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 (
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.
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.
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.
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
Anatomy is an important knowledge for medical practice. Insufficient anatomy knowledge leading to errors in identification of anatomical structures during medical practices has been reported in many countries. Many medical students seem to have difficulties in learning anatomy and retaining the knowledge for future practice, thus this might reflect the possible flaws in anatomy education. In order to achieve optimum anatomy education environment and to close the gaps in education, measuring the students' perception on anatomy teaching and learning is a pre-emptive measure needed by educationists. At present, there is no valid and reliable inventory available to specifically evaluate the anatomy education environment. Therefore, this article highlights the importance of having such inventory.
Objective: To determine association between academic performance and absenteeism in classroom among first year medical students.
Methods: A one-year prospective study was conducted on 196 first year medical students. Academic performance was measured by examination scores at four examinations. Absenteeism score was measured by the cumulative number of absence in an academic session of each student recorded by academic office at the end of the first year of medical training. The academic performance was categorized into pass and fail for analysis purpose. Data was analyzed by SPSS version 20.
Results: The independent-t analysis showed that, in all examinations, students who passed the examinations had significantly lower absenteeism scores than those who failed (p < 0.001).
Conclusion: This study found significant associations between academic performances and absenteeism scores among first year medical students. Medical schools should pay more attention on this matter since it may result in poor academic performances.
There are five sources of validity evidence that are content, response process, internal structure, relation to other variables, and consequences. Content validity is the extent of a measurement tool represents the measured construct and it is considered as an essential evidence to support the validity of a measurement tool such as a questionnaire for research. Since content validity is vital to ensure the overall validity, therefore content validation should be performed systematically based on the evidence and best practice. This paper describes a systematic approach to quantify content validity in the form of content validity index based on the evidence and best practice.
The flipped classroom (FC), an innovative teaching and learning pedagogy has grown in medical education since last decade. In FC modality, students learn by means of print, audio or video-based material self-reliantly, before built-in teaching sessions in the classroom to overcome passive learning. In this review, the key concepts, benefits and best practices of the FC in health professions education have been described. The review was carried out using Medline, Scopus, Ovid, and Cochrane. The keywords were “Flipped method, Teaching strategy, Role of the teacher, and Medical students”. Flipped is an effective teaching modality which enables learners to be independent. Students do take ownership of what they learn. Tutors are also satisfied with what their learners acquire. The benefits of FC are robust and likely to augment the learning abilities of the students as well as supplementing the learning course content; group events can deliver added benefits too.
Validity evidence can be supported by five sources that are content, response process, internal structure, relation to other variables, and consequences. Response process validity measures the thought processes of users of the tested inventory as they respond to the assessment tool. These are commonly evaluated in the form of clarity of instructions and language used in the assessment tool, as well as the comprehension of instruction after training or an observation session. Response process validity contributes to the overall validity of an assessment tool; therefore, it should be quantified systematically based on the evidence and best practice. This paper describes a systematic approach to quantify response process validity in the form of face validity index based on the evidence.
Objective: This paper describes the patterns of professional identity development (PID) among
medical graduates of a SPICES (i.e., Student-centred/teacher-centred; Problem-based/information
gathering; Integrated/discipline-based; Community based; Elective/uniform; and Systematic/
apprenticeship-based) curriculum implemented by the School of Medical Sciences, Universiti Sains
Malaysia (USM). Methods: The phenomenological study design evaluated 50 medical graduates of
USM who underwent housemanship at government hospitals in the Peninsular of Malaysia. Focus
group interviews (FGI) were conducted to explore and capture the experience of the participants
in relation to PID during medical training. Eight FGI sessions were conducted at a specific place
as agreed by both researchers and participants. A thematic analysis technique assisted by Atlas.ti
software was used to analyse the qualitative data. Results: The thematic analysis revealed that there
were two themes: self-development and professional development. The self-development theme was
represented by four categories: self-confidence, internal and external motivation, communication skills,
and problem solving. The professional development theme was represented by five categories: social
adjustment, leadership skills and management, team work, hands-on skills, and creativity. Conclusion:
The formation of professional identity among USM medical graduates was related to self-development
and professional development. This suggests that the USM medical curriculum is vital in shaping
professionalism attributes among its medical graduates that are balanced among knowledge, skills,
behaviours and values. Producing balanced medical graduates will ensure the highest quality of
healthcare sevices provided to the country. The implications of this study and recommendations are
discussed.
Introduction: Entrepreneurship CMIE 1022 module was introduced in February 2012 and was made compulsory to all first year undergraduate students in all faculties of Universiti Kebangsaan Malaysia (UKM). The main objective of CMIE 1022 is to expose the students to entrepreneurship with implementation of online teaching and business game simulation.
Method: Module evaluation form was distributed among medical and nursing students at the end of the module.
