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Intellectual development of Malaysian medical students: a follow-up study

Coomaraswamy SD

Br J Med Educ, 1974 Sep;8(3):187-91.
PMID: 4421860
Matched MeSH terms: Education, Medical, Undergraduate*
Fulltext Using Kahoot! as a formative assessment tool in medical education: a phenomenological study

Ismail MA, Ahmad A, Mohammad JA, Fakri NMRM, Nor MZM, Pa MNM

BMC Med Educ, 2019 Jun 25;19(1):230.
PMID: 31238926 DOI: 10.1186/s12909-019-1658-z

BACKGROUND: Gamification is an increasingly common phenomenon in education. It is a technique to facilitate formative assessment and to promote student learning. It has been shown to be more effective than traditional methods. This phenomenological study was conducted to explore the advantages of gamification through the use of the Kahoot! platform for formative assessment in medical education.
METHODS: This study employed a phenomenological design. Five focus groups were conducted with medical students who had participated in several Kahoot! sessions.
RESULTS: Thirty-six categories and nine sub-themes emerged from the focus group discussions. They were grouped into three themes: attractive learning tool, learning guidance and source of motivation.
CONCLUSIONS: The results suggest that Kahoot! sessions motivate students to study, to determine the subject matter that needs to be studied and to be aware of what they have learned. Thus, the platform is a promising tool for formative assessment in medical education.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Teaching of pharmacology in Universiti Malaya and the other medical schools in Malaysia -- a historical perspective

Sim SM

Acta Pharmacol Sin, 2004 Sep;25(9):1209-19.
PMID: 15339399

Traditional pharmacology teaching has focused more on drug instead of therapeutics, such that although pharmacological knowledge is acquired, practical skills in prescribing remain weak. In Malaysia many new medical schools (both public and private) have been set up in the last 12 years due to a change in government policy, resulting in a wide spectrum of medical curricula. Universiti Malaya (UM) being the oldest medical school in Malaysia was deep set in its traditional way of teaching-learning, since its inception in 1962, until a visit from the General Medical Council of the United Kingdom in 1984 triggered off a change of tide. Since then the medical curriculum in UM has undergone two major revisions. The first revised curriculum (1988) aimed to inject more clinical relevance into basic science teaching, through introducing clinical lectures and skills in the paraclinical year. Professional behaviour was also addressed. The second revised curriculum (1998) sought to improve further the integration of knowledge as well as to produce a holistic doctor, viewing the patient as a person instead of a clinical entity. The teaching-learning of pharmacology has gradually moved from factual regurgitation to more clinical reasoning, from lab-based to more patient-oriented approach. As more new medical schools are being set up in Malaysia, exchange of experience in this area of learning will hopefully help us find a happy medium between "the old is best" and "the new is better" type approach so that a pedagogically sound and yet logistically practical curriculum can be found in our local setting, to help produce doctors with good prescribing practice.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
The impact of stressors on the learning outcome of high-fidelity patient simulation in undergraduate medical students

Nachiappan M, Bikramjit P, Aung WT, Htoo HKS, Sudipta P

Med J Malaysia, 2020 05;75(3):209-215.
PMID: 32467534

INTRODUCTION: Simulation of the clinical setting incorporates an educational approach connecting a learner to a particular environment of learning. Undergraduate students in the health sector experience anxiety during simulation that influences their performance which ultimately affects their learning outcome. This study attempts to correlate the impact of stressors on learning outcome of high-fidelity patient simulation (HFPS) in undergraduate medical education.
OBJECTIVE: This research is to analyze the impact of stressors and its relevance on the learning outcome of HFPS as a teaching-learning tool for the management of emergency surgical conditions including trauma.
MATERIALS AND METHODS: This study is a Quasi-experimental time series design. A total number of 347 final-year undergraduate (MBBS) students of Melaka-Manipal Medical College, Malaysia. They were grouped and assessed individually by pre-test and post-tests on their knowledge, performance and associated stressor scores. The one-way repeated measure of Analysis of Variance (ANOVA) was used to determine the statistically significant differences in total score at pre-test simulation and post-test-simulation sessions. Friedman test was used for assessment of individual components of stressors. Pre-test and post-tests scores were compared to note progress in confidence and stress reduction. P value <0.001 was considered statistically significant.
RESULTS: ANOVA with Bonferroni post hoc analysis showed a statistically significant (p <0.001) difference in stressor score over time. The drop-in stress was significant initially but flattened out later.
CONCLUSION: Stress significantly decreased as the students were exposed to more sessions of HFPS which ultimately translated into better learning outcome.

