intervention and post intervention. Result: Repeated Measure ANOVA revealed there was a statistically significant reduction in the mean of job dissatisfaction (p = 0.048). Multiple Linear Regression revealed that co- worker support (β= 0.034 (95% CI = 0.009, 0.059)), having less decision authority (β: -0.023; 95% CI: -0.036, -0.01) and being single (β: -0.107; 95% CI: -0.176,-0.038) were significantly associated with decreases in job dissatisfaction. Conclusion: The intervention program elicited improvement in job satisfaction. Efforts should be made to sustain the effect of the intervention in reducing job dissatisfaction by continuous support visits to CBR centres.
Many researchers have emphasized the importance of teaching stress management and self-care skills to medical students as they are vulnerable to develop psychological health problems. The researchers designed a 4-hour intervention based on the DEAL model to address these problems. This study aimed to determine outcomes of the DEAL-based intervention on medical students’ stress, anxiety and depression symptoms. Methods: A randomized controlled trial study was conducted on 171 medical students. Their stress, anxiety and depression symptoms were measured by the 21-item Depression Anxiety Stress Scale at five intervals; at 2 weeks before the intervention, and at 1 week, 8 weeks, 16 weeks and 32 weeks after the intervention. The mixed model ANCOVA was applied to determine the effect of the intervention on the participants’ psychological health at five intervals. Results: A total of 153 medical students (intervention = 73 and control = 80) completed this study. Results showed that the intervention group experienced significantly lower stress and depression symptoms than the control group. Although anxiety scores are consistently lower in the intervention group, no significant differences between groups were found. Conclusion: These results support the favourable outcomes of the intervention on psychological health of medical students. It is a promising intervention to be considered by medical schools as it consumes minimal amount of time, money, training and man power as well can be implemented easily.
Introduction: Peer mentoring is one of the mentoring essential components in any higher institution of learning. In the Medical Faculty of Universiti Malaysia Sarawak (UNIMAS), this mentoring system has existed long but has not undergone any formal evaluation. Objective: The main objective of this study is to determine the perception of peer mentoring among medical students of Faculty of Medicine and Health Sciences (FMHS), UNIMAS. Method: It was a cross-sectional study using self-administered questionnaire. All medical undergraduate students of FMHS were recruited. Data was analyzed using SPSS version 22. Result: A total of 234 respondents participated in this study. Peer mentoring system was preferred against other mentoring system. Majority of the respondents reported that academic gain was the main benefits they gained from peer mentoring system. Negative attitude of the mentee and poor time management for the meeting were the top two worst experience encountered by both mentors and mentees respectively. More than half of the mentor and mentee perceived that peer mentoring system was beneficial to them compared to other systems, with reason that the interaction between student themselves were more easier and comfortable. Nevertheless, there should be more interaction between the mentors and mentees. Conclusion: The findings indicated there is a positive contribution of peer mentoring towards the mentoring system of the faculty. There is a need to relook at the current mentoring system and consider peer mentoring to improve the student support.
Introduction: Emotional intelligence (EI) refers to the ability to perceive, control and evaluates emotion. Research results found that EI is relevant to organizational development and manpower development. It is also important to academic success, emotional adaptability, stress management and other lifestyle issues. EI principles help one to understand and assess people's behaviors, interpersonal skills, attitudes and potentials. It also plays an important role in human resource planning, job placement and recruitment interviews and selection, business development, customer care services, and more. The study focused on exploring students’ EI, subscales of EI (i.e., personal competencies and social competencies) and its associated factors. Methods: A cross-sectional study was conducted on 571 medical students from year 1, 3 and 5. Years of study, gender, and ethnic groups were included as factor variables. USM Emotional Quotient Inventory (USMEQ-i) was used to measure EI, personal competence and social competence. Results: Years of study significantly associated with EI (F = 18.41, p < 0.001), personal competency (F = 16.93, p < 0.001) and social competency levels (F = 12.92, p < 0.001). There was a decreasing pattern of EI, personal competency and social competency level as medical training progresses. Male significantly had a higher EI (t = -1.99, p < 0.05) and personal competence (t = -1.99, p < 0.05) levels than female medical students. Nevertheless, male and female students had equal levels of social competence (t = -1.39, p = 0.730). Ethnic groups demonstrated no significant association with EI, personal competency and social competency level. Conclusion: This study found that years of study were the main associated factor, followed by gender. In addition, there is a cause of concern regarding the decreasing pattern of EI throughout medical training. Further research is required to investigate this concern, so that appropriate intervention can be taken to alleviate the concern.
