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Fulltext Test anxiety: state, trait and relationship with exam satisfaction

Ping LT, Subramaniam K, Krishnaswamy S

Malays J Med Sci, 2008 Apr;15(2):18-23.
PMID: 22589620

Test anxiety is defined as the reaction to stimuli that is associated with an individual's experience of testing or evaluating situations. This study aims to examine the fluctuation pattern of anxiety symptoms during a clinical examination and its relationship with underlying anxiety traits. Fourth year medical students of Penang Medical College undertaking the Ophthalmology clinical examination participated in this study. First phase of the survey, on anxiety symptoms was conducted immediately after the Ophthalmology clinical examination while the second phase, on pre-existing anxiety traits was conducted six weeks later with the aid of STAI instrument. Responses for both stages were combined and analyzed. Sixty-three of 122 students responded to both phases of the study, giving a response rate of 52%. All symptoms except trembling peaked 10 minutes before the exam begun showing a downward progression with no resurgence thereafter. Students with pre-existing anxiety traits had high anxiety scores 10 minutes into the examination and while with the examiners. Anticipatory anxiety is a source of concern and can effect performance and appropriate steps should be taken to help the students with this. A few other studies should be done to conclude.

Matched MeSH terms: Students, Medical
Fulltext A Study of Psychological Distress in Two Cohorts of First-Year Medical Students that Underwent Different Admission Selection Processes

Yusoff MS, Rahim AF, Baba AA, Ismail SB, Esa AR

Malays J Med Sci, 2012 Jul;19(3):29-35.
PMID: 23610547 MyJurnal

Medical training is often regarded as a stressful period. Studies have previously found that 21.6%-50% of medical students experience significant psychological distress. The present study compared the prevalence and levels of psychological distress between 2 cohorts of first-year medical students that underwent different admission selection processes.

Matched MeSH terms: Students, Medical
Fulltext Factor Structure and Reliability of the Malay Version of the Perceived Stress Scale among Malaysian Medical Students

Al-Dubai SA, Alshagga MA, Rampal KG, Sulaiman NA

Malays J Med Sci, 2012 Jul;19(3):43-9.
PMID: 23785249 MyJurnal

BACKGROUND: The Perceived Stress Scale 10 (PSS-10) is a validated and reliable instrument to measure global levels of perceived stress. This study aims to assess the internal consistency, reliability, and factor structure of the Malay version of the PSS-10 for use among medical students.
METHODS: The original English version of the PSS-10 was translated and back-translated into Malay language. The Malay version was distributed to 242 Bachelor of Medical Science students in a private university in Malaysia. Test-retest reliability was assessed in 70 students. An exploratory principal component factor analysis with varimax rotation was performed. Reliability was tested using the intraclass correlation coefficient (ICC).
RESULTS: All 242 students participated in the initial questionnaire study (validity and factor structure), and 70 students participated in the test-retest reliability of the study. Exploratory factor analysis yielded 2 factors that accounted for 57.8% of the variance. Cronbach's alpha coefficients for the 2 factors were 0.85 and 0.70, respectively. The reliability test showed an ICC of 0.82 (95% CI: 0.70, 0.89).
CONCLUSION: The Malay version of the PSS-10 showed adequate psychometric properties. It is a useful instrument for measuring stress among medical students in Malaysia.
KEYWORDS: Malaysia; medical; psychological; reliability and validity; stress; students

Matched MeSH terms: Students, Medical
Fulltext Interactions between students and tutor in problem-based learning: the significance of deep learning

Azer SA

Kaohsiung J. Med. Sci., 2009 May;25(5):240-9.
PMID: 19502144 DOI: 10.1016/S1607-551X(09)70068-3

Problem-based learning (PBL) is an excellent opportunity for students to take responsibility for their learning and to develop a number of cognitive skills. These include identifying problems in the trigger, generating hypotheses, constructing mechanisms, developing an enquiry plan, ranking their hypotheses on the basis of available evidence, interpreting clinical and laboratory findings, identifying their learning needs, and dealing with uncertainty. Students also need to work collaboratively in their group, communicate effectively, and take active roles in the tutorials. Therefore, interaction in the group between students and their tutor is vital to ensure deep learning and successful outcomes. The aims of this paper are to discuss the key principles for successful interaction in PBL tutorials and to highlight the major symptoms of superficial learning and poor interactions. This comprises a wide range of symptoms for different group problems, including superficial learning. By early detection of such problems, tutors will be able to explore actions with the group and negotiate changes that can foster group dynamics and enforce deep learning.

