Background: Misinterpretation of abbreviations by healthcare workers has been reported to compromise patient safety. Medical students are future doctors. We explored how early medical students acquired the practice of using abbreviations, and their ability to interpret commonly used abbreviations in medical practice.
Method: Eighty junior and 74 senior medical students were surveyed using a self-administered questionnaire designed to capture demographic data; frequency and reasons for using abbreviations; from where abbreviations were learned; frequency of encountering abbreviations in medical practice; prevalence of mishaps due to misinterpretation; and the ability of students to correctly interpret commonly used abbreviations. Comparisons were made between senior and junior medical students.
Results: Abbreviation use was highly prevalent among junior and senior medical students. They acquired the habit mainly from the clinical notes of doctors in the hospital. They used abbreviations mainly to save time, space and avoid writing in full sentences. The students experienced difficulties, frustrations and often resorted to guesswork when interpreting abbreviations; with junior students experiencing these more than senior students. The latter were better at interpreting standard and non-standard abbreviations. Nevertheless, the students felt the use of abbreviations was necessary and acceptable. Only a few students reported encountering mishaps in patient management as a result of misinterpretation of abbreviations.
Conclusion: Medical students acquired the habit of using abbreviations early in their training. Senior students knew more and correctly interpreted more standard and non-standard abbreviations compared to junior students. Medical students should be taught to use standard abbreviations only.
Poor adherence to anti-hypertensive agents may be a major contributor for suboptimal blood pressure control among patients with hypertension. This study was conducted to assess the adherence to antihypertensive agents using Morisky Medication Adherence Scale (MMAS-8) among primary care patients, and to determine whether the blood pressure control is associated with the level of adherence.
In recent years, the internet has become an increasingly popular tool for people to obtain information due to the overwhelming availability of material. As internet access becomes more readily available, the newer generation of patients, medical students and doctors are starting to prefer the internet as a source of reference to acquire medical knowledge. The main objectives of this study were to determine the accuracy of using Google search in establishing a clinical diagnosis based on information provided from the New England Journal of Medicine (NEJM) and to determine the concordance rate of Google diagnosis with the actual diagnosis from NEJM.
The sale of tobacco-based cigarettes has declined in western countries, and ‘Big Tobacco’ is trying to make up the deficit in profits from the developing world. The recent introduction of e-cigarette, in which they have invested both their hopes and their finances, has been a boon to them as it serves to confuse smokers and non-smokers about the real issues relating to the toxicity, dangers, and the promotion of nicotine addiction especially among youths who have not previously smoked cigarettes. E-cigarettes cause inflammation and damage to epithelial cells in human airways and increased risk of infection. E-cigarette vapour contains more carcinogens like formaldehyde and acetaldehyde compared to a regular cigarette. Longterm vaping is associated with an incremental lifetime cancer risk. E-cigarettes are neither safe nor effective in helping smokers quit; there is enough evidence to caution children, adolescents, pregnant women, and women of reproductive age about e-cigarette’s potential for long term consequences to foetal and adolescent brain development that sub-serve emotional and cognitive functions. The nicotine effects that cause modification of late CNS development constitute a hazard of adolescent nicotine use. The American Heart Association (AHA), Food and Drug Administration (FDA), World Health Organisation (WHO) and two-thirds of the major nations in the world discourage the promotion of e-cigarettes as an alternative to proven nicotine-addiction treatments. Doctors, health care workers, and medical students should be armed with the facts about e-cigarettes, its dangers, and the legal status concerning its use, in order to be able to offer proper counselling to patients and adolescents, in particular, with special reference to the Malaysian context.
Most countries around the world have experienced a shortage in organs needed for transplantation. Organ donation performance is widely attributed to two important factors: the legislation and the role of the family. Thus, this literature review aims to examine the willingness of people for organ donation while highlighting the importance of having a presumed consent system.
Background: The present study describes the morphology of sparganum (larva) of the Malaysian Spirometra spp. collected from naturally infected frogs (Rana cancrivora) from rice fields in Tanjung Karang, Malaysia.
