Professional behavior is an area of medical education that has long been of concern to medical educator. Professional behavior is one of the domains of the professionalism and it’s a behavior reflection of professionalism. But in spite of its perceived importance, until recently it has not been actively taught or reliably assessed. The purposes of this writing are:
1) To provide appropriate definition of professional behavior.
2) To identify characteristics of professional behavior.
3) To identify valid and reliable assessment tools to assess professional behavior.
For the purpose of teaching statistics, lecturers often rely on data from real studies, text book examples or painstakingly created datasets. The process of creating a dataset can be made easier with the utilization of PASW Statistics to generate random values. The objective of this article is to demonstrate the creation of data which are measured on continuous scale, using PASW Statistics menus and syntax.
Objective: BigSib Students' Peer-Group Mentoring Programme was implemented as an innovative, interactive and integrated instructional method in the Universiti Sains Malaysia medical school curriculum designed to enhance and strengthen medical students training in soft skills and professional development. This study was conducted to evaluate first- and second-year medical students’ perceptions of and attitudes towards the Programme.
Methodology: A cross sectional study was carried on 314 medical students. Questionnaires assessing medical students' perceptions and attitudes towards the Programme were administered. Data were analysed by using SPSS version 12.
Results: 45.9 % of the students perceived the BigSib Students' Peer-Group Mentoring Programme as successful. More than 50% of the students are willing to participate in the Programme. About 60% of the students perceived it as an effective Programme in developing their soft skills and professionalism.
Conclusion: Medical students have positive attitudes toward the Programme and it is perceived as a successful and effective Programme in developing students' personal attributes. Similar peer-group mentoring programme may be considered relevant to be incorporated into the medical curriculum in the future.
Background: One of important educational climate roles is to provide an environment that promotes positive development of medical students' psychological wellbeing during training. Unfortunately, many studies have reported that educational climate in medical education are not favourable to them. Therefore, it is a real need for a simple, valid, reliable and stable tool that will help medical schools to screen psychological wellbeing of their students so that early intervention could be done.
Objective: This study aimed to explore the psychometric properties of the Medical Student Wellbeing Index (MSWBI) to measure psychological wellbeing at different interval of measurements in a cohort of medical students.
Method: A prospective study was done on a cohort of medical students. MSWBI was administered to the medical students at five different intervals. The confirmatory factor analysis, Cronbach's alpha and intra-class correlation analysis were applied to measure construct validity, internal consistency and agreement level at different interval of measurements.
Result: A total of 153 (89.5%) medical students responded completely to the MSWBI. The MSWBI showed that the one-factor model had acceptable values for most of the goodness of fit indices signified its construct was stable across multiple measurements. The overall Cronbach's alpha values for the MSWBI at the five measurements ranged between 0.69 and 0.78. The ICC coefficient values for the MSWBI total score was 0.58 to 0.59.
Conclusion: This study found that the MSWBI had stable psychometric properties as a screening tool for measuring psychological wellbeing among medical students at different time and occasions. Continued research is required to refine and verify its psychometric credentials at different educational settings.
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.
Introduction: Various studies had been done on medical students stress, but there is yet no comparative study done between universities in Asia and Europe. Universiti Sains Malaysia (USM) and Universiteit Maastricht (UM) share a lot in common in terms of medical education as both actively apply PBL-oriented education into their curriculum. It will be interesting to find out the effect of differing culture, one Eastern and another Western, on the prevalence of stress and stressors among medical students of both universities.
Method: A comparative study was conducted on medical students from USM and UM. Psychological distress was measured by the 12 item General Health Questionnaire and stressors were measured by the 40 item Medical Student Stressor Questionnaire. The calculated sample size was 215 per university. The collected data was analyzed using Statistical Package for Social Sciences (SPSS) version 20.
Result: Results showed that the overall prevalence of psychological distress among medical students of USM and UM was 25.9% and no significant difference was found between the two universities. Binary logistic regression test showed that medical students in pre-clinical phase were 1.84 times more likely to develop psychological distress than medical students in clinical phases (B = 0.612, odd ratio (CI95%) = 1.84 (1.16, 2.93), p = 0.010). The major stressors were related to academic requirements, UM medical students perceived the stressors as causing less stress than USM medical students (t-stat (df) = 5.33 (380), p-value < 0.001).