Matched MeSH terms: Students, Medical/psychology*
Fulltext Use of portfolios by medical students: significance of critical thinking

Azer SA

Kaohsiung J. Med. Sci., 2008 Jul;24(7):361-6.
PMID: 18805751 DOI: 10.1016/S1607-551X(08)70133-5

Portfolios have been used in the medical curriculum to evaluate difficult-to-assess areas such as students' attitudes, professionalism and teamwork. However, their use early in a problem-based learning (PBL) course to foster deep learning and enhance students' self-directed learning has not been adequately studied. The aims of this paper are to: (1) understand the uses of portfolios and the rationale for using reflection in the early years of a PBL curriculum; (2) discuss how to introduce portfolios and encourage students' critical thinking skills, not just reflection; and (3) provide students with tips that could enhance their skills in constructing good portfolios.

Matched MeSH terms: Students, Medical/psychology*
Incidence of meticillin-resistant Staphylococcus aureus contamination on mobile phones of medical students

Goh ZNL, Chung PY

J Hosp Infect, 2019 Apr;101(4):482-483.
PMID: 30711530 DOI: 10.1016/j.jhin.2019.01.022
Matched MeSH terms: Students, Medical*
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: Students, Medical
Student-involved demonstration approach to teach the physiology of vestibular apparatus for undergraduate medical students

Narayanan SN, Kumar RS, Nayak S

Teach Learn Med, 2011 Jul-Sep;23(3):269-77.
PMID: 21745063 DOI: 10.1080/10401334.2011.586930

It is quite difficult to teach complex topics like the physiology of vestibular apparatus to undergraduate students. Understanding the orientation and mode of stimulation of receptors in vestibular apparatus is also quite challenging for the students. As faculty we attempt to use innovative methods to teach physiology and enhance student learning.

Matched MeSH terms: Students, Medical*
Anatomy learning styles and strategies among Jordanian and Malaysian medical students: the impact of culture on learning anatomy

Mustafa AG, Allouh MZ, Mustafa IG, Hoja IM

Surg Radiol Anat, 2013 Jul;35(5):435-41.
PMID: 23292088 DOI: 10.1007/s00276-012-1067-z

The study aims to investigate anatomy learning styles and strategies of Jordanian and Malaysian medical students at the Jordan University of Science and Technology.

Matched MeSH terms: Students, Medical
Fulltext Self-reported tobacco smoking practices among medical students and their perceptions towards training about tobacco smoking in medical curricula: A cross-sectional, questionnaire survey in Malaysia, India, Pakistan, Nepal, and Bangladesh

Sreeramareddy CT, Suri S, Menezes RG, Kumar HN, Rahman M, Islam MR, et al.

Subst Abuse Treat Prev Policy, 2010;5:29.
PMID: 21080923 DOI: 10.1186/1747-597X-5-29