Matched MeSH terms: Education, Medical, Undergraduate*
Fulltext The first graduates in 1910

Cheah JS, Ho TM, Ng BY

Ann Acad Med Singap, 2005 Jul;34(6):19C-24C.
PMID: 16010376

The Medical School in Singapore was founded on 3 July 1905 and named the Straits and Federated Malay States Government Medical School. There were 23 students in the first enrollment; 16 students attended the full course, while 7 attended a 2-year course for hospital assistants. The pioneer group of 7 that graduated in May 1910 (the Magnificent Seven) consisted of Drs Chen Su Lan, Edwin Williborod deCruz, and John Gnanapragasam from Singapore; Drs Willie Carnegie and Mark W Chill from Penang; Dr SR Krishnan from Seramban and Dr John Scott Lee from Ipoh. In December 1910, a further 6 students graduated. Of this first batch of 13 graduates in 1910, we describe the careers of 6; no records exist of the remaining 7.

Matched MeSH terms: Education, Medical, Undergraduate/history*
Fulltext Prevalence, reasons, and determinants of dietary supplements use among undergraduate female students of health and non-health colleges in a Saudi public university

Islam MA, Al-Karasneh AF, Rizvi M, Nisa ZU, Albakheet AM, Alshagawi MA, et al.

PLoS One, 2021;16(3):e0247295.
PMID: 33657129 DOI: 10.1371/journal.pone.0247295

PURPOSE: The aim of this study was to gather data from female students studying in both health and non-health colleges at Imam Abdulrahman Bin Faisal University and report the prevalence, reasons, and determinants of dietary supplements use.
METHODS: A month-long cross-sectional study was conducted in health and non-health colleges affiliated to Imam Abdulrahman Bin Faisal University in Dammam, Saudi Arabia. Convenient sampling was employed, and the data was gathered through an online survey using the English and Arabic versions of the Dietary Supplement Questionnaire (DSQ). The data was analyzed using SPSS version 23 and Medcalc. The study was approved by an ethics committee.
RESULTS: Data from 545 participants was collected. The overall prevalence of dietary supplement use was 32.7% (95% CI: 29.06%- 36.51%). The prevalence was 29.77% (95% CI: 25.29%- 34.56%) among students at all health colleges combined and, it was 37.50% (95% CI: 31.36%- 43.96%) among students at all non-health colleges. Most students used a brand product, spent a monthly cost of SAR 286 (USD 76.3) on supplements and agreed that supplements were good for health (N = 392, 71.9%). Students from non-health- colleges agreed that dietary supplements are good for health in greater numbers as compared to non-health college students (p < 0.001). Students aged ≥ 20 years, studying in a non-health college and up to 3rd year of study, were more 2 times more likely to agree that dietary supplements are good for health.
CONCLUSION: Supplements were commonly used among female students at this university however, it was quite low as compared to students from other local and regional universities. Prevalence was higher in non-health colleges as compared to health colleges and the most commonly used supplements were brand products and, multivitamins, used for general health and well-being. This highlights the inclination of students towards supplement use.