Introduction: Clinical educators around the globe agreed that an optimal educational climate is a vital aspect for effective learning to take place. This study was conducted to evaluate the perceptions of graduates toward the quality of clinical education climate in USM medical school. Methods: A cross-sectional study was conducted on a cohort of USM medical graduates. Questionnaires were administered to the graduates to measure their perception on four aspects of clinical education climate that include structure of clinical rotation, clinical teaching and learning activities, quality of lecturers and end clinical rotation assessment across 13 clinical rotations. The graduates were requested to respond to seven-Likert scale ranging from 1(poor) to 7(excellent). Scores of equal to or more than 5 was considered as positive areas, scores of between 4 and 5 were considered as areas for improvement, and scores less than 4 were considered as areas of concern. Data analysis was performed using SPSS version 20. Results: A total of 105 (96.3%) graduates responded to the questionnaire. Results showed only the paediatric rotation obtained positive ratings on all areas of the clinical rotation structure. With regards to teaching and learning activities, the graduates scored most of the clinical rotations between 4 and 5. With regards to the quality of lecturers, most of the clinical rotations obtained score more than 5. Most of the areas related to the end-of-assessment of clinical rotation obtained score more than 5 except for the feedback adequacy, indicating inadequacy of feedback they received. Conclusion: USM medical graduates positively perceived the quality of lecturers during clinical training, however several areas of clinical education related to clinical rotation structure, clinical teaching and learning activities, and feedback practice were perceived by them as areas for improvement. Medical schools should introduce strategic measures to address the concerns raised by the graduates to ensure the best clinical learning experience are provided to the current and future medical students.
Objective: The idea of humanitarianism is evolving with progressing life. Awareness about this global issue has to be emphasized particularly among the younger generation and thus be encouraged to be exposed and involved in humanitarian projects in need. Being responsible citizens of the country one should develop concern about the humanitarian issues, and this attitude needs to be developed from student life. Methods: A cross sectional survey was conducted on 200 participants of the Malaysian and Indian (100 each) health science students using faculty validated close ended questionnaire. Results of the data were analyzed statistically by testing with chi square analysis from SPSS software. Results: From the present study, it has been observed that, despite the cultural and economical diversity between the two nations, there was no observable difference in student’s point of view on humanitarian issues in most of the areas concerned. Overall evaluation also reflected effect of the socio-economic status of the countries on the perception of the issue amongst the students. Conclusion: Despite of different geography, diverse culture and dissimilar socio-economic status, the need of concern towards humanitarian issues is observable. Students of both nations have positive attitude towards the humanitarian issues as well.
Introduction: Mentoring medical students is one of the essential responsibilities or missions of a medical school faculty. Objective: This study aimed to determine the perceptions of mentorship and mentoring practices among mentors using a convergent parallel method. Method: Quantitative data was collected by using an adopted validated self- administered questionnaire and analyzed using SPSS version 20. Qualitative data was done using one-to-one interview based on semi structured interview guide and analyzed using thematic analysis. Result: A total of 61 respondents participated in the quantitative survey. Approximately 75% of the respondents had 5 to 10 mentees, with majority rated themselves as satisfactory mentor. More than 60% of them met their mentees at least once every six months. Most respondents were friendly (86.9%) and frank to their mentees (68.9%) and were interested in their mentees’ professional development (95.1%). Phone calling (93.4%) and E-mail (95.1%) were preferred as modes of contact. Mentees were allowed to call their mentors anytime of the day (74.1%). Respondents preferred to counsel their mentees (80.3%) and would refer them for professional help whenever necessary (70.5%). For qualitative data, a total of 5 participants participated with themes emerged: concepts of mentoring, factors contributing to ineffective mentoring and ways to improve mentoring practices. Conclusion: The respondents had positive perceptions regarding their mentorship and practices. A more structured approach with clear mentoring guideline and proper training should be in place.
