Objective: Missing values is commonly encountered in data analysis in all types of research. Various methods were introduced to handle this matter. This study aims to compare the result of using complete data analysis, missing indicator method, means substitution and single imputation in dealing with this issue. Methods: 202 patients who were discharged from the psychiatric ward, University Malaya Medical Centre (UMMC) from 27th August 2007 to 15th April 2008 were recruited. The general psychopathology was measured with Brief Psychiatric Rating Scale (BPRS-24). The information on age, gender, race, marital status and psychiatric diagnosis were collected. On follow up, the patients who had early readmission (
Medical students in Malaysia face enormous amount of stress that can compromise their medical training. A brief group Mindfulness-based Cognitive Therapy (bMBCT)/Mindful-Gym) programme has been developed to help medical students cope more effectively with stress. The intervention was found to be effective for reducing stress and increasing subjective well-being among medical students in University Putra Malaysia (UPM). One of the training methodologies used in the programme, ‘Mindful-S.T.O.P.,’ was particularly popular among the students. The aim of this paper is to describe the concept and application of this mindfulness-based psychological tool (Mindful-S.T.O.P.) for stress reduction in medical students.
Introduction: Palliative care teaching has little emphasis during the undergraduate period. Most
teachings in medical school are geared towards preventive and curative approach. Competency in
palliative care including therapeutic and effective communication has been the taught indirectly
without emphasis on other areas. We investigate medical students’ preparedness on palliative care
subjects using past studies questionnaire to evaluate knowledge, attitudes and understanding on end
of life issues. Method: Cross sectional study was performed on the final year medical students (class
2015) from a public university in the northern state of Peninsular Malaysia. Proforma was adopted
from the previously published studies covering the aspect of knowledge, attitude, end-of-life, advanced
directive and bioethical principles in palliative care. Conceptual framework of final year medical
students’ preparedness was ascertained following impartment of palliative care knowledge, either
directly or indirectly, after the exposure and completion of the clinical attachment. Results: The
study elicited a 78.5% response rate where 133 students replied out of 177 total students. Overall the
knowledge and attitude of palliative care were good. There were some misconceptions especially the
use of morphine and role of physician in the management of dying patients. Conclusion: There were
gaps identified following the completion of the study. Misunderstanding in different aspect of care
should be remedied with more exposure and practicality suitable to undergraduate medical curriculum
learning
Introduction: Clinical educators around the globe agreed that an optimal educational climate is a vital aspect for effective learning to take place. This study was conducted to evaluate the perceptions of graduates toward the quality of clinical education climate in USM medical school. Methods: A cross-sectional study was conducted on a cohort of USM medical graduates. Questionnaires were administered to the graduates to measure their perception on four aspects of clinical education climate that include structure of clinical rotation, clinical teaching and learning activities, quality of lecturers and end clinical rotation assessment across 13 clinical rotations. The graduates were requested to respond to seven-Likert scale ranging from 1(poor) to 7(excellent). Scores of equal to or more than 5 was considered as positive areas, scores of between 4 and 5 were considered as areas for improvement, and scores less than 4 were considered as areas of concern. Data analysis was performed using SPSS version 20. Results: A total of 105 (96.3%) graduates responded to the questionnaire. Results showed only the paediatric rotation obtained positive ratings on all areas of the clinical rotation structure. With regards to teaching and learning activities, the graduates scored most of the clinical rotations between 4 and 5. With regards to the quality of lecturers, most of the clinical rotations obtained score more than 5. Most of the areas related to the end-of-assessment of clinical rotation obtained score more than 5 except for the feedback adequacy, indicating inadequacy of feedback they received. Conclusion: USM medical graduates positively perceived the quality of lecturers during clinical training, however several areas of clinical education related to clinical rotation structure, clinical teaching and learning activities, and feedback practice were perceived by them as areas for improvement. Medical schools should introduce strategic measures to address the concerns raised by the graduates to ensure the best clinical learning experience are provided to the current and future medical students.