BACKGROUND: Tobacco smoking issues in developing countries are usually taught non-systematically as and when the topic arose. The World Health Organisation and Global Health Professional Student Survey (GHPSS) have suggested introducing a separate integrated tobacco module into medical school curricula. Our aim was to assess medical students' tobacco smoking habits, their practices towards patients' smoking habits and attitude towards teaching about smoking in medical schools.
METHODS: A cross-sectional questionnaire survey was carried out among final year undergraduate medical students in Malaysia, India, Nepal, Pakistan, and Bangladesh. An anonymous, self-administered questionnaire included items on demographic information, students' current practices about patients' tobacco smoking habits, their perception towards tobacco education in medical schools on a five point Likert scale. Questions about tobacco smoking habits were adapted from GHPSS questionnaire. An 'ever smoker' was defined as one who had smoked during lifetime, even if had tried a few puffs once or twice. 'Current smoker' was defined as those who had smoked tobacco product on one or more days in the preceding month of the survey. Descriptive statistics were calculated.
RESULTS: Overall response rate was 81.6% (922/1130). Median age was 22 years while 50.7% were males and 48.2% were females. The overall prevalence of 'ever smokers' and 'current smokers' was 31.7% and 13.1% respectively. A majority (> 80%) of students asked the patients about their smoking habits during clinical postings/clerkships. Only a third of them did counselling, and assessed the patients' willingness to quit. Majority of the students agreed about doctors' role in tobacco control as being role models, competence in smoking cessation methods, counseling, and the need for training about tobacco cessation in medical schools. About 50% agreed that current curriculum teaches about tobacco smoking but not systematically and should be included as a separate module. Majority of the students indicated that topics about health effects, nicotine addiction and its treatment, counselling, prevention of relapse were important or very important in training about tobacco smoking.
CONCLUSION: Medical educators should consider revising medical curricula to improve training about tobacco smoking cessation in medical schools. Our results should be supported by surveys from other medical schools in developing countries of Asia.

Matched MeSH terms: Students, Medical/psychology*
General health mediates the relationship between loneliness, life satisfaction and depression. A study with Malaysian medical students

Swami V, Chamorro-Premuzic T, Sinniah D, Maniam T, Kannan K, Stanistreet D, et al.

Soc Psychiatry Psychiatr Epidemiol, 2007 Feb;42(2):161-6.
PMID: 17180631

OBJECTIVE: To examine the associations between life satisfaction, loneliness, general health and depression among 172 medical students in Malaysia.
METHOD: Participants completed a questionnaire battery, which included the 12-item General Health Questionnaire, Beck's Depression Inventory, the Revised UCLA Loneliness Scale and the Satisfaction With Life Scale.
RESULTS: Life satisfaction was negatively and significantly correlated with suicidal attitudes, loneliness and depression; and positively with health, which was negatively and significantly correlated with depression and loneliness. Self-concept was negatively correlated with loneliness and depression, depression was positively and significantly correlated with loneliness. Mediational analyses showed that the effects of loneliness and life dissatisfaction on depression were fully mediated by health.
CONCLUSION: Even though less satisfied, and particularly lonelier, individuals are more likely to report higher levels of depression, this is only the case because both higher loneliness and life dissatisfaction are associated with poorer health. These results are discussed in terms of their implications for the diagnosis and treatment of mental health disorders in developing nations.

Matched MeSH terms: Students, Medical/psychology*; Students, Medical/statistics & numerical data*
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: Students, Medical
Fulltext Teaching metacognition in clinical decision-making using a novel mnemonic checklist: an exploratory study

Chew KS, Durning SJ, van Merriënboer JJ

Singapore Med J, 2016 Dec;57(12):694-700.
PMID: 26778635 DOI: 10.11622/smedj.2016015

INTRODUCTION: Metacognition is a cognitive debiasing strategy that clinicians can use to deliberately detach themselves from the immediate context of a clinical decision, which allows them to reflect upon the thinking process. However, cognitive debiasing strategies are often most needed when the clinician cannot afford the time to use them. A mnemonic checklist known as TWED (T = threat, W = what else, E = evidence and D = dispositional factors) was recently created to facilitate metacognition. This study explores the hypothesis that the TWED checklist improves the ability of medical students to make better clinical decisions.
METHODS: Two groups of final-year medical students from Universiti Sains Malaysia, Malaysia, were recruited to participate in this quasi-experimental study. The intervention group (n = 21) received educational intervention that introduced the TWED checklist, while the control group (n = 19) received a tutorial on basic electrocardiography. Post-intervention, both groups received a similar assessment on clinical decision-making based on five case scenarios.
RESULTS: The mean score of the intervention group was significantly higher than that of the control group (18.50 ± 4.45 marks vs. 12.50 ± 2.84 marks, p < 0.001). In three of the five case scenarios, students in the intervention group obtained higher scores than those in the control group.
CONCLUSION: The results of this study support the use of the TWED checklist to facilitate metacognition in clinical decision-making.

