Displaying publications 41 - 60 of 238 in total

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  1. Foo ML, Tang LY, Vimala R, Chui PL, Chong MC
    J Contin Educ Nurs, 2017 Aug 01;48(8):347-352.
    PMID: 28759691 DOI: 10.3928/00220124-20170712-05
    BACKGROUND: Because nurses need to handle a broad range of issues related to patients' health status, it is necessary to make reliable and sound clinical judgments for professional accountability and the patients' safety.

    METHOD: A quasi-experimental pre- and posttest design with a control group was used to study the effectiveness of an educational intervention on the clinical judgment skills of 80 RNs from two district hospitals. The change in clinical judgment skills during a 6-week period was evaluated using a complex case-based scenario after the completion of the educational intervention.

    RESULTS: The mean scores of clinical judgment skills of the experimental group had significantly improved from 24.15 ± 6.92 to 47.38 ± 7.20. (p < .001). However, only a slight change was seen in mean scores for the control group (23.80 ± 5.77 to 26.50 ± 6.53).

    CONCLUSION: The educational intervention was effective postintervention. Continuing nursing education using a traditional and case-based method is recommended to improve clinical judgment skills in clinical settings. J Contin Educ Nurs. 2017;48(8):347-352.

    Matched MeSH terms: Clinical Competence/statistics & numerical data*
  2. Ramoo V, Abdullah KL, Tan PS, Wong LP, Chua PY
    Nurs Crit Care, 2016 Sep;21(5):287-94.
    PMID: 25271143 DOI: 10.1111/nicc.12105
    BACKGROUND: Sedation management is an integral component of critical care practice. It requires the greatest attention of critical care practitioners because it carries significant risks to patients. Therefore, it is imperative that nurses are aware of potential adverse consequences of sedation therapy and current sedation practice recommendations.

    AIMS AND OBJECTIVES: To evaluate the impact of an educational intervention on nurses' knowledge of sedation assessment and management.

    DESIGNS AND METHODS: A quasi-experimental design with a pre- and post-test method was used. The educational intervention included theoretical sessions on assessing and managing sedation and hands-on sedation assessment practice using the Richmond Agitation Sedation Scale. Its effect was measured using self-administered questionnaire, completed at the baseline level and 3 months following the intervention.

    RESULTS: Participants were 68 registered nurses from an intensive care unit of a teaching hospital in Malaysia. Significant increases in overall mean knowledge scores were observed from pre- to post-intervention phases (mean of 79·00 versus 102·00, p < 0·001). Nurses with fewer than 5 years of work experience, less than 26 years old, and with a only basic nursing education had significantly greater level of knowledge improvement at the post-intervention phase compared to other colleagues, with mean differences of 24·64 (p = 0·001), 23·81 (p = 0·027) and 27·25 (p = 0·0001), respectively. A repeated-measures analysis of variance revealed a statistically significant effect of educational intervention on knowledge score after controlling for age, years of work and level of nursing education (p = 0·0001, ηp (2) = 0·431).

    CONCLUSION: An educational intervention consisting of theoretical sessions and hands-on sedation assessment practice was found effective in improving nurses' knowledge and understanding of sedation management.

    RELEVANCE TO CLINICAL PRACTICE: This study highlighted the importance of continuing education to increase nurses' understanding of intensive care practices, which is vital for improving the quality of patient care.