Conclusion: Psychological health among medical students in the two universities was comparable. Academic requirements were the most stressful events as perceived by the students, but UM medical students had more positive perception toward the stressors than USM medical students. Pre-clinical students experienced higher psychological pressures than the clinical students. The medical schools should provide more attention to pre-clinical students because they might need psychological support from them.
Context: Community-based medical education (CBME) has become widely accepted as an important innovation in undergraduate medical education. In curriculum featuring CBME, students are acquainted with the community early in their studies however; the impact of this training can be judged best to see them practice the required aspects of CBME. Malaysia is a multiracial country with a very strong community dependant life style. Main national health problems have called for a change in health profession education from traditional hospital based health care to community-based delivery system. Three major university's medical schools that either practice community oriented or community based medical education in undergraduate medical curriculum are evaluated. Universiti Sains Malaysia (USM) has a community based medical education (CBME) curriculum as Community and Family Case Study (CFCS) compared to a community oriented education curriculum (COE) adopted by Universiti Malaya (UM) and Universiti Kebangsaan Malaysia (UKM). However, UM at the time of undertaking this study back in 2005 was though practicing COE has also later opted CBME as CFCS.
Objective: To determine whether medical graduates from USM with a community-based medical education in its curriculum for more than 25 years are inspired to have stronger commitment towards community health as shown in their on-job practice of medicine compared to other graduates from UM and UKM, who have adopted community-oriented medical education program.
Method: A questionnaire-based pilot study with 12 items (variables) was designed to obtain supervisor's opinion on commitment of interns towards the health of community they serve. The questionnaire was administered to a randomized group of 85 specialists supervising the internship training program in five major disciplines including internal medicine, surgery, orthopaedic, gynaecology and obstetrics and paediatric medicine. The data received from 62 respondents from five major disciplines was analyzed utilizing SPSS version 12.0.1.
Result: The responses received from 62 supervisors on an inventory in which 9 out of 12 variables were directly related to community commitments of interns. It was shown that the USM graduates who were taught through a CBME curriculum have performed better than the graduates from UM and UKM who followed a COE curriculum. P-value (< 0.001) was highly significant and consistent with higher mean score in those variables.
Conclusion: The graduates taught through a CBME curriculum performed better in community commitments towards patients care compared to graduates from COE curriculum.
Introduction: Crime is an immoral act capable of tearing the well-being of society and the nation. Various factors have been accredited as potential factors for crime engagement for example natural inclination, nurture or a combination of these factors. Within the domain of natural inclination, lack of self-control is often viewed as the primary cause of crime and delinquency. However, there are no valid and reliable Malay language psychometric instruments to measure the level of self-control among Malaysians.
Objective: The aim of this study was to validate the Self Control Scale (SCS) for use among Malay speaking populations. Henceforth the Malay language version is identified as SCS-M.
Method: A cross-sectional study was carried out on 150 inmates incarcerated within two prisons in Peninsular Malaysia in June 2012. Forward and Backward translations of the original SCS were carried out followed by content and face validation processes. Exploratory factor analysis and Cronbach's Alpha reliability analysis were performed.
Result: Both content and face validation processes showed promising and good outcomes. Preliminary analysis for factor analysis supported factorability of the items. The factor loadings of SCS-M items did not correspond to the original six SCS dimensions. Since SCS is often administered as a unidimensional scale, a forced one factor analysis was performed and items with factor loadings exceeding 0.3 were retained. The result of internal consistency reliability of SCS-M demonstrated a good Cronbach's alpha value of 0.80.
Conclusion: The findings supported that SCS-M is a valid and reliable unidimensional scale to measure the level of self-control among Malay speaking populations. It is anticipated that the emergence of SCS-M is vital for self-control assessment, treatment, and rehabilitation purposes.
In recent years, the popularity of using complementary and alternative medicine (CAM) as a health care option has increased dramatically all over the world especially in developing countries. As Malaysian statistics showed an increased in chronic diseases among our population, the demand to consume CAM for healing process as well as in pursuit of health and well-being also has increased. Thus it increased patient’s interest to request more information from medical practitioners and nurses who are front health care providers. The objective of this study is to compare the knowledge, attitudes, and practice (KAP) of CAM among final year nursing and medical students in Universiti Sains Malaysia (USM). A cross-sectional comparative study was conducted among final year medical and nursing students using self administered questionnaire. This study utilized the Knowledge-Attitude-Practice (KAP) model to explain how level of knowledge may reflect nursing and medical students’ attitudes and practice of CAMs. There were 74 students participated where 33 of them were nursing students, and 41 were medical students. Independent t-test was used to compare the KAP of CAM between both groups of students and there was a significant different. As a conclusion, this study revealed that nursing students were more knowledgeable about CAM, possessed positive attitudes, and more willing to practice CAM compared to medical students.
