Introduction : Stress is part of our life. It can happen anywhere including in medical school. Medical school is perceived as being stressful because their difficulties in education, longest period of study and dealing with the patients. Stress can be perceive as negative or positive. Coping strategies are the method that we can use to prevent stress when it comes to us. The aim of this study was to determine the prevalence of stress and coping strategies among of medical students in National University of Malaysia, Malaysia University of Sabah and Universiti Kuala Lumpur Royal College of Medicine Perak.
Methods : This study involved 450 medical students through stratified sampling in which 150 medical students from each of the three universities. This study was conducted through self administered questionnaires. The questionnaires included were socio demographic factor, Personal Stress Inventory (using Stress Symptoms Scale with 52 items), BRIEF COPE (Coping Orientation for Problems Experienced with 28 items). The determination of cut off point for stress symptoms score was using Receiver Operating Characteristic (ROC) curve.
Results : Response rate was 90.8%. The prevalence of stress among medical students were 44.1%. The contributory factors to the stress were financial problems, stress of up coming examination period, relationship problems with parents, peers, siblings and lecturers. Coping mechanisms which had significant association with stress includes self distraction, venting of emotion, denial, behavioral disengagement, humor and self blaming. Multiple linear regression analysis revealed a significant association (p
A mucous cyst is a benign, self limiting mucous containing cyst of the salivary glands commonly occuring in the oral cavity. Mucocele may develop following the obstruction of the salivary flow from secretory apparatus of the salivary gland. Mucoceles commonly occur on the lower lip but may occur in other locations too. The objective of the study was to determine the factors associated with mucocele in patients attending the dental clinic of Penang Hospital from January 2000 to December 2005. This is a retrospective record review analysis of all the total 35 cases treated during this period, comprising of 20 males (57.1%) and 15 females (42.9%) with Malays as the largest group of patients treated and, mainly students had seek treatment. Mucocele was frequently treated in patients aged 21 to 24 year old. The site of the mucocele was the lower lip and all of the cases were treated surgically. The size of the mucocele ranged from 0.5 to 5 centimetres with 1.0 cm as the most common size. Most of the patients gave a history of spontaneous development (71.4%), followed by lip biting (25.7%) and trauma (2.9%). Lip biting was more common among students (55.6%) as compared to others. There were only two recorded cases of recurrence.
The aim of this study was to assess the wear of tungsten carbide burs and round rotary diamond instruments through measurements of rake angle and visual observations respectively under a field emission scanning electron microscope. Sixty short and long head pear-shaped tungsten carbide burs and 18 round rotary diamond instruments that had been used to complete < 5, > 5 and > 10 cavity preparations (n=10/group) were selected from the 3rd and 4th year dental students, Faculty of Dentistry, University of Malaya. There were two control groups consisting of long and short tungsten carbide burs of ten each. Two-way ANOVA was used to analyse the rake angle data. The data from the two control groups were collectively analysed following multiple paired t-test (p>.05) which showed no significant difference between the two types of tungsten carbide bur (short and long head). The mean rake angle of the control group was significantly higher (p < .05) compared to the < 5, > 5 and > 10 cavity preparation groups. The rake angle of the > 10 cavity preparation group was significantly lower than the other two test groups (p < .05). Round rotary diamond instruments in the < 5 cavity preparation group showed intact diamond particles with distinct cutting facets comparable to the control group. However, diamonds instruments in the > 5 and > 10 cavity preparation groups showed blunt diamond particles. In conclusion, wear of tungsten carbide burs and round rotary diamond instruments were evident after repeated use. Wear was more pronounced when instruments were used to prepare more than ten cavities.
The oral health awareness and status among the Universiti Kebangsaan Malaysia first year dental students were studied. Seventy-three subjects underwent two components of assessment: questionnaire assessing oral health awareness and behaviour, and clinical examination of oral health status. Indices used including Plaque, Calculus, Community Periodontal Index for Treatment Needs (CPITN) and total score of Decayed, Missing, Filled and teeth indicated for Extraction (DMFX[T]). More than 90% of the subjects were reported to brush their teeth twice or more daily and used supplemental cleaning tools. They also knew the importance of healthy oral condition, the various causes and prevention of tooth decay and gum diseases. Although 70.3% felt they need dental treatment, the majority (81.9%) visited the dentist only when they feel it is necessary to do so. Clinical examination showed low scores of 0.99 and 0.40 for mean plaque and calculus indices, respectively, while 80.8% of the subjects have mild calculus accumulation. Code 2 of the CPITN Index was the highest (70.3%) among the subjects. The total DMFX was 291, with mean score of 0.14 per subject and the decayed component was the highest (D=186 teeth). These findings suggest that the subjects have acceptable oral health awareness, and also good existing oral health status.
Stress has been recognized one of the factors causing disease. About 70-80% of all diseases may be stress related. Thus, stress management can be a part of an early measure of disease prevention. A descriptive cross sectional, randomized study was conducted to determine the stress inducing factors among preclinical students (universal sampling) in a public university in Selangor, Malaysia from 24th April to May 2005. A total of 163 students (52.8% year 1, 36.8% year 2 and 10.4% year 3) were interviewed in the data collection process. The main reasons students entered - medical school was because of their own interest or ambition (65%) and family influence (20.9%). Majority (76.4%) suffered moderate to great stress over hot conditions in lecture hall, tutoriaV small group session rooms and laboratories while 53.4% suffered when using the other facilities like cafeteria, toilet and transportation:. Almost all (95.1%) felt