    Matched MeSH terms: Clinical Competence/standards
  3. Kamal RM, Ward E, Cornwell P
    Int J Speech Lang Pathol, 2012 Dec;14(6):569-76.
    PMID: 22974073 DOI: 10.3109/17549507.2012.713394
    There are competency standards available in countries with established speech-language pathology services to guide basic dysphagia training with ongoing workplace mentoring for advanced skills development. Such training processes, however, are not as well established in countries where speech-language pathology training and practice is relatively new, such as Malaysia. The current study examines the extent of dysphagia training and workplace support available to speech-language pathologists (SLPs) in Malaysia and Queensland, Australia, and explores clinicians' perceptions of the training and support provided, and of their knowledge, skills, and confidence. Using a matched cohort cross-sectional design, a purpose-built survey was administered to 30 SLPs working in Malaysian government hospitals and 30 SLPs working in Queensland Health settings in Australia. Malaysian clinicians were found to have received significantly less university training, less mentoring in the workplace, and were lacking key infrastructure needed to support professional development in dysphagia management. Over 90% of Queensland clinicians were confident and felt they had adequate skills in dysphagia management; in contrast, significantly lower levels of knowledge, skills, and confidence were observed in the Malaysian cohort. The findings identify a need for improved university training and increased opportunities for workplace mentoring, training, and support for Malaysian SLPs.
    Matched MeSH terms: Clinical Competence*
  4. Lum SK, Crisostomo AC
    Asian J Surg, 2009 Jul;32(3):137-42.
    PMID: 19656752 DOI: 10.1016/S1015-9584(09)60384-5
    A survey of the current status of surgical training in Hong Kong, Malaysia, Singapore, Philippines and Thailand, in comparison with the UK and Australia, was done to explore the possibility of cross border training in South East Asia (SEA).
    Matched MeSH terms: Clinical Competence
  5. Dewi FD, Gundavarapu KC, Cugati N
    Oral Health Prev Dent, 2013;11(2):131-9.
    PMID: 23757453 DOI: 10.3290/j.ohpd.a29735
    PURPOSE: To find the differences in patient satisfaction related to dental services among three ethnic groups - Chinese, Indian and Malay - at AIMST University Dental Centre and analyse them with an importance-performance grid, identifying the weak and strong points, in order to provide better service.

    MATERIALS AND METHODS: This questionnaire-based study consisted of convenience samples of 174 patients of Chinese, Indian and Malay ethnicity. Importance-performance analysis for 20 attributes were compared using Likert's scale. The data obtained were statistically analysed using the Kruskal-Wallis test.

    RESULTS: Chinese and Indians both emphasised low performance on the interpersonal relationship attribute in terms of the receptionist's courtesy, whereas the Malay participants were concerned with convenience attributes. All the ethnic groups favoured maintaining existing major attributes towards technical competency, interpersonal relationship and facility factors. This study demonstrated priority differences between the ethnic groups' perception of the quality of dental services, where ethnic Chinese showed the highest gap (measure of dissatisfaction) between importance and performance compared to ethnic Malays, followed by ethnic Indians.

    CONCLUSION: The patients from the three major ethnic groups of Malaysia were generally well satisfied. Perhaps more priority should be placed on improving the interpersonal relationship attribute, especially with the receptionists.

    Matched MeSH terms: Clinical Competence
  6. Datta A
    Malays J Med Sci, 2021 Feb;28(1):105-108.
    PMID: 33679226 DOI: 10.21315/mjms2021.28.1.13
    Clinical history taking and physical examination are the essence of clinical medicine. However, the glare of modern diagnostic tools and techniques has overshadowed these basic but indispensable steps of diagnosis. Deterioration of clinical skills is a burning issue in this era due to over-reliance on high-end technology. Poor clinical judgment not only leads to mismanagement but also results in over-utilisation of health care resources. Moreover, with lesser time at the bedside, the physician-patient relationship is also getting compromised.
    Matched MeSH terms: Clinical Competence
  7. Abd-Rahman ANA, Baharuddin IH, Abu-Hassan MI, Davies SJ
    J Dent Educ, 2021 Jul;85(7):1210-1216.
    PMID: 33792052 DOI: 10.1002/jdd.12600
    BACKGROUND: The outcome of assessments is determined by the standard-setting method used. Standard setting is the process of deciding what is good enough. A cutoff score of 50% was commonly used in dental schools in Malaysia. This study aims to compare the conventional, norm-referenced, and modified-Angoff standard-setting methods.

    METHODS: The norm-referenced method of standard setting was applied to the real scores of 40 final-year dental students on a multiple-choice question (MCQ), a short answer question (SAQ), and an objective structured clinical examination (OSCE). A panel of 10 judges set the standard using the modified-Angoff method for the same paper in one sitting. One judge set the passing score of 10 OSCE questions after 2 weeks. A comparison of the grades and pass/fail rates derived from the absolute standard, norm-referenced, and modified-Angoff methods was made. The intra-rater and inter-rater reliabilities of the modified-Angoff method were assessed.

    RESULTS: The passing rate for the absolute standard was 100% (40/40), for the norm-referenced method it was 62.5% (25/40), and for the modified-Angoff method it was 80% (32/40). The modified-Angoff method had good inter-rater reliability of 0.876 and excellent test-retest reliability of 0.941.