Matched MeSH terms: Education, Medical, Undergraduate*
The missing link: introducing travel medicine into the undergraduate medical curriculum

Flaherty G, Thong Zi Yi C, Browne R

J Travel Med, 2016 May;23(5).
PMID: 27378364 DOI: 10.1093/jtm/taw038
Matched MeSH terms: Education, Medical, Undergraduate/methods*
Ethical Concerns When Minors Act as Standardized Patients

Khoo EJ, Schremmer RD, Diekema DS, Lantos JD

Pediatrics, 2017 Mar;139(3).
PMID: 28174202 DOI: 10.1542/peds.2016-2795

When minors are asked to assist medical educators by acting as standardized patients (SPs), there is a potential for the minors to be exploited. Minors deserve protection from exploitation. Such protection has been written into regulations governing medical research and into child labor laws. But there are no similar guidelines for minors' work in medical education. This article addresses the question of whether there should be rules. Should minors be required to give their informed consent or assent? Are there certain practices that could cause harm for the children who become SPs? We present a controversial case and ask a number of experts to consider the ethical issues that arise when minors are asked to act as SPs in medical education.

Matched MeSH terms: Education, Medical, Undergraduate/ethics*
Medical sociology in the undergraduate medical curriculum in Malaysia

Chen PC

Br J Med Educ, 1972 Dec;6(4):323-4.
PMID: 4664477
Matched MeSH terms: Education, Medical, Undergraduate*
Medical student knowledge and critical appraisal of machine learning: a multicentre international cross-sectional study

Blacketer C, Parnis R, B Franke K, Wagner M, Wang D, Tan Y, et al.

Intern Med J, 2021 Sep;51(9):1539-1542.
PMID: 34541769 DOI: 10.1111/imj.15479

To utilise effectively tools that employ machine learning (ML) in clinical practice medical students and doctors will require a degree of understanding of ML models. To evaluate current levels of understanding, a formative examination and survey was conducted across three centres in Australia, New Zealand and the United States. Of the 245 individuals who participated in the study (response rate = 45.4%), the majority had difficulty with identifying weaknesses in model performance analysis. Further studies examining educational interventions addressing such ML topics are warranted.

Matched MeSH terms: Education, Medical, Undergraduate*
Educational environments in Asian medical schools: A cross-national comparison between Malaysia, Singapore, and China

Arokiamary B, Russell V, Lim HA, Koay JM, Xia J, Zhao XH, et al.

Asia Pac Psychiatry, 2021 Jun;13(2):e12454.
PMID: 33646626 DOI: 10.1111/appy.12454

INTRODUCTION: Perceptions of the educational environment (EE) represent an important source of information on medical students' learning experience. Understanding and addressing these perceptions can help inform initiatives designed to improve the learning experience and educational outcomes, while comparison of student perceptions across medical schools can provide an added perspective. The aim of the study was to compare the EEs of three Asian medical schools: Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Yong Loo Lin School of Medicine, Singapore and Xiangya School of Medicine, China.
METHODS: Medical students in the clinical years (N = 1063) participated in a cross-sectional study using the Dundee Ready Educational Environment Measure (DREEM). Data were analyzed using SPSS version 22.
RESULTS: There were significant differences between the three medical schools in the total DREEM scores (F [2, 1059] = 38.29, p

Matched MeSH terms: Education, Medical, Undergraduate*
Fulltext Extramural training of medical students: lessons from Southeast Asia

Smilkstein G

J Fam Pract, 1977 May;4(5):873-6.
PMID: 864412

Several medical schools in Southeast Asia have identified deficiencies in their undergraduate medical education that result in inappropriate training of students for the health-care problems that exist in their respective countries. Curriculum changes have been made that take students out of the laboratory and the subspecialty-oriented university hospital and place them in extramural programs in the community. Both the deficiencies identified and the solutions developed merit study by North American medical educators, especially those teaching primary care in family practice.

