It is common to see chapters on acid-base physiology state that the goal of acid-base regulatory mechanisms is to maintain the pH of arterial plasma and not arterial Pco(2) (Pa(CO(2))) or plasma HCO(3). A hypothetical situation in which the Pa(CO(2)) of arterial plasma is 80 mmHg and the plasma HCO(3) concentration is 48 mM is presented and analyzed to get over this misconception. As per the modified Henderson equation, the pH of arterial plasma would be 7.4; however, we explain that this may be associated with intracellular acidosis due to intracellular hypercapnia and that derangement of homeostasis is evident from the occurrence of respiratory depression and, eventually, coma in the patient described. This suggests that the ultimate goal of acid-base regulatory mechanisms is not just the maintenance of the pH of arterial plasma but the maintenance of the steady-state pH of intracellular fluid as well.
Clinical skills program as a laboratory method is a valuable adjunct to other forms of undergraduate medical training. This article describes the process of developing a core curriculum in clinical skills based on the Dundee model for a clinical skills centre. The School of Medical Sciences, in Universiti Sains Malaysia (USM) has been provided with a well equipped skills centre. However, the PBL curriculum in the undergraduate medical program in the school needs to be integrated with a clinical skills lab program. This is to counter the general feeling that the contribution of PBL is insignificant in terms of building clinical competency in an integrated system such as that used in USM compared to the traditional curriculi of other medical teaching institutions in Malaysia. Integrating clinical skills laboratory training with the PBL curriculum will provide evidence of PBL as an effective and innovative method for teaching and learning in Malaysia.
An artificial neural network (ANN) was applied for the determination of V(V) based on immobilized fatty hydroxamic acid (FHA) in poly(methyl methacrylate) (PMMA). Spectra obtained from the V(V)-FHA complex at single wavelengths was used as the input data for the ANN. The V(V)-FHA complex shows a limited linear dynamic range of V(V) concentration of 10 - 100 mg/ L. After training with ANN, the linear dynamic range was extended with low calibration error. A three layer feed forward neural network using backpropagation (BP) algorithm was employed in this study. The input layer consisted of single neurons, 30 neurons in hidden a layer and one output neuron was found appropriate for the multivariate calibration used. The network were trained up to 10000 epochs with 0.003 % learning rate. This reagent also provided a good analytical pedormance with reproducibility characters of the method yielding relative standard deviation (RSD) of 9.29% and 7.09% for V(V) at concentrations of 50 mg/ L and 200 mg/ L, respectively. The limit of detection of the method was 8.4 mg/ L.
It has been decided that IeJSME should be a general rather than specialty medical journal in that it would cover work ranging from bench science to clinical and medical education research. While this is to ensure the ease of soliciting sufficient manuscripts for sustainability of the journal, the other important reason is to provide learning opportunities for novice researchers, including undergraduate medical students, to improve their work in such a way that are publishable at a certain research quality. This intention is being birthed primarily with our 16-year old medical university and Malaysia in mind, although, as the journal title suggests, we aim that the work published in IeJSME will have international relevance and importance. (Copied from article).
Stress has been recognized one of the factors causing disease. About 70-80% of all diseases may be stress related. Thus, stress management can be a part of an early measure of disease prevention. A descriptive cross sectional, randomized study was conducted to determine the stress inducing factors among preclinical students (universal sampling) in a public university in Selangor, Malaysia from 24th April to May 2005. A total of 163 students (52.8% year 1, 36.8% year 2 and 10.4% year 3) were interviewed in the data collection process. The main reasons students entered - medical school was because of their own interest or ambition (65%) and family influence (20.9%). Majority (76.4%) suffered moderate to great stress over hot conditions in lecture hall, tutoriaV small group session rooms and laboratories while 53.4% suffered when using the other facilities like cafeteria, toilet and transportation:. Almost all (95.1%) felt that examination was the most stressful, followed by early clinical exposure sessions (68.1%), problem·based learning sessions (62.5%), hospital visitations (59.7%), tutoriay small group sessions (49.3%), practical class (44.5%) and attending lectures (3 8.5%). Musculoskeletal System was the most stressful module among the first year students, followed by Nervous System and Gastrointestinal System with the percentage of 94.2%, 90.7% and 88.4% respectively while, 95% of the second year students felt that General, Hemopoietic ci? Lymphoid and Nervous System are the most stressful modules. This study revealed that academic sessions and lack of conducive teaching and learning environment as the main stress inducing contributors to preclinical medical students.