Journal business models are basically classified based on the source of income to cover publication costs and in general there are two main journal business models which are the toll-access and open-access. These leading to a question that still remains around the ethics of publishing academic work across the different journal business models in terms of (a) editorial decision-making and (b) the dissemination of research that has not been appropriately peer-reviewed for quality and rigor. This paper discussed about these two areas based on the literature and the authors' observations.
Introduction: Investigation on spiritual issue in healthcare practice received less attention. Muslims valued pray activity or known as salat as one of the important daily activity. However, negligible study is available on salat as the end goal of occupational therapy intervention. This study aims to investigate the awareness and the impact of Muslim-culture on occupational therapists in Malaysia. Methods: A cross-sectional survey study was conducted via internet-based and manual paper-and-pencil survey throughout occupational therapists in Malaysia. Descriptive and inferential statistics using percentage, Cronbach’s alpha and Chi-square was implemented on the findings. Results: In total, 119 occupational therapists responded. The questionnaire has overall internal consistency ofα = 0.74. Occupational therapists have positive perceptions on spiritual activity but poorly translated into service implementation and faced challenges. Factors such as level of education, years of experience, religion, working location and work setting were significant on the awareness, perception, practice and challenges. Cultural-based practice is challenging for occupational therapy even in the majority-practice context. Occupational therapists should differentiate between belief and activity in spiritual issue to provide a better assistance for the clients. Conclusion: This study showed continuing education is desired to drive the occupational therapy profession for a better cultural-sensitivity service delivery.
Medical education in Malaysia is facing challenges related to the increasing number of local private
and foreign medical universities. The key issue is whether the system is producing doctors who have
adequate competencies for fundamental patient-centred care. The Malaysian Medical Licensing
Examination (MMLE) was proposed by the Ministry of Health (MOH) as a common licensing
examination for which all graduates must sit prior to obtaining registration to practice. Currently, this
exam is only taken by Malaysian students graduating from foreign medical colleges. However, the local
Malaysian universities, both public and private, have different curricula for preparing undergraduates
for future housemanships. The question is whether the educational programs of these universities
are robust enough in delivering curricula that produce safe and competent doctors. Moving forward,
it must be determined whether there is a need for extending the Malaysian Medical Licensing
Examination (MMLE) to all graduates of both local and foreign medical universities, thereby creating
a marker of excellence by which to measure Malaysian education and practice.
This study aimed to translate Oldenburg Burnout Inventory (OLBI) into Malay language, and test its
response process (face validity) and internal structure (factor structure and internal consistency). To
the author’s knowledge, OLBI is not yet validated in Malay language, thus this study aimed to produce
a validated Malay version of OLBI (OLBI-M) in order to measure burnout among the healthcare
learner population in Malaysia. OLBI has great potentials mainly due to its accessibility and free of
any cost to use it, thus might promote more researchers to conduct burnout research in Malaysia. The
forward-backward translation was performed as per standard guideline. The OLBI-M was distributed
to 32 medical students to assess face validity and later to 452 medical students to assess construct
validity. Data analysis was performed by Microsoft Excel, Statistical Package for the Social Sciences
(SPSS), and Analysis of Moment Structures (AMOS). The face validity index of OLBI-M was more
than 0.70. The two factors of CBI-M achieved good level of goodness of fit indices (Cmin/df = 3.585,
RMSEA = 0.076, GFI = 0.958, CFI = 0.934, NFI = 0.912, TLI = 0.905) after removal of several
items. The composite reliability values of the two factors ranged from 0.71 to 0.73. The Cronbach’s
alpha values of the three factors ranged from 0.70 to 0.74. This study shows OLBI-M is a reliable
and valid tool to measure burnout in medical students. Future burnout studies in Malaysia are highly
recommended to utilise OLBI-M. However, it is crucial for further validity to be carried out to verify
the credential of OLBI-M.
