Introduction: The academic life of medical students can be considered as psychological toxic. About half of United States medical students experience burnout and more than 25% experience depression. This study aimed to determine the prevalence of burnout among medical students in a Malaysian medical school and its associated factors.
Methods: This is a cross sectional study of 452 medical students from Universiti Sains Malaysia (USM). Copenhagen Burnout Inventory was distributed via Google Forms through Facebook Messenger. Ethical approval was obtained from the Human Research Ethics Committee USM. Data were collected via Google Sheets. Each respondent only submitted one Google Form as no resubmission link was provided once completed Google Form was submitted.
Result: The prevalence of burnout among USM medical students was 67.9%. Personal burnout was the highest (81.6%), followed by work-related burnout (73.7%) and client-related burnout (68.6%). The analysis showed that regardless of year of study, gender and ethnicity (all P > 0.05), USM medical students were vulnerable to burnout.
Conclusion: The prevalence of burnout among USM medical students was high and the most prevalent type of burnout was personal burnout. Therefore, burnout among medical students should be a concern and must be addressed to prevent subsequent unwanted consequences.
Introduction: Palliative care teaching has little emphasis during the undergraduate period. Most
teachings in medical school are geared towards preventive and curative approach. Competency in
palliative care including therapeutic and effective communication has been the taught indirectly
without emphasis on other areas. We investigate medical students’ preparedness on palliative care
subjects using past studies questionnaire to evaluate knowledge, attitudes and understanding on end
of life issues. Method: Cross sectional study was performed on the final year medical students (class
2015) from a public university in the northern state of Peninsular Malaysia. Proforma was adopted
from the previously published studies covering the aspect of knowledge, attitude, end-of-life, advanced
directive and bioethical principles in palliative care. Conceptual framework of final year medical
students’ preparedness was ascertained following impartment of palliative care knowledge, either
directly or indirectly, after the exposure and completion of the clinical attachment. Results: The
study elicited a 78.5% response rate where 133 students replied out of 177 total students. Overall the
knowledge and attitude of palliative care were good. There were some misconceptions especially the
use of morphine and role of physician in the management of dying patients. Conclusion: There were
gaps identified following the completion of the study. Misunderstanding in different aspect of care
should be remedied with more exposure and practicality suitable to undergraduate medical curriculum
learning
Palliative care for life limiting conditions usually starts at birth. In neonatal period, planning,
discussion and goal of care should focus towards improving the baby quality of life. It does not mean
palliative care in this age group mainly as end of life care. We illustrate a complex 30 weeks baby
who was born with genetic abnormality complicated with intracranial bleeding and acute myeloid
leukaemia. There were various ethical issues related to the approach of death and dying infant and
psychosocial challenges surrounding the case.
This study aimed to translate Oldenburg Burnout Inventory (OLBI) into Malay language, and test its
response process (face validity) and internal structure (factor structure and internal consistency). To
the author’s knowledge, OLBI is not yet validated in Malay language, thus this study aimed to produce
a validated Malay version of OLBI (OLBI-M) in order to measure burnout among the healthcare
learner population in Malaysia. OLBI has great potentials mainly due to its accessibility and free of
any cost to use it, thus might promote more researchers to conduct burnout research in Malaysia. The
forward-backward translation was performed as per standard guideline. The OLBI-M was distributed
to 32 medical students to assess face validity and later to 452 medical students to assess construct
validity. Data analysis was performed by Microsoft Excel, Statistical Package for the Social Sciences
(SPSS), and Analysis of Moment Structures (AMOS). The face validity index of OLBI-M was more
than 0.70. The two factors of CBI-M achieved good level of goodness of fit indices (Cmin/df = 3.585,
RMSEA = 0.076, GFI = 0.958, CFI = 0.934, NFI = 0.912, TLI = 0.905) after removal of several
items. The composite reliability values of the two factors ranged from 0.71 to 0.73. The Cronbach’s
alpha values of the three factors ranged from 0.70 to 0.74. This study shows OLBI-M is a reliable
and valid tool to measure burnout in medical students. Future burnout studies in Malaysia are highly
recommended to utilise OLBI-M. However, it is crucial for further validity to be carried out to verify
the credential of OLBI-M.