Materials and Methods: Spargana of Spirometra spp. collected from naturally infected frogs (Rana cancrivora) were used for the morphological studies. Stretched on a metal ruler, measurements of the worm were recorded. Specimens were stained in Alum-carmine.
Results: The length of the body ranged from 11-50 mm and the width ranged from 0.5-1.5 mm. Specimens stained with Alum-carmine showed ridges (formation of segments) on the surface of the body, and no sexual organs in the body.
Conclusion: The Malaysian Spirometra spp. are similar in measurement and morphology to Spirometra erinacei but further studies are required for confirmation.
Introduction: Standard precautions in health care is the essence of medical practice encompassing the safety of patients and health care workers including medical students. Barriers to the proper use of personal protective equipment (PPE) exist across the world but identification of areas of weaknesses and appropriate remedies will reduce them. This study assesses knowledge and use of PPE among fourth year students after a period of educational interventions.
Objective: To evaluate appropriate use, awareness and knowledge about PPE among fourth year students after interventions.
Method: A cross- sectional study where forty year 4 students (Group B) were randomly observed and later asked to answer a questionnaire. Students had undergone interventions to improve PPE use, which included lectures and video sessions during each posting. Results were compared with a previous group (Group A). Chi-square test or Fisher’s exact test was used to analyse the data.
Results: There was statistically significant improvement in the use of PPE like wearing and removing mask during invasive procedures (p < 0.001) and hand-washing before and after a non- invasive task (p < 0.001) . Comparison of Groups A and B on the results of the questionnaire for ‘Questions in which more than 10% students answered incorrectly’, showed that there was improvement in Group B in all the questions, some being statistically significant with p value=0.01.
Conclusion: An overall improvement in the use of the PPE and knowledge was noted. Sometimes, students’ attitude and personality may be a challenge and these students may defy changes, but this can be overcome if the strategies are embedded in the curriculum and taught from as early as the first semester.
In ancient times, before Hippocrates, disease and illness were attributed as a sign of divine dismay, and the Gods needed to be appeased to achieve a cure. Hippocrates and his followers showed courage in breaking away from this paradigm. They moved away from the divine and supernatural, to focus on the biology of the body. In the process they put the patient at the centre of their focus. They collected detailed case histories, dismissed religious and supernatural explanations and developed remedies in the form of diets, exercise and mixed minerals and herbs based on their understanding of ill health.
Interprofessional learning (IPL) promotes collaboration among healthcare professionals in providing quality healthcare. For the IPL to have a positive influence on inter-professional collaboration, opportunities must be made available for the healthcare students to learn together. Attitudinal factors have been identified as the major factor hindering the implementation of IPL. In Malaysia, little is known about attitudes of healthcare students towards IPL. Students from different health disciplines often have poor conception of each other’s roles as a member of the healthcare team. IPL increases this knowledge and gives students an understanding of the interpersonal skills needed for liaison and communication. Students from different disciplines who learn together develop interpersonal and teamwork skills, and gain knowledge of how other professionals work. IPL has been shown to create teams that work together better and improve patient experience. In general, IPL aims to improve patient safety, enhance patient satisfaction, and increase levels of innovation in patient care, and increase staff motivation, well-being and retention. There has been increasing emphasis on the important role that interprofessional education (IPE) must play in educating and developing present and future healthcare professionals. This review aims to examine how learning outcomes are articulated in the field of IPE and includes the benefits, importance, ethical concepts and application of IPL in nursing.
Keriorrhoea is the involuntarily passing of orange oil per rectum. One of us (PMB) had the misfortune to experience this symptom, together with considerable gastrointestinal disturbances for a prolonged period of time after consumption of a deep sea fish, orange roughy, which is rich in liquid wax esters (LWEs). This paper presents a summary of available evidence concerned with the physiology and pathology of ingestion of LWEs, which can enter the human diet in substantial amounts from consumption of several species of deep-sea fish. LWEs are poorly digested and absorbed by the human body. They generally cause keriorrhoea when ingested deliberately or accidentally. Jojoba oil, which is a plant LWE, together with certain nutritional products (e.g. olestra) and medical (e.g. Orlistat) which are not LWEs may mimic the effects of LWEs, and cause similar gastrointestinal disturbances. This paper discusses the potential effects of LWEs as components of gastrointestinal micelles, and predicts that the orange oil which is leaked from a bout of keriorrhoea may contain considerable volumes of triacylglycerols (TAGs).
