Displaying publications 121 - 140 of 238 in total

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  1. Fulltext Students' performance in the different clinical skills assessed in OSCE: what does it reveal?
    Sim JH, Abdul Aziz YF, Mansor A, Vijayananthan A, Foong CC, Vadivelu J
    Med Educ Online, 2015;20:26185.
    PMID: 25697602 DOI: 10.3402/meo.v20.26185
    INTRODUCTION: The purpose of this study was to compare students' performance in the different clinical skills (CSs) assessed in the objective structured clinical examination.

    METHODS: Data for this study were obtained from final year medical students' exit examination (n=185). Retrospective analysis of data was conducted using SPSS. Means for the six CSs assessed across the 16 stations were computed and compared.

    RESULTS: Means for history taking, physical examination, communication skills, clinical reasoning skills (CRSs), procedural skills (PSs), and professionalism were 6.25±1.29, 6.39±1.36, 6.34±0.98, 5.86±0.99, 6.59±1.08, and 6.28±1.02, respectively. Repeated measures ANOVA showed there was a significant difference in the means of the six CSs assessed [F(2.980, 548.332)=20.253, p<0.001]. Pairwise multiple comparisons revealed significant differences between the means of the eight pairs of CSs assessed, at p<0.05.

    CONCLUSIONS: CRSs appeared to be the weakest while PSs were the strongest, among the six CSs assessed. Students' unsatisfactory performance in CRS needs to be addressed as CRS is one of the core competencies in medical education and a critical skill to be acquired by medical students before entering the workplace. Despite its challenges, students must learn the skills of clinical reasoning, while clinical teachers should facilitate the clinical reasoning process and guide students' clinical reasoning development.

