Displaying publications 41 - 60 of 69 in total

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  1. Nadarajah A, Shankar PR, Jayaraman S, Sreeramareddy CT
    BMC Med Educ, 2022 Nov 16;22(1):796.
    PMID: 36384571 DOI: 10.1186/s12909-022-03845-2
    PURPOSE: Shortage and maldistribution of medical specialists hamper healthcare quality. The specialist career choices of house officers determines the future composition of healthcare systems. We studied house officers'' specialist career choices and motivators for their choice.

    PARTICIPANTS AND METHODS: We conducted online in-depth interviews among seven house officers using an interview guide developed based on a literature review. The transcripts were analyzed. Major themes were identified. A 33-item questionnaire was developed, and the main and sub-themes were identified as motivators for specialist career choice. An online survey was done among 185 house officers. Content validation of motivators for specialist choice was done using exploratory factor analysis. First, second and third choices for a specialist career were identified. Multinomial logistic regression analyses were done to determine the socio-demographic factors and motivators associated with the first choice.

    RESULTS: HOs perceived that specialist training opportunities provide a wide range of clinical competencies through well-structured, comprehensive training programs under existing specialist training pathways. Main challenges were limited local specialist training opportunities and hurdles for 'on-contract' HO to pursue specialist training. Motivators for first-choice specialty were related to 'work schedule', 'patient care characteristics', 'specialty characteristics', 'personal factors', 'past work experience', 'training factors', and 'career prospects.' House officers' first choices were specialties related to medicine (40.5%), surgery (31.5%), primary care (14.6%), and acute care (13.5%). On multivariate analysis, "younger age", "health professional in the family", "work schedule and personal factors", "career prospects" and "specialty characteristics" were associated with the first choice.

    CONCLUSIONS: Medical and surgical disciplines were the most preferred disciplines and their motivators varied by individual discipline. Overall work experiences and career prospects were the most important motivators for the first-choice specialty. The information about motivational factors is helpful to develop policies to encourage more doctors to choose specialties with a shortage of doctors and to provide career specialty guidance.

  2. 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.

  3. Banneheke H, Nadarajah VD, Ramamurthy S, Sumera A, Ravindranath S, Jeevaratnam K, et al.
    BMC Med Educ, 2017 Aug 08;17(1):130.
    PMID: 28789645 DOI: 10.1186/s12909-017-0966-4
    BACKGROUND: Student perspectives of clinical preparedness have been studied in the literature, but the viewpoint of supervisors is limited. Hence, the aim was to examine the perspective of supervisors on the characteristics of health professional students important for preparedness for clinical learning.

    METHODS: This was a descriptive, questionnaire-based, cross-sectional study conducted at three higher education institutions in Malaysia. A previously published questionnaire with 62 characteristics was adopted with modifications after pre-testing. Descriptive analysis was completed for the demographic data. The sample was grouped based on health profession, clinical practice experience and teaching experience for further analysis. Non-parametric Kruskal-Wallis test was selected to evaluate differences in mean ranks to assess the null hypothesis that the medians are equal across the groups. Kruskal-Wallis post-hoc pair wise comparison was performed on samples with significant differences across samples.

    RESULTS: The sample was comprised of 173 supervisors from medicine (55, 32%), pharmacy (84, 48%) and nursing (34, 20%). The majority (63%) of the supervisors were currently in professional practice. A high percentage (40%) of supervisors had less than 4 years of teaching experience. The highest theme ratings were for willingness (6.00) and professionalism (5.90). There was a significant difference (p 

  4. Mohajer S, Li Yoong T, Chan CM, Danaee M, Mazlum SR, Bagheri N
    BMC Med Educ, 2023 Feb 15;23(1):114.
    PMID: 36793032 DOI: 10.1186/s12909-023-04097-4
    BACKGROUND: Professional self-concept is one of the important outcomes of nursing professionalism. There is a lack of adequately planned curriculum may limit nursing students' practical knowledge, skills and professional self-concept in providing comprehensive geriatric-adult care and promoting nursing professionalism. Professional portfolio learning strategy has allowed nursing students to continue professional development and enhance nursing professionalism in professional clinical practice. However, there is little empirical evidence in nursing education to support the use of professional portfolios in blended learning modality among internship nursing students. Therefore, this study aims to examine the effect of the blended professional portfolio learning on professional self-concept among undergraduate nursing students during Geriatric-Adult internship.