    CONCLUSION: There were significant differences in the outcomes of these three standard-setting methods, as shown by the difference in the proportion of candidates who passed and failed the assessment. The modified-Angoff method was found to have good reliability for use with a professional qualifying dental examination.

    Matched MeSH terms: Clinical Competence*
  8. Deva MP
    Med J Malaysia, 2006 Mar;61(1):4-6.
    PMID: 16708727
    Depression as a symptom and a disease has been recognized from antiquity. While numerous references to melancholia, illnesses of the heart broken, and delusions of guilt are found in Shakespearean literature, world literature, stories, and dramas the world over, yet the development of modern western medicine has by and large tended to ignore all things psychological in the process of disease recognition and understanding. Even the face of a depressed patient, so obvious to the initiated, is a rarely taught and recognized sign of ill health by non- psychiatrists. The long association of psychiatry with severe psychoses in the minds of medical teachers has dulled the sense of astuteness in the picking up of anxiety and depression. It has also dulled the medical profession into the delusion that mental illnesses do not occur in general hospitals. Thus the fairly large number of mental problems in every day clinical practice remains an area of darkness. In practice, the pick up rate of all mental illnesses in primary care remains very low at less than 5% of all mental illnesses while studies show that about 25% of all primary care patients have significant mental problems that necessitate their attendance in the primary care clinics.
    Matched MeSH terms: Clinical Competence
  9. Devaraj NK
    Sleep Breath, 2020 Dec;24(4):1581-1590.
    PMID: 32096012 DOI: 10.1007/s11325-020-02040-1
    PURPOSE: Obstructive sleep apnea (OSA) has been linked with inflammation, hypertension, and higher cardiovascular risk which cause substantial morbidity and mortality worldwide. However, OSA is underdiagnosed and its prevalence is increasing. Primary care doctors are the first contact for most patients and primary care providers play an important role in promoting, screening, and educating patients regarding OSA. This study aims to determine the knowledge, attitudes, and practices regarding OSA among primary care doctors in Kuala Lumpur, Malaysia.

    METHODS: A cross-sectional survey was conducted among physicians who were currently working in primary care clinics in the capital state of Kuala Lumpur. The validated "Obstructive Sleep Apnea Knowledge and Attitudes Questionnaire" (OSAKA) and nine additional practice questions were used as the survey instrument.

    RESULTS: Of 207 physicians queried, the response rate was 100%. The mean (± SD) total knowledge score was 11.6 (± 2.8) (range 1-18). The majority of respondents had a positive attitude towards the importance of OSA but lacked confidence in managing OSA. Primary care doctors' most common practice for patients with suspected OSA was referral to the ear, nose, and throat (ENT) clinic.

    CONCLUSIONS: The study shows that primary care doctors demonstrated adequate knowledge about OSA and were aware of the importance of OSA as a core clinical problem. However, only a minority felt confident in managing patients with OSA. The results of the study may encourage improvement of primary care doctors' efforts to prevent and manage OSA.

    Matched MeSH terms: Clinical Competence*
  10. Dias PL
    Med Educ, 1987 Jul;21(4):334-9.
    PMID: 3626901
    The knowledge and clinical and minor surgical skills acquired by 257 medical students in three universities in Sri Lanka and Malaysia were assessed by a questionnaire after they had completed their training period in ophthalmology. This study showed that many medical students graduating from these universities lacked the basic clinical and minor surgical skills essential for a doctor practising in a community in south-east Asia. The responses also indicated that teaching by consultants in all three universities was inadequate and due to these inadequacies the students requested that the duration of their training period be doubled. Ophthalmology is an important component of clinical practice and proper education in this subject is important. An urgent revision of the aims and objectives of the curriculum in ophthalmology is essential to place greater emphasis on this important and much neglected subject, for which very little curricular time is allotted.
    Matched MeSH terms: Clinical Competence
  11. Kusmiati M, Bahari R, Sanip S, Hamid NAA, Emilia O
    Korean J Med Educ, 2020 Mar;32(1):1-11.
    PMID: 32130846 DOI: 10.3946/kjme.2020.148
    PURPOSE: This study was designed to develop an evaluation tool for assessing professional behavior and clinical competencies from the graduates' perspective.