Introduction: Greater needs of medical doctors to provide appropriate care for both genders related diseases, however men face more problem since their problems have less been recognized. Objective: The objective was to determine the level of men’s health knowledge among final year medical students in USM and MU. Method: A total of 199 final year medical students from Universiti Sains Malaysia (USM), Kelantan, Malaysia and Monash University, Melbourne, Australia (75 students from USM and 124 students from MU) were enrolled in the study and completed self-administered questionnaire on the topics related to male sexual and reproductive health. Result: The response rate for USM and MU was 44% and 68.9% respectively. Out of 52 items, 17 items were significantly had higher percentage in answering correctly (p
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.
There is a growing concern of unintended consequences of inappropriate medications disposal on the environment and public health. Objective: The aims of this study are to determine patients’ medications disposal methods and their awareness of the pharmacy medications take back program.
Method: A cross sectional survey using a self-administered closed-ended questionnaire on information, medications disposal and views, awareness of medications take back program and reasons for their unwillingness to return the unused and unwanted medication to pharmacy or doctor. A convenient sample of 438 patients at Out Patient Pharmacy and Patient Registration areas in the hospital was collected and completed within three months.
Results: Only 44.5% had ever received information about medications disposal and were significantly more likely to return to pharmacy or doctor (29.2% versus 6.0%, p < 0.001). There were significant differences between tertiary and nontertiary with regard to not returning to pharmacy or doctor (22.8% versus 42.0 %, p = 0.004). Some common medications disposal methods were throwing medications away with household garbage, 38.3% (n = 168), returning to pharmacy or doctor, 35.1% (n = 154) and flushing medications down the toilet or sink 11.0% (n = 48). About 50.2% (n = 220) knew about medications take back program and were significantly more willing to return the medication to the assigned location (34.7 % versus 20.1%, p < 0.001). The main reasons for unwillingness were availability of time, not convenient or a bother and out-of-vicinity location.
Conclusion: There is a clear need to create public awareness about issues on safe medication disposal and medications take back program,
Study site: Outpatient pharmacy, and patient registration area in Sultanah Aminah Hospital, Johor, Malaysia
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.
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.
When patients are tethered with uncontrolled pain, health care practitioners usually resort to several
modes of symptomatic relief for their patients. In palliative care the goal is identifying and managing
the cause of pain in addition to addressing associated problems. To administer effective symptom
control in patient with chronic non-cancer associated pain, healthcare professionals may need to
consider alternative non-pharmacological modes of treatment such as psychological intervention. Pain
perception can be influenced by non-organic factors such as emotional, psychosocial status of the
patient and their religious and spiritual beliefs. Taking these factors into consideration are an essential
part of treatment goals. The paper illustrates an ethical dilemma which has arisen in the aggressive
management of pain and highlights the importance of multi-disciplinary involvement in patient care.
Failure to consider these aspects of care can cause patient and parental anxiety, poor symptom control
and could compromise doctor-patient relationship.
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: Medical and allied health educators around the globe agreed that an optimal educational climate is a vital aspect for effective learning to take place. Without a doubt, appraisal of the educational climate has been emphasized as a key to the delivery of high quality medical education. In addition, the appraisal provides useful feedback to particular institution to improve their curriculum.
Objective: This study was employed as part of the School of Medical Sciences (SMS) Universiti Sains Malaysia curriculum review process. It aimed to explore the strengths and weaknesses of the current medical curriculum thus could provide useful information to guide the curriculum review committee during the review process.
Method: A cross sectional study was conducted on a total of 656 medical students from the first, third and fifth year of study. Purposive sampling method was applied. DREEM was administered to the medical students to evaluate the educational climate in the studied medical school.
Result: A total of 511 (77.9%) medical students completely responded to the 50 statements of DREEM. The mean global score across phases of medical training was 128.36/200. The global scores for year 1, year 3 and year 5 were 138.94/200, 122.27/200 and 125.49/200 respectively. Results showed that; 1) the medical school had reasonably level of educational climates across phases of medical training; 2) the medical teachers were knowledgeable and well prepared for the teaching; 3) the students were overloaded with factual knowledge; 4) the medical teachers were quite harsh to students during teaching session especially in clinical phase; 5) students experienced a significant amount of stress that led to poor memory; 6) the learning process was inclined toward teacher-centered rather than student-centered learning; 7) students had a considerable healthy social relationships with peers as well as others; and 8) academic dishonesty became more apparent in the clinical phase.
