It is generally accepted that assessment is a single powerful tool that drives students’ learning.
However, assessment of anatomy subject in medical curriculum is disputable as it focusses more on
testing the low order thinking skills. In medical education context, it is of paramount importance to
align the assessment with the curriculum (i.e., learning outcomes) and teaching methods as to enhance
learning through a meaningful learning experience. Hence, the use of learning taxonomy should be
emphasised in designing a proper and suitable assessment for anatomy subject. Among the most
commonly used taxonomies in higher education, are the Bloom’s taxonomy, Miller’s pyramid, SOLO
taxonomy, Krathwohl’s taxonomy of affective domain, and Simpson’s psychomotor domain. However,
being a core basic medical subject with high cognitive input, it is often difficult to achieve contextual
learning in anatomy through application of these taxonomies. Therefore, with raising concern of lack
in the evaluation of higher order thinking skills, affective and psychomotor domains, the anatomy
assessment in modern medical curriculum have been improvised to address the aforementioned
issues. The modern form of assessment in anatomy facilitates the contextual learning with beneficial
attributes gained by students including better understanding of anatomy knowledge, synthesis of
anatomical concept, appreciation of the clinical importance of anatomy, increases communication
skills, and increase in the confidence level.
Situated learning characterises the learning that takes place in the clinical environment. Learning in the workplace is characterised by transferring classroom knowledge into performing tasks and this may take various forms. In the medical education field, the cognitive apprenticeship instructional model developed by Collins (2016) supported this learning in the workplace setting due to its common characteristics of apprenticeship. This paper analysed two concrete learning situations in a Malaysian undergraduate and an Omani postgraduate learning environment. Both learning situations occurred in the primary healthcare outpatient setting. The cognitive apprenticeship model was used to identify characteristics of the individual learning environments and discusses factors that stimulate learning. Attention was paid to the role of reflection in stimulating learning in the described settings. The paper provided the context in both institutes, described the learning situation and provided an analysis based on the theoretical framework. Based on the analysis of the situations, solutions to problems in the two settings were suggested.
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.
Histology, a branch of anatomy is a correlational science between structure of tissues and their
functions. Knowledge of histology is emphasised for undergraduate medical students as a basic for
clinical knowledge and research. To impart retainable and reproducible knowledge in histology, a new
laboratory manual with images and clinical correlates was introduced to the Year I MBBS students
in the Academic Session 2017/2018 during their general anatomy module. The objective structured
practical examination marks between 101 students of Batches 2016/17 and 2017/18 were analysed.
The difference in marks between both the batches were analysed using SPSS 20. Batch 2017/18
students who used the new lab manual scored better than the previous batch who used the old
manual. Independent t-test was not statistically significant. The students who used the new manual
fared better than their seniors. Since the difference was not statistically significant, it can be concluded
that if existent, drawbacks in the lab manual should be improved and adequate usage of the manual by
the students should be emphasised. Nevertheless, usage of the new lab manual shows that the students
could understand the subject and score better with less study hours.
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.
Phy-Antastic is the pioneering horizontally-integrated pedagogy that adopts physiology-oriented
anatomy teaching. A decline in time allocation for basic medical sciences (BMS) modules triggers
the conflict of interests among educators. “Physiology-then-Anatomy” temporal synchronisation
(and therefore Phy-Antastic) facilitates deep learning. The five highlighted features of Phy-Antastic
are: (i) explicit declaration of learning outcomes and prerequisite knowledge as groundwork for
the forthcoming topics; (ii) explanation of subject-related glossary to improve comprehension;
(iii) elucidation of the related physiological mechanism to calibrate the learners into appreciating
the cardinal anatomical features; (iv) the creative utilisation of multimodal teaching aids to simulate
consolidated learning experience; (v) lesson was concluded by revisiting learning objectives, reflection
on principal inquiry questions and recapitulating fundamental elements. The strength of Phy-Antastic
depends on homeostatic teaching with rigorous educational outcome set-point and interdisciplinary
feedback mechanisms. Small group discussion, problem-based learning and technology-assisted
teaching can easily incorporate Phy-Antastic. Inertia among BMS educators in embracing
interdisciplinary collaborative teaching remains the institutional barrier to the implementation of
Phy-Antastic. This article proposes a prospective advancement in anatomical education for the
contemplation of educators.
