Due to cost containment considerations, it is common to have medical schools being
located in buildings or campuses built for some other purposes. These buildings are converted into
medical schools which often compromising the functional architectural aspects. Objectives: The
paper examines, explores and proposes an architectural concept of a purpose-built medical school. The
architectural design proposed is sensitive to the values and norms of many schools around the globe.
Methods: An Internet search and personal communication were conducted, focusing on the concepts
of the functionality of medical school. It emphasises on general design of the main building, keeping
in mind the various kinds of teaching, learning and assessment activities. We examined lecture hall,
pre-clinical laboratory, skill laboratory, general facilities of Objective Structured Practical Examination
(OSPE) and Objective Structured Clinical Examination (OSCE). Results: We present hypothetical
structural designs based on built-functions concepts. For example, for the better vision of students
around a demonstration table, an inclined floor surface is proposed. The concept is as illustrated by
anatomy dissection area built inclined upward from the cadaver table. It inevitably provides a better
visual access to the students around the table. Other teaching and learning areas are also illustrated
wherever appropriate in the text. Conclusion: The paper is hypothetical and explores innovative
structural designs of modern medical schools. While most are built to meet the demands of current
technology, it cannot however completely replace face-to-face teaching and learning processes.
Research in architectural designs of education buildings and facilities may be further developed into a
new research niche of medical education.
INTRODUCTION: Stress is a particularly important issue in education because it has the potential to decline learning and performance. However, little empirical evidence about the influence of stress in nurse students’ clinical practices.
Methods: There are 346 totals of respondents for this study. Perceived Stress Scale (PSS), which have six domains of stressors and Brief COPE inventory, consisted of 28 items which measure 14 different coping styles was used. By using Likert scale in order to measure the degree of stress for each stressor. Higher mean score indicates higher degree of stress.
Results: In this study, stress from clinical assignments and workload was the most stressful having by nursing students (Mean = 3.19, SD = 1.09). Among the 14 types of coping strategies, religion was the most frequently used, religion (Mean = 3.30, SD = 0.71).
Conclusion: The results provided valuable information for nurse educators, clinical educators and clinical staff in identifying students’ needs, facilitating their learning in the clinical setting and developing effective interventions to reduce the stress. Therefore it is important, especially nursing students can handle the pressure because it will affect the level of achievement in academic and thereby affecting student skills in the field of clinical nursing. And this affects the care of patients.
Introduction: The LA-i was found to be valid, reliable, simple and easy to be administered and consumed minimal time. However, to author knowledge, none of articles reported its stability across multiple observations. Realising its potential, continued research is required to optimize its role, usefulness and applicability as a tool to help educators to understand their students’ learning approaches. Objective: To determine stability of the LA-i to measure characteristics of students’ learning approaches at different time and occasions in a sample of medical students.Method: A prospective cohort study was done on 177 first year medical students. It was administered to a cohort of medical students at four different intervals. The Cronbach’s alpha and intra-class correlation analysis were applied to measure internal consistency and agreement level across the
intervals. The analysis was done using SPSS 18. Result: A total of 157 (88.7%) first year medical students responded completely to the inventory. The overall Cronbach’s alpha value of the LA-i at different intervals ranged between 0.79 and 0.92, The Cronbach’s alpha values for surface learning
approach subscale ranged between 0.65 and 0.80. The Cronbach’s alpha value for strategic learning approach subscale ranged between 0.76 and 0.84. The Cronbach’s alpha value for deep learning approach subscale ranged between 0.83 and 0.95. ICC values for the three learning approach subscales ranged between 0.46 and 0.50. Conclusion: This study reflected that the LA-i had high level of internal stability to measure students’ learning approaches at different time and occasions. Continued research is required to optimize its role, usefulness and applicability at various educational settings.
This paper presents observation made during a brief observation of the PBL programme at School of Medical Sciences (SMS), Universiti Sains Malaysia (USM). It provides a classification for the type of PBL offered at USM highlights the main aspects of the tutorial process there and reviews the experience of students and tutors engaged in PBL at this SMS. The paper proposes a series of recommendations with regards to the planned 2014 curricular reform.
Introduction: Poor sleep quality among university students has become an important issue to be concerned as it can hugely influence the students especially on their academic performance. However, there are inadequate studies published on the sleep quality of medical students in Malaysia.
