MyMedR

Fulltext Severe pulmonary leptospirois associated with high fatality rate: an autopsy series in Galle, southern Sri Lanka

Ruwanpura R, Rathnaweera A, Hettiarachchi M, Dhahanayake K, Amararatne S

Med J Malaysia, 2012 Dec;67(6):595-600.

PMID: 23770952

INTRODUCTION: According to statistical unit of the Karapitiya Teaching Hospital, Galle, the main tertiary care institution of the Southern Province serving approximately three million population, in 2008, there were 459 patients with clinical diagnosis of leptospirosis, with 25 fatalities, 21 out of which were referred for autopsy examination.

OBJECTIVES: The present study to study and correlate pathological changes in deaths associated with pulmonary form of leptospirosis with clinico-diagnostic aspects of the infection.

METHOD: There had been 21 leptospirosis related autopsy examinations performed at forensic medicine unit of the Karapitiya Teaching Hospital from January to December 2008. The clinical, laboratory and autopsy findings of these cases were recorded in detail and analyzed.

RESULTS: The characteristic autopsy feature of all these cases was a moderate to severe pulmonary haemorrhage in association with hepato-renal, myocardial and cerebral lesions. The histology of the lung tissues in most cases showed extensive alveolar haemorrhages, hyaline like deposits, neutrophilic infiltrations, swollen septa with congested blood vessels.

CONCLUSION: Severe pulmonary complications are mostly responsible for all fatalities due to leptospirosis in our series. Though there are no reliable clinical indicators that suggest probability of developing pulmonary haemorrhages, we emphasize that respiratory functions and haematological parameters need to be closely monitored in all hospitalized patients with leptospirosis for early detection and prevention of haemorrhagic complications.

Matched MeSH terms: Hospitals, Teaching

Fulltext Diabetes Mellitus in a Malaysian Teaching Hospital: Prevalence of Diabetes Mellitus and Frequency of Testing for Hypercholesterolaemia, Proteinuria and HbAlc

Ooi CG, Haizee HN, Kando OV, Lua GW, Philip H, Chan SP, et al.

Med J Malaysia, 2002 Jun;57(2):195-200.

PMID: 24326650

We examined the prevalence of diabetes among inpatients in our hospital, the relationship of the diagnoses on admission to diabetes, and the frequency of testing for HbA1c as a marker of long-term glycaemic control, proteinuria, and hypercholesterolaemia. In addition, patients with raised laboratory plasma glucose without a know history of diabetes mellitus, were studied to see if these had been further evaluation. The overall prevalence of diabetes in our hospital was 25.% with the highest prevalence found (37.8%) on medical wards. 10.5% of admissions were due directly to diabetes and a further 58.9% of patients were admitted with illness which were significant related to diabetes. Overall testing rates for HbA31c, proteinuria, and hypercholesterolaemia were less than ideal (51.6, 73.4 and 45.% respectively). Less than 50% of patients without previously diagnosed diabetes but with high plasma glucose values had further evaluation for diabetes. In conclusion, this study has detected a high overall prevalence of diabetes among inpatients in an urban Malaysian hospital. Rates of testing for HbA51c, proteinuria, and hypercholesterolaemia, are disappointingly low, as is further evaluation of patients without known diabetes, but with elevated glucose values. More effective measures to improve the delivery of inpatient diabetes care are needed.

Matched MeSH terms: Hospitals, Teaching

Continuing medical education

Todd D

Ann Acad Med Singap, 1987 Apr;16(2):366-9.

PMID: 3688816

With the rapid advances in medical science and increasing complexities of patient care, the need for continuing medical education (CME) is widely accepted by the profession. CME follows general and higher professional training, and should be a life long process. Teaching hospitals and postgraduate professional institutions play vital roles in organising, promoting, and monitoring this activity. CME directorates should be established. University authorities must recognise the important role of medical teachers in postgraduate and continuing medical education, and the staff establishment and terms of service should be held regularly. Medical libraries should have easy borrowing facilities. Self-assessment and audio-visual material are particularly helpful to the busy practitioner and inexpensive local or regional journals of quality can provide pertinent and up-to-date information. All charges for attending scientific meetings and educational material should be tax deductible or subsidized. The effectiveness of CME is difficult to assess and participation is almost impossible to enforce. Much depends on the standard of medical practice wanted by society. Recertification of general practitioners or specialists poses many problems. On the other hand, completion of self-assessment programmes, active participation at medical meetings, contributions to scientific literature, and membership of medical societies with built-in peer review could be monitored and regularly used to evaluate professional status.

Matched MeSH terms: Hospitals, Teaching

University Hospital--a new concept for Malaysia

Cumberworth M

Nurs Mirror Midwives J, 1972 Aug 11;135(6):42-3.

PMID: 4484275

Matched MeSH terms: Hospitals, Teaching

Transfer of knowledge, skills and confidence from a faculty development programme for health professions educators into practice

Chia CF, Nadarajah VD, Lim V, Kutzsche S

Med Teach, 2021 Jul;43(sup1):S46-S52.

