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Fulltext Sustainable Medical Teaching and Learning During the COVID-19 Pandemic: Surviving the New Normal

Yusoff MSB, Hadie SNH, Mohamad I, Draman N, Muhd Al-Aarifin I, Wan Abdul Rahman WF, et al.

Malays J Med Sci, 2020 May;27(3):137-142.
PMID: 32684814 MyJurnal DOI: 10.21315/mjms2020.27.3.14

During the first phase of the Movement Control Order, many medical lecturers had difficulty adapting to the online teaching and learning methods that were made compulsory by the institutional directives. Some of these lecturers are clinicians who need to juggle between clinical work and teaching, and consider a two-week adaptation during this period to be not enough. Furthermore, converting traditional face-to-face learning to online formats for undergraduate and postgraduate clinical programmes would reduce the learning outcomes, especially those related to clinical applications and the acquisition of new skills. This editorial discusses the impact that movement restrictions have had on medical teaching and learning, the alternatives and challenges and the way forward.

Matched MeSH terms: Education, Medical
Fulltext Unveiling the Hurdles in Cultivating Humanistic Physicians in the Clinical Setting: An Exploratory Study

Mustika R, Soemantri D

Malays J Med Sci, 2020 May;27(3):117-124.
PMID: 32684812 DOI: 10.21315/mjms2020.27.3.12

Background: The importance of cultivating a humanistic physician has gained attention in medical education. Humanistic values are established in early education and medical schools should provide a suitable environment to nurture and grow these values into professional identity. The clinical setting has a significant impact due to its direct involvement of students in real-life situations.
Objectives: The present study aims to explore the hurdles in cultivating humanistic physicians in the clinical setting.
Methods: We conducted a qualitative study involving medical students in the clinical phase, as well as residents, clinical teachers, and module administrators in the clinical setting under study.
Results: Respondents from different groups of stakeholders shared the same definition for 'humanistic physician': a physician who provides patient-centred care while demonstrating empathy, respect, compassion, integrity, knowledge, competence and a collaborative spirit. Despite changes in the healthcare system and technological advancements, humanistic physicians are still needed.
Conclusion: Cultivating humanistic physicians is a complex process, requiring various methods and assessments. Role models play a significant role in this process, which included not only clinical teachers but also peers. Feedback from peers was perceived as an important factor. The key hurdles identified were negative role models, and a less humanistic learning environment and the students' personal backgrounds.

Matched MeSH terms: Education, Medical
Improving undergraduate obstetrics and gynaecology education through the use of WhatsApp™

Soe MZ, Pang NTP, Loo JL

Eur J Obstet Gynecol Reprod Biol, 2020 Apr;247:269.
PMID: 32145995 DOI: 10.1016/j.ejogrb.2020.02.036
Matched MeSH terms: Education, Medical, Undergraduate*
Fulltext Perceptions and attitudes towards dementia among university students in Malaysia

Griffiths AW, Cheong WL, Saw PS, Parveen S

BMC Med Educ, 2020 Mar 20;20(1):82.
PMID: 32192471 DOI: 10.1186/s12909-020-1972-5

BACKGROUND: One of the major challenges worldwide is the stigma associated with dementia. There is limited dementia awareness within Malaysian communities, including levels of confusion regarding the differences between dementia and the usual ageing progress, which can lead to delays in support seeking. The need for additional training and education for healthcare professionals has been highlighted. The present study aimed to evaluate the benefits of a one-hour dementia education session (Dementia Detectives workshop) for pharmacy and medicine undergraduate students at a Malaysian university.
METHODS: Participants attended the workshop and completed pre- (Time 1) and post-workshop (Time 2) questionnaires consisting of validated measures exploring attitudes towards dementia and older people more broadly.
RESULTS: A total of 97 students were recruited. Attitudes towards people with dementia showed significant positive changes between Time 1 and Time 2, whereas no differences were found for attitudes towards older people.
CONCLUSIONS: As medical and pharmacy students develop theoretical knowledge, practical skills and professional attitudes during their undergraduate studies, it is important for students to also learn about the humanistic side of diseases and conditions through workshops such as the one presented here. Further research should now be conducted to consider how Dementia Detectives can be delivered to non-healthcare students and what the barriers and facilitators to wider delivery are.