Objective: This study aimed at determining the sleep quality of pre-clinical medical students in Universiti Putra Malaysia (UPM) and Universiti Malaya (UM). Methods: This is a cross-sectional study that used self-administered questionnaire to collect data from the pre-clinical medical students
of UPM and UM. Sleep quality of the students was measured using Pittsburgh Sleep Quality Index (PSQI) questionnaire. All data were analysed by SPSS version 21.
Results: Findings revealed that 63.9% respondents with poor sleep quality (PSQI score: more than 5). The prevalence of poor sleepers
in UM (67%) was slightly higher compared to UPM (60.9%). However, the comparison of PSQI score showed no significant difference between UPM and UM respondents (p = 0.082). Meanwhile, the average sleep duration per night among respondents was 5 hours 39 minutes (± 1.21 hrs), whereas
only 6.1% students practiced recommended sleep value per night (> 7 hrs). Significant association was found between caffeine intake and sleep quality. Besides, this present study showed no association between sleep quality with gender and year of study.
Conclusion: Majority of the pre-clinical students in UPM and UM had poor sleep quality and short sleep duration. Only a small number of students practiced recommended sleep value per night.
Assessment of medical professionalism is often challenged by the subjectivity of its construct and
lack of feedback practice to nurture professional growth. However transmitting professionalism alone
has not been shown to improve professional behaviour therefore professionalism need to be assessed
if it is viewed as relevant. The authors provided description and guidelines on the use of Simplified
Thematic Engagement of Professionalism Scale (STEPS) as summative and formative assessment
tool for assessing professionalism attributes. STEPS was developed based on the Professionalism
Mini-Evaluation Exercise (P-MEX) format that utilise multiple short encounter assessment and
incorporated professionalism values from a local study. The formative component has 15 attributes
that were categorised into personal, profession, patient and public. This is assessed using seven scale
rubric that promotes feedback practice using feed up, feed back and feed forward concept. The
summative component utilises global rating that will be collated longitudinally to form a more robust
evaluation of student professionalism. Current investigations are ongoing especially to ascertain the
usability and validity of STEPS as peer assessment and self-assessment tool.
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.
This case illustrates the issue of truth-telling about a diagnosis of a potentially terminal illness. A family member of an elderly patient requests that the treating doctor does not disclose the diagnosis to the mother for fear that it will distress her and cause her anxiety. The challenge of the treating doctor is how to deal with this in a professional and ethical manner.
The significance of learning research methodology and performing research has been accepted by various medical schools in Malaysia as well as in other countries. The aim of integrating research into medical curriculum is to inculcate the research culture and form part of the evidence-based practice among medical professionals. Hence, the Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak has incorporated the research component into the preclinical year of the medical curriculum. A survey was conducted to gauge the second year medical students' level of knowledge of research process at the end of the course using a set of questionnaires. Seventy nine of second year medical students participated in the study. The outcome of the study shows significant improvement in the students’ knowledge on research components after completing the one year course (p
Introduction: Self-awareness and reflective-skill are important components of personal and professional development of medical students.
Objective: The objective of this study was to determine whether self awareness and reflective skill could be improved by direct teaching intervention.
Method: This was a cross sectional intervention study conducted among 75 third year medical students of UKM Medical Centre Malaysia in 2010. Malaysian Emotional Quotient Inventory (MEQI) was used to measure self-awareness and reflective writing scripts were used to measure the reflective skills of the respondents before and after teaching intervention. Experimental group comprised of 30 students while the control group constituted the rest 45 students selected randomly. The factors contributing to self awareness with gender and learning styles were determined.
Result: There was no significant improvement observed in self-awareness of the respondents but reflective skills was significantly improved (p=0.007) following intervention. A non-significant relationship between self-awareness and gender (p=0.588) as well as self-awareness and learning styles (p=0.435) was also noticed.
Conclusion: It is concluded that intervention programs improved students' reflective skills but not their self-awareness. Effectiveness of the intervention programme is an important factor. Continuous effort should be focused to train students in an effective way in order to be more self-reflective, self-regulative as well as self-corrective, to ensure a high level of personal and professional development in their daily practices.