A recently published meta-analysis showed that each additional serving of rice increased risk of type 2 diabetes mellitus (DM) by an alarming 11%. We investigated whether this phenomenon is seen in the Malaysian population by studying the effect of rice intake and added sugar consumption on fasting plasma glucose (FPG) and fasting triacylglycerol (TAG).
Community-acquired pneumonia (CAP) is one of the most common infectious diseases and the world’s leading cause of mortality and morbidity, especially in patients aged 65 years and above.1,2 It is the 6th cause of mortality and the most important cause of hospitalisation in Malaysia. According to the British Thoracic Society, the gold standard in diagnosing CAP is based on radiological findings and it is defined into 2 different settings – community and hospital.3
Background: Continuing professional development (CPD) is a primary strategy for nurses to keep abreast with the rapid changes in the health care practices of current times. Evidence has shown that nurses lack the initiative to take up the additional CPD offered by their organisation and have to be persuaded to do so once they have achieved the minimum 25 points of CPD mandated by Malaysia Professional Regulatory Board of Nursing (MNB).
Objective: To determine the extent to which nurses from a private hospital in Melaka will participate in CPD and the challenges affecting them from participating in CPD
upon achieving the mandatory CPD points specified by MNB.
Methods: This is a cross-sectional descriptive survey. A sample of 188 registered nurses (RNs) from a private hospital in Melaka was recruited via purposive sampling technique to complete a self-reporting questionnaire. The instrument which was adapted and used with permission was pilot-tested for reliability and validated by content experts to ensure its suitability for this local study.
Results: The survey showed that 82.4% of the registered nurses (RNs) had attained additional CPD points apart from the minimum 25 CPD points stipulated by MNB. The findings on RNs reading journals or engaged in distance learning programmes were not encouraging as the percentages were only 31.4% and the latter, 9%. In-service talks, grand round discussions and online sources of continual nursing education that do not require the RNs to be away from their work duties were the most frequent type of CPD activities participated by the RNs as compared to conferences, workshops, distance learning programmes or post basic courses. The top 3 challenges that affect RNs’ participation in CPD were time constraint (90.4%), work commitments (85.6%) and difficulty in getting nominated (53.7%) to attend the CPD activities of their choice.
Conclusions: The results of this study highlighted the respondents’ views to the management on the importance to align the approach of sponsoring CPD courses according to the nurses’ needs in order to meet their context of practice. The management also ought to take into consideration the identified challenges encountered by the nurses to participate in CPD upon achieving their mandatory CPD points specified by MNB.
Background: Nurses are the highest numbered healthcare professionals who work in a knowledgedriven environment, where accurate and updated information is needed when delivering care to clients. Information literacy has therefore become one of the criteria in determining nurses’ readiness for evidencebased practice in recent years. In the actual day-to-day care practice, are nurses ready for this?
Objective: To determine the information literacy competency in readiness for evidence-based practice among clinical practicing registered nurses in a private hospital in Penang, Malaysia.
Methods: This cross sectional descriptive study was conducted in the selected private hospital. Universal sampling method was used. At the time of study, there were 443 registered nurses who met the eligibility criteria of this study. The registered nurses were asked to complete a self-reporting questionnaire about information literacy for evidence-based practice.
Results: The response rate was 86.2%, with a total of 382 returned questionnaires. Less than half of the participants (47%) stated that they frequently sourced information to support nursing practice. Poor research experiences among these participants were identified where 56% of the registered nurses never identified researchable problems, 59% have not evaluated a research report and 54% have never utilised research into practice. Registered nurses frequently sought information sources from colleagues or peers (65%) rather than from printed resources, where only 43% and 33% respectively make use of CINAHL and MEDLINE bibliography databases as the electronic resources for their practice.