Palliative care for life limiting conditions usually starts at birth. In neonatal period, planning,
discussion and goal of care should focus towards improving the baby quality of life. It does not mean
palliative care in this age group mainly as end of life care. We illustrate a complex 30 weeks baby
who was born with genetic abnormality complicated with intracranial bleeding and acute myeloid
leukaemia. There were various ethical issues related to the approach of death and dying infant and
psychosocial challenges surrounding the case.
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.
Medical knowledge, skills, and social requirements for patient care are quickly changing, thus, doctors
are anticipated to be life-long learners to provide effective care for the patients. This paper addresses
instructional issues how to prepare medical students to be self-directed learners and how to improve
medical school and postgraduate training curricula. Now the big question is self-directed learning
(SDL) an agent in cultivating lifelong learning skills for medical students as claimed by educational
experts? This will be the focus of my critical reflection on lifelong learning.
Planning a validation study of a questionnaire or measurement tool requires consideration for testing
the validity and reliability aspects of the measurement tool. When it comes to the reliability aspect,
a number of commonly used statistical coefficients such as Cronbach’s alpha, intraclass correlation,
kappa and Pearson’s correlation coefficients would be considered to provide empirical evidence of the
reliability of the tool during the validation process. To ensure that the reliability is accurately assessed,
a researcher must consider the sample size requirement for the statistical analyses. In this article, I will
introduce a newly developed web-based sample size calculator, which includes the ability to calculate
the sample sizes of these four important coefficients. I will also show how to use the calculator for each
of the coefficients.
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.
It is well established that accidental and non-accidental injuries/child abuse and neglect (CAN) are a
major public health problem globally. Not only do they affect individuals, injuries affect families, the
community, government and internationally as well. Injuries span throughout childhood and into
adulthood. Purpose of this study is to identify what are the difficulties and challenges in identifying
and reporting CAN cases at the emergency (ED) department in Malaysian hospitals. Thirty in-depth
interviews were conducted at the ED in three major hospitals in the Klang Valley, Malaysia which
consists of specialists, medical officers, nurses and medical assistants. The study found that there is a
significant gap identified in medical professionals’ knowledge and skills related to understanding,
identifying and detecting CAN, particularly among medical officers who are in charge of diagnosis and
reports in the hospital. Those who had previous experience or encounters in dealing with CAN cases
would have higher suspicion index compared to those who haven’t. Other medical professionals such
as nurses and medical assistants although do not have the mandate to diagnose or report of CAN cases,
needed to have the basic knowledge and awareness and play more active role in their respective settings.
Many educators adopt feedback models from articles and books which contain various feedback
strategies rather than depending on their own experiences. Mini Clinical Evaluation Exercise (MiniCEX) is a Workplace-Based Assessment (WPBA) that requires the examiner to observe the student
performing a focused task within 15-20 minutes at the clinic or ward with compulsory immediate
feedback. The aim of this study is to identify the feedback strategies adopted by family physician
lecturers during the feedback session at the end of the mini-CEX assessment. A qualitative methodology
using indirect observation was adopted for this cross-sectional study. Thirty-three Mini-CEX feedback
sessions were selected using a purposive sampling involving 33 Final Year Medical Students and
fourteen Family Physician lecturers at the Department of Family Medicine, National University of
Malaysia. The feedback sessions were audio-recorded, transcribed and analysed using content analysis.
Results showed eight feedback strategies were adopted in the feedback sessions. The majority of the
feedback sessions were conducted in a dialogic approach through self-reflection (96.7%). However, the
students’ contribution was minimal in student’s plan for improvement (36.3%) and self-scoring
(39.4%). 90.9% of the students were also praised on their correct performance and received plan for
improvement. From 60.6% of the candidates who were informed of their final scores, 45.4% of the
scores were justified. 24.2% of the students were offered to ask questions during the feedback session.