Evaluating scientific quality of a journal is a notoriously cumbersome problem that so far no standard consensus. Preferably, scientific journals should be examined by real experts in the field and given scores on quality according to standard guidelines. Nevertheless, information scientists (i.e. scientometricians) have developed a diverse range of tools to examine scientific merits of scientific publications that mainly depending on various indexes that counting citations. The impact factor (IF) is commonly used to examine the visibility of a journal. It is the average number of citations a paper of a journal attracts in the two years following its publication.
Medical knowledge, skills, and social requirements for patient care are quickly changing, thus, doctors
are anticipated to be life-long learners to provide effective care for the patients. This paper addresses
instructional issues how to prepare medical students to be self-directed learners and how to improve
medical school and postgraduate training curricula. Now the big question is self-directed learning
(SDL) an agent in cultivating lifelong learning skills for medical students as claimed by educational
experts? This will be the focus of my critical reflection on lifelong learning.
Community and family case study (CFCS) is a community based educational (CBE) programme commenced in 1980 at School of Medical Sciences, Universiti Sains Malaysia. It serves to help and resolve health needs of the individual patients, family and their community. This will help to develop generic skills such as organization, communication and problem solving in relation to local norms, beliefs and socio-cultural influences. Students should have good awareness, sensitivity and empathic response based on health needs and environment that they are living in. Knowledge, skills, attitudes, emotions and values are repeatedly exposed to inculcate optimal learning environment with the community, as well as triggered response by the student to give back to the community by volunteerism. CFCS activism can be revitalized within the individual and group context. This can be achieved by multi-dimensional learning, collaborative effort, effective leadership and supervision, creative programme initiation, effectual research activities and sustainable service to the community. It is hopeful with active community engagement, life experiences learning process, self-directed and reflective learning, students are able to acquire refined attributes such as skills, behaviour, knowledge and attitudes, towards successful personal growth and advancement.
Educational environment is an important determinant of medical students’ behaviour. It impacts their
academic performance, motivation, and psychological well-being. Quantitative evidence have shown
that there is a decrease in the positive perception of clinical medical students towards the educational
environment. The primary focus on this study was to explore the clinical education environment
through the lived experience of clinical medical students during medical training. Using hermeneutic
phenomenology we aimed to interpret participants’ experience of personal clinical learning journey
through free text input. Thematic analysis was performed to analyse the written texts. Various
measures were taken to enhance the trustworthiness of the findings. A total of 154 (74.8%) fourth year
students and 144 (74.6%) final year students participated in the study. We identified six overarching
themes of education environment in clinical setting that are personal development, teaching and
learning, assessment for learning, facility, support and nurturing curriculum. The overlapping
relationship of the themes is illustrated in the Clinical Education Environment Framework. While
many themes were consistent with existing framework, our findings also proposed assessment as an
important component to influence perception on education environment. The themes in this study
finding conform to the definition of education environment which covers physical, social, and
psychological aspects of students learning. Medical schools should take active measures to incorporate
a nurturing education environment especially in clinical year where students struggle with the hidden
curriculum.
Objective: To determine the internal consistency and construct validity of the Adult Learning Inventory (AL-i) among first year medical students in a Malaysian medical school. Methods: Cross sectional study was done on 196 first year medical student in Universiti Sains Malaysia (USM). The Cronbach’s alpha reliability analysis, exploratory factor analysis and confirmatory factor analysis were applied to measure internal consistency and construct validity of the AL-i respectively. These analyses were done using Predictive Analytics SoftWare (PASW) version 18 and Analysis of Moment Structure (AMOS) version 19. Result: A total of 196 medical students responded to this study. Exploratory factor analysis showed that two potential constructs would be extracted from the inventory. The confirmatory factor analysis showed the two factor model with six items had a good fit with the latent constructs (X2 (df) = 25.63 (8), p = 0.048, RMR = 0.045, GFI = 0.974, AGFI = 0.933, NFI = 0.974, RFI = 0.951, IFI = 0.987, TLI = 0.975, CFI = 0.987, RMSEA = 0.07). Each domain of the final model of the AL-i has three items. The Cronbach’s alpha value of the AL-i was 0.72. The Cronbach’s alpha values of andragogy and pedagogy domains were 0.87 and 0.86 respectively. Composite Reliability and Average Variance Extracted values were more than 0.6 and 0.5 respectively indicating good construct reliability and adequate convergent validity. Conclusion: This study suggested that the two factor model with 6 items of the AL-i has a good fit and shown good psychometric values. It is a valid and reliability measurement to determine types of leaner among first year medical students.