PMID: 32552199 DOI: 10.1080/0142159X.2020.1776239

BACKGROUND: Faculty development programmes should incorporate the transfer of knowledge, skills, and confidence from the training to educational practice. However, there is a risk that transfer may fail due to inadequate integration of knowledge, skills, and confidence. The study evaluated transfer levels, guided by learned principles from a faculty development programme.

METHOD: The submitted self-reports on a pedagogical intervention of 92 out of 190 health professions educators who participated in a mandatory teaching and learning training programme, were analysed by a mixed-method approach guided by a structured conceptual framework.

RESULTS: Overall 93.4% reported the successful transfer of learning. Participants incorporated sustainable changed practice (level A, 57.6%), showed reflection on the impact of changed practice (level B, 21.7%), and performed effect analysis (level C, 14.1%). The rest planned application of learning (level D, 4.4%) and identified gaps in current practice or developed an idea for educational intervention but did not implement (level E, 2.2%).

CONCLUSION: The majority of participants transferred their learning. Faculty development programmes must ensure successful transfer of knowledge, skills, and confidence from the training to educational practice to ensure sustainable development of teaching and learning practices.

Matched MeSH terms: Teaching

Teaching attitudes among teachers at the Faculty of Medicine, University of Malaya

Jakiyah D, Azhary JMK, Mazkiah B, Mohd Hashim I, El-Sabban F

JUMMEC, 1999;4:51-57.

This paper involves the obtained results of an "Elective Program" project which was carried out by Phase I Medical Students of the 1998-1999 academic year at the Faculty of Medicine (FOM), University of Malaya (UM). A questionnaire was designed to survey the attitudes of teachers at FOM-UM, the subject of choice of a 4-student group who were supervised by a faculty member. Students obtained a list of faculty members (teachers) of all academic departments from the Dean's Office and rehearsed their interviewing skills prior to collecting the data of the questionnaire, within a 1-week period. Respondents were 146 out of 275 in total (53%), which included all academic ranks and clinical and non-clinical teachers. Results showed that respondents were well qualified, have enough teaching experience and teach in a variety of forms. All teachers liked to teach and were motivated; however, 15% felt unhappy about their teaching and 6% did not think that their teaching was effective. The nlajority (96%) of teachers liked their teaching to be evaluated and many revealed several means to assist and 111otivate students. Teachers felt that there was room for improvenlent in the aspect of student-teacher interactions. Results of this project revealed that FOM-UM is well endowed by qualified, motivated and caring teachers who wish for better interactions with their students. I

Matched MeSH terms: Teaching

Fulltext Effectiveness of education intervention of tuberculosis treatment adherence in Khartoum State: A study protocol for a randomized control trial

Khamis KM, Kadir Shahar H, Abdul Manaf R, Hamdan HM

PLoS One, 2022;17(11):e0277888.

PMID: 36441678 DOI: 10.1371/journal.pone.0277888

BACKGROUND: Treatment failure and disease relapse among tuberculosis (TB) patients are commonly caused by non-adherence. It can lead to prolonged infection, increased transmission, drug resistance, and loss of life. Even though the causative microorganism of TB has been identified for more than a century, the disease is still a substantial public health problem worldwide. This research aims to devise, implement, and assess an educational intervention to improve adherence to TB treatment.

METHODS AND FINDINGS: A randomised clinical trial involving 146 Sudanese TB patients will be conducted at the Abu Anga hospital in Khartoum. The participants will be randomly assigned to the intervention and control groups. A 2-hour session will be offered to the intervention group in a one-day TB educational intervention course. The same educational materials will also be provided to the control group after the randomised controlled trial (RCT). Data will be collected at baseline, one month, and four months after the intervention. The primary outcome of interest is TB treatment adherence, while secondary outcomes include quality of life score, tuberculosis knowledge, and health belief domains. Generalised estimating equations (GEE) in SPSS software version 25.0 will be utilised to evaluate the changes over time.

CONCLUSIONS: This trial will provide information that could be used in improving TB control strategies to achieve better results in the adherence of healthcare services to the norms of the National Program and patient adherence to the disease treatment and cure.

TRIAL REGISTRATION: This study is registered at TCTR: (TCTR20210607006).

Matched MeSH terms: Teaching Materials

Effects of COVID-19 on Patient Safety Culture among Staff at a Teaching Hospital in Malaysia

Krishnasamy K, Zakaria MI, Tan MP, Chinna K, Narayanan V, Hasnan N

Disaster Med Public Health Prep, 2023 Sep 25;17:e494.

PMID: 37746761 DOI: 10.1017/dmp.2023.141

Matched MeSH terms: Hospitals, Teaching

The use of jigsaw learning technique in teaching medical students prescribing skills

Sim SM, Foong CC, Tan CH, Lai PS, Chua SS, Mohazmi M

Med Teach, 2014 Feb;36(2):182.

PMID: 24156275 DOI: 10.3109/0142159X.2013.848977

Matched MeSH terms: Teaching/methods*

Training surgeons to teach anatomy: an innovative approach

Azer SA

Med Educ, 2010 Nov;44(11):1128-9.