Conclusion: The medical school's educational environment across different phases of study was more positive than negative. However, there are plenty of rooms for improvement as perceived by the medical students. The medical school should address various important issues highlighted in this article during the curriculum review process.
Introduction: Attitudes towards animal welfare are important in influencing how animals are treated. Studies of attitudes towards animal welfare in veterinary students are scarce. It is hope that the findings will enhace a diverse research in the future in order to explore variety of factors in relation to animal welfare since such study is currently limited.
Objective: The study is to determine the associations of gender,year of study and empathy level of undergraduate DVM students in UPM into their attitude towards animal welfare.
Method: Questionnaires were given to 440 Doctor of Veterinary Medicine undergraduate students in UPM to study the associations between gender,year of study and empathy level with attitudes towards animal welfare. Data were collected from respondents through two sets of self guided questionnaires. Interpersonal Reactivity Index (IRI) which assessed empathy level where only two sub-scales from the IRI were used. Empathic Concern (EC) and Perspective Taking (PT). Animal Attitude Scales (AAS) were used to assess attitudes towards animal welfare. Data collected were analysed using Statistical Package for Social Science (SPSS) version 20.
Result: 367 (83.4%) out of 440 students participated in this study. Antu-animal welfare attitude (74.9%) was the highest compared to the pro-animal welfare attitude (25.1%). Analysis showed a significant difference (p0.005) between gender and attitudes towards animal welfare (p=0.057) as well as between empathy level and attitudes towards animal welfarefor empathic concern sub-scale (p=0.194) and perspective taking sub-scale (p=0.320).
Conclusion: Majority of sudents were categorized as anti-animal welfareand the attitudes were significantly different among years of study. Female and malestudents have nomsignificant differences in their attitudes towards animal welfare. Students with ggod and poor empathy level also have no significant difference in their attitudes towards animal welfare.
The main purpose of formative assessment is to improve students' learning and it
should be seen as a part of the learning process. Game-based learning has become more common in
the education and one of the emerging game-based learning platform used in education institutions is
Kahoot. This paper investigated the perception of students towards Kahoot as a formative assessment
tool in undergraduate medical education and its association with gender. Methods: A cross-sectional
study was carried out on first year medical students in a Malaysian public medical school. The study
employed a survey that consists of 12 items through Kahoot survey platform. Result: A total of 113
subjects participated in this study; majority was female (68.1%) and Malay (58.4%). The students
highly perceived Kahoot as fun, effective and better than e-learning platform for feedback as its
median score was 4. The rest of items were satisfactorily perceived by the students as indicated by
the score of 3 except for simplifying complex subjects that obtained unsatisfactory level. There were
significant median score differences between male and female students for motivation and perceived
knowledge retention, whereby males scored higher than females (p < 0.05). Conclusion: Kahoot is a
promising formative assessment tool that is feasible, practical and makes learning fun and enjoyable. It
can be used to motivate students to learn. However, Kahoot was not the best tool to simplify complex
subjects as perceived by medical students.
Many educators adopt feedback models from articles and books which contain various feedback
strategies rather than depending on their own experiences. Mini Clinical Evaluation Exercise (MiniCEX) is a Workplace-Based Assessment (WPBA) that requires the examiner to observe the student
performing a focused task within 15-20 minutes at the clinic or ward with compulsory immediate
feedback. The aim of this study is to identify the feedback strategies adopted by family physician
lecturers during the feedback session at the end of the mini-CEX assessment. A qualitative methodology
using indirect observation was adopted for this cross-sectional study. Thirty-three Mini-CEX feedback
sessions were selected using a purposive sampling involving 33 Final Year Medical Students and
fourteen Family Physician lecturers at the Department of Family Medicine, National University of
Malaysia. The feedback sessions were audio-recorded, transcribed and analysed using content analysis.