Conclusions: Results demonstrated that information literacy among registered nurses from this hospital was lacking. Organisation efforts are needed to create awareness of information for evidence-based practice as well as to encourage more research activities and the search of bibliography database among its registered nurses.
Study site: Private hospital, Pulau Pinang, Malaysia
Background: Clinical reasoning is the name given to
the cognitive processes by which doctors evaluate and
analyse information from patients. It is a skill developed
by experiential learning and is difficult to assess
objectively. The script concordance test, an assessment
tool introduced into the health sciences about 15 years
ago, is a way of assessing clinical reasoning ability in
an objective manner and allows comparisons of the
decisions made by medical students and experts in
situations of uncertainty.
Methods: Twenty-six final year medical students from
the International Medical University, Kuala Lumpur,
were tested on their decision making skills regarding a
young febrile patient. The students evaluated different
pieces of information in five different scenarios and
made decisions on a five-point Likert scale in the
standard format of the script concordance test. Their
decisions were compared to the decisions of a panel of
experienced clinicians in Internal Medicine.
Results: The script concordance test scores for the
different scenarios were calculated with higher scores
being indicative of greater concordance between the
reasoning of students and doctors. The students showed
poor concordance with doctors in evaluating clinical
information. Overall, only 20 percent of the choices
made by students were the same as the choices made by
the majority of doctors.
Conclusion: Medical students vary in their ability to
interpret the significance of clinical information. Using
the script concordance test, this preliminary study looked
at the ability of final year medical students to interpret
information about a patient with a febrile illness. The
results showed poor concordance between students and
doctors in the way they interpreted clinical information.
The script concordance test has the potential to be a
tool for teaching and assessing clinical reasoning.
Background: Some argue that Malaysia’s extremely low organ donation rate is attributed to religion, specifically Islam. Testing this argument, this study asked Malaysian Muslims their views regarding various issues on organ donation and examined whether their decisions to donate organs are framed by religious beliefs.
Materials and Methods: This study investigated the perspectives of Malaysian Muslims between October and December 2013 in Kuala Lumpur. Self-administered questionnaires were distributed to 900 people, with 829 responses collected (92% response rate). Respondents’ verbal consent was taken before proceeding with the survey.
Results: The survey found that more than half of respondents felt that organ donation is permitted in
Islam and that it is a communal responsibility. However, the same proportions were unsure on the issues of rewards for organs or on whether Islam permits the procuring of organs from brain dead patients.
Conclusions: Malaysian Muslims are not against organ donation; however, encouraging organ donation requires the state to address public concerns on Islam’s views on this sensitive issue through effective policy tools to help address these gaps in Malaysian Muslims’ understanding of organ donation. The organ donation rate could improve by using Islamic scholars as ambassadors for an organ donation drive to convey the message of Malaysia’s urgent need for organ donation.
Malignant melanoma is a rare malignancy of the external auditory canal. The vast majority of them occur in the areas of the body that are exposed to the sun. Early histological examination may possibly favor better prognosis. We report a case of a 38-year-old female who presented with a small mass in right ear canal, earache and minimum discharge since 4 months. Initially scraping was done in the ENT clinic. Subsequently she had a wide excision done by the end aural approach at a different hospital. A year later the patient presented with a swelling involving the ear canal which extended to the helix and supratemporal region with the histology report as malignant melanoma. A literature review of the disease, radiological findings, immunohistochemical features and treatment options are discussed.
Background: Nurses are the “front line” staff in most
health systems and their contribution is recognised as
essential in meeting development goals and delivering
safe and effective care (ICN, 2007). Nurses are in high
demand not only in developed countries but also in
developing countries like Malaysia. However, more
than 70% of Malaysian hospitals currently do not have
adequate nursing staff. At least 174,000 nurses need to
be trained by 2020 to meet WHO’s nurse-to-patient
ratio of 1:200. The purpose of this study is to identify
the main factors that influence the nursing students’
decision to choose nursing as their career.
Method: A descriptive study guided by Self
Determination Theory was used for this study. A 29-
item questionnaire adapted from McCabe, Nowak
and Mullen (2005) was distributed to all students in a
nursing college (n=117).