    METHODS: This study employed mixed method in a sequential exploratory design. The semi-structured interviews were conducted with three graduates from different cohorts. The qualitative analysis of the interviews found six emerging themes for professional behavior and clinical competencies development. These themes were then developed into a 55-item questionnaire. The questionnaire was then distributed to 84 medical graduates for exploratory factor analysis (EFA) from February to April 2019. The quantitative data were analyzed using IBM SPSS ver. 21.0 (IBM Corp., Armonk, USA) for principal axis factoring. After conducting EFA, we proceeded with confirmatory factor analysis (CFA) with another 120 graduates to validate the tool.

    RESULTS: Eighty-four graduates completed the questionnaire for EFA. Upon completion of EFA, 35 out of 55 items of the questionnaire were found to be valid and reliable. The most appropriate fit was seven factors, which explained 58.18% of variance between them after 15 iterations with Cronbach's α of 0.916. The personal satisfaction factor was noted to be weak. It was therefore added to patient management factor due to its similar intention. The final EFA factor after the modification was six. The CFA found that 34 out of 35 items was valid and reliable that representation of the latent variables.

    CONCLUSION: The questionnaire has achieved the desired construct validity score and can be used as an evaluation tool to assess professional behavior and clinical competencies from the graduates' perspective.

    Matched MeSH terms: Clinical Competence*
  12. Woods C, Naroo S, Zeri F, Bakkar M, Barodawala F, Evans V, et al.
    Cont Lens Anterior Eye, 2023 Apr;46(2):101821.
    PMID: 36805277 DOI: 10.1016/j.clae.2023.101821
    INTRODUCTION: Evidence based practice is now an important part of healthcare education. The aim of this narrative literature review was to determine what evidence exists on the efficacy of commonly used teaching and learning and assessment methods in the realm of contact lens skills education (CLE) in order to provide insights into best practice. A summary of the global regulation and provision of postgraduate learning and continuing professional development in CLE is included.

    METHOD: An expert panel of educators was recruited and completed a literature review of current evidence of teaching and learning and assessment methods in healthcare training, with an emphasis on health care, general optometry and CLE.

    RESULTS: No direct evidence of benefit of teaching and learning and assessment methods in CLE were found. There was evidence for the benefit of some teaching and learning and assessment methods in other disciplines that could be transferable to CLE and could help students meet the intended learning outcomes. There was evidence that the following teaching and learning methods helped health-care and general optometry students meet the intended learning outcomes; clinical teaching and learning, flipped classrooms, clinical skills videos and clerkships. For assessment these methods were; essays, case presentations, objective structured clinical examinations, self-assessment and formative assessment. There was no evidence that the following teaching and learning methods helped health-care and general optometry students meet the intended learning outcomes; journal clubs and case discussions. Nor was any evidence found for the following assessment methods; multiple-choice questions, oral examinations, objective structured practical examinations, holistic assessment, and summative assessment.

    CONCLUSION: Investigation into the efficacy of common teaching and learning and assessment methods in CLE are required and would be beneficial for the entire community of contact lens educators, and other disciplines that wish to adapt this approach of evidence-based teaching.

    Matched MeSH terms: Clinical Competence*
  13. Nadarajah VD, Sow CF, Syed Aznal SS, Montagu A, Boursicot K, Er HM
    J Med Educ Curric Dev, 2020 11 19;7:2382120520970894.
    PMID: 33283046 DOI: 10.1177/2382120520970894
    A preparatory framework called EASI (Evaluate, Align, Student-centred, Implement and Improve) was developed with the aim of creating awareness about interim options and implementation opportunities for online Clinical and Communication Skills (CCS) learning. The framework, when applied requires faculty to evaluate current resources, align sessions to learning outcomes with student-centred approaches and to continuously improve based on implementation experiences. Using the framework, we were able to generate various types of online CCS learning sessions for implementation in a short period of time due to the recent Covid-19 pandemic. Importantly we learnt a few lessons post-implementation from both students and faculty perspective that will be used for planning and delivery of future sessions. In summary, the framework was useful for creating or redesigning CCS sessions which were disrupted during the pandemic, however post-implementation experience suggests the framework can also be used for future solutions in online CCS learning as healthcare systems and delivery are increasingly decentralised and widely distributed.
    Matched MeSH terms: Clinical Competence
  14. Hanizah N, Affirul CA, Fadzlon MY
    Clin Ter, 2014;165(5):e336-41.
    PMID: 25366949 DOI: 10.7417/CT.2014.1759
    BACKGROUND: Cricoid pressure (CP) is a step during rapid sequence induction. Previous studies showed a poor clinical application of CP despite a reasonable theoretical knowledge of CP. This study aims to evaluate the proficiency and knowledge retention on CP among the emergency staff in the Emergency Department, Universiti Kebangsaan Malaysia Medical Centre.