    METHODS: A quasi-experimental study two-group pre-test post-test design. A total of 153 eligible senior undergraduate students completed the study (76 in the intervention group and 77 in the control group). They were recruited from two Bachelor of Sciences in Nursing (BSN) cohorts from nursing schools at Mashhad University of Medical Sciences (MUMS), in Iran, in January 2020. Randomization was undertaken at the level of school via a simple lottery method. The intervention group received the professional portfolio learning program as a holistic blended learning modality, though the control group received conventional learning during professional clinical practice. A demographic questionnaire and the Nurse Professional Self-concept questionnaire were used for data collection.

    RESULTS: The findings imply the effectiveness of the blended PPL program. Results of Generalized Estimating Equation (GEE) analysis was indicated significantly improved professional self-concept development and its dimensions (self-esteem, caring, staff relation, communication, knowledge, leadership) with high effect size. The results of the between-group comparison for professional self-concept and its dimensions at different time points (pre, post and follow up test) showed a significant difference between groups at post-test and follow up test (p  0.05).The results of within-group comparison for both control and intervention showed that there were significant differences in professional self-concept and for all its dimensions across the time from pre-test to post-test and follow-up (p 

  5. Wadi MM, Yusoff MSB, Taha MH, Shorbagi S, Nik Lah NAZ, Abdul Rahim AF
    BMC Med Educ, 2023 Apr 05;23(1):213.
    PMID: 37016407 DOI: 10.1186/s12909-023-04177-5
    BACKGROUND: Burnout and depression among health professions education (HPE) students continue to rise, leading to unwanted effects that ultimately jeopardise optimal medical care and patient health. Promoting the resilience of medical students is one solution to this issue. Several interventions have been implemented to foster resilience, but they focus on aspects other than the primary cause: the assessment system. The purpose of this study is to develop a framework to promote resilience in assessment planning and practice.

    METHODS: We followed the guidelines suggested by Whetten for constructing a theoretical model for framework development. There were four phases in the model development. In the first phase, different literature review methods were used, and additional students' perspectives were collected through focus group discussions. Then, using the data, we constructed the theoretical model in the second phase. In the third phase, we validated the newly developed model and its related guidelines. Finally, we performed response process validation of the model with a group of medical teachers.

    RESULTS: The developed systematic assessment resilience framework (SAR) promotes four constructs: self-control, management, engagement, and growth, through five phases of assessment: assessment experience, assessment direction, assessment preparation, examiner focus, and student reflection. Each phase contains a number of practical guidelines to promote resilience. We rigorously triangulated each approach with its theoretical foundations and evaluated it on the basis of its content and process. The model showed high levels of content and face validity.

    CONCLUSIONS: The SAR model offers a novel guideline for fostering resilience through assessment planning and practice. It includes a number of attainable and practical guidelines for enhancing resilience. In addition, it opens a new horizon for HPE students' future use of this framework in the new normal condition (post COVID 19).

  6. 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.

  7. Woon LS, Mohd Daud TI, Tong SF
    BMC Med Educ, 2023 Nov 09;23(1):851.
    PMID: 37946151 DOI: 10.1186/s12909-023-04834-9
    BACKGROUND: At the Faculty of Medicine of the National University of Malaysia, a virtual patient software program, DxR Clinician, was utilised for the teaching of neurocognitive disorder topics during the psychiatry posting of undergraduate medical students in a modified team-based learning (TBL) module. This study aimed to explore medical students' learning experiences with virtual patient.