    Matched MeSH terms: Clinical Competence*
  2. Does guideline knowledge affect treatment compliance among emergency doctors?
    Aftab RA, Khan AH, Syed Sulaiman SA, Ali I, Khan K
    Am J Med Sci, 2014 Nov;348(5):357-61.
    PMID: 25118657 DOI: 10.1097/MAJ.0000000000000269
    BACKGROUND: The insufficient adoption of internationally accepted clinical guidelines may lead to less than adequate patient care of patients with asthma.
    OBJECTIVE: To evaluate the knowledge and treatment compliance with Global Initiative of Asthma (GINA, 2011) asthma treatment guidelines among emergency physicians (EPs) at a referral hospital in northern Malaysia.
    METHODS: A cross-sectional study was designed in the territory-level referral hospital in northern Malaysia. Twenty-seven EPs were asked to complete an asthma guideline questionnaire to assess their knowledge regarding GINA 2011 asthma treatment guidelines. A total of 810 patients were enrolled, and 30 patients were selected per physician. The authors evaluated the physicians' compliance with GINA 2011 asthma treatment guidelines.
    RESULTS: Of 27 EPs, 20 (74.1%) had adequate knowledge of GINA 2011 asthma treatment guidelines. A total of 615 (75.9%) patients received guideline-recommended emergency treatment. Shortness of breath (n = 436, 53.8%) was the most frequently reported chief complaint. Furthermore, there was a significant but weak association between knowledge of the guideline and treatment compliance among emergency doctors (P = 0.003, φ = 0.110). Moreover, there was no significant change in therapy for patients with comorbid conditions. The mean age of respondents was 27.3 years.
    CONCLUSIONS: Overall, a fair level of guideline knowledge and treatment compliance was noted among EPs. Doctors with adequate guideline knowledge were more likely to comply with GINA 2011 asthma treatment guidelines.
    Matched MeSH terms: Clinical Competence/standards*
  3. Fulltext Comparing effectiveness of high-fidelity human patient simulation vs case-based learning in pharmacy education
    Lee Chin K, Ling Yap Y, Leng Lee W, Chang Soh Y
    Am J Pharm Educ, 2014 Oct 15;78(8):153.
    PMID: 25386018 DOI: 10.5688/ajpe788153
    To determine whether human patient simulation (HPS) is superior to case-based learning (CBL) in teaching diabetic ketoacidosis (DKA) and thyroid storm (TS) to pharmacy students.
    Matched MeSH terms: Clinical Competence/standards
  4. Fulltext Assessors for communication skills: SPs or healthcare professionals?
    Liew SC, Dutta S, Sidhu JK, De-Alwis R, Chen N, Sow CF, et al.
    Med Teach, 2014 Jul;36(7):626-31.
    PMID: 24787534 DOI: 10.3109/0142159X.2014.899689
    The complexity of modern medicine creates more challenges for teaching and assessment of communication skills in undergraduate medical programme. This research was conducted to study the level of communication skills among undergraduate medical students and to determine the difference between simulated patients and clinical instructors' assessment of communication skills.
    Matched MeSH terms: Clinical Competence/standards*
  5. Pediatric resident resuscitation skills improve after "rapid cycle deliberate practice" training
    Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, Bradshaw JH, Diener-West M, Perretta JS, et al.
    Resuscitation, 2014 Jul;85(7):945-51.
    PMID: 24607871 DOI: 10.1016/j.resuscitation.2014.02.025
    Previous studies reveal pediatric resident resuscitation skills are inadequate, with little improvement during residency. The Accreditation Council for Graduate Medical Education highlights the need for documenting incremental acquisition of skills, i.e., "Milestones". We developed a simulation-based teaching approach "Rapid Cycle Deliberate Practice" (RCDP) focused on rapid acquisition of procedural and teamwork skills (i.e., "first-five minutes" (FFM) resuscitation skills). This novel method utilizes direct feedback and prioritizes opportunities for learners to "try again" over lengthy debriefing.
    Matched MeSH terms: Clinical Competence*
  6. Performance of emergency physicians in point-of-care echocardiography following limited training
    Bustam A, Noor Azhar M, Singh Veriah R, Arumugam K, Loch A
    Emerg Med J, 2014 May;31(5):369-73.
    PMID: 23428721 DOI: 10.1136/emermed-2012-201789
    OBJECTIVES: The aim of this study was to evaluate if emergency medicine trainees with a short duration of training in echocardiography could perform and interpret bedside-focused echocardiography reliably on emergency department patients.
    METHODS: Following a web-based learning module and 3 h of proctored practical training, emergency medicine trainees were evaluated in technical and interpretative skills in estimating left ventricular function, detection of pericardial effusion and inferior vena cava (IVC) diameter measurements using bedside-focused echocardiography on emergency department patients. An inter-rater agreement analysis was performed between the trainees and a board-certified cardiologist.
    RESULTS: 100 focused echocardiography examinations were performed by nine emergency medicine trainees. Agreement between the trainees and the cardiologist was 93% (K=0.79, 95% CI 0.773 to 0.842) for visual estimation of left ventricular function, 92.9% (K=0.80, 95% CI 0.636 to 0.882) for quantitative left ventricular ejection fraction by M-mode measurements, 98% (K=0.74, 95% CI 0.396 to 1.000) for the detection of pericardial effusion, and 64.2% (K=0.45, 95% CI 0.383 to 0.467) for IVC diameter assessment. The Bland-Altman limits of agreement for left ventricular function was -9.5% to 13.7%, and a Pearson's correlation yielded a value of 0.82 (p<0.0001, 95% CI 0.734 to 0.881). The trainees detected pericardial effusion with a sensitivity of 60%, specificity of 100%, positive predictive value of 100% and negative predictive value of 97.9%.
    CONCLUSIONS: Emergency medicine trainees were found to be able to perform and interpret focused echocardiography reliably after a short duration of training.