    MATERIALS AND METHODS: This is questionnaire-based observational comparative study. Once the questionnaire is filled, the application of CP is tested on an airway model and competency level is documented. An education hand out is passed to all participants after the procedure. The improvement and knowledge retention were assess after 2 month.

    RESULTS: A total of 81 completed surveys were returned comprises of of 34 medical officers, 23 staff nurses and 24 assistant medical officers. 75.3% subjects have work experience more than a year but only 59.3% of them were trained in CP application. A total of 69.1% participants passed the pre educational handout test and 100% passed the post educational handout test. However, for pre educational handout phase, 81.5% participants passed the theory part while only 42% passed the practical component. In post educational handout phase, the number of respondents who passed both components was 97.5% and 63% respectively. There are positive correlation between designation and working experience with overall passes in this study.

    CONCLUSIONS: The theoretical knowledge of CP is satisfactory but clinical application is poor especially in the pre educational handout phase. The educational handout is proved to improve the knowledge transfer and retention with regards to CP.

    Matched MeSH terms: Clinical Competence/standards*
  15. Ludin SM, Fathullah NM
    Nurse Educ Today, 2016 Sep;44:79-85.
    PMID: 27429333 DOI: 10.1016/j.nedt.2016.05.007
    BACKGROUND: Clinical teachers are a critical determinant of the quality of nursing students' clinical learning experiences. Understanding students' perceptions of clinical teachers' behaviours can provide the basis for recommendations that will help improve the quality of clinical education in clinical settings by developing better clinical teachers.

    OBJECTIVES: To understand clinical teaching behaviours and their influence on students' learning from the perspective of undergraduate nursing students.

    DESIGN: A cross-sectional, correlational survey.

    SETTING: A nursing faculty in Kuantan, Pahang, Malaysia.

    PARTICIPANTS: A sample of 120/154 (78%) students from Year 2-Year 4 were recruited according to set criteria.

    METHODS: A self-administered questionnaire was employed to collect demographic data, and students' perceptions of clinical teaching behaviours and their impact on learning using the Nursing Clinical Teaching Effectiveness Inventory (NCTEI).

    RESULTS: Year 3 and 4 students perceived faculty clinical teaching behaviours positively. There was a significant association between clinical teaching behaviours and their influence on students' clinical learning. Teachers' competence rated as the most significant influential factor, while teachers' personality rated as least influential.

    CONCLUSION: Participants were able to identify the attributes of good clinical teachers and which attributes had the most influence on their learning. Overall, they perceived their teachers as providing good clinical teaching resulting in good clinical learning. Novice clinical teachers and nursing students can use this positive association between teaching behaviours and quality of clinical learning as a guide to clinical teaching and learning.

    Matched MeSH terms: Clinical Competence
  16. Fauzi ARM
    Med J Malaysia, 2003 Jun;58(2):205-12.
    PMID: 14569740 MyJurnal
    This study was done to ascertain the knowledge and practice of medical officers on spirometry and management of COPD in a medical department of a state hospital. A total of 81 questionnaires with nine items were distributed to medical officers in the medical department (MD) and in other departments (controls). Eight incomplete questionnaires were rejected. In all 15 (21%) respondents were analysed from MD and 58 (79%) from the control group. The respondents from MD were aware that spirometry was important in COPD (100% versus 69%, P < 0.01) but in practice both groups were as likely to use peak expiratory flow rate. Respondents from MD were more likely to treat mild COPD (73% versus 12%, P < 0.001) according to Malaysian Thoracic Society COPD guidelines and also more likely to perform steroid trial (93% versus 37%, P < 0.001). Only 9 (60%) from MD and 33(57%) would refer patients for home oxygen assessment. This preliminary survey suggests that there was lack of translation of knowledge into practice particularly in terms of use of spirometry in COPD as well as lack of awareness for home oxygen assessment. A bigger survey involving all doctors in the state to answer issues raised in this preliminary survey is being conducted.
    Matched MeSH terms: Clinical Competence/statistics & numerical data*
  17. Brands B, Chomtho S, Suthutvoravut U, Chiong Meng Boey C, Tang SF, Godfrey KM, et al.
    Nutrients, 2020 Jun 18;12(6).
    PMID: 32570814 DOI: 10.3390/nu12061817
    BACKGROUND: The double burden of both under- and overnutrition during the first 1000 days is highly prevalent in Southeast Asia (SEA), with major implications for lifelong health. Tackling this burden requires healthcare professionals (HCPs) to acquire evidence-based current knowledge and counselling skills. We assessed the needs of HCPs in SEA and developed a continuing medical education/professional development (CME/CPD) program using an e-learning platform to reduce existing gaps.