Matched MeSH terms: Education, Medical, Undergraduate
A global perspective on the challenges and opportunities in learning about rheumatic and musculoskeletal diseases in undergraduate medical education : White paper by the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD)

Al Maini M, Al Weshahi Y, Foster HE, Chehade MJ, Gabriel SE, Saleh JA, et al.

Clin Rheumatol, 2020 Mar;39(3):627-642.
PMID: 31127461 DOI: 10.1007/s10067-019-04544-y

Rheumatic and musculoskeletal diseases (RMDs) encompass a spectrum of degenerative, inflammatory conditions predominantly affecting the joints. They are a leading cause of disability worldwide and an enormous socioeconomic burden. However, worldwide deficiencies in adult and paediatric RMD knowledge among medical school graduates and primary care physicians (PCPs) persist. In October 2017, the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD), an international think tank of RMD and related experts, met to discuss key challenges and opportunities in undergraduate RMD education. Topics included needs analysis, curriculum content, interprofessional education, teaching and learning methods, implementation, assessment and course evaluation and professional formation/career development, which formed a framework for this white paper. We highlight a need for all medical graduates to attain a basic level of RMD knowledge and competency to enable them to confidently diagnose, treat/manage or refer patients. The importance of attracting more medical students to a career in rheumatology, and the indisputable value of integrated, multidisciplinary and multiprofessional care are also discussed. We conclude that RMD teaching for the future will need to address what is being taught, but also where, why and to whom, to ensure that healthcare providers deliver the best patient care possible in their local setting.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext A Preliminary Vietnamese Comparative Study of Postgraduate Radiological Thesis Characteristics

Duc NM, Huy HQ, Keserci B, Thong PM

Med Arch, 2020 Feb;74(1):42-46.
PMID: 32317834 DOI: 10.5455/medarh.2020.74.42-46

Introduction: Each country has its system of the training program, but to be concordant with the world in the radiology field, the process needs to have common points or common criteria. On maintaining the integrity of intersociety collaboration in the field of radiology, it is necessary to understand each country's training program for each specialty.
Aim: This retrospective study aims to compare the postgraduate thesis characteristics from various sources in the field of radiology.
Methods: This was a retrospective study evaluating data that is publicly available online and at libraries and institutional review board approval, as such, was not demanded. We selected 40 published theses from the library of Pham Ngoc Thach University of Medicine and University of Medicine and Pharmacy at Ho Chi Minh City and Hanoi Medical University in Vietnam which graduated from 2008 to 2018. Of these, there were 10 PhD, 10 specialists II, 10 master's, and 10 residency theses selected.
Results: A total of 40 theses were analyzed from participants with a median age of 36.5. The male/female ratio was 23/17. Most of the theses were subspecialty in diagnostic radiology (87.5%) and focused on pathological radiology (95%). Adult patients were the major objectives of the theses accounted for 87.5% with predominant materials of magnetic resonance imaging counted for 47.5%. Theses in PhD group were the largest items regarding the total number of pages as well as the number of figures, and the number of references. Nonetheless, both domestic and international publications related to all theses were truly low.
Conclusion: The postgraduate thesis of radiology in Vietnam has many different forms but mainly focuses on diagnostic and pathological radiology with materials of magnetic resonance imaging in adults. The number of international publications regarding the thesis was very small.

Matched MeSH terms: Education, Medical, Graduate/statistics & numerical data*
Educating universal professionals or global physicians? A multi-centre study of international medical programmes design

Brouwer E, Driessen E, Mamat NH, Nadarajah VD, Somodi K, Frambach J

Med Teach, 2020 02;42(2):221-227.
PMID: 31630598 DOI: 10.1080/0142159X.2019.1676885

Introduction: Medical schools increasingly offer curricula that specifically aim to prepare students for an international medical career. This is challenging as well as controversial: curriculum designers must balance specific local healthcare requirements with global health competencies doctors need in our globalised world. By investigating how international medical programme designers experience this balancing act, this study aims to contribute insights to the debate on local versus global medical education.Methods: We conducted a multi-centre instrumental case study across three universities with international medical programmes in three countries. The study involved 26 semi-structured interviews with key curriculum designers recruited through purposive sampling. Additionally, we performed a curriculum document analysis. Data were thematically analysed within a multidisciplinary team.Results: Participants described two profiles of international medical programme graduates: 'a global physician', equipped with specific competencies for international practice, and 'a universal professional', an overall high-level graduate fit for future practice anywhere. These perspectives presented different curriculum design challenges.Conclusions: International medical programmes teach us how we can rethink graduate profiles in a globalising world. Yet, educational standardisation poses risks and securing equity in global health education is challenging, as is preparing students to be adaptable to the requirements of a rapidly changing future local healthcare context.