Result: One hundred seventy-seven students responded to the survey with 50.3% of the respondents agreed that their soft skill have improved, 37.8% for increased awareness of entrepreneurship, 25.6% has increased their interest in entrepreneurship and 22.22% agreed to apply in their own courses. More than three quarter of the students agreed that the lecturers and teaching assistants teaching methodology were acceptable. However, only 18.4% agreed that this course should be taken by all students of UKM.
Conclusion: This study showed despite increase in soft skills and interests including high performance of the academics, most students disagreed on the introduction of CMIE 1022 course to all UKM students. It is suggested that the course curriculum to be reviewed in order to achieve the objectives.
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: Appropriate professional conduct of clinical teacher is vital in their medicine practice. In UKM medical centre Malaysia, personal and professional development (PPD) of future medical professionals is greatly emphasized. The objective of this study was to determine the medical students' perception about the professional conduct of their clinical teachers at UKM medical centre. Methods: It was an online questionnaire survey conducted among the clinical students enquiring about the professional conduct of their clinical teachers. There were five statements and one open ended question which described students' preference about PPD teaching- learning method, expectation on PPD session, need of teachers training and experience about the excellent and inappropriate professional conduct of clinical teachers. The open ended question described what students had observed regarding the 'doctor-patient relationship' medical ethics and 'student-teacher relationship. A total of 77 questionnaires were returned after complete evaluation. The data were compiled and analysed using SPSS version 20 and the answers to the open ended questions were transcribed. Result: Role modelling was the preferred teaching-learning method for PPD as stated by 38% respondents; subsequent preferred methods were small group (30%), role play (24%), large group (7%) and reflective writing (1%). Majority (67.5%) respondents indicated that professional conduct of their clinical teachers was frequent enough as they had expected while 29.9% claimed that professional conduct was infrequently emphasized. Excellent professional conduct of clinical teachers was witnessed by 73% respondents while 27% indicated that they had never seen excellent conduct. When asked about inappropriate professional behaviours by clinical teachers, 53% indicated to have witnessed. Qualitative data also revealed both positive and negative experiences as reflected in open comments. According to 70% respondents clinical teachers required training to apply PPD in their daily practices. Conclusion: Professional conduct of clinical teachers as perceived by the students was excellent and frequents enough with experience of inappropriate behaviour too. Role modeling was the preferred teaching method while attention needed on reflective assignment. Educators must emphasize on role modelling in their daily practices and curriculum planners should give due importance on training needs of clinical teachers to apply PPD in their daily practices.
One of the challenges in mentoring relationships is to understand the real issues faced by the mentees. A mechanism has been established to offer a credible mentoring inventory. The aim of the study was to determine the construct validity and reliability index of the Universiti Sains Malaysia Mentoring Inventory (USM-MT-i) among early phase medical students in a Malaysian public medical school. A cross-sectional study was conducted in June 2017 among 208 early phase of the medical students of School of Medical Sciences, Universiti Sains Malaysia. USM-MT-i is a self-administered inventory and was established based on the information gained from the mentors and mentees. The prevalidated inventory entailed 44 primary items. Exploratory factor analysis (EFA) and Cronbach’s alpha reliability analysis were utilised to determine the construct validity and reliability of such inventory. The result revealed three potential constructs with 39 items extracted from the USMMT- i; academic leadership (19 items), communication skills (12 items) and examination competence (8 items) with factor loading ranges from 0.50–0.77, 0.51–0.80 and 0.65–0.87, respectively. Internal consistency reliability (Cronbach’s alpha) for each domain were 0.95, 0.93 and 0.92, respectively. The overall Cronbach’s alpha was 0.96. The present study promoted that the three factors with 39 items of the USM-MT-i has a good validity and reliability value to survey for mentoring needs among medical students in their early phase.
Objective: To determine the factor structure of the Health Promoting Behaviours (HPB) component of Health Promoting Lifestyle Profile-II among undergraduate students in Universiti Sains Malaysia (USM) by confirmatory factor analysis (CFA).
Methods: A cross sectional study was conducted among undergraduate students. The data was collected in the USM campus using a proportionate cluster sampling method. The HPB questionnaire was handed to students in the lecture hall and collected immediately when the lecture finished. CFA was conducted using robust maximum likelihood estimation due to violation of multivariate normality assumption. A three-factor model was tested for measurement model validity and construct validity.
Results: A total of 788 students participated in the study. CFA of a 21-item, three-factor model yielded an adequate goodness-of-fit values. The measurement model also showed a good convergent and discriminant validity after model re-specification.
Conclusion: The health promoting behaviours scale was proven to have a valid measurement model and reliable constructs. It was deemed suitable for use to measure the health promoting behaviours components of a healthy lifestyle among Malaysian undergraduate students. It was recommended to further conduct cross-validation studies in other Malaysian public universities to provide additional empirical evidence to support its use.