    METHODS: Ten students who previously underwent the learning module were recruited through purposive sampling. The inclusion criteria were: (a) Fourth-year medical students; and (b) Completed psychiatry posting with the new module. Students who dropped out or were unable to participate in data collection were excluded. Two online focus group discussions (FGDs) with five participants each were conducted by an independent facilitator, guided by a questioning route. The data were transcribed verbatim and coded using the thematic analysis approach to identify themes.

    RESULTS: Three main themes of their learning experience were identified: (1) fulfilment of the desired pedagogy (2), realism of the clinical case, and (3) ease of use related to technical settings. The pedagogy theme was further divided into the following subthemes: level of entry for students, flexibility of presentation of content, provision of learning guidance, collaboration with peers, provision of feedback, and assessment of performance. The realism theme had two subthemes: how much the virtual patient experience mimicked an actual patient and how much the case scenario reflected real conditions in the Malaysian context. The technical setting theme entailed two subthemes: access to the software and appearance of the user interface. The study findings are considered in the light of learning formats, pedagogical and learning theories, and technological frameworks.

    CONCLUSIONS: The findings shed light on both positive and negative aspects of using virtual patients for medical students' psychiatry posting, which opens room for further improvement of their usage in undergraduate psychiatry education.

  8. Taleb OK, Siti-Azrin AH, Sarimah A, Abusafia AH, Baharuddin KA, Wan-Nor-Asyikeen WA
    BMC Med Educ, 2023 May 22;23(1):356.
    PMID: 37217957 DOI: 10.1186/s12909-023-04314-0
    BACKGROUND: Environmental factors are important for students' learning during online classes, especially during a pandemic, such as COVID-19. This study aimed to validate the environmental factors' questionnaire during online learning.

    METHODS: A total of 218 undergraduate medical students at the Health Campus, Universiti Sains Malaysia, participated in a cross-sectional study that involved an online survey. Environmental factor scales were assessed with the nine-item lighting, noise, and temperature (LNT) scale and the six-item technology scale. Analysis was performed using confirmatory factor analysis (CFA).

    RESULTS: The English version of the LNT scale with nine items and three factors showed a good fit to the data, with no item deleted. For LNT, the composite reliability (CR) was 0.81, 0.81, and 0.84, respectively, while the average variance extracted (AVE) was 0.61, 0.59, and 0.6, respectively. The English version of the technology scale, with six items and one factor, also showed a good fit to the data, with no item deleted. The CR was 0.84, and the AVE was 0.51.

    CONCLUSIONS: The results provide psychometric evidence for environmental questionnaire scales in evaluating the factors associated with online learning among Malaysian university medical students. All items were retained and confirmed to fit the sample data.

  9. Muhaimin M, Habibi A, Riady Y, Alqahtani TM, Chaerunisaa AY, Wijaya TT, et al.
    BMC Med Educ, 2023 May 23;23(1):367.
    PMID: 37221539 DOI: 10.1186/s12909-023-04346-6
    The Covid-19 outbreak necessitated the implementation of social distancing mechanisms, such as the enforcement of lockdowns in numerous nations. The lockdown has disrupted many parts of everyday life, but this unusual event has particularly affected education. The temporary closure of educational institutions ushered in dozens of new reforms, including a shift into the distance and online learning. This study investigates the transition from traditional education in physical classrooms to online and distance and online learning in pharmacy education during Covid-19, especially about the challenges and benefits of distance and online learning. We did Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for literature sources between 2020 and 2022 (n.14). The study elaborates on how the transition has influenced teachers and students of pharmacy education. The research also summarizes several recommendations, which may assist in minimizing the adverse impacts of lockdown and encourage streamlined processes to distance and online learning, particularly in pharmacy education.
  10. Mani SA, Uma E, John J, Nieminen P
    BMC Med Educ, 2023 May 25;23(1):384.
    PMID: 37231460 DOI: 10.1186/s12909-023-04359-1
    BACKGROUND: Professional and personal boundaries are blurred with the wide application of social media (SM) in the health professions line of work. Little is known about practice of extending friend requests to patients and faculty members among dental students, which encompass a part of E-professionalism. The aim of this study is to assess the factors associated with the perceptions and practices of interactions with patients and faculty on SM among dental students from Malaysia and Finland.