Reflection is a process of reviewing an experience of practice in order to describe, analyse and evaluate information. This leads to critical reflection which one can view and focus on self-experience within the context of his/her own life. Objective: The study aims to understand palliative care values with the use of reflective diary following home visit to patients who require palliative care.
Method: Interview was performed during the house visit by the undergraduate medical students. This outreach house visits were supervised under community palliative care nurse. The students were required to develop a learning activity, using assessment of palliative care patients’ needs, through qualitative questionnaire. This was recorded in the reflective diary upon return of such activity. The questions asked covered explorative learning and holistic medical tasks such as the impact of patient’s life from emotional, psychosocial, medical and spiritual perspective. Guided questioning was done to avoid
unnecessary communication issues that may aggravate emotional distress. Students were asked to probe using vetted and agreed questions, and explore multidimensional issues in relation to culturally naïve Kelantanese population.
Result: Enjoyful learning experience was recorded. The reality of thisdealing with patients with chronic disease has put forth a positive intention to perform better as future doctors.
Conclusion: Reflective diary is an effective tool in community palliative care learning. It documents patients’ plight and students’ sense of responsibility to community. This has invaluable and indirect learning impact as part of the students’ soft skills development.
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.
Among most important aspects in conducting a clinical trial are random sampling and allocation of subjects. The processes could be easier if done with familiar software used for data entry and analysis instead of relying on other programs or methods. The objective of this article is to demonstrate random sampling and allocation using SPSS in step-by-step manners using examples most relevant to clinicians as well as researchers in health sciences.
Psychosocial issues have been seen as minor in medicine despite the importance for holistic medical
care involving emotional, spiritual and psychological domains. Most patients with chronic conditions
have complex and complicated psychosocial needs especially when dealing children with life limiting
conditions. These needs have a dynamic extension to patients’ care as their impact can also affect the
extended family members. Across the trajectory of the illnesses, the pattern of psychosocial needs
changes and, this demands attending physicians to perform accurate psychosocial assessment and
understanding issues from patients and caregivers perspective. Non-judgmental decision making
is essential to avoid friction and misunderstanding between the healthcare providers and caregivers
especially during the consultative process. Resolving psychosocial issue may involve various techniques
from moral support, bridging the services to helping the family, counseling on relationship issues and
many other areas. There is a need to equip healthcare workers with different skills in order to deliver a
better psychosocial care and input even after the bereavement period.
Objective: To determine the internal consistency and construct validity of the Learning Approach Inventory (LA-i) among first year medical students in a Malaysian medical school. Methods: Cross sectional study was done on 196 first year medical students in Universiti Sains Malaysia (USM). The items of the LA-i were framed based on characteristics of three learning approaches. The Cronbach’s alpha reliability analysis, exploratory factor analysis and confirmatory factor analysis were applied to measure internal consistency and construct validity. These analyses were done using Predictive Analytics SoftWare (PASW) version 18 and Analysis of Moment Structure (AMOS) version 19. The Composite Reliability (CR) and Average Variance Extracted (AVE) were calculated manually to measure construct reliability and convergent validity. Result: A total of 196 medical students responded to this study. Exploratory factor analysis showed that three potential constructs were extracted from the inventory. The confirmatory factor analysis showed the three factor model with nine items had a good fit with the latent constructs (X2(df) = 26.07 (20), p = 0.163, RMR = 0.04, GFI = 0.969, AGFI = 0.93, NFI = 0.967, RFI = 0.941, IFI = 0.992, TLI = 0.985, CFI = 0.992, RMSEA = 0.04). Each domain of the final model of the LA-i has three items. The Cronbach’s alpha value of the AL-i was 0.86. The Cronbach’s alpha values of surface, strategic and deep approach domains were 0.62, 0.73 and 0.88 respectively. Most of learning approach domains had Composite Reliability and Average Variance Extracted values were more than 0.6 and 0.5 respectively indicating good construct reliability and adequate convergent validity. Conclusion: This study suggested that the three factor model with 9-items of the LA-i has a good fit and shown good psychometric values. It is a valid and reliability measurement to determine learning approaches among first year medical students.