Matched MeSH terms: Students, Medical
Fulltext Effectiveness of the use of internet search by third year medical students to establish a clinical diagnosis

Nalliah S, Chan SL, Ong CL, Suthan TH, Tan KC, She VN, et al.

Singapore Med J, 2010 Apr;51(4):332-8.
PMID: 20505913

Internet search has been the main source for information and data mining in medical research. Its use by medical students has immensely contributed to learning activities. The main aim of the study was to determine the effectiveness of internet use by medical students during their initial years of clinical instruction in order to establish a diagnosis after being provided with the history and physical findings of a clinical problem.

Matched MeSH terms: Students, Medical*
Fulltext The prevalence of obesity among clinical students in a Malaysian medical school

Boo NY, Chia GJ, Wong LC, Chew RM, Chong W, Loo RC

Singapore Med J, 2010 Feb;51(2):126-32.
PMID: 20358151

INTRODUCTION: This study aimed to determine the prevalence of obesity among medical students and its relationship with their dietary intake and physical activities.
METHODS:This observational study was carried out on 240 medical students during the clinical phase of their medical course in a private medical school. Their body weight and height were measured, and a standardised questionnaire was used to collect information on their physical activities and dietary intake.
RESULTS: The median body weight of the participants was 59.0 kg (interquartile range: 51.3-66.8), the mean body height was 166.1 cm (standard deviation [SD] 8.5 cm), and the mean body mass index (BMI) was 21.8 kg/m2 (SD 3.4 kg/m2). Based on the World Health Organization BMI cut-offs for the Asian population, 30.1 percent (n is equal to 72) of the students were overweight or obese, with a BMI that was equal to or greater than 23.0 kg/m2. Logistic regression analysis showed that, after controlling for various potential confounders, the only significant risk factors associated with overweight/obesity among these students were: male gender (adjusted odds ratio [OR] 2.1; 95 percent confidence intervals [CI] of 1.1 and 4.1; p is equal to 0.03), Malay ethnic group (adjusted OR 2.4; 95 percent CI 1.0 and 5.7; p is equal to 0.04), Indian ethnic group (adjusted OR 3.6; 95 percent CI 1.5 and 8.9; p is equal to 0.005), and the number of soft drinks consumed per week (adjusted OR 1.3; 95 percent CI 1.0 and 1.5; p is equal to 0.02). Skipping breakfast, the frequency of physical exercise per week, the number of hours of sleep per day, and eating noodles or roti canai (a type of Malaysian pancake) for breakfast were not significant risk factors.
CONCLUSION: Obesity remains a common problem among medical students in their clinical years.

Matched MeSH terms: Students, Medical/statistics & numerical data*
Fulltext Should clinical normality be examined in medical course?

Tiong TS

Singapore Med J, 2008 Apr;49(4):328-32.
PMID: 18418526

INTRODUCTION: In medical practice, some patients consult doctors for reassurance of normality, e.g. patients with throat discomfort. Therefore, medical graduates should be competent in diagnosing clinical normality. One way to assess clinical competence is by the objective structured clinical examination (OSCE).
METHODS: In 2002-2006, five batches of medical students who completed their otorhinolaryngology posting in Universiti Malaysia Sarawak were examined with the same OSCE question on clinically normal vocal cords. There were five subquestions concerning structures, clinical features, diagnosis and management. All students had prior slide show sessions regarding normal and abnormal laryngeal conditions.
RESULTS: The total number of students in 2002, 2003, 2004, 2005 and 2006 was 25, 41, 20, 30 and 16, respectively, and 100 percent responded. The average percentage of students with correct answers was 19.4, 2.4, 2.2, 21.2, and 2.4, in the subquestions 0.1 to 0.5, respectively, leaving the remaining relatively larger percentages with incorrect answers of various clinical abnormalities. A reason for these findings is examination fever by the students, who also assumed that all the stations had clinical abnormalities and required differentiating abnormalities from abnormalities, and not from normality. Without clinical normality OSCE questions, the assessment of the undergraduates' clinical competence in real life would seem incomplete.
CONCLUSION: This study showed that a significantly large percentage of students answered incorrectly in the clinical normality OSCE. This may mean that more clinical normality OSCE questions should be included in the undergraduate medical examination to help undergraduates practise the need to look for, and become competent in, clinical normality in real life.