More exposure to various feedback strategies may provide better advantage for the students to monitor
and improve their level of achievement. Adopting a dialogic feedback approach is crucial to encourage
a sense of belonging in the process of feedback.
Universiti Sains Malaysia (USM) Attitudes toward Statistics (USM-AS) is a newly developed, selfadministered inventory for measuring attitudes toward statistics among postgraduate students. The
USM-AS consists of three factors (affect, cognition, and behavior) and 58 items. This study was
aimed to validate the USM-AS and provide evidence of its construct validity by investigating its
internal structure. This study consists of four validation studies, which were conducted consecutively
among postgraduate students (master’s degree and PhD students) in the medical and health sciences.
The revised USM-AS, consisting of three factors and 12 items, was found to have good construct
validity, which was demonstrated by good model fit, high factor loadings (0.62 to 0.92), high
construct reliability (0.84 to 0.89), good discrimination between factors and good test-retest reliability
(intraclass correlation coefficients = 0.63 to 0.82). However, validity was limited to postgraduate
students in the medical and health sciences in Malaysia. Further validation studies among
postgraduate students in other scientific fields are recommended to provide additional construct
validity evidence of the USM-AS.
This study aimed to evaluate the perceptions of medical students towards use of internet in problembased learning (PBL). Methods: A descriptive observational approach was followed in analysis of perceptions about use of internet in a convenience sample of 141 students. A questionnaire was selected after analysis of perceptions received from a pilot study and was divided into three aspects of the PBL sessions. Students’ and facilitators’ role in PBL, mode and scope of use of internet in PBL and reasons for use of internet in PBL. Descriptive analysis of the data was done. Significant difference between the mean values was analyzed. A difference in agreement among the students was observed about the role of lecturer in the process of PBL. A higher percentage of students (65.2%) agreed that they used internet to search for information during PBL session 1 compared to PBL session 2 (58.2%). Majority of the students (81%) agreed on searching internet for new information. Regarding preparation for PBL session 2, comparatively more students from earlier semesters agreed about using textbooks than using internet. Higher percentage of students searched internet for information on clinical sciences (52.5%) compared to basic sciences (24.8%). Among basic science subjects, information related to pathology was searched more often and information on management was searched more often among clinical science topics. Students actively use internet for searching new information and learning during PBL sessions. They also use textbooks to prepare for PBL session. Online search for journal articles is not popular.
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.
Standards of physiotherapy practice by respective regulatory bodies and authorities is well documented. However, the triad alignment reported, and efforts taken by physiotherapy stakeholders is unclear and limited. This article aims to highlight any constructive alignment that exist between the three stakeholders namely the regulatory bodies, employers and the higher educational institutions (HEIs). Literature searched was conducted using Google Scholar using keywords on “physiotherapy standards”, “clinical competence”, “regulatory bodies” and “physiotherapy”. Results showed evidence of physiotherapy regulatory bodies, educational institutions and healthcare employers advocating standards of physiotherapy. Physiotherapy authorities advocates the standards of physiotherapy competence, while educational institutions develop various competency assessment tools to measure the outlined standards on their physiotherapy graduate’s. However, the healthcare providers’ (employers) feedback on their expected employability skills is not promising. Evidence suggest discrepancy in the alignment, between these stakeholders and an improved mechanism could be proposed to ensure these standards are well communicated and integrated. Such constructive alignment is imperative in ensuring the physiotherapy workforce produced meet the current 21st century health care demands for optimal patient outcome.
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.
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.
We describe a case of nephrotic syndrome case who defaulted treatment but presented with acute medical complication due to non-compliance to treatment. He subsequently developed neurological sequalae following definitive hemodialysis. Due to disease severity and its complication, active dialysis has been abandoned. There are many factors leading to this decision, but are palliative care physician right to follow the primary team’s decision, in palliating a patient with chronic kidney disease with potential hyperkalaemia consequences? The article focuses on potential ethical dilemma faced by the palliative care team in the subsequent management of this scenario.