    METHODS: Dental students from 4 institutions in Malaysia and Finland completed self-administered questionnaires on the practices and perceptions of SM use. The main variables assessed were the perceptions and practices of student-patient and student-faculty communication on SM, between the two countries. Students' country, age, gender, time spent on SM and perceived importance of communicating dental related aspects over SM were analysed as potential explanatory variables. Crosstabulation was used to estimate the distributions of the response variables by the background characteristics. Multivariate analyses were performed using a dichotomous logistic regression model to investigate relevant associations between the responses and the explanatory variables independent from other factors.

    RESULTS: A total of 643 students completed the survey in March-April 2021. More Malaysian students agreed with "guiding patients online is a new responsibility for dentists in the digital age" compared to Finnish students (86.4% vs. 73.4%). Similarly, significantly more Malaysian students befriended patients (14.1% vs. 1%) and invited faculty to be friends on SM (73.6% vs. 11.8%). Expectedly, clinical year students befriended patients more than pre-clinical (13.8% vs. 6.8%). Significantly more students who felt 'communication of dental related issues over SM' were likely to extend friend requests to faculty rather than accept patient friend requests.

    CONCLUSIONS: Social media regulations and socio-cultural practices contribute to dental students' attitudes and behaviour when befriending patients and faculty members on social media. Future dental curriculum should incorporate guidelines for professional communication on social media based on local and cultural needs. Students' should be encouraged to interact with their patients using professional identities on social media.

  11. Chew KS, Wong SS, Tarazi ISB, Koh JW, Ridzuan NA'B, Wan Allam SASB
    BMC Med Educ, 2023 Jun 12;23(1):432.
    PMID: 37308907 DOI: 10.1186/s12909-023-04356-4
    BACKGROUND: Although tabletop exercise is a commonly used method for disaster response training, it is labor-intensive, requires a tutor for facilitation and may not be ideal in a pandemic situation. Board game is a low-cost and portable alternative that can be utilized for this purpose. The purpose of this study was to compare the perception of interaction engagement and behavioral intention to use a newly developed board game with tabletop exercise for disaster training.

    METHODS: Using the Mechanics-Dynamics-Aesthetics' (MDA) framework, a new, tutorless educational board game known as the Simulated Disaster Management And Response Triage training ("SMARTriage") was first developed for disaster response training. Subsequently, the perceptions of 113 final year medical students on the "SMARTriage" board game was compared with that of tabletop exercise using a crossover design.

    RESULTS: Using Wilcoxon signed rank test, it was that found that tabletop exercise was generally rated significantly higher (with p 

  12. Lin GSS, Foo JY, Foong CC
    BMC Med Educ, 2023 Oct 02;23(1):716.
    PMID: 37784112 DOI: 10.1186/s12909-023-04717-z
    BACKGROUND: Dental materials science is an important subject, but research on curriculum mapping in preclinical dental materials science courses is still scarce. The present study aimed to conduct a curriculum mapping in analysing elements and suggesting recommendations for an institutional dental materials science course.

    METHODS: Curriculum mapping was conducted for the Year 2 undergraduate dental materials science course (Bachelor of Dental Surgery programme) in a Malaysian dental school. Based on Harden's framework, the following steps were used to map the curriculum of the institutional dental materials science course: (1) scoping the task; (2) deciding the mapping format; (3) populating the windows, and (4) establishing the links. Two analysts reviewed the curriculum independently. Their respective analyses were compared, and discrepancies were discussed until reaching a consensus. A SWOT analysis was also conducted to evaluate the strengths, weaknesses, opportunities, and threats associated with the curriculum.