    Study site: Trauma and emergency department, University of Malaya Medical Centre, Kuala Lumpur
    Matched MeSH terms: Clinical Competence*
  7. Role of simulation in arthroscopy training
    Madan SS, Pai DR
    Simul Healthc, 2014 Apr;9(2):127-35.
    PMID: 24096921 DOI: 10.1097/SIH.0b013e3182a86165
    Arthroscopy uses a completely different skill set compared with open orthopedic surgery. Hitherto, arthroscopy had not been given enough emphasis in the core orthopedic curricula. Simulation has been seen as an excellent way to teach the skills required in arthroscopy. The simulators used for arthroscopy training can be broadly classified into physical simulators such as cadavers, animals, models and box trainers, virtual-reality simulators, and hybrid simulators that combine virtual-reality simulation with physical components that allow real tactile feedback. The advantages and disadvantages of each of these types have been described in this article. The factors that determine skill acquisition using these simulators have been highlighted. In conclusion, simulation seems to be a valuable tool for arthroscopy training, although further studies are needed to state whether this translates into better operative skill on real patients.
    Matched MeSH terms: Clinical Competence*
  8. Emergency skills learning on video (ESLOV): A single-blinded randomized control trial of teaching common emergency skills using self-instruction video (SIV) versus traditional face-to-face (FTF) methods
    Mohd Saiboon I, Jaafar MJ, Ahmad NS, Nasarudin NM, Mohamad N, Ahmad MR, et al.
    Med Teach, 2014 Mar;36(3):245-50.
    PMID: 24295218 DOI: 10.3109/0142159X.2013.857013
    Self-instruction video (SIV) has been widely explored as a teaching mode for cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED), but not with other basic emergency skills.
    Matched MeSH terms: Clinical Competence*
  9. Clinical audit teaching in record-keeping for dental undergraduates at International Medical University, Kuala Lumpur, Malaysia
    Chong JA, Chew JK, Ravindranath S, Pau A
    J Dent Educ, 2014 Feb;78(2):206-12.
    PMID: 24489028
    This study investigated the impact of clinical audit training on record-keeping behavior of dental students and students' perceptions of the clinical audit training. The training was delivered to Year 4 and Year 5 undergraduates at the School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. It included a practical audit exercise on patient records. The results were presented by the undergraduates, and guidelines were framed from the recommendations proposed. Following this, an audit of Year 4 and Year 5 students' patient records before and after the audit training was carried out. A total of 100 records were audited against a predetermined set of criteria by two examiners. An email survey of the students was also conducted to explore their views of the audit training. Results showed statistically significant improvements in record-keeping following audit training. Responses to the email survey were analyzed qualitatively. Respondents reported that the audit training helped them to identify deficiencies in their record-keeping practice, increased their knowledge in record-keeping, and improved their record-keeping skills. Improvements in clinical audit teaching were also proposed.
    Matched MeSH terms: Clinical Competence
  10. Adopting programmatic feedback to enhance the learning of complex skills
    Yusoff MS, Hadie SN, Abdul Rahim AF
    Med Educ, 2014 Feb;48(2):108-10.
    PMID: 24528391 DOI: 10.1111/medu.12403
    Matched MeSH terms: Clinical Competence*
  11. Pairing as an instructional strategy to promote soft skills amongst clinical dental students
    Abu Kasim NH, Abu Kassim NL, Razak AA, Abdullah H, Bindal P, Che' Abdul Aziz ZA, et al.
    Eur J Dent Educ, 2014 Feb;18(1):51-7.
    PMID: 24423176 DOI: 10.1111/eje.12058
    Training dentists today is challenging as they are expected to provide a wide range of dental care. In the provision of good dental care, soft skills are equally important as clinical skills. Therefore in dental education the development of soft skills are of prime concern. This study sought to identify the development of soft skills when dental students are paired in their clinical training. In this perception study, four open-ended items were used to elicit students' feedback on the appropriateness of using clinical pairing as an instructional strategy to promote soft skills. The most frequently cited soft skills were teamwork (70%) and communication (25%) skills. However, both negative and positive behaviours were reported. As for critical thinking and problem solving skills, more positive behaviours were reported for abilities such as to explain, analyze, find ideas and alternative solutions, and make decisions. Leadership among peers was not evident as leading without legitimate authority could be a hindrance to its development. If clinical pairing is to be used as an effective instructional strategy to promote soft skills amongst students, clear guidelines need to be developed to prepare students to work in a dental team and the use of appropriate assessment tools can facilitate the development of these soft skills.
    Matched MeSH terms: Clinical Competence*
  12. The use of jigsaw learning technique in teaching medical students prescribing skills
    Sim SM, Foong CC, Tan CH, Lai PS, Chua SS, Mohazmi M
    Med Teach, 2014 Feb;36(2):182.
    PMID: 24156275 DOI: 10.3109/0142159X.2013.848977
    Matched MeSH terms: Clinical Competence
  13. An evaluation of knowledge and skill on cricoid pressure among emergency personnel
    Hanizah N, Affirul CA, Fadzlon MY
    Clin Ter, 2014;165(5):e336-41.
    PMID: 25366949 DOI: 10.7417/CT.2014.1759
    BACKGROUND: Cricoid pressure (CP) is a step during rapid sequence induction. Previous studies showed a poor clinical application of CP despite a reasonable theoretical knowledge of CP. This study aims to evaluate the proficiency and knowledge retention on CP among the emergency staff in the Emergency Department, Universiti Kebangsaan Malaysia Medical Centre.