The objective of this part of the study was to understand the current trend on readership of the Malaysian Dental Journal (MDJ) among Malaysian dentists. Their views on the contents and quality of the Malaysian Dental Journal were enquired. We also enquired the reasons they chose-to/chose-not-to read the MDJ. Of the 225 dentists surveyed, the number of MDJ readers was 101; with only 24.75% reading all issues published. The editorial section was rated as “useful” by 70.3% of readers, while 79.2%, 87.1%, 87.1% and 80.2% of readers rated the research article section, the review article section, the case reports section and book recommendation section similarly respectively. Feedback from readers indicated that they wanted more case reports, more review articles on “how to do it” and on medical problems in dentistry. More than half (55.45%) of the MDJ readers preferred to receive the journal in both hard and soft copies. For the non-readers, the most common reasons cited for not reading the MDJ was not being able to access to the journal, followed by not having time to read. Our finding suggested that the respondents preferred to learn from colleagues’ experience and to read article that can improve their clinical knowledge and skill.
For about 50 years, clinical pharmacology and therapeutics have been taught in the medical schools via traditional lectures and practical classes. During this time, significant changes have occurred in our understanding of medicine and basic sciences. Also the needs for our community have changed dramatically. The explosion of scientific discoveries, the use of new technologies in disease diagnosis, the availability of a wide range of therapeutic options, and the availability of knowledge to everyone via the Internet have necessitated new approaches for teaching medical and other health professional students. Finding information related to a topic has not become a priority in teaching, what has become more important is to teach undergraduate students how to think in addition to what to think. Applying information learnt and assessing its significance in real life situations has become mandatory. The aims of this paper were: (i) to discuss the model we used in introducing clinical pharmacology and therapeutics teaching in the undergraduate course at the University of Melbourne and the educational principles behind the model, and (ii) to discuss the new tools of assessment used in a problem-based learning (PBL) curriculum.
Portfolios have been used in the medical curriculum to evaluate difficult-to-assess areas such as students' attitudes, professionalism and teamwork. However, their use early in a problem-based learning (PBL) course to foster deep learning and enhance students' self-directed learning has not been adequately studied. The aims of this paper are to: (1) understand the uses of portfolios and the rationale for using reflection in the early years of a PBL curriculum; (2) discuss how to introduce portfolios and encourage students' critical thinking skills, not just reflection; and (3) provide students with tips that could enhance their skills in constructing good portfolios.
Evidence based on average patient data, which occupies most of our present day information databases, does not fulfil the needs of individual patient-centred health care. In spite of the unprecedented expansion in medical information we still do not have the types of information required to allow us to tailor optimal care for a given individual patient. As our current information is chiefly provided in disconnected silos, we need an information system that can seamlessly integrate different types of information to meet diverse user group needs. Groups of certain individual medical learners namely patients, medical students and health professionals share the patient's need to increasingly interact with and seek knowledge and solutions offered by others (individual medical learners) who have the lived experiences that they would benefit to access and learn from. A web-based user-driven learning solution may be a stepping-stone to address the present problem of information oversupply in medicine that mostly remains underutilized, as it doesn't meet the needs of the individual patient and health professional user. The key to its success would be to relax central control and make local trust and strategic health workers feel more engaged in the project such that it is truly user-driven.
Teaching is a complex activity which consists not only of giving instructions but also promotion of learning. Different students have different preference for learning styles. Dental educators must therefore attempt to mix and match their methods of teaching to accommodate students with differing learning styles to provide an opportunity to maximize their learning. This paper aims to share the writer's experience and students' perceptions towards a different mode of teaching/learning method. The Jigsaw Classroom method was employed on University of Malaya's third-year dental students during their Water Fluoridation lecture. At the end of the session, students were asked to reflect upon the learning experience and to inscribe their feelings. Initially, students showed their resentment towards the new learning style but their resistance changed once they got into a group and started to learn from each other. In the reflective essay, most students expressed that learning through teaching and discussing as required in the Jigsaw method enhanced their understanding of the topic and they claimed that they were able to retain the information better. In this study, the Jigsaw method proved that learning in the lecture hall can be fun, educational and enriching.