Introduction: Ratings are known to have a generosity error, provide limited discrimination and distorted interpretation, and often fail to document serious deficits. A potential source of these problems is rater judgement. These problems compromise the capability of raters to maintain the standards of rating. The authors propose a simple grading system to improve this situation including providing feedback to raters. Method: The authors developed a grading system named the Discrepancy-Agreement Grade (DAG) to provide feedback on rater judgments. Dependent-t and intraclass correlation tests were applied to determine discrepancy and agreement levels of raters. Rater judgments were then classified into grades A, B, C or D. This grading system was tested in an examination and a student selection interview to assess rating judgments of examiners and interviewers. The purpose was to evaluate the practicability of the grading system to provide feedback on examiners’ and interviewers’ rating judgements. Results: in the examination, five short essays were rated by five pairs of senior lecturers. Out of 5 pairs, 2 (40%) obtained grade A and 3 (60%) obtained grade B. In the student selection interview, a total of 48 pairs of interviewers interviewed ten applicants. Out of 48 pairs, 20 (41.7%) obtained grade A, 1 (2.1%) obtained grade B, 23 (47.9%) obtained grade C and 4 (8.3%) obtained grade D. Conclusion: The grading system showed variability of rater judgments on medical students’ and applicants’ performance in an examination and interview session respectively. It provided feedback on the examiners’ and interviewers’ judgments on candidate performances. This exercise demonstrated practicability of the grading system to provide feedback on rater judgements.
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.
Several studies reveal high rates of alcohol use among college students affecting their health and performances. This cross-sectional survey was done to study medical students' drinking pattern, its predictors and to develop any possible link between their academic performance and alcohol consumption. Data was collected using newly designed, validated questionnaire from students (n= 348) who consumed and not consumed alcohol. The response rate was 60% (209/348). 94% of drinkers started consuming alcohol before entering into the medical school. Most of them (85%) drank with parents' awareness. Among drinkers, 63% were of Chinese race and 35% of Indian race. None of the Malay respondents reported of drinking. 63% of drinkers and 23% of non-drinkers reported that most of their friends consumed alcohol. Drinking was not associated with smoking or drug abuse. There were no statistically significant differences in exam scores between drinkers and nondrinkers. Non-drinkers considered religious and moral obligations for not consuming alcohol. In conclusion, at our Institute, students did not allow their alcohol use to interfere with their academic performance. The drinking habit developed during school time is more likely to continue during college years. Those who have non-drinking friends are more likely not to consume alcohol themselves. Moral and religious obligations have positive impact on alcohol intake.
Objective: To determine the perception of medical students towards mentor-mentee system in Faculty of Medicine and Health Sciences of UNIMAS. Method: It was a cross-sectional study involving all 104 second year and 80 fifth year medical students. A self-administered questionnaire consisting of socio-demographic details, general perceptions on mentor-mentee system, academic support, personal development, and emotional and psychological support was distributed. The data was analysed using the SPSS version 19. Result: Majority of the subjects had a positive outlook towards the mentor-mentee system with a range of 45.6% to 57%. Three of the top rated perceptions were ‘mentor analyses mentee’s examination results and provides constructive feedback’, ‘mentor advises how to improve academic performance’, and ‘mentor gives encouragement and support for the challenges faced’ (66.8%, 68.0% and 62.9% respectively). Pre-cinical medical students had significantly better perception on mentor-mentee system than clinical students (p≤0.002) while those with non-clinician mentors significantly had better perceptions than those with clinician mentors (p≤0.003) on the system. No significant difference was found between the perceptions of males and females for all components (p=0.234 to 0.722). Conclusion: The mentor-mentee system was found to be successful as more than half of the respondents had posititve perception on the system and its aspects. However, pre-clinical students benefited more compared to clinical students, which reflects the need to look at the support given to clinical students. It was recommended that future studies should incorporate the perceptions of mentors.