Matched MeSH terms: Students, Medical
Fulltext Medical students in their final six months of training: progress in self-perceived clinical competence, and relationship between experience and confidence in practical skills

Lai NM, Sivalingam N, Ramesh JC

Singapore Med J, 2007 Nov;48(11):1018-27.
PMID: 17975692

INTRODUCTION: We evaluated the progress in the self-perceived competence of medical students in a range of common clinical, practical and personal skills, in their final six months of training.
METHODS: The study was conducted on 65 final-year medical students undertaking their senior clerkship training at International Medical University, Malaysia. Questionnaire surveys were conducted at the beginning and the end of the six-month period, with 44 items covering clinical, practical, personal skills and readiness to work. Correlations were performed for experience and self-perceived competence, with the respective skills.
RESULTS: 64 students returned the first survey and 63 returned the second survey. When the two survey results were compared, significant increases were found in self-perceived competence for the majority of the skills examined. The items with no significant improvement were divided into those which the students were already proficient in before senior clerkship, and those in which experience and confidence remained poor at the end of training. There were significant, but moderate, correlations between the experience and confidence of all common practical skills (correlation coefficients: 0.348-0.522, p-value is less than 0.001 for all items). At the end of training, students were, in general, more prepared to work as house officers (mean rating in the first survey: 3.05, second survey: 3.97, p-value is less than 0.001).
CONCLUSION: Significant progresses in clinical experience and confidence can be observed in the final stages of medical training. The findings of inadequate improvements in some skills call for dedicated training sessions and strengthening of on-site supervision.
Study site: International Medical University, Batu Pahat Campus, Johor, Malaysia

Matched MeSH terms: Students, Medical/psychology*
Fulltext Emotional disorders among medical students in a Malaysian private medical school

Zaid ZA, Chan SC, Ho JJ

Singapore Med J, 2007 Oct;48(10):895-9.
PMID: 17909672

A study was done between December 2005 and January 2006 to determine the prevalence of emotional disorders among medical students in a private medical school in Ipoh, Perak, Malaysia and to determine the demographical characteristics, contributing factors and the key person consulted for emotional problems.

Matched MeSH terms: Students, Medical/psychology*; Students, Medical/statistics & numerical data
Fulltext The evaluation of Engerix-B in healthy Malaysian medical students

Isahak I, Abdul Malik Y, Hakim AS, Baharin R

Singapore Med J, 1990 Aug;31(4):314-6.
PMID: 2147781

Fifty medical students were screened for hepatitis B serological markers of whom 42 students entered the study. Those who were found to be negative for all markers were vaccinated with 1.0 ml (20 mcg HBsAg) Engerix-B vaccine intramuscularly in the deltoid region according to the 0, 1, 6 month schedule. Blood samples were taken at 1, 2, 3, 6, 9 months. One month following the first dose, 7% showed detectable AntiHBs with a GMT of 11 IU/I. By the sixth month, just before the third dose was given, 79% seroconverted with a GMT of 2952 IU/I. Three months following the third dose all had seroconverted with a GMT of 18,381 IU/I. No serious adverse reactions were noted and none of the subjects showed evidence of hepatitis B infection during the study. This study thus confirms the high immunogenicity and safety of recombinant yeast-extract hepatitis B vaccine.

Matched MeSH terms: Students, Medical*
Fulltext Short-term psychotherapy by medical students: its therapeutic effectiveness and its educational value

Teoh JI, Woon TH

Singapore Med J, 1975 Jun;16(2):128-37.
PMID: 1162391

This paper deals with the evaluation of the effectiveness of individual psychotherapy by students on patients' subjective symptomatic improvement and the therapeutic benefits to medical students. The results of the study indicated that student psychotherapy was of significant benefit to psychoneurotic patients, but was of dubious value in the clinical teaching of psychotherapy in the psychiatric curriculum of the medical course at the University of Malaya, Kuala Lumpur.

Matched MeSH terms: Students, Medical*

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