Introduction: Pregnancy is common among women in the reproductive age and is associated with several risks. Preconception care has thus been introduced to promote health before conception and to improve pregnancy-related outcomes. The aim of this study was to determine the level of knowledge, attitudes and practices regarding preconception care among women attending antenatal care appointments. Methodology: This was a cross-sectional study conducted from April to December 2012 at Klinik Kesihatan Bachok. A self-administered questionnaire was administered to 135 respondents from 18 to 45 years of age. The questionnaire consisted of four domains, assessing socio-demographic data and knowledge, attitudes and practice of preconception care. Results: The mean (SD) knowledge, attitude and practice scores were 11.37 (3.94), 15.39 (2.12) and 10.13 (2.30), respectively. In total, 98.5% of the respondents had good attitudes, 45.2% had good practices, and 51.9% had good knowledge of preconception care. Conclusion: Women in Bachok have fair knowledge of and good attitude towards preconception care. However, they have poor preconception care practices.
Introduction: Greater needs of medical doctors to provide appropriate care for both genders related diseases, however men face more problem since their problems have less been recognized. Objective: The objective was to determine the level of men’s health knowledge among final year medical students in USM and MU. Method: A total of 199 final year medical students from Universiti Sains Malaysia (USM), Kelantan, Malaysia and Monash University, Melbourne, Australia (75 students from USM and 124 students from MU) were enrolled in the study and completed self-administered questionnaire on the topics related to male sexual and reproductive health. Result: The response rate for USM and MU was 44% and 68.9% respectively. Out of 52 items, 17 items were significantly had higher percentage in answering correctly (p
Introduction: Nurses are generally trained on the procedures of blood transfusion during their years of service. However, the level of knowledge varies among individuals and healthcare centres. Thus, this study addresses a knowledge gap regarding nurses’ knowledge and transfusion safety in the local clinical setting. Objectives: This study aimed to determine nurses’ level of knowledge of various phases of blood transfusion and associate this knowledge with their socio-professional details. Methods: This was a cross-sectional, quantitative study. The target population was in-patient ward nurses at Hospital Pulau Pinang. The systematic random sampling method was used to select 185 nurses to participate in this study. Data were collected using a validated research questionnaire that consisted of 31 items (9 items related to socio-professional factors and 22 knowledge items). Data were analysed using descriptive and inferential analyses. Results: The overall knowledge score was moderate (mean = 70.44%, SD = 11.35). None of the nurses was able to answer all of the knowledge questions correctly. Of the participants, 72.29%, 71.75%, and 67.14% exhibited knowledge of blood bag collection and patient preparation; pre-transfusion nursing activities; and during and post-transfusion nursing responsibilities and management of transfusion reactions, respectively. Factors such as age, years of service, department, and availability of the transfusion policy in the ward significantly affected the mean knowledge scores. Conclusion: Nurses’ knowledge of blood transfusion at Hospital Pulau Pinang was moderate. More training and courses should be provided to improve their knowledge.
Feedback and students’ perception towards it has gained increasing attention in the educational literature recently, yet it is an underresearched area. The importance of feedback has not been perceived in a positive manner among medical students. This may be due to students’ lack of knowledge on the concept of feedback and their awareness of the benefits of feedback. This study focused on students’ knowledge on the concept of feedback and their perception towards the feedback system practiced in School of Medical Sciences, University Sains Malaysia. Methods: This was a cross-sectional study involving 433 numbers of students from year 1, 3 and 5 medical students. The variables that were included in this were the gender and their year of study. A validated questionnaire was used to perform this study. School and ethical committee clearance were obtained prior to the start of the study. Data obtained was analysed using Statistical Package for Social Sciences (SPSS) version 20. Results: Findings revealed that students have an average level of knowledge on the concept of feedback and have a neutral perception towards the feedback system that is practiced in School of Medical Sciences, USM. There was no association between students’ knowledge level on feedback and their perception with their year of study and gender differences. However, although there was not much difference in students’ perception level about feedback with their year of study but it was found those students’ perception level decreases as their year of study progresses. It was also found that there was a poor correlation between medical students’ knowledge level on feedback with their perception towards the feedback system in School of Medical Sciences, USM. Conclusions: The area in which it raised concern in students’ perception about feedback was the factors that are involved in feedback practice, which are the givers of feedback, timing of feedback and the mode of feedback. Further study addressing students’ poor engagement and involvement in feedback can be done and issues identified from this study can be included in together for further improvements of the feedback system.