Results: The five main reasons for choosing nursing
as a career were “ability to help others”, “training was
provided on the job”, “ability to work closely with
people”, “parental advice”, and “accommodation was
provided while training”. The top three main domains
that influenced the nursing students’ decision to choose
nursing as their career include “travel opportunities
of nursing”, “intrinsic attraction of nursing” and
“immediacy of support on entry to nursing”. A total of
19 (0.2%) will not choose nursing if given a chance.
The main reasons were “want to take another course”,
“no time to spend with family” and “nursing is a stressful
job”.
Conclusion: The findings of this study provided valuable
information regarding motivating factors which attract
the current generation to join nursing. It is of concern
that items representing nurses’ image were not rated
highly.
Introduction: Dietary fibre (DF) and fluid intakes
have been reported elsewhere to reduce the risk
of constipation. The association of these dietary
components on Agachand’s Constipation Score (CS)
was investigated in the present study.
Methods: A total of 202 Malaysian participants
comprising 50 adolescents (aged 12.4 ± 5.3 yrs),
50 adults (aged 46.3 ± 11.3 yrs), 52 women of childbearing
age (aged 29.1 ± 9.3 yrs) and 50 elderly persons
(aged 70.0 ± 7.4 yrs) were recruited by convenience
sampling from five venues - two communities in Cheras,
one community in Klang, the IMU campus, Bukit Jalil
and a private secondary school in Klang. All participants
were interviewed with a previously-evaluated food
frequency questionnaire (FFQ) and an Agachand’s
Constipation Score (CS) Questionnaire.
Results: Mean daily DF intakes were low across all
age groups with means ranging from 10.0 – 15.6g.
The percentage of subjects with daily DF intakes below
the “deficient” cut-off of 20g was alarmingly high;
80% in adolescents, 45% in adults, 85% in women of
child-bearing age and 70% in the elderly. About onefifth
or 20% of subjects in all age groups had CS values
≥15 which indicated a problem of constipation.
Mean daily total fluid consumption (TFC) ranged
from 2128 – 5490 ml in the four categories of subjects.
Overall, both daily DF intakes and TFC were negatively
associated with CS values. This inverse association was
significant for DF vs CS scores in adolescents (r = -0.500,
p = 0.001), adults (r = -0.351, p = 0.013), the elderly
(r = -0.392, p = 0.005) and all subjects combined
(r = -0.366, p=0.001). For TFC vs CS scores, the
inverse association was only significant for the elderly
(r = -0.312, p = 0.027) and all subjects combined
(r = -0.245, p = 0.001).
Conclusion: The results of this study support the role
of dietary fibre intake and TFC in reducing the risk of
constipation, as well as reinforcing previous data for low
DF intakes among the Malaysian population.
Background: Many nurses are leaving for various
destinations and leaving intention was found to be the
immediate precursor for actual turnover, but studies
examining the different forms of leaving intention (unit,
hospital, country, and profession) and exit destinations
are scarce.
Objectives: To determine the different forms of nurses’
leaving intention (i.e., leaving the unit, hospital, country,
and profession), exit destinations and associations of
demographic variables on the different forms of leaving
intention and exit destinations.
Methods: The study design was a cross-sectional survey.
Private hospital nurses in the Peninsular Malaysia were
the study population and a total of 942 (73% response
rate) nurses participated in the study. A self-reported
questionnaire was used for data collection.
Results: The results revealed that intention of leaving
the organisation (M = 2.81, SD = 1.33) was the
highest and followed by intention of leaving the unit
(M = 2.54, SD = 1.31). In terms of exit destinations,
advancing nursing qualification (M = 2.95, SD = 1.31)
and practising nursing in another country (M = 2.55,
SD = 1.31) were the most preferred exit destinations
among the nurses.
Conclusions: Nursing managers play a significant role in
retaining nurses within the units and organisations. The
findings on nurses’ exit destinations are crucial because
they serve as the direction for nurses’ retention strategies
which include professional development opportunities
through training, education and staff mobility.