Practice-based educator role is one of the core roles for health care practitioners. This role has an immense responsibility in enhancing learners’ knowledge towards the actual clinical practice, to prepare them to work with clients and for future professional development. Practitioners, even though they are aware and understand the importance of this role, lacking in exposure in educating and learning just on-the job make them not wellprepared to carry the role. This reflective essay has allowed the author to evaluate her performance as an educator, identifying the weaknesses, to obtain a clearer picture and better outlook on precisely on educators’ role in practice-based learning. Hence, she will able to improve; be a much better, more consistent and more competent educator as well as share it with others.
Myth, believe in powerful ‘being’ commonly known as jinn and usage of ‘bomoh’ as the medium is still widespread in our community in Kelantan especially among the Malay community. This believe and practice of usin ‘bomoh’ to cure and help with known and unknown disease believe to be caused by the jinn, occasionally poses a significant complication and threat to the management of patient in the hospital. Our case is just one of many cases that happen in our local hospital, and we hope by sharing this case will illustrate how ethical discussion occasionally surpassed the four common ethical pillars.
Recently, the integration of mobile phone apps into healthcare system is increasing as a result of the availability of medical applications. This study determined the perception of readiness of community pharmacists on the use of mobile smartphone as a health monitoring tool and the relationships between perception and readiness with selected demographic variables of the respondents. Methods: A crosssectional survey was conducted by distributing a modified 15-item instrument to a convenience sample of pharmacists (n = 245) across Malaysia by post. Statistical analyses were performed using SPSS version 20. Results: Response rate was 31.4% (n= 77). The mean age of the respondents was 35.5 ± 6. 52 years. The sample consisted of mostly women (71.4%). Overall, there were moderate “positive responses” across the two domains. Positive perception ranged from 54.5% to 66.2% and positive readiness ranged from 55.8% to 64.9%. No significant associations between perception and readiness with the selected demographic variables were detected (age, gender, location and outlet type). Conclusions: This study demonstrated that there was generally positive perception of mobile phone use for pharmaceutical care among community pharmacists in Malaysia. They were also ready to adapt it to improve pharmaceutical care delivery to patients.
Feedback and students’ perception towards it has gained increasing attention in the educational literature recently, yet it is an underresearched area. The importance of feedback has not been perceived in a positive manner among medical students. This may be due to students’ lack of knowledge on the concept of feedback and their awareness of the benefits of feedback. This study focused on students’ knowledge on the concept of feedback and their perception towards the feedback system practiced in School of Medical Sciences, University Sains Malaysia. Methods: This was a cross-sectional study involving 433 numbers of students from year 1, 3 and 5 medical students. The variables that were included in this were the gender and their year of study. A validated questionnaire was used to perform this study. School and ethical committee clearance were obtained prior to the start of the study. Data obtained was analysed using Statistical Package for Social Sciences (SPSS) version 20. Results: Findings revealed that students have an average level of knowledge on the concept of feedback and have a neutral perception towards the feedback system that is practiced in School of Medical Sciences, USM. There was no association between students’ knowledge level on feedback and their perception with their year of study and gender differences. However, although there was not much difference in students’ perception level about feedback with their year of study but it was found those students’ perception level decreases as their year of study progresses. It was also found that there was a poor correlation between medical students’ knowledge level on feedback with their perception towards the feedback system in School of Medical Sciences, USM. Conclusions: The area in which it raised concern in students’ perception about feedback was the factors that are involved in feedback practice, which are the givers of feedback, timing of feedback and the mode of feedback. Further study addressing students’ poor engagement and involvement in feedback can be done and issues identified from this study can be included in together for further improvements of the feedback system.