Chronic kidney disease (CKD) causes 70% of all death globally. The prevalence of CKD has shown an increasing trend for the past 20 years in Malaysia. Thus, determining the knowledge and awareness of CKD among healthcare students in preparing them to be a good healthcare provider in the future is important. This study aimed to determine the association between knowledge and awareness about CKD among International Islamic University Malaysia (IIUM) undergraduate students. A crosssectional study was conducted among 108 students using simple random sampling method. The questionnaire was given to the class representative to be self-administered to interested students. It had close-ended questions consisting of Part A to Part D. The scoring given for correctly answered items was one and the total score for Part C was 7 marks. Most of the students were female (70.4%). The mean knowledge score of CKD was 3.65 (SD = 1.12) with nearly half of the students (43.5%) classified as having poor knowledge. Most respondents were aware about CKD (99.1%) and have heard about it from medical personnel (48.1%) and the Internet (25.9%). Further analysis showed that only courses taken by the respondents were significantly associated with knowledge on CKD (p = 0.039). The level of knowledge among undergraduate students is still poor, yet they are aware about the existence of CKD and its aetiology. Therefore, the health sciences curriculum should emphasise on CKD management from a multidisciplinary aspect of care. It is recommended to conduct similar research among different student populations to create awareness and obtain important baseline findings.
The main purpose of formative assessment is to improve students' learning and it
should be seen as a part of the learning process. Game-based learning has become more common in
the education and one of the emerging game-based learning platform used in education institutions is
Kahoot. This paper investigated the perception of students towards Kahoot as a formative assessment
tool in undergraduate medical education and its association with gender. Methods: A cross-sectional
study was carried out on first year medical students in a Malaysian public medical school. The study
employed a survey that consists of 12 items through Kahoot survey platform. Result: A total of 113
subjects participated in this study; majority was female (68.1%) and Malay (58.4%). The students
highly perceived Kahoot as fun, effective and better than e-learning platform for feedback as its
median score was 4. The rest of items were satisfactorily perceived by the students as indicated by
the score of 3 except for simplifying complex subjects that obtained unsatisfactory level. There were
significant median score differences between male and female students for motivation and perceived
knowledge retention, whereby males scored higher than females (p < 0.05). Conclusion: Kahoot is a
promising formative assessment tool that is feasible, practical and makes learning fun and enjoyable. It
can be used to motivate students to learn. However, Kahoot was not the best tool to simplify complex
subjects as perceived by medical students.
Item analysis (IA) is commonly used to describe difficulty and discrimination indices of multiple
true-false (MTF) questions. However, item analysis is basically a plain descriptive analysis with
limited statistical value. Item response theory (IRT) can provide a better insight into the difficulty
and discriminating ability of questions in a test. IRT consists of a collection of statistical models that
allows evaluation of test items (questions) and test takers (examinees) at the same time. Specifically,
this article focuses on two-parameter logistic IRT (2-PL IRT) model that is concerned with estimation
of difficulty and discrimination parameters. This article shows how 2-PL IRT analysis is performed in
R software environment, guides the interpretation of the IRT results and compares the results to IA on
a sample of MTF questions.
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.
