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.
Suboptimal management of asthma can lead to increase morbidity and mortality. Unfortunately, this has become global issue and approximately 40% of asthmatic patients received suboptimal management in emergency department. Therefore, this study aimed to develop a tool to assess knowledge and clinical reasoning of healthcare providers on acute asthmatic management in emergency setting.
Method: The tool was developed via three phases: (a) domain identification, (b) domain blueprinting based the Global Initiative of Asthma (GINA) and the British Thoracic Society (BTS) guidelines, and (c) item generation for each domain for assessing knowledge and clinical reasoning. Three forms of validity evidence related to content, response process and internal structure were appraised. Content validity index (CVI), face validity index (FVI), and intraclass correlation coefficient (ICC) estimate the content validity, response process and internal structure of the tool.
Results: A new tool was developed, named as Knowledge and Clinical Reasoning of Acute Asthma Management in Emergency Department (K-CRAMED), which assesses knowledge and clinical reasoning on three domains related to management of acute asthma – diagnosis, treatment and disposition. CVI values for the three domains were more than 0.83. FVI values for the three domains among doctors and paramedics were at least 0.83. The ICC between scores given by emergency specialists was 0.989 (CI 95% 0.982, 0.994, p-value < 0.001).
Conclusion: The newly developed tool, named as K-CRAMED, is a valid tool to assess knowledge and clinical reasoning of healthcare providers who manage patients with acute asthma. Further validation is required to verify its validity in other setting.
Introduction: Student selection is important for selecting the best candidates into medical courses.
The Multiple Mini Interview (MMI) is a valid selection tool for the task. The School of Medical
Sciences (SMS), Universiti Sains Malaysia (USM) has employed MMI as a medical admission
tool to select potential candidates into its medical program. Objective: This paper described the
implementation of the MMI and reported the preliminary evaluation data on its validity evidence.
Method: A 9-station MMI (with 5 manned and 4 rest stations) was employed for the 2015 student
selection exercise. Interview data were analysed and questionnaire surveys were administered to both
interviewers and candidates. Validity, reliability, feasibility and acceptability were determined. Results:
Unidimensional construct on confirmatory factor analysis (CFA) and interviewer comments provided
evidence of construct validity. Overall reliability was 0.94, good enough for high-stakes decisions.
Interviewers and candidates’ comments on feasibility and acceptability were also generally positive.
The consistency of the difficulty and discrimination indices of similar stations between sessions was
identified as among the areas for improvement. Conclusions: We are cautiously optimistic regarding
the utility of the MMI in the SMS; future improvements are planned but the present implementation
seems sufficient for the stated purposes
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.
Lecturers are expected to teach effectively and evaluating their teaching effectiveness are essential to
ensure students get the best learning experience. A systematic evaluation of teaching behaviours with a
proper feedback mechanism will help to improve their teaching effectiveness. Improvement of teaching
effectiveness will result in better students’ learning experience, and thus attaining the intended
educational outcomes. This study aimed to evaluate teaching effectiveness among lecturers by
assessing their teaching behaviours during lectures. A cross-sectional study was conducted on lecturers
in a Malaysian public medical school. Their teaching behaviours were rated by 30 trained pre-clinical
medical students using Teacher Behaviour Inventory (TBI) on seven aspects – organisation, speechpacing,
clarity, enthusiasm, interaction, rapport, and disclosure. A total of 55 lecturers were rated
by the medical students. The organisation and speech-pacing aspects were highly rated as the mean
scores were 4.02 and 4.15, respectively. The clarity, enthusiasm, interaction, and rapport aspects
attained satisfactory level as the mean scores ranged from 3.10 to 3.59. The disclosure aspect was
poorly rated as the mean score was 2.20. Eventhough all lecturers in this school are considered expert
in their area, findings from this study suggest that some teaching behaviour need some improvement.
Findings from this study also provide useful data for the medical school to chart direction of faculty
development activities to improve their lecturers’ teaching effectiveness during lectures.
Educational environment is an important determinant of medical students’ behaviour. It impacts their
academic performance, motivation, and psychological well-being. Quantitative evidence have shown
that there is a decrease in the positive perception of clinical medical students towards the educational
environment. The primary focus on this study was to explore the clinical education environment
through the lived experience of clinical medical students during medical training. Using hermeneutic
phenomenology we aimed to interpret participants’ experience of personal clinical learning journey
through free text input. Thematic analysis was performed to analyse the written texts. Various
measures were taken to enhance the trustworthiness of the findings. A total of 154 (74.8%) fourth year
students and 144 (74.6%) final year students participated in the study. We identified six overarching
themes of education environment in clinical setting that are personal development, teaching and
learning, assessment for learning, facility, support and nurturing curriculum. The overlapping
relationship of the themes is illustrated in the Clinical Education Environment Framework. While
many themes were consistent with existing framework, our findings also proposed assessment as an
important component to influence perception on education environment. The themes in this study
finding conform to the definition of education environment which covers physical, social, and
psychological aspects of students learning. Medical schools should take active measures to incorporate
a nurturing education environment especially in clinical year where students struggle with the hidden
curriculum.