Matched MeSH terms: Education, Medical/methods*
Academic staff perspectives on delivering a shared undergraduate medical module on three transnational campuses: Practical considerations and lessons learned

Morgan MP, Thomas W, Rashid-Doubell F

Med Teach, 2020 01;42(1):36-38.
PMID: 31411913 DOI: 10.1080/0142159X.2019.1649380

The Royal College of Surgeons in Ireland (RCSI) was among the first medical institutions to establish a global education community which now provides high-quality transnational health professions education aligned across three locations: Europe, the Middle East and South-East Asia. The successful implementation of a shared modularized curriculum in this context can be complex and challenging. Here we describe our insights, gained from a decade of working together as shared module Academic Leads to deliver a system-based medical module to an international student cohort. The themes covered are some of the areas where we consider our joint deliberations have led to improved outcomes for the delivery and assessment of the module, which may be helpful to academic staff embarking on similar module sharing experiences.

Matched MeSH terms: Education, Medical, Undergraduate/methods*; Education, Medical, Undergraduate/standards
Fulltext Cross-sectional study of perceptions of qualities of a good medical teacher among medical students from first to final year

Low MJW, Khoo KSM, Kuan WS, Ooi SBS

Singapore Med J, 2020 Jan;61(1):28-33.
PMID: 31423541 DOI: 10.11622/smedj.2019097

INTRODUCTION: Defining the characteristics of a good medical teacher has implications for faculty selection and development. Perceptions of characteristics may differ with cultural context and level of training, as medical students progress from didactic preclinical training based on cognitivist learning theory to more complex integration of theory and practice in specific contexts in clinical training based on constructivist learning theory.
METHODS: We modified a validated questionnaire with permission from the original authors at Melaka Manipal Medical College, Melaka, Malaysia. Participants rated 35 characteristics on a 5-point Likert scale. The modified questionnaire was validated in a pilot pool of medical students (n = 69), with a Cronbach's alpha of 0.90, and administered to Year 1-5 medical students (n = 917) at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
RESULTS: Based on the proportion of favourable Likert scoring, four top desirable characteristics were common across Year 1-5 students: good communication skills (84.4%); sound knowledge of subject (82.7%); enthusiasm (78.4%); and providing effective explanations (74.4%). Approachability (p = 0.005), encouraging participation (p < 0.001) and constructive criticism (p < 0.001) were more important to clinical students (Year 3-5) than preclinical students (Year 1-2).
CONCLUSION: The top four characteristics were consistent across all years of medical students in this study. Characteristics emphasised in the clinical years facilitate active learner participation, consistent with constructivist learning theory.

Matched MeSH terms: Education, Medical, Undergraduate
Fulltext Enhancing attendance and student exam score based on mobile attendance application

Nurhafizah Ahmad, Siti Asmah Mohamed, Ahmad Zia Ul-Saufie, Hasfazilah Ahmat, Fadzilawani Astifar Alias

ESTEEM Academic Journal, 2020;16(1):38-46.
MyJurnal

In today’s digital era, it is possible to use the latest technology to improve student attendance and performance. The purpose of the present study is to determine the relationship between absenteeism and academic performance among Calculus students, as well as to measure the impact of class absence on the student’s final exam scores. Based on this, the use of appropriate
strategy was employed, which is the mobile attendance application to reduce absenteeism among students in higher educational institution. The selection of sample was based on cluster sampling, involving the selection of 87 repeater students. The data collected were analyzed using quartile
regression and independent sample t-test. The result of the findings revealed that the class absence has an impact on the student’s final exam scores. This is because, if the student was absences by 1 class, the final exam score is expected to decrease on average by 1.89%. Hence, findings show that the percentage of absences for the students with manual attendance was higher
than the percentage of absences for the students with mobile attendance application. The application can help to reduce absenteeism by reminding students about recent attendance records.