Results showed eight feedback strategies were adopted in the feedback sessions. The majority of the
feedback sessions were conducted in a dialogic approach through self-reflection (96.7%). However, the
students’ contribution was minimal in student’s plan for improvement (36.3%) and self-scoring
(39.4%). 90.9% of the students were also praised on their correct performance and received plan for
improvement. From 60.6% of the candidates who were informed of their final scores, 45.4% of the
scores were justified. 24.2% of the students were offered to ask questions during the feedback session.
More exposure to various feedback strategies may provide better advantage for the students to monitor
and improve their level of achievement. Adopting a dialogic feedback approach is crucial to encourage
a sense of belonging in the process of feedback.
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
In today’s challenging and highly complex health care settings nurses must be able to think critically.
With the current traditional and rote methods of learning, the critical thinking skills among the
students are seen to diminish. As nurse educators must find a different method in their teaching on
how to encourage students to engage in analytical thinking and how to make the analytical thinking
process part of their daily practice due to increase safety of the patients. This will give challenge for
the nurse educators to reshape education by adopting instructional strategies to equip students with
foundational knowledge in critical thinking, creative problem solving and collaboration. Through
concept mapping, students should be able to transfer applied didactic objectives from the classroom
to the clinical practice, where critical thinking and problem solving skills are needed for success. It also
provide nurse educators with the ability to help students learn how to organise data, prioritise patient
needs and can relate patient medical illness and nursing intervention.
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.
The Delphi technique is a widely used and accepted method for gathering data from participantswithin domain of expertise. The objective of this study is to discuss the process of the three roundsDelphi technique in seeking a consensus of concept mapping structure and Multiple Choice Questions(MCQ) in Diabetic Mellitus subject. In the first, round, participants were given a structuredquestionnaire regarding item of concept mapping structure and MCQ in Diabetic Mellitus subject.The second were added mean and median value of round one. In the third round were add meanand median value of round two were added. Participants were asked to rate the categorised responsesfrom Round 1 on a scale of 1 to 5, with 1 being “Very irrelevant” and 5 being “Very relevant”. Thistechnique does not require participants to meet face-to-face, thereby making it useful to conductsurveys with qualified people over a wide geographic area. The feedback process allows and encouragesthe selected Delphi participants to reassess their initial judgements about the information providedin previous iterations. Data is then analysed to check for consistency of experts’ responses betweenrounds. Instrument developed from the Delphi technique research findings is also examined forvalidation from experts in educational medical health sciences on content and constructs validity.Analysis on the consensus of data from experts was based on median, inter quartile range and quartiledeviation on Round 1, 2 and 3 data. Therefore, the Delphi technique is an appropriate method foridentifying significant issues related with academic.
Introduction: In Malaysian nursing education, concept mapping is not widely practiced among nurse
educators and students. Therefore, the researcher aims to develop and evaluate the impact of the
Rusnani Concept Mapping (RCM) protocol on academic achievement and clinical practices among
diploma nursing students. RCM is one of the teaching learning methods that specifies guidelines for
nurse educators to harmonise classroom and clinical setting methods. Method: RCM is a concept
mapping protocol guideline developed by the researcher and is validated with content and face validity
and the Delphi technique. The study design is quasi-experimental with two groups. The experimental
and control groups received education using RCM and the lecture method, respectively. Data were
analysed using descriptive and inferential statistics using paired t-tests. P values less than 0.05 were
interpreted as significant. Results: In the pre-test, the students taught using RCM had a mean
achievement score of 11.23 with and SD = 2.59, while at post-test, the mean achievement score was
13.19 with and SD = 1.71 and a mean gain score of 1.96. In contrast, students taught using lecture
method had a mean achievement score of 10.71 and SD = 2.23 in the pre-test and a mean score of
12.60, SD = 1.64 in post-test achievement with a mean gain score of 1.89. The post-test scores of the
experimental and control group were significantly different (t = 2.53, p < 0.05). The mean concept
mapping care plan score was 59.33 and 65.23, respectively, for the control group and experimental
group. The paired t-test revealed that there was a significant difference between experimental and
control groups, p value < 0.05. The result of students’ perceptions regarding concept mapping in the
experimental group showed as positive moderate with a mean score of 3.44. Conclusion: This study
provides additional evidence that RCM is instructionally valuable as a learning method and is an active
learning strategy for meaningful learning and motivating superior achievement in students.