Introduction: There is lacking of evidence available in literatures on faking good in personality and emotional intelligent (EI) tests among medical school applicants. Thus more research is required to address the faking good issues in medical context specifically related to student admission. Objective: This study aimed to estimate the prevalence of faking good in personality and EI tests during a high stake situation which was during student selection process. Method: A one-year prospective study was carried out on a cohort of medical school applicants. Data collection was carried out at five different intervals; one measurement at pre-selection (Time 1) and four measurements at post-selection (Time 2 to Time 5). The USMaP-i and USMEQ-i were used to measure personality and EI. Faking good was positive if the scores at Time 1 beyond the 95% CI of average scores of Time 2 to Time 5.Result: The highest prevalence of faking good among personality traits was in conscientiousness (83.1%) and the lowest was in openness (74.1%). The highest prevalence of faking good among EI constructs was in emotional conscientiousness (77%) and the lowest was in emotional awareness (51.7%). About 1.7% of applicants were not faking good at any of the personality dimensions while 11.5% of them were not faking good at any of the EI constructs. About 47.4% faked good at all the personality dimensions and 33.9% faked good at all the EI constructs. Conclusion: The prevalence of faking good in the self-reporting personality and EI tests was high. Certain personality traits and EI constructs were more susceptible to faking good. The personality test was more susceptible to faking good than the EI test. Considering the potential positive impacts of personality and EI on individual performance, alternative ways should be designed to address the faking good issues.
This case illustrates the role of a woman's autonomy in deciding her medical management and the ethical issue which occurred when a husband refuses the management for her even though it was clearly indicated.
Introduction: Just-in-Time Teaching (JiTT) is a novel method of teaching-learning used in various disciplines of science and humanities. It is a technique that scaffolds the students learning process by reducing the cognitive load which is the load related to the executive control of working memory. Just in time teaching underpins the concept that expertise in learning originates from the knowledge already stored in long term memory and with subsequent interaction between the learner and teacher motivates enhanced active learning and optimizes the intellectual performance.
Objective: The objective of the study is to assess the acceptability of JiTT over traditional lecture teaching among the medical students.
Method: In a cross sectional pilot study, three hundred thirty five students participated in a questionnaire based study that grades the various aspects of the traditional lecture series. After the implementation of JiTT method for a period of four months, three hundred two students completed the questionnaire, grading the same variables for JiTT. The analysis was done by using SPSS version 11 applying Paired t test and McNemar's Test.
Result: The results of our study highlighted that JiTT technique was perceived superior to traditional teaching with statistically significant outcomes in the clarity of the topic (p=0.003,) duration of the session (p=0.002), knowledge gained and orientation for exams (p=0.044). The students perceived JiTT method as less monotonous (p=0.005) increasing their alertness during these sessions (p=0.002).
Conclusion: We therefore propose that Just-in-Time Teaching method is a more interactive and acceptable teaching-learning tool shifting the nature of teaching to a more student-centric approach as perceived by the medical students. This is the first pioneer study on JiTT to be performed on undergraduate medical students so far.
One of the most common reasons why researchers seek help from statistician is sample size calculation. However despite the common believe that it only involves formula and calculation, researchers often ignore other aspects of research design that leads to proper sample size calculation. In this article, the author outlines basic steps toward sample size calculation. The author also introduces the logic behind sample size calculation for single mean and single proportion in simplified and less intimidating forms to those not statistically inclined.
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: A clear concept and understanding about the measure and the measuring tools is essential for good practice of assessment. Assessors need to have information about the full range of assessment tools inclusive of psychometric validity and purpose of its use. Subjective inferences drawn from the readily available data as numbers of summative scores over the years and statistical evidences of reliability and validity of assessment tools used to measure student’s performance are good sources of feedback for competent assessment program. It also provides meaningful evaluation of learning and teaching in medical education. Method: A retrospective study of 119 candidates was carried out to analyze the summative assessment scores of their certifying examination of Masters of Surgery in School of Medical Sciences (SMS) at Universiti Sains Malaysia. Subjective judgment of raw data followed by internal consistency as reliability, convergent validity and discriminant validity as constructs of individual assessment tool was analyzed. Finally each assessment tool as a measure of written or clinical construct was evaluated against six aspects of Messick’s criteria for quality control. Result: The correlation coefficient for validity and Cronbach’s alpha for reliability was evaluated for clinical measures. However, the test of internal reliability was not possible for essay being the only measure in written construct of summative assessment in surgery. All measures of clinical construct were found highly reliable with Cronbach’s alpha between 0.962-0.979. Long case and the short cases have shown excellent correlations (r=0.959 at p