    RESULTS: Course learning outcomes, course contents, levels of cognitive and psychomotor competencies, learning opportunities, learning resources, learning locations, assessments, timetable, staff, curriculum management and students' information were successfully scoped from the institutional dental materials science course. The present curriculum's strengths included comprehensiveness, alignment with standards, adequate learning opportunities, well-defined assessment methods, and sufficient learning resources. However, the identified weaknesses were repetition in curriculum content, limited emphasis on the psychomotor domain, dependency on a single academic staff, and limited integration of technology. The SWOT analysis highlighted the opportunities for curriculum improvement, such as revising repetitive content, emphasising the psychomotor domain, and incorporating advanced teaching strategies and technology.

    CONCLUSIONS: The present dental materials science curriculum demonstrated several strengths with some areas for improvement. The findings suggested the need to revise and optimise the course content to address gaps and enhance student learning outcomes. Ongoing monitoring and evaluation are necessary to ensure the curriculum remains aligned with emerging trends and advancements in dental materials science.

  13. Jeppu AK, Kumar KA, Sethi A
    BMC Med Educ, 2023 Oct 06;23(1):734.
    PMID: 37803418 DOI: 10.1186/s12909-023-04734-y
    BACKGROUND: Modern clinical practice increasingly relies on collaborative, cooperative and team-based approaches for effective patient care. Recently, Jigsaw cooperative learning has gained attention in medical education. There is a need for studies in Southeast Asian context to establish its effectives in developing various core competencies expected of health professionals such as interpersonal, communication, collaborative, and teamwork skills. This current study explores the impact of using Jigsaw Cooperative Learning on undergraduate medical students.

    METHOD: An explanatory mixed method research design was carried out on first year medical students at a private university in Malaysia. In Phase I, a survey was conducted to explore the effectiveness of jigsaw learning. Descriptive and inferential statistics were calculated using SPSS. In Phase II, a focus group interview was conducted to explore their in-depth experiences. Qualitative data were thematically analysed.

    RESULTS: Fifty-seven students participated in the survey and seven students took part in the focus group interview. Quantitative data analysis showed a statistically significant improvement in the student's individual accountability, promotive interaction, positive interdependence, interpersonal skill, communication skill, teamwork skill, critical thinking and consensus building after jigsaw learning sessions. Qualitative data explained their experiences in-depth.

    CONCLUSION: Jigsaw cooperative learning improves collaboration, communication, cooperation and critical thinking among the undergraduate medical students. Educators should use jigsaw learning methods to encourage effective collaboration and team working. Future studies should explore the effectiveness of the jigsaw cooperative learning technique in promoting interprofessional collaboration in the workplace.

  14. Liew SC, Tan MP, Breen E, Krishnan K, Sivarajah I, Raviendran N, et al.
    BMC Med Educ, 2023 Oct 25;23(1):796.
    PMID: 37880711 DOI: 10.1186/s12909-023-04777-1
    BACKGROUND: Virtual consultation is a synchronous mode of telemedicine provided remotely via information and communication technology. The projected growth of digitalization in healthcare delivery, however, necessitates medical student training in virtual consultation (VC) to ensure safe and effective patient care. This study describes the implementation and preliminary evaluation of a competency-based VC training module for undergraduate medical students.

    METHODS: A newly developed six-week VC module was implemented online through asynchronous microlearning and synchronous simulation-based experiential learning modalities. Clinical students in years 4 and 5 and fresh graduates, who had not started pre-registration house officer or residency programmes, were invited to participate. Training outcomes using checklist-based video-recorded assessments of VC encounters between medical students and simulated patients were compared. Each video was independently assessed by two facilitators trained in VC teaching and assessment, using a direct observed virtual consultation skills checklist derived from established VC competencies. The participants completed course evaluations electronically as additional outcome measures.