Matched MeSH terms: Education, Medical, Undergraduate
Fulltext Smart Logbook as alternative solution for continouos industrial training supervision problem: a purview study on student’s perception

Sulaiman Mahzan, Siti Fairuz Nurr Sadikan, Mohd Ab Malek Md Shah, Mohd Harun Shahudin, Zaini Saat, Shamsol Shafie

Jurnal Inovasi Malaysia, 2020;4(1):113-132.
MyJurnal

Supervision and monitoring of practical students are among the pertinent components in the management of industrial training among students in institutions of higher learning (IPT) in Malaysia. The easiest way to monitor is by reporting such students’ daily activities in their logbooks. Due to the dispersal of offshore industries, it directly impacts to students, institution and industry such as management costs, wastes supervision time for travel and stresses other factors in managing industry supervision such as ongoing supervision, verification of customization of industry entities regarding needs and reduction of allocation by IPT. Thus, a new mechanism needs to be implemented by considering the advantages and benefits that can be developed throughout the use of information technology (IT). In conjunction with this circumstance, a Smart LogBook prototype has been developed to address the problems encountered in the supervision process of the industry training students as stated. A study of students’ perceptions of the Smart Logbook prototype was also tailored to assess student perception compared to using supervisory methods using the old logbook. The Rapid Application Development (RAD) methodology was used in software development while a set of questionnaires was distributed to 65 respondents to obtain their assessment feedback data. The findings show that students have a positive assessment of their perception of the use of this prototype.

Matched MeSH terms: Education, Medical, Undergraduate
Fulltext Improving the appropriateness of therapeutic drug monitoring sampling in Hospital Sultanah Nur Zahirah, Kuala Terengganu

Lukman Nul Hakim Md Khairi, Farah Syakirah Ahmad, Aimi Shazana Muhammad Anuar, Nurul Ain Wan Omar, Nurul Najmi Muhammad, Nurulhayati Abd. Jamal, et al.

Q Bulletin, 2020;1(29):28-35.
MyJurnal

Therapeutic drug monitoring (TDM) is a valuable clinical tool in optimisation of drug regimens. However, improper utilisation of TDM may lead to significant resource wastage and expose patients to avoidable trauma, toxicity, therapeutic failure and prolonged hospitalisation. This study aimed to reduce the percentage of inappropriate TDM sampling to our proposed standard of less than 20% within a four-month intervention period. A cross-sectional study was undertaken from January to December 2015 at the inpatient setting of Hospital Sultanah Nur Zahirah. Gentamicin and Vancomycin analytes were studied because these analytes accounted for 69.2% of total samples received in 2014. TDM Monitoring Form was used to collect sampling and dosage information to assess sampling appropriateness. A closed-ended self-administered questionnaire was distributed to a group of medical doctors to assess their knowledge on appropriate Gentamicin and Vancomycin TDM sampling method pre- and post-intervention. Prior to the intervention phase in October to December 2014, 79.4% of TDM were inappropriately sampled. The main contributing factors were inadequate knowledge among medical doctors, lack of sampling reminders for new TDM requests, and misunderstanding on sampling information for repeated TDM requests. 60-minute face-to-face educational sessions on TDM sampling method were conducted specifically for staff at the General Medical and Paediatric Departments, and two continuing medical education (CME) slots were held at the hospital level. Guidelines on TDM sampling was initiated and laminated copies were distributed to all wards. Implementation of TDM Alert System which consisted of digital reminders and physical stickers was also introduced. The interventions were able to reduce the inappropriate sampling percentage from 79.4% to 41.8% post-intervention, and to 19.1% in the recent monitoring phase of January until June 2019. Continuous close monitoring and sustainable implementation of the measures are vital as TDM sampling appropriateness may affect clinical interpretation of the results.

Matched MeSH terms: Education, Medical, Continuing
Fulltext A systematic literature review on technology-enhanced learning in medical education