Matched MeSH terms: Education, Medical, Undergraduate*
Fulltext Pathology crossword competition: an active and easy way of learning pathology in undergraduate medical education

Htwe TT, Sabaridah I, Rajyaguru KM, Mazidah AM

Singapore Med J, 2012 Feb;53(2):121-3.
PMID: 22337187

INTRODUCTION:
In line with the trend to engage students in active learning, it is imperative to introduce new strategies that make learning more interesting, especially in undergraduate curricula. This study aimed to determine students' performance and perception in pathology crosswords as an active way of learning and to assess their ability to memorise difficult terms in pathology.

METHODS:
A crossword competition in pathology was conducted for two batches (year 2009 and 2010) of Phase 2 medical students in Malaysia. Crossword puzzles were prepared using an online application. Two sets of puzzles were prepared, with 20 questions for the assessment of general pathology and 20 for systemic pathology. The purpose was to compare the students' recent and remote memorising abilities, as general pathology was taught a year before proceeding to systemic pathology teaching. There were 12 groups per batch, with 8-10 students in a group. Survey questionnaires were used to assess the students' perception of the competition. Descriptive analysis was performed for comparison of performance.

RESULTS:
The mean score of correctly answered questions in general pathology was 12.75 and 11.50 in batch 2009 and 2010, respectively. The mean score for systemic pathology was 14.50 in 2009 and 13.83 in 2010. Students in the 2009 batch performed better, but this was not statistically significant (p-value > 0.05). A positive response was observed from the questionnaires.

CONCLUSION:
Applying crossword puzzles as a new strategy is a useful and easy way for undergraduate medical students to learn pathology.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext The product of outcome-based undergraduate medical education: competencies and readiness for internship

Lai NM, Ramesh JC

Singapore Med J, 2006 Dec;47(12):1053-62.
PMID: 17139402

INTRODUCTION: Outcome-based curriculum is adopted at the International Medical University (IMU), Malaysia, where specific learning objectives are laid out progressively under eight major outcomes. We present an outcome-guided, self-reported competency profile of our undergraduate students near the end of their training, focusing on elements that are considered most immediately relevant for their internship.
METHODS: Anonymous surveys were conducted on two cohorts of medical students in their final semester at IMU. The surveys covered a range of competencies, including practical skills, ward routines, generic attributes and evidence-based medicine, grouped under the exit outcomes as defined by the university.
RESULTS: A total of 92 students were assessed. In general, the students were confident of their ability on common practical skills and ward routines. They were comfortable with the level of professionalism and personal attributes required for internship, with the prospect of handling unexpected additional tasks and working away from home perceived as the main difficulties. Most students referred to at least three sources of clinical information to answer their clinical queries. However, they referred more to single journals than databases or collections. The majority could critically appraise journal articles to a variable extent, but nearly half took 30 minutes or longer to trace an abstract of interest.
CONCLUSION: This report demonstrates the strength of outcome-based curriculum in its ability to produce competent students that are well prepared for their internship. Assessing students using this educational approach provides a clear picture of their strengths and weaknesses, and identifies stages in their training where additional inputs are required.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Answering questions in a co-created formative exam question bank improves summative exam performance, while students perceive benefits from answering, authoring, and peer discussion: A mixed methods analysis of PeerWise

Guilding C, Pye RE, Butler S, Atkinson M, Field E

Pharmacol Res Perspect, 2021 Aug;9(4):e00833.
PMID: 34309243 DOI: 10.1002/prp2.833