To ensure the reliability of manual blood pressure (BP) readings in a clinical trial, sources of error due to measurement must be reduced as much as possible. Apart from following standard procedure for BP measurement and ensuring good equipments, the measurement errors that come from the assessors themselves should be assessed. Objective: To demonstrate the use of two-way random effects, interactions absent, absolute agreement (Type A), single measures (Type 1) intraclass correlation coefficient (ICC) in the assessment of reliability of manual BP readings among assessors involved in a clinical trial using manual BP measurement, by using an interrater reliability study conducted by the authors as an example study. Methods: The steps involved in obtaining ICC in the study were discussed. Sample size given the number of assessors in the study was calculated. BP was measured using regularly maintained mercury sphygnomanometers, following recommendations by Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) for BP measurement in office setting. The outcomes were systolic and diastolic BP readings. A type of ICC, two-way random effects, interactions absent, absolute agreement (Type A), single measures (Type 1) ICC was chosen for the analysis and specifically discussed. Pre-requisite assumptions for ICC were meticulously checked and described. The interrater reliability for systolic and diastolic BP readings as expressed by ICC (single measure) were presented with confidence interval (CI). The ICCs obtained in the example study were discussed and concluded. The flaws of the study were also criticised. Results: The interrater reliability for systolic and diastolic BP measurements as expressed by ICC (single measure) were 0.87 (95% confidence interval [CI] 0.722, 0.956) and 0.77 (95% CI 0.560, 0.918) respectively. Conclusion: We demonstrated the steps required to obtain ICC. Since the use of manual BP measurement using mercury sphygmomanometer is still considered as gold standard of BP measurement, it is important that studies in which the BP outcome is measured using such method conduct interrater reliability studies properly.
The Ministry of Higher Education introduced the integrated cumulative grade point average (iCGPA)
system in 2016 as an aspiration to produce holistic and well-balanced graduates based on Malaysian
Qualification Agency’s (MQA) learning domains. In this article, we provide a comparison of iCGPA
with other established medical competency frameworks and share our experience in implementing
iCGPA in the medical faculty. Throughout the process, it was noted that medical educators require
several core competencies in order to successfully implement iCGPA in their courses. Two of the most
important core competencies are understanding the pedagogies of the 21st century (heutagogies,
paragogies, and cybergogies) and apprehending the concept of outcome-based education. On top of
the requirement of core competencies, there were also challenges in tailoring teaching and learning to
meet the requirement of the Industrial Revolution 4.0. We also describe in detail the benefits and other
challenges of iCGPA implementation in our faculty. We conclude this article with our recommendation
for successful iCGPA implementation in the future for the medical faculty.
Mastering the art of conducting a research along with the competitive era of publishing papers showed the importance of undergraduate research. The purpose of this research was to study the impact of undergraduate research “Special Study Module (SSM)” on Universiti Kebangsaan Malaysia (UKM) medical students and alumni.
Methodology: This was a cross-sectional study whereby 64 fifth year UKM medical students of academic-session 2014/2015 and 49 alumni of year 2010 were participated on their SSM research activities. The questionnaire administered online which enquired on participants’ level of interest, confidence and SSM research experiences. Frequency and percentage distribution were used for descriptive analysis.
Result: Out of 119 participants,113 responded giving a response rate of 95%. More than 90% respondents in both group felt that SSM experience was enriching and 80%–90% felt SSM experience was pleasant. In both groups 47%–50% respondents believed, SSM experience contributed their high level of interest on research. The most influencing factors on their level of interest were supervisor guidance as reported by73%–80% respondents. It was said that SSM supervisor was academically stimulating, impressive as role model and supportive. The most confidence skill was the ability to function within a group and least confidence skill was manuscript writing.
Conclusion: Undergraduate SSM research showed positive impact on participants’ research activities. More in-depth analysis should be considered especially on manuscript writing as the students were least confident in this skill.
Histology, a branch of anatomy is a correlational science between structure of tissues and their
functions. Knowledge of histology is emphasised for undergraduate medical students as a basic for
clinical knowledge and research. To impart retainable and reproducible knowledge in histology, a new
laboratory manual with images and clinical correlates was introduced to the Year I MBBS students
in the Academic Session 2017/2018 during their general anatomy module. The objective structured
practical examination marks between 101 students of Batches 2016/17 and 2017/18 were analysed.
The difference in marks between both the batches were analysed using SPSS 20. Batch 2017/18
students who used the new lab manual scored better than the previous batch who used the old
manual. Independent t-test was not statistically significant. The students who used the new manual
fared better than their seniors. Since the difference was not statistically significant, it can be concluded
that if existent, drawbacks in the lab manual should be improved and adequate usage of the manual by
the students should be emphasised. Nevertheless, usage of the new lab manual shows that the students
could understand the subject and score better with less study hours.