May Honey Ohn

Borneo Journal of Medical Sciences, 2020;14(1):3-17.
MyJurnal

This systematic review was aimed to evaluate the effectiveness of technology-enhanced learning (TEL) used in medical teaching for undergraduate medical students. The objectives are to (a) identify various teaching modalities which are used to enhance TEL; (b) evaluate whether TEL is more effective than traditional learning (TL) in cognitive and affective learning domain outcome. The empirical studies were searched in the following databases: Google Scholar, MEDLINE, ERIC, ProQuest, Cochrane Library and Scopus. All papers published from 2008 to 2018 were included. From eligible studies, the study design, study field, study population, intervention methods, type of assessment and learning achievement were abstracted and summarized the information. The search results were independently reviewed by two authors. From a pool of 1384 articles, 43 eligible articles were identified, enrolling 7292 undergraduate medical students examining comparative study between TEL and traditional learning. The results showed that there was a high degree of heterogeneity seen amongst the included studies in terms of TEL modalities used. The majority of intervention studies favoured online resources, while the rest used various offline multimedia electronic devices, virtual simulations and blended modes. Overall findings showed promising data that TEL is better than TL with regards to knowledge gain and skill acquisition, as well as providing higher student satisfaction. In all, the findings present blended learning in a positive and promising light in time, particularly where systematic reviews on technology-enhanced learning in the field of the undergraduate medical programme have produced mixed result.REVIEW ARTICLEA Systematic Literature Review on Technology-Enhanced Learning in Medical EducationMay Honey Ohn1*, Bareth Ravindran2, Chan Zhi Wei3, Khin Maung Ohn4, Ng Pey Luen5Borneo Journal of Medical Sciences 14 (1) January, 2020: 3 – 171 Emergency Department, Sandwell & West Birmingham NHS Trust, United Kingdom2 Surgical Department, Hospital Tuanku Ja’afar Seremban, Kuala Lumpur, Malaysia3 Orthopaedics Department, Hospital Sungai Buloh, Kuala Lumpur, Malaysia4 Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia5 Radiology Department, Hospital Queen Elizabeth II, Sabah, Malaysia* Corresponding author’s email: mayhoney.ohn@gmail.com Received: 14 July 2019 Accepted: 5 November 2019Borneo Journal of Medical SciencesBJMSKeywords: blended learning, technology-enhanced learning, medical education, hybrid learning, undergraduate medical students

Matched MeSH terms: Education, Medical
Fulltext Readiness for interprofessional education among preclinical and clinical year medical students - does it change over the years?

Kavitha Ashok Kumar, Ashok Kumar Jeppu

Malaysian Journal of Medicine and Health Sciences, 2020;16(107):63-66.
MyJurnal

Introduction: Health care involves team work. Physicians, nurses, pharmacists and social workers need to work in collaboration to deliver quality health care. It is therefore vital that team work and collaboration are integrated into the training of medical students. In a medical school where interprofessional education has not been introduced, the preclinical students are trained in silos whereas the clinical students have interprofessional experiences in hospital and community centers. This study was conducted to explore medical student’s receptiveness for interprofessional education and to identify any differences in attitude among the preclinical and clinical year students. Methods: This study adopted a cross-sectional study design using purposive sampling technique at a private medical school in Malaysia. Participants completedthe standardized Readiness for inter-professional learning Scale and the data was analyzed. Results: 436 students witha mean age of 22 years participated in this study. Among them, 170 were from preclinical and 266 were from clinical years Both the groups scored high on team work while clinical students scored better than preclinical students in understanding professional identity and recognizing their roles. Conclusion: This study shows a readiness among medical students for IPE. Clinical year medical student’s attitude was similar to preclinical students.

Matched MeSH terms: Education, Medical
Fulltext Developing a bank of faculty-authored, valid and reliable objective questions for institutional use: sharing the experience

Rukhsana Hussain Malik, Alam Sher Malik

Malaysian Journal of Medicine and Health Sciences, 2020;16(107):28-35.
MyJurnal

Introduction: With the increasing number of institutions implementing competency-based education which demands to provide feedback to students at regular intervals, there is an increase in the frequency of assessments. For this purpose, the written examinations using multiple choice questions (MCQs) are the most feasible form of assessment. However, constructing MCQs is an arduous task and significantly adds to the work-load of the academ- ic staff members. To ease this burden, the institutions may consider to develop banks of valid and reliable MCQs. Methods: Based and built on our experience and literature review, the steps – relating to the process of constructing valid and reliable questions and development of question banks (QBs) – are the actions needed to develop new QBs or improve on the existing ones. Results: We have described ten practical steps for developing and banking of MCQs. The first five steps relate to the development of quality items and the remaining steps relate to the development of QBs, their maintenance, growth and safety and security. We have also established the criteria for selection and the frequency of reuse of questions. Conclusion: Using QBs will alleviate some of the burden of constructing novel quality questions needed for frequent assessments of students using 21st century teaching/learning approaches. The use of banked questions with known psychometric properties would allow the authorities to take charge and control of items’ quality and overall examination standards.