PMID: 20946493 DOI: 10.1111/j.1365-2923.2010.03836.x

Matched MeSH terms: Teaching/methods*

Seeing the wood for the trees: approaches to teaching and assessing clinical pharmacology and therapeutics in a problem-based learning course

Azer SA, Frauman AG

Ann Acad Med Singap, 2008 Mar;37(3):204-9.

PMID: 18392299

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.

Matched MeSH terms: Teaching/methods

Evaluation of basic science knowledge retention in clinical teaching

Vadivelu J

Med Educ, 2008 May;42(5):520-1.

PMID: 18412895 DOI: 10.1111/j.1365-2923.2008.03047.x

Matched MeSH terms: Teaching/methods*

Fulltext Modeling the anatomy and function of the pelvic diaphragm and perineal body using a "string model"

B SN, Rodenbaugh DW

Adv Physiol Educ, 2008 Jun;32(2):169-70.

PMID: 18539862 DOI: 10.1152/advan.00106.2007

Matched MeSH terms: Teaching/methods*

Peer-guided cooperative learning enhances the performance of refresher students

Torke S, Abraham RR, Ramnarayan K, Upadhya S

Adv Physiol Educ, 2007 Mar;31(1):118.

PMID: 17327594

Matched MeSH terms: Teaching/methods*

The broken lecture: an innovative method of teaching

Nayak SB

Adv Physiol Educ, 2006 Mar;30(1):48.

PMID: 16481611

Matched MeSH terms: Teaching/methods*

The blanket method: a novel method of teaching peritoneal relations of female reproductive organs

Nayak S

Adv Physiol Educ, 2006 Jun;30(2):95-6.

PMID: 16709742

Matched MeSH terms: Teaching/methods*

Clinically oriented physiology teaching: strategy for developing critical-thinking skills in undergraduate medical students

Abraham RR, Upadhya S, Torke S, Ramnarayan K

Adv Physiol Educ, 2004 Dec;28(1-4):102-4.

PMID: 15319191

Medicine is an applied science, interpreting evidence and applying it to real life by using clinical reasoning skills and experience. COPT (clinically oriented physiology teaching) was incorporated in physiology instruction aiming to relate the study of physiology to real-life problems, to generate enthusiasm and motivation for learning, and to demonstrate the vocational relevance of physiology among students by integrating clinical experience with teaching. COPT consisted of two elements: 1) critical-thinking questions (CTQ) and 2) clinical case studies. After a few topics were taught, CTQ and case studies were given as an assignment. Answers were discussed in the next class. Two exams, each of which contained CTQ and recall questions, were conducted, one before (exam 1) and one after (exam 2) the implementation of COPT. Analysis of student performance in the examinations revealed that the students did better in exam 2 (P < 0.0001). Feedback from students indicated that this method was useful and challenging.

Matched MeSH terms: Teaching/methods*

Review of PBL 'problems' and examination questions

Majumder AA

Med Teach, 2005 Aug;27(5):474.

PMID: 16231863

Matched MeSH terms: Teaching/methods

Portfolio as a learning tool: students' perspective

Elango S, Jutti RC, Lee LK

Ann Acad Med Singap, 2005 Sep;34(8):511-4.

PMID: 16205830

Portfolio writing is a method of encouraging reflective learning among professionals. Although portfolio-based learning is popular among educators, not many studies have been done to determine students' perceptions of portfolio as a learning tool. A questionnaire survey was conducted among 143 medical students to find out their perceptions of the portfolio as a learning tool. A majority of the students felt that the portfolio is a good learning tool. However, they also perceived that it is stressful and time-consuming to develop a proper portfolio. The study indicates that students need appropriate guidance from the academic staff for the system to succeed.

Matched MeSH terms: Teaching/methods*

The direct cost of treating bronchial asthma in a teaching hospital in Malaysia

Chan PW, Hussain S, Ghani NH, Debruyne JA, Liam CK

Southeast Asian J. Trop. Med. Public Health, 2002 Sep;33(3):600-3.

PMID: 12693597

A pilot study to evaluate the direct cost of treating 51 adults and 50 children with bronchial asthma was conducted. All aspects of the medical care provided over a 6-month period were considered. The mean treatment costs per month were US dollars 22.97 (adults) and US dollars 15.56 (children). The cost of maintenance therapy accounted for 55.5% and 73.4% of the total direct cost treatment for adults and children respectively. Only 27 (52.9%) adults and 17 (34.0%) children paid for their inhaled prophylactic drugs, amounting to 12.3% of the total maintenance therapy costs. Thirteen (25.4%) adults and 9 (18.0%) children were using alternative therapy at a monthly cost of US dollars 41.50 and US dollars 16.77 respectively. A substantial proportion of the direct cost of asthma treatment is heavily subsidized in Malaysia. Adequate attention to the allocation of the health budget, to ensure the optimal provision of health care, is warranted.

Matched MeSH terms: Hospitals, Teaching/economics*

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