Multiple choice questions (MCQs) are a common form of assessment in medical schools and students seek opportunities to engage with formative assessment that reflects their summative exams. Formative assessment with feedback and active learning strategies improve student learning outcomes, but a challenge for educators, particularly those with large class sizes, is how to provide students with such opportunities without overburdening faculty. To address this, we enrolled medical students in the online learning platform PeerWise, which enables students to author and answer MCQs, rate the quality of other students' contributions as well as discuss content. A quasi-experimental mixed methods research design was used to explore PeerWise use and its impact on the learning experience and exam results of fourth year medical students who were studying courses in clinical sciences and pharmacology. Most students chose to engage with PeerWise following its introduction as a noncompulsory learning opportunity. While students perceived benefits in authoring and peer discussion, students engaged most highly with answering questions, noting that this helped them identify gaps in knowledge, test their learning and improve exam technique. Detailed analysis of the 2015 cohort (n = 444) with hierarchical regression models revealed a significant positive predictive relationship between answering PeerWise questions and exam results, even after controlling for previous academic performance, which was further confirmed with a follow-up multi-year analysis (2015-2018, n = 1693). These 4 years of quantitative data corroborated students' belief in the benefit of answering peer-authored questions for learning.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext E-Learning in Teaching Emergency Disaster Response Among Undergraduate Medical Students in Malaysia

Saiboon IM, Zahari F, Isa HM, Sabardin DM, Robertson CE

Front Public Health, 2021;9:628178.
PMID: 33996711 DOI: 10.3389/fpubh.2021.628178

Introduction: Teaching disaster response medicine (DRM) to medical students requires considerable resources. We evaluate the effectiveness of e-learning in teaching emergency disaster response (ELITE-DR), a novel initiative, in educating medical students of the cognitive aspect of DRM. Methods: A prospective cross-sectional study among pre-clinical year medical students was carried out to determine their knowledge on DRM and perception regarding the ELITE-DR initiative using a validated online questionnaire. A three-part self-learning video covering the principles and medical management of DRM were distributed before answering the questionnaire served as the training. Results: A total of 168 students participated in the study. Their overall knowledge showed a significant increase in between pre-and-post-interventions. Recall and simple decision-making knowledge aspects were better than complex decision-making knowledge. It appeared that participants assimilate knowledge better from visual rather than audio stimuli. Participants with high perception-scores demonstrated better knowledge-scores. However, e-learning was not preferred as a substitute for face-to-face (F2F) teaching. Conclusion: ELITE-DR shows promise in teaching DRM. Simple recall and comprehension levels of knowledge were well-served through this technique. However, for more complex decision-making knowledge, a different approach might be required. ELITE-DR offers flexibility, accessibility, and personalized learning. The content presentation is improved by using several different visual stimuli. This approach is useful for cognitive aspect learning, but it should not replace standard F2F teaching.

Matched MeSH terms: Education, Medical, Undergraduate*
Fulltext Validating the effectiveness of Clinically Oriented Physiology Teaching (COPT) in undergraduate physiology curriculum

Abraham R, Ramnarayan K, Kamath A

BMC Med Educ, 2008 Jul 24;8:40.
PMID: 18652649 DOI: 10.1186/1472-6920-8-40

BACKGROUND: It has been proved that basic science knowledge learned in the context of a clinical case is actually better comprehended and more easily applied by medical students than basic science knowledge learned in isolation. The present study intended to validate the effectiveness of Clinically Oriented Physiology Teaching (COPT) in undergraduate medical curriculum at Melaka Manipal Medical College (Manipal Campus), Manipal, India.
METHODS: COPT was a teaching strategy wherein, students were taught physiology using cases and critical thinking questions. Three batches of undergraduate medical students (n = 434) served as the experimental groups to whom COPT was incorporated in the third block (teaching unit) of Physiology curriculum and one batch (n = 149) served as the control group to whom COPT was not incorporated. The experimental group of students were trained to answer clinically oriented questions whereas the control group of students were not trained. Both the group of students undertook a block exam which consisted of clinically oriented questions and recall questions, at the end of each block.
RESULTS: Comparison of pre-COPT and post-COPT essay exam scores of experimental group of students revealed that the post-COPT scores were significantly higher compared to the pre-COPT scores. Comparison of post-COPT essay exam scores of the experimental group and control group of students revealed that the experimental group of students performed better compared to the control group. Feedback from the students indicated that they preferred COPT to didactic lectures.
CONCLUSION: The study supports the fact that assessment and teaching patterns should fall in line with each other as proved by the better performance of the experimental group of students compared to the control group. COPT was also found to be a useful adjunct to didactic lectures in teaching physiology.