Matched MeSH terms: Education, Medical, Undergraduate
Fulltext Using an integrated teaching approach to facilitate student achievement of the learning outcomes in a preclinical medical curriculum in India

Vashe A, Devi V, Rao R, Abraham RR, Pallath V, Umakanth S

Adv Physiol Educ, 2019 Dec 01;43(4):522-528.
PMID: 31642706 DOI: 10.1152/advan.00067.2019

Today most education institutions around the world have adopted the philosophy of outcome-based education. The emphasis in outcome-based education is achievement of outcomes; hence the curriculum should be designed in a way that it includes the components targeted specifically at achieving these outcomes. A discipline-based approach results in fragmentation of learning and lack of clinical applicability. Integrated teaching could be a solution to achieve required outcomes in a holistic way. Hence, the aim of this study was to develop, implement, and evaluate an integrated teaching module. Temporal coordination of the basic sciences, along with correlation of learned topics to clinical settings, was done in the first year of the undergraduate medical program. The module was evaluated by obtaining qualitative and quantitative feedback from students. Student assessment was conducted with a test that had case vignettes and multiple-choice questions. In addition, students' change in learning approaches and self-directed learning readiness were collected. Students' perception regarding the educational environment was also obtained. Analysis of the data showed positive feedback from the students regarding the integrated teaching. Students' average score in the test was 86%. There was a significant increase in the scores for the deep approach and self-directed learning readiness in the posttest compared with the pretest. Moreover, students were found to be satisfied with the educational environment. Evaluation of integrated teaching revealed that it was well accepted by the students. Moreover, it facilitated the achievement of the students' outcomes.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Improving the position of resuscitation team leader with simulation (IMPORTS); a pilot cross-sectional randomized intervention study

Saiboon IM, Apoo FN, Jamal SM, Bakar AA, Yatim FM, Jaafar JM, et al.

Medicine (Baltimore), 2019 Dec;98(49):e18201.
PMID: 31804343 DOI: 10.1097/MD.0000000000018201

BACKGROUND: Leadership and teamwork are important contributory factors in determining cardiac resuscitation performance and clinical outcome. We aimed to determine whether fixed positioning of the resuscitation team leader (RTL) relative to the patient influences leadership qualities during cardiac resuscitation using simulation.
METHODS: A cross-sectional randomized intervention study over 12 months' duration was conducted in university hospital simulation lab. ACLS-certified medical doctors were assigned to run 2 standardized simulated resuscitation code as RTL from a head-end position (HEP) and leg-end position (LEP). They were evaluated on leadership qualities including situational attentiveness (SA), errors detection (ED), and decision making (DM) using a standardized validated resuscitation-code-checklist (RCC). Performance was assessed live by 2 independent raters and was simultaneously recorded. RTL self-perceived performance was compared to measured performance.
RESULTS: Thirty-four participants completed the study. Mean marks for SA were 3.74 (SD ± 0.96) at HEP and 3.54 (SD ± 0.92) at LEP, P = .48. Mean marks for ED were 2.43 (SD ± 1.24) at HEP and 2.21 (SD ± 1.14) at LEP, P = .40. Mean marks for DM were 4.53 (SD ± 0.98) at HEP and 4.47 (SD ± 0.73) at LEP, P = .70. The mean total marks were 10.69 (SD ± 1.82) versus 10.22 (SD ± 1.93) at HEP and LEP respectively, P = .29 which shows no significance difference in all parameters. Twenty-four participants (71%) preferred LEP for the following reasons, better visualization (75% of participants); more room for movement (12.5% of participants); and better communication (12.5% of participants). RTL's perceived performance did not correlate with actual performance CONCLUSION:: The physical position either HEP or LEP appears to have no influence on performance of RTL in simulated cardiac resuscitation. RTL should be aware of the advantages and limitations of each position.