    RESULTS: Fifty-two clinical phase medical students and alumni completed both the instructional and practical phases of this module. Altogether, 45 (95.7%) students found the module beneficial, and 46 (95.9%) reported increased self-efficacy for conducting VC. In total, 46 (95.9%) students would recommend the course to others. Post-test results showed a significant increase in the students' abilities to conduct a VC (t-test = 16.33, p 

  15. Er HM, Wong PS, Nadarajah VD
    BMC Med Educ, 2023 Jun 02;23(1):397.
    PMID: 37268906 DOI: 10.1186/s12909-023-04368-0
    BACKGROUND: Open book examinations have been used to assess students' higher order cognitive skills. These examinations can be conducted online remotely with the advancement of technology. However, there are concerns regarding its validity and reliability particularly if the examinations are not proctored. The objective of this study was to explore the perceptions of faculty and students in health professions programmes about remote online open book examinations (ROOBE).

    METHODS: Semi-structured interviews were conducted among 22 faculty staff who were involved in ROOBE in health professions programmes. All interviews were audio recorded, transcribed verbatim and analysed using a thematic analysis approach. The perceptions of 249 medical students were obtained using an online questionnaire after they completed ROOBE.

    RESULTS: The faculty agreed that open book examinations could promote students' higher order cognitive skills and reduce students' stress. However, they were concerned about students' academic integrity during non-invigilated ROOBE which could affect recognition by accreditation and professional bodies. The shift from traditional practice of closed-book examinations to ROOBE required change management with the support of guidelines and faculty training.  Majority of the students claimed that the examinations were challenging as they assessed their ability to apply knowledge in real world problems. Nevertheless, they preferred ROOBE due to less anxiety and memorisation, and more emphasis on problem solving skills. The shortcomings were insufficient time for information searching during examinations and uncertainty in preparedness for future practice as they focused less on memorisation of factual knowledge during examination preparation. Cheating among peers and internet instability during non-invigilated ROOBE were the concerns highlighted by some students.

    CONCLUSIONS: Faculty and students expressed favourable views about ROOBE in promoting higher order cognitive skills. Adequate technological support was essential during ROOBE. While there was a need to address issues related to academic integrity, ROOBE could be included as an authentic assessment within the systems of assessment.

  16. Khairul Anhar Holder NA, Pallath V, Vadivelu J, Foong CC
    BMC Med Educ, 2023 May 05;23(1):310.
    PMID: 37147649 DOI: 10.1186/s12909-023-04285-2
    BACKGROUND: Academic failure is common among medical schools worldwide. However, the process behind this failure itself is underexplored. A deeper understanding of this phenomenon may avert the vicious cycle of academic failure. Hence, this study investigated the process of academic failure among medical students in Year 1.

    METHODS: This study employed a document phenomenological approach, which is a systematic process to examine documents, interpret them to attain understanding, and develop empirical knowledge of the phenomenon studied. Using document analysis, interview transcripts and reflective essays of 16 Year 1 medical students who experienced academic failure were analysed. Based on this analysis, codes were developed and further reduced into categories and themes. Thirty categories in eight themes were linked to make sense of the series of events leading to academic failure.

    RESULTS: One or more critical incidents commenced during the academic year, which led to possible resulting events. The students had poor attitudes, ineffective learning methods, health problems or stress. Students progressed to mid-year assessments and reacted differently to their results in the assessments. Afterwards, the students tried different types of attempts, and they still failed the end-of-year assessments. The general process of academic failure is illustrated in a diagram describing chronological events.

    CONCLUSION: Academic failure may be explained by a series of events (and consequences) of what students experience and do and how they respond to their experiences. Preventing a preceding event may prevent students from suffering these consequences.