Community and family case study (CFCS) is a community based educational (CBE) programme commenced in 1980 at School of Medical Sciences, Universiti Sains Malaysia. It serves to help and resolve health needs of the individual patients, family and their community. This will help to develop generic skills such as organization, communication and problem solving in relation to local norms, beliefs and socio-cultural influences. Students should have good awareness, sensitivity and empathic response based on health needs and environment that they are living in. Knowledge, skills, attitudes, emotions and values are repeatedly exposed to inculcate optimal learning environment with the community, as well as triggered response by the student to give back to the community by volunteerism. CFCS activism can be revitalized within the individual and group context. This can be achieved by multi-dimensional learning, collaborative effort, effective leadership and supervision, creative programme initiation, effectual research activities and sustainable service to the community. It is hopeful with active community engagement, life experiences learning process, self-directed and reflective learning, students are able to acquire refined attributes such as skills, behaviour, knowledge and attitudes, towards successful personal growth and advancement.
Introduction: Bioethics subject which is part of the curriculum in higher education has a slightly different orientation compared to the science subjects. This study investigates the challenges of teaching bioethics subject to the health sciences students and the outcome of using mixed educational background classes in bioethics. Methods: Discussions among lecturers of bioethics were conducted to determine the possible challenges when teaching bioethics to the health sciences students who are accustomed to the format of science subjects. Results of written bioethics tests (multiple choice questions [MCQs] versus short essays) were also analysed among students from nine different health sciences background (biomedical sciences, nursing, speech pathology, dietetics, nutrition, medical radiation, audiology, sports science, and occupational safety and health) as a measure of the students’ understanding of the bioethics subject. Findings: The challenges of bioethics teaching were divided into five categorical themes; (i) attitude/discipline, (ii) background knowledge, (iii) reasoning/critical thinking, (iv) knowledge/jargon, and (v) diverse educational background. Excellence performances were demonstrated by the students across the ten disciplines in the direct MCQs while they did very poorly (p < 0.01) in the critical thinking short essay questions. Conclusions: Bioethics proof to be a challenging subject for the health sciences students as this subject deal with complex issues of ethical concerns which differ with most science subjects. Combined efforts of the educators and students are needed in order to address these challenges and stimulate the understanding of bioethics.
Floods are known to be commonly occurring natural disasters in most part of the world. In 2014, the
east coast of Peninsular Malaysia was affected by the worst flood ever recorded in history. The worst
flood affected area were Kelantan, Terengganu and Pahang. The 2014 flood caused physical and
monetary losses amounting nearly millions of dollars. Among the worst hit infrastructures in 2014 flood
disaster were hospitals. This has led to the realization of hospital disaster preparedness and management
is important which needs to be closely monitored and addressed. This paper investigates the disaster
preparedness level of selected hospitals affected by flood disasters in Kelantan. Guided interviews with
the flood-affected hospital disaster committees were carried out and summarized in a summary table to
give a clear picture of the level of hospital disaster preparedness during the 2014 flood disaster. The
results show that despite the existence of disaster action plan and protocols there is no standard disaster
preparedness model being used by hospitals.
Introduction: USMaP-i is an English, 66-item self-administered inventory, consisting of personality
(60 items, 5 factors) and faking (one factor) components, which was mainly developed to measure
personality traits among Malaysian students based on local cultures and values. The personality
component was based on the Big Five dimensions as suggested by numerous personality researchers.
Previous exploratory studies showed promising validity, reliability and stability of USMaP-i.
Objective: To provide further validity evidence of USMaP-i for use among medical degree program
applicants by confirmatory factor analysis (CFA). Methods: Data were collected as a part of screening
of medical degree program applicants for year 2010–2013 intakes in Universiti Sains Malaysia
(USM), of which 657 cases were suitable for analyses following a data screening measures. CFA was
performed by bootstrap maximum likelihood estimation due to non-normality of items at multivariate
level. Results: Although the revised five-factor model of personality showed good model fit (X2(df) =
144.36(55), P-value < 0.001; CFI = .944, TLI = .921; RMSEA = .050; SRMR = .032, Bollen-Stine
bootstrap P-value = 0.004), the reliability of the factors is very poor (composite reliabilities (CR) =
.483 to .650). In contrast, the unidimensional faking component exhibited good model fit (X2(df)
= 14.15(5), P-value = 0.015; CFI = .984, TLI = .968; RMSEA = .053; SRMR = .011, BollenStine
bootstrap P-value = 0.068) and factor reliability (CR = 0.731). Conclusion: The personality
component should be revised and revalidated due to poor reliability, despite showing good model fit.
In contrast, the faking component showed good model fit and reliability. Further validation studies are
recommended before its use among medical degree program applicants.