Matched MeSH terms: Education, Medical, Graduate
Fulltext Developing a preliminary questionnaire for the faculty development programme needs of medical teachers using Delphi technique

Nor MZ

J Taibah Univ Med Sci, 2019 Dec;14(6):495-501.
PMID: 31908636 DOI: 10.1016/j.jtumed.2019.09.007

Objective: The study aimed to develop a preliminary medical teachers' faculty development programme (FDP) needs questionnaire through two rounds of Delphi technique.
Methods: This study utilised the Delphi study between April to June 2019. Face-to-face interviews and a literature review were conducted to propose a set of domains and items for the FDP needs of medical teachers. Two rounds of the Delphi technique were incorporated to obtain a consensus for the proposed questionnaire by 10 expert panels from their respective fields. The consensus was pre-defined as a mean score of four or above and with a percent agreement of 75%.
Results: Initially, four domains and 26 items were proposed. Finally, a total of six domains and 38 items were endorsed by the expert panels. The selected domains included six competencies, including teaching, assessment, research, curriculum, publication, and public service. These domains consisted of seven, nine, six, seven, four, and five items, respectively.
Conclusion: This study developed the first preliminary FDPs needs questionnaire specifically designed for medical teachers. It would be an effective instrument to measure the needs of the FDPs in medical education.

Matched MeSH terms: Education, Medical
Survey of postgraduate medical physics programmes in the Asia-Oceania region

Wong JHD, Ng KH, Sarasanandarajah S

Phys Med, 2019 Oct;66:21-28.
PMID: 31546154 DOI: 10.1016/j.ejmp.2019.09.079

The increased use of medical imaging and radiation therapies has resulted in a high demand for medical physicists. Although medical physics programmes are well established in advanced countries, the same cannot be said for many low- and medium-income countries. In some countries, there may be huge variations in the graduates' skill and quality, which pose a problem in ensuring patient safety, providing quality assurance in treatments, optimisation of protocols and standardisation of quality. It also makes any yet-to-be-established regional peer recognition efforts problematic. In order to understand the depth of this problem, a survey was carried out as part of the home-based assignment under the RAS 6088 IAEA programme. A large diversity in terms of course content, duration, clinical training and student profile could be observed across the Asia-Oceania universities surveyed. Out of 25 programmes, only six received recognition from professional bodies, and they were mostly in Australia and New Zealand. Hence, to ensure quality education, a regional curriculum model needs to be developed to harmonise standards. And there is still a long way to go towards standardizing medical physics education and clinical training in the region.

Matched MeSH terms: Education, Medical/statistics & numerical data*; Education, Medical, Graduate/statistics & numerical data*
Antimicrobial prescribing and determinants of antimicrobial resistance: a qualitative study among physicians in Pakistan

Saleem Z, Hassali MA, Godman B, Hashmi FK, Saleem F

Int J Clin Pharm, 2019 Oct;41(5):1348-1358.
PMID: 31273588 DOI: 10.1007/s11096-019-00875-7

Background Understanding physicians' perception about antimicrobial use and resistance is essential to ensure that the objectives of the Pakistan national action plan on antimicrobial resistance are met. Little is currently known about physicians' perceptions in Pakistan. Objective Assess physicians' perception surrounding antibiotic use and resistance, factors influencing antibiotic prescribing and potential interventions to improve future antibiotic prescribing. Settings The study was conducted in Lahore, the capital of the province of Punjab, which is the second largest and most populous city of Pakistan. Method Qualitative study was conducted with a semi-structured interview guide involving in-depth face-to-face interviews with purposively selected physicians. Audiorecorded interviews were transcribed verbatim and transcripts analyzed by thematic content analysis. Main outcome measures Themes surrounding the perspectives of physicians on issues of antimicrobial use and resistance. Results Five major themes emerged: (1) knowledge and perception of physicians about antimicrobials, (2) antimicrobial prescribing behaviors of physicians, (3) factors influencing prescribing, (4) determinants of antimicrobial resistance, (5) and potential interventions to reduce antimicrobial resistance. The main challenges and issues associated with antibiotic prescribing were the improvement of knowledge, implementation of hygienic measures, access to and clarity of treatment recommendations and minimizing external factors influencing prescribing including pharmaceutical company activities. Suggestions for the future included stricter regulations for prescribing, improved diagnosis, availability of local guidelines and monitoring of prescribing and resistance patterns. Conclusion Identification of concerns regarding inappropriate antimicrobial prescribing will enable specific initiatives and approaches to improve future antimicrobial use and reduce antimicrobial resistance in Pakistan.

Matched MeSH terms: Education, Medical, Continuing

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