  17. Foong CC, Bashir Ghouse NL, Lye AJ, Khairul Anhar Holder NA, Pallath V, Hong WH, et al.
    BMC Med Educ, 2021 Jun 05;21(1):320.
    PMID: 34090439 DOI: 10.1186/s12909-021-02712-w
    BACKGROUND: Self-regulated learning (SRL) is an important contributing element to the academic success of students. Literature suggests that the understanding of SRL among medical students is obscure as there is still some uncertainty about whether high performing medical students use SRL. This study explored the characteristics of high performing medical students from the SRL perspective to gain a better understanding of the application of SRL for effective learning.

    METHODS: Twenty-one students who scored at the 90th percentile in written knowledge-based assessment consented to participate in this study. Each student wrote a guided reflective journal and subsequently attended a semi-structured interview. Students were prompted to explain the rationales for their answers. The data were then analysed using thematic analysis to identify patterns among these students from the SRL perspective. Two coders analysed the data independently and discussed the codes to reach a consensus.

    RESULTS: High performing students set goals, made plans, and motivated themselves to achieve the goals. They put consistent efforts into their studies and applied effective learning strategies. They also employed coping mechanisms to deal with challenges. High performing students regularly evaluated their performance and adopted new strategies.

    CONCLUSIONS: This study reported that high performing students applied SRL and described the rationales of practice. Medical schools could design SRL-driven interventions to enhance the learning experiences of medical students. Recommendations are made for students on how to apply SRL.

  18. Saraswathy T, Nalliah S, Rosliza AM, Ramasamy S, Jalina K, Shahar HK, et al.
    BMC Med Educ, 2021 Sep 09;21(1):482.
    PMID: 34503488 DOI: 10.1186/s12909-021-02907-1
    BACKGROUND: This study aimed at determining the effectiveness of an innovative approach using interprofessional simulation scenarios (IPSS) in improving knowledge, attitude, and practice (KAP) of hospital-acquired infection control (HAIC) among health professionals.

    METHODS: The interventional study was conducted in a teaching hospital in Malaysia. Purposive sampling was used to recruit participants from surgical, intensive care, and other units. Thirty-six health professionals in the experimental and forty in the control group completed the study. All subjects participated in an interactive lecture and demonstrated four IPSS on HAIC i.e. (i) taking blood specimen (ii) bedsore dressing (iii) collecting sputum for acid-fast bacilli and (iv) intermittent bladder catheterization. Each team consisted of a doctor and a nurse. A self-administered questionnaire on KAP on HAIC was completed by respondents during the pre-, immediately and, post-intervention. An independent t-test was conducted to measure the significance between the experimental and control group.

    RESULTS: The mean scores for KAP among the experimental group increased following the intervention. Significant differences in scores were seen between the two groups post-intervention (p 

  19. Spooner M, Larkin J, Liew SC, Jaafar MH, McConkey S, Pawlikowska T
    BMC Med Educ, 2023 Nov 22;23(1):895.
    PMID: 37993832 DOI: 10.1186/s12909-023-04842-9
    INTRODUCTION: While feedback aims to support learning, students frequently struggle to use it. In studying feedback responses there is a gap in explaining them in relation to learning theory. This study explores how feedback experiences influence medical students' self-regulation of learning.

    METHODS: Final-year medical students across three campuses (Ireland, Bahrain and Malaysia) were invited to share experiences of feedback in individual semi-structured interviews. The data were thematically analysed and explored through the lens of self-regulatory learning theory (SRL).

    RESULTS: Feedback interacts with learners' knowledge and beliefs about themselves and about learning. They use feedback to change both their cognitive and behavioural learning strategies, but how they choose which feedback to implement is complex. They struggle to generate learning strategies and expect teachers to make sense of the "how" in addition to the "what"" in planning future learning. Even when not actioned, learners spend time with feedback and it influences future learning.

    CONCLUSION: By exploring our findings through the lens of self-regulation learning, we advance conceptual understanding of feedback responses. Learners' ability to generate "next steps" may be overestimated. When feedback causes negative emotions, energy is diverted from learning to processing distress. Perceived non-implementation of feedback should not be confused with ignoring it; feedback that is not actioned often impacts learning.

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