    MATERIALS AND METHODS: This is questionnaire-based observational comparative study. Once the questionnaire is filled, the application of CP is tested on an airway model and competency level is documented. An education hand out is passed to all participants after the procedure. The improvement and knowledge retention were assess after 2 month.

    RESULTS: A total of 81 completed surveys were returned comprises of of 34 medical officers, 23 staff nurses and 24 assistant medical officers. 75.3% subjects have work experience more than a year but only 59.3% of them were trained in CP application. A total of 69.1% participants passed the pre educational handout test and 100% passed the post educational handout test. However, for pre educational handout phase, 81.5% participants passed the theory part while only 42% passed the practical component. In post educational handout phase, the number of respondents who passed both components was 97.5% and 63% respectively. There are positive correlation between designation and working experience with overall passes in this study.

    CONCLUSIONS: The theoretical knowledge of CP is satisfactory but clinical application is poor especially in the pre educational handout phase. The educational handout is proved to improve the knowledge transfer and retention with regards to CP.

    Matched MeSH terms: Clinical Competence/standards*
  14. Does clinical experience help oncology nursing staff to deal with patient pain better than nurses from other displines? Knowledge and attitudes survey amongst nurses in a tertiary care in Malaysia
    Yaakup H, Eng TC, Shah SA
    Asian Pac J Cancer Prev, 2014;15(12):4885-91.
    PMID: 24998558
    BACKGROUND: Successful implementation of pain management procedures and guidelines in an institution depends very much on the acceptance of many levels of healthcare providers.

    AIM: The main purpose of this study was to determine the level of knowledge and attitudes regarding pain among nurses working in tertiary care in a local setting and the factors that may be associated with this.

    MATERIALS AND METHODS: This cross-sectional research study used a modified version of the Nurses' Knowledge and Attitudes Survey (NKAS) regarding pain. Basic demographic data were obtained for further correlation with the level of pain knowledge.

    RESULTS: A total of 566 nurses, 34 male and 532 female, volunteered to participate in this study. The response rate (RR) was 76%, with an overall mean percentage score of 42.7±10.9 (range: 5-92.5). The majority of participants were younger nurses below 40 years of age and more than 70% had worked for less than 10 years (6.6±4.45). Up to 92% had never had any formal education in pain management in general. The total mean score of correct answers was 58.6±9.58, with oncology nursing staff scoring a higher percentage when compared with nurses from other general and critical care wards (63.52±9.27, p<0.045). Only 2.5% out of all participants obtained a score of 80% or greater. The majority of the oncology nurses achieved the expected competency level (p<0.03).

    CONCLUSIONS: The present findings give further support for the universal concern about poor knowledge and attitudes among nurses related to the optimal management of pain. The results indicated that neither number of years working nor age influenced the level of knowledge or attitudes of the practising nurses. Oncology nursing staff consistently scored better than the rest of the cohort. This reflects that clinical experience helps to improve attitudes and knowledge concerning better pain management.

    Matched MeSH terms: Clinical Competence*
  15. Fulltext Factors affecting knowledge and skills retained among nurses after a neonate resuscitation training programme
    Sek SC, Chan SG
    The Malaysian Journal of Nursing, 2014;6(1):50-55.
    Neonate Resuscitation Program, NRP training is given to nurses in batches. Such programs are vital because neonate resuscitation procedure or aid given to new born during delivery, help them begin breathing on their own, which can save many lives. Although such training is given to the nurses, no assessment has been done on the effectiveness of such training with regard to knowledge retention and transfer of training among the trainees. This study is retrospective in nature; it evaluates the level of knowledge and the confidence in carrying out the neonate resuscitation procedure among 91 nurses involved such training. Besides that, the study ascertains their preparedness before undergoing the training and the opportunities provided to them to practice the skills learnt from the training at their work place. Factors that influence both their knowledge and skills after the training are also indentified. Study sample consist of 51 nurses from hospitals and 40 nurses from health clinics. Results show that skills acquired from training as measured by their confidence at carrying out the learnt skill deteriorate faster than knowledge. Level of knowledge retained, confidence at carrying out the neonate resuscitation procedure and opportunities for practicing the skill are all significantly higher for the nurses at the hospitals compared to their counterparts in the health clinics at the 95 percent level. The recent trainees (2009) scored higher compared to the old trainees (2007 and 2008) with regard to their preparedness or motivation before the training although memory factor could play a part here. Confidence at carrying out the neonate resuscitation procedure at the work place is a measure of the effectiveness of the NRP training because it constitutes transfer of training. Level of knowledge retained and opportunities for practicing skill at work place after the training, together with trainees' preparedness and motivation before the NRP training, all three contribute 35.7% towards trainees' confidence in carrying out the NRP procedure at their work place. Contribution of these three variables is significant at the 95% level or p< 0.05. Findings are consistent with the Model of factors that affect Learning Outcomes and Transfer of Training by Goldstein and Ford (2002).
    Keywords: NEONATE RESUSCITATION
    Matched MeSH terms: Clinical Competence
  16. Managing dental fear and anxiety in pediatric patients: A qualitative study from the public's perspective
    Hamzah HS, Gao X, Yung Yiu CK, McGrath C, King NM
    Pediatr Dent, 2014 Jan-Feb;36(1):29-33.
    PMID: 24717706
    PURPOSE:
    Internet social media offers a rich source for soliciting the public's views on health issues. This qualitative research, using You-Tube as a platform, aimed to explore the public's perspectives on management of dental fear and anxiety (DFA) in pediatric patients.