    METHODS: European, Thai and Malaysian universities collaborated with SEA national nutrition associations in the Early Nutrition eAcademy Southeast Asia (ENeA SEA) project. We assessed HCPs' needs using questionnaires and mapped CME/CPD programmes and regulations through stakeholder questionnaires. Using a co-creation approach, we established an e-learning platform. Evaluation in users was undertaken using questionnaires.

    RESULTS: HCPs in SEA reported major training gaps relating to the first 1000 days of nutrition and limited impact of existing face-to-face training. Existing pre/postgraduate, residency and CME/CPD programmes did not adequately address the topic. To address these gaps, we produced a targeted e-learning platform with six modules and CME-tests. National ministries, Thai and Malaysian universities, and professional associations endorsed the training platform. To date, over 2600 HCPs have registered. Evaluation shows high acceptance and a very positive assessment.

    CONCLUSIONS: Dedicated e-learning can reduce major gaps in HCP training in SEA regarding nutrition during the first 1000 days of life at scale and is highly valued by both users and key stakeholders.

    Matched MeSH terms: Clinical Competence/statistics & numerical data*
  18. Lai NM, Ngim CF, Fullerton PD
    Educ Health (Abingdon), 2012 Nov;25(2):105-10.
    PMID: 23823593 DOI: 10.4103/1357-6283.103457
    Despite being an essential clinical skill, many junior doctors feel unprepared to perform neonatal resuscitation. We introduced a neonatal resuscitation training workshop in 2009 for our final-year medical students.
    Matched MeSH terms: Clinical Competence/standards
  19. Khan F, Amatya B, de Groote W, Owolabi M, Syed IM, Hajjoui A, et al.
    J Rehabil Med, 2018 May 08;50(5):472-479.
    PMID: 29487941 DOI: 10.2340/16501977-2313
    OBJECTIVE: Despite the prevalence of disability in low-and middle-income countries, the clinical skills of the rehabilitation workforce are not well described. We report health professionals' perspectives on clinical skills in austere settings and identify context-specific gaps in workforce capacity.

    METHODS: A cross-sectional pilot survey (Pakistan, Morocco, Nigeria, Malaysia) of health professionals' working in rehabilitation in hospital and community settings. A situational-analysis survey captured assessment of clinical skills required in various rehabilitation settings. Responses were coded in a line-by-line process, and linked to categories in domains of the International Classification of Functioning, Disability and Health (ICF).

    RESULTS: Respondents (n = 532) from Pakistan 248, Nigeria 159, Morocco 93 and Malaysia 32 included the following: physiotherapists (52.8%), nurses (8.8%), speech (5.3%) and occupational therapists (8.5%), rehabilitation physicians (3.8%), other doctors (5.5%) and prosthetist/orthotists (1.5%). The 10 commonly used clinical skills reported were prescription of: physical activity, medications, transfer-techniques, daily-living activities, patient/carer education, diagnosis/screening, behaviour/cognitive interventions, comprehensive patient-care, referrals, assessments and collaboration. There was significant overlap in skills listed irrespective of profession. Most responses linked with ICF categories in activities/participation and personal factors.

    CONCLUSION: The core skills identified reflect general rehabilitation practice and a task-shifting approach, to address shortages of health workers in low-and middle-income countries.

    Matched MeSH terms: Clinical Competence/standards*
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