This paper describes a systematic and practical guide on manuscript writing. A step-by-step approach
as easy as learning ABC to facilitate authors to plan their manuscript writing. Research has shown that
experienced writers plan extensively, in which a writing plan is a road map, without it we will probably
lose our way in circles. Generally, authors start writing a manuscript by introduction, methods, results,
discussion and conclusion. However, this paper proposes a different approach to start writing a
manuscript based on the ABC of manuscript writing worksheet.
Assessment of medical professionalism is often challenged by the subjectivity of its construct and
lack of feedback practice to nurture professional growth. However transmitting professionalism alone
has not been shown to improve professional behaviour therefore professionalism need to be assessed
if it is viewed as relevant. The authors provided description and guidelines on the use of Simplified
Thematic Engagement of Professionalism Scale (STEPS) as summative and formative assessment
tool for assessing professionalism attributes. STEPS was developed based on the Professionalism
Mini-Evaluation Exercise (P-MEX) format that utilise multiple short encounter assessment and
incorporated professionalism values from a local study. The formative component has 15 attributes
that were categorised into personal, profession, patient and public. This is assessed using seven scale
rubric that promotes feedback practice using feed up, feed back and feed forward concept. The
summative component utilises global rating that will be collated longitudinally to form a more robust
evaluation of student professionalism. Current investigations are ongoing especially to ascertain the
usability and validity of STEPS as peer assessment and self-assessment tool.
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.
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.
In today’s challenging and highly complex health care settings nurses must be able to think critically.
With the current traditional and rote methods of learning, the critical thinking skills among the
students are seen to diminish. As nurse educators must find a different method in their teaching on
how to encourage students to engage in analytical thinking and how to make the analytical thinking
process part of their daily practice due to increase safety of the patients. This will give challenge for
the nurse educators to reshape education by adopting instructional strategies to equip students with
foundational knowledge in critical thinking, creative problem solving and collaboration. Through
concept mapping, students should be able to transfer applied didactic objectives from the classroom
to the clinical practice, where critical thinking and problem solving skills are needed for success. It also
provide nurse educators with the ability to help students learn how to organise data, prioritise patient
needs and can relate patient medical illness and nursing intervention.
INTRODUCTION: Stress is a particularly important issue in education because it has the potential to decline learning and performance. However, little empirical evidence about the influence of stress in nurse students’ clinical practices.
Methods: There are 346 totals of respondents for this study. Perceived Stress Scale (PSS), which have six domains of stressors and Brief COPE inventory, consisted of 28 items which measure 14 different coping styles was used. By using Likert scale in order to measure the degree of stress for each stressor. Higher mean score indicates higher degree of stress.
Results: In this study, stress from clinical assignments and workload was the most stressful having by nursing students (Mean = 3.19, SD = 1.09). Among the 14 types of coping strategies, religion was the most frequently used, religion (Mean = 3.30, SD = 0.71).
Conclusion: The results provided valuable information for nurse educators, clinical educators and clinical staff in identifying students’ needs, facilitating their learning in the clinical setting and developing effective interventions to reduce the stress. Therefore it is important, especially nursing students can handle the pressure because it will affect the level of achievement in academic and thereby affecting student skills in the field of clinical nursing. And this affects the care of patients.
The Delphi technique is a widely used and accepted method for gathering data from participantswithin domain of expertise. The objective of this study is to discuss the process of the three roundsDelphi technique in seeking a consensus of concept mapping structure and Multiple Choice Questions(MCQ) in Diabetic Mellitus subject. In the first, round, participants were given a structuredquestionnaire regarding item of concept mapping structure and MCQ in Diabetic Mellitus subject.The second were added mean and median value of round one. In the third round were add meanand median value of round two were added. Participants were asked to rate the categorised responsesfrom Round 1 on a scale of 1 to 5, with 1 being “Very irrelevant” and 5 being “Very relevant”. Thistechnique does not require participants to meet face-to-face, thereby making it useful to conductsurveys with qualified people over a wide geographic area. The feedback process allows and encouragesthe selected Delphi participants to reassess their initial judgements about the information providedin previous iterations. Data is then analysed to check for consistency of experts’ responses betweenrounds. Instrument developed from the Delphi technique research findings is also examined forvalidation from experts in educational medical health sciences on content and constructs validity.Analysis on the consensus of data from experts was based on median, inter quartile range and quartiledeviation on Round 1, 2 and 3 data. Therefore, the Delphi technique is an appropriate method foridentifying significant issues related with academic.
Introduction: In Malaysian nursing education, concept mapping is not widely practiced among nurse
educators and students. Therefore, the researcher aims to develop and evaluate the impact of the
Rusnani Concept Mapping (RCM) protocol on academic achievement and clinical practices among
diploma nursing students. RCM is one of the teaching learning methods that specifies guidelines for
nurse educators to harmonise classroom and clinical setting methods. Method: RCM is a concept
mapping protocol guideline developed by the researcher and is validated with content and face validity
and the Delphi technique. The study design is quasi-experimental with two groups. The experimental
and control groups received education using RCM and the lecture method, respectively. Data were
analysed using descriptive and inferential statistics using paired t-tests. P values less than 0.05 were
interpreted as significant. Results: In the pre-test, the students taught using RCM had a mean
achievement score of 11.23 with and SD = 2.59, while at post-test, the mean achievement score was
13.19 with and SD = 1.71 and a mean gain score of 1.96. In contrast, students taught using lecture
method had a mean achievement score of 10.71 and SD = 2.23 in the pre-test and a mean score of
12.60, SD = 1.64 in post-test achievement with a mean gain score of 1.89. The post-test scores of the
experimental and control group were significantly different (t = 2.53, p < 0.05). The mean concept
mapping care plan score was 59.33 and 65.23, respectively, for the control group and experimental
group. The paired t-test revealed that there was a significant difference between experimental and
control groups, p value < 0.05. The result of students’ perceptions regarding concept mapping in the
experimental group showed as positive moderate with a mean score of 3.44. Conclusion: This study
provides additional evidence that RCM is instructionally valuable as a learning method and is an active
learning strategy for meaningful learning and motivating superior achievement in students.
The Delphi technique is a widely used and accepted method to obtain consensus among the
experts. This technique uses a judgement to prove the accuracy of the content item when evaluating
instrument. The objective of this study is to discuss the process of the three rounds Delphi technique
to obtain consensus of concept mapping care plan and multiple choice questions (MCQ) in Diabetic
Mellitus subject. In the first round, participants were given a structured questionnaire regarding item
of concept mapping care plan and MCQ in Diabetic Mellitus subject. In the second round, the mean
and median values of round one were added. In the third round, the mean and median values of round
two were added. Participants were asked to rate the categorised responses from Round 1 on a scale of
1 to 5, with 1 being “Very Irrelevant” and 5 being “Very Relevant”. This technique does not require
that participants be collocated or meet face-to-face, thereby making it useful to conduct surveys
with qualified people over a wide geographic area. The feedback process allows and encourages the
selected Delphi participants to reassess their initial judgements about the information provided in
previous iterations. The analysis of consensus data of the experts was done based on median, inter
quartile range and quartile deviation on round one, two and three data. The median score was used to
analyse the level of consensus of experts and result shows that in all three rounds Delphi the medium
result more than 4. It reported that level of importance of the statements were high. As a conclusion,
the concept mapping care plan and MCQ have meets the consensus by using three rounds of Delphi
techniques. Therefore, the Delphi technique is the best method to obtain consensus in health care
education research.
Introduction: Concept mapping is an innovative teaching learning strategy for students who have
the ability to develop concept maps. A planned and well-developed concept mapping protocol is
needed, so that nursing educators have a teaching guideline, enabling them to improve their teaching
techniques through concept mapping. Therefore, the researcher seeks to develop and validate the
impact of the Rusnani Concept Mapping (RCM) protocol guideline for application among nursing
students. Objectives: To develop, validate, and test the reliability of the RCM protocol guideline.
Methods: The development of RCM based on Mohd Afifi Learning model (MoAFF), ADDIE model
and integrating with Kemp model. This model protocol has five phases: analysis, design, development,
implementation and evaluation. The validity of the protocol was determined based on content and
face validity and the Delphi technique. The content validity of this lesson plan was established through
expert review, involving seven expert panels. Results: After obtaining feedback from the expert panel,
the researcher analysed content validity, using a formula based on percentages. This formula suggested
that good content validity is indicated by a percentage of content validity achievement greater than
70%, whereas if the percentage of content validity is below 70%, it is advisable to recheck the content,
according to the study objective. Conclusion: The reliability of the protocol was 0.816, showing that
the RCM protocol has high reliability and validity. RCM is thus a positive and innovative teaching
method that could be helpful in improving the academic performance of nursing students.
The ultimate aim of faculty development programmes (FDPs) is to boost teachers’ competence in their journey of becoming a respectable educator. It takes place when a faculty member joins such activity with a hope of cultivating their knowledge and skills in desired areas such as pedagogy, research, motivation, and administration. However, to design the best practices of FDPs, it needs a great deal of consideration on numerous factors. This paper discusses principles of the best practice in FDPs, challenges and its solutions, its impacts on professional identity, and finally highlights the future trend of FDPs. Since it is beneficial in fostering professionalism of a faculty member, it is important for school administrators to address FDPs as a prominent agenda in seeking a professional medical teacher.
Introduction: Medical school expected to be a time of personal development, achievement, and well-being. However, research shows that there are many negative effects on students’ mental health due to the current educational process. Objective: This research aimed to determine the prevalence and risk factors of depression, anxiety, and stress among medical students of a private medical university in Malaysia. Method: Cross sectional study was conducted using self-administered questionnaires including socio-demographic factors, DASS-21 and MSSQ-40 questionnaires. Result: Prevalence of stress, anxiety, and depression were 46.9%, 76.2% and 60.2% respectively. Multiple logistic regression analysis showed that academic related stressors were only associated with stress [adjusted OR 1.78, 95% CI (1.23, 2.58), p=0.002]. Group activities related stressors were significantly associated with stress [adjusted OR=1.45, 95%CI (1.20, 1.75), p