    METHODS:
    Using three keywords ("dental fear," "dental phobia," and "dental anxiety"), YouTube videos were searched. Twenty-seven videos related to DFA in children and adolescents were reviewed by three investigators, including a nondental layperson. Inductive thematic analysis was adopted for interpreting the data.

    RESULTS:
    Several strategies were considered useful for controlling DFA in pediatric patients, including: verbal and nonverbal communication to establish closeness and effective guidance (explanation, permission-seeking, reassurance, and negotiation); desensitization to dental settings and procedures; tell-show-do; positive reinforcement; distraction by imagination and thoughtful designs of clinic; and parental presence and support. Some self-coping strategies adopted by patients alleviated their DFA, such as self-reasoning and trust-building through long-term connection. Dentists' clinical competence, favorable treatment outcomes, and state-of-the-art devices and technologies (dental lasers, intraoral camera, and adapted anaesthesia method) contributed to reducing DFA.

    CONCLUSIONS:
    Authentic testimonials in YouTube videos endorsed and interpreted a variety of strategies adoptable by patients, parents, and dental professionals for managing children's and adolescents' dental fears and anxieties.
    Matched MeSH terms: Clinical Competence
  17. Senior dentists' perceptions of dental therapists' roles and education needs in Malaysia
    Nor NA, Murat NA, Yusof ZY, Gamboa AB
    Int J Dent Hyg, 2013 Nov;11(4):280-6.
    PMID: 23802751 DOI: 10.1111/idh.12038
    To describe the perceptions of senior dental officers (SDOs) on the roles of dental therapists (DTs) and their education needs in Malaysia.
    Matched MeSH terms: Clinical Competence
  18. Identifying factors associated with diagnostic concordance/discordance in oral lichen planus
    Siar CH, Lim JS, Tang SP, Chia HS, Loh YM, Ng KH
    J Oral Maxillofac Surg, 2013 Oct;71(10):1688-93.
    PMID: 23773425 DOI: 10.1016/j.joms.2013.04.026
    To identify factors associated with concordance and discordance between clinical and histopathologic diagnoses of oral lichen planus lesions.
    Matched MeSH terms: Clinical Competence
  19. Structured student-generated videos for first-year students at a dental school in Malaysia
    Omar H, Khan SA, Toh CG
    J Dent Educ, 2013 May;77(5):640-7.
    PMID: 23658411
    Student-generated videos provide an authentic learning experience for students, enhance motivation and engagement, improve communication skills, and improve collaborative learning skills. This article describes the development and implementation of a student-generated video activity as part of a knowledge, observation, simulation, and experience (KOSE) program at the School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. It also reports the students' perceptions of an activity that introduced first-year dental students (n=44) to clinical scenarios involving patients and dental team aiming to improve professional behavior and communication skills. The learning activity was divided into three phases: preparatory phase, video production phase, and video-watching. Students were organized into five groups and were instructed to generate videos addressing given clinical scenarios. Following the activity, students' perceptions were assessed with a questionnaire. The results showed that 86 percent and 88 percent, respectively, of the students agreed that preparation of the activity enhanced their understanding of the role of dentists in provision of health care and the role of enhanced teamwork. In addition, 86 percent and 75 percent, respectively, agreed that the activity improved their communication and project management skills. Overall, the dental students perceived that the student-generated video activity was a positive experience and enabled them to play the major role in driving their learning process.
    Matched MeSH terms: Clinical Competence
  20. Soft skills and dental education
    Gonzalez MA, Abu Kasim NH, Naimie Z
    Eur J Dent Educ, 2013 May;17(2):73-82.
    PMID: 23574183 DOI: 10.1111/eje.12017
    Soft skills and hard skills are essential in the practice of dentistry. While hard skills deal with technical proficiency, soft skills relate to a personal values and interpersonal skills that determine a person's ability to fit in a particular situation. These skills contribute to the success of organisations that deal face-to-face with clients. Effective soft skills benefit the dental practice. However, the teaching of soft skills remains a challenge to dental schools. This paper discusses the different soft skills, how they are taught and assessed and the issues that need to be addressed in their teaching and assessment. The use of the module by the Faculty of Dentistry, University of Malaya for development of soft skills for institutions of higher learning introduced by the Ministry of Higher Education, Malaysia.
    Matched MeSH terms: Clinical Competence*
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