Matched MeSH terms: Education, Medical, Undergraduate*
Pattern of answer changes to multiple choice questions in physiology

Shahabudin SH

Med Educ, 1983 Sep;17(5):316-8.
PMID: 6621433

The belief that it is unwise to alter the initial response to a multiple choice question is questioned. Among 39 380 MCQ responses, there were 1818 changes (4.62%) of which 21.9% were correct to incorrect responses, 46.3% incorrect to correct responses and 31.8% incorrect to incorrect. This effect was very much more marked among the better students, incorrect to correct changes accounting for 61% of the responses in the upper group, 42% in the middle group and 34% in the lower group.

Matched MeSH terms: Education, Medical, Undergraduate
Fulltext Determining the impact of pre-lecture educational video on comprehension of a difficult gross anatomy lecture

Hadie SNH, Simok AA, Shamsuddin SA, Mohammad JA

J Taibah Univ Med Sci, 2019 Aug;14(4):395-401.
PMID: 31488974 DOI: 10.1016/j.jtumed.2019.06.008

Objective: Students commonly perceive gross anatomy lectures as difficult because they contain complex information that requires three-dimensional visualisation in order to be understood. Without prior preparation, a gross anatomy topic expounded via lecture can be cognitively challenging. Hence, this study aimed to investigate the impact of a pre-lecture activity in the form of viewing a video on students' lecture comprehension.
Method: A quasi-experimental study was conducted using 254 first-year medical students with no prior exposure to the lecture topic during the 2016/17 and 2017/18 academic sessions. The students from each batch were divided into two groups and exposed to different video material. Group A watched an action movie, while Group B watched an educational video related to the lecture topic. After 15 min, both groups attended a lecture on the gross anatomy of the heart, which was delivered by a qualified anatomist. At the end of the lecture, their understanding of the material was measured through a post-lecture test using ten vetted multiple choice true/false questions.
Results: Group B's test scores were found to be significantly higher than Group A's (p > 0.001, t-stats [df] = -4.21 [252]).
Conclusion: This study concluded that the pre-lecture activity had successfully provided the students with some prior knowledge of the subject before they attended the lecture sessions. This finding was aligned with cognitive load theory, which describes a reduction in learners' cognitive load when prior knowledge is stimulated.

Matched MeSH terms: Education, Medical, Undergraduate
Fulltext Descriptive study on the medical students well-being workshop

Yusoff MSB, Abdul Rahim AF

Education in Medicine Journal, 2009;1(1):1-6.
MyJurnal

Background: Tertiary education environment has always been regarded as highly stressful to students. Medical training further adds to the already stressful environment. The stress of medical training was associated with negative consequences to the mental and physical health of medical students. We describe in this article a stress-management program known as the 'Medical Student Well-Being Workshop' in our medical school.

Methodology: The workshop was run over two half-days over a weekend. Prior to the workshop the society announced the workshop to the students and participation was voluntary. It was open to students from all years of the medical course except for first year students. A separate stress management workshop is planned for them.

Results: A total of 55 students participated in the workshop, out of which 55 (82%) were female students. The years of study were almost equally represented; 14 students (26%) from years two and three, 20 (37%) from year four and 6 (11%) from year five. All sessions were rated as highly useful; the lowest rated, the introduction session, obtained an overall usefulness rating of 3.73 out of the possible 5 (74.6%).

Conclusion: Medical Students Well-being Workshop is a promising intervention program in improving medical students' ability in managing stress. Perhaps similar approach can be considered relevant to be incorporated in other medical schools.

Matched MeSH terms: Education, Medical, Undergraduate

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