With the introduction of problem-based learning (PBL) in medical and health professionals’ undergraduate courses, self-directed learning (also known as self-regulated learning) becomes an integral component of the learning process. There may be slight variations in how educators and students perceive self-directed learnin .However, self-directed learning provides an opportunity for collaborative discussion of the new information collected and allows learners to construct new knowledge as they address their learning issues. Therefore, self-directed learning is not just about researching for new knowledge or finding answers for questions; self-directed learning is about developing competencies, skills and attitudes that foster the learning processes. Interestingly, not all learners will be able to adapt this approach of learning once they enroll in a PBL course. The process will develop gradually and require a number of actions from the learner, including: (i) Realising the need to change their learning style to suite the needs of the medical curriculum, (ii) constructing a plan that accommodates the new learning objectives, (iii) Practicing self-directed learning and sharing their experiences with peers, and (iv) Continuing evaluation of their self-directed learning approach and improving their learning style. Therefore, the aims of this manuscript are: (i) discuss the meaning of self-directed learning in the context of PBL, and review the research outcomes in this area, (ii) understand the different factors that may affect student’s self-directed learning strategies, and (iii) briefly explore the meaning of construction of knowledge and how it can enforce students’ self-directed learning, integration of knowledge and deeper understanding of topics learnt.
Background: The Medical Faculty of the International Islamic University Malaysia (IIUM) runs an undergraduate medical programme which is a combination of the traditional and the newer trends of medical curriculum. The IIUM curriculum in Phase I (Years 1, 2: preclinical) is integrated organ system based, with lectures being the main method of curriculum delivery and also incorporating problem-based learning (PBL) as one of the teaching-learning approaches. Methods: The aim of this study is to examine the effectiveness of PBL teaching-learning method in IIUM in achieving the aims of the medical school as viewed by the students. A total of 287 students from Phase I and Phase II (Year 3: clinical) participated in this study at the end of academic session 2006/2007. The questionnaires distributed consisted of 33 items with four different aspects of PBL being evaluated namely; i) PBL objectives, ii) assessment of performance of the facilitators, iii) assessment of the PBL packages and iv) preferred teaching-learning approach. Results: An average of 86.4 % of students agreed that PBL sessions achieved its aims of preparing students for professional training in the clinical years. Also approximately 80% of students felt that the facilitators fulfilled their roles as PBL tutors. Students were generally satisfied with the PBL packages prepared. However about 50% of Year 2 students did not look forward to PBL sessions and only about 20% of preclinical students wanted more PBL sessions to be scheduled. This latter finding differed as 60% of the clinical (Year 3) students wanted more PBL sessions to be implemented. A significant proportion of the students also believed that they needed some prior information about the PBL case in question in order to generate lively exchange of ideas in the first sessions. Preclinical students preferred lectured-based approach as compared to PBL in contrast to the clinical (Year 3) students of whom 57% (62) preferred the PBL teaching-learning approach. Nearly 80% of the Year 3 students found the exposure to PBL sessions during their preclinical years beneficial during the clinical year. Discussion: Although our findings supported the effectiveness of PBL as one of the teaching-learning approaches (as perceived by our students) there are a few areas of concern. These include believing that a prior knowledge of the topic in question is needed to generate a lively discussion; the group not being motivated; the group members confining themselves to individual assignments only; PBL not being supportive of on-going self- assessment; the consequence of a facilitator being too dominant; and cases constructed do not reflect real clinical scenarios. Despite agreeing to its effectiveness preclinical students still preferred lecture-based approach to the PBL as they are more confident with the knowledge as obtained through the former learning modality. Conclusion: PBL is an effective learning strategy and it contributes to the teaching-learning process of IIUM undergraduate preclinical medical programme which implements a non-Problem Based Curriculum. We are of the opinion that a combination of lecture sessions and PBL best suit the IIUM medical students.
107 secondary school teachers were surveyed to find out about their observations of children with learning disorders at schools. The respondents reported that the most commonly observed disorders involved difficulty paying attention, difficulty learning a second language, being fidgety and having difficulty sitting still, and having poor comprehension. They also indicated that whilst some children made fun of their classmates with learning disorder, others tried to assist their classmates. The most common reaction of parents was to send the child for lots of tuition, and to be very frustrated with the child. In addition, some parents neglected their children’s learning disorder, and many did not seem to realise how serious the problem was. When it came to the needs of teachers, the most common need that the teachers reported was to have the parents cooperate with them and to have support from the education authorities. The paper discusses the implications of these findings and proposes suggestions for dealing with the training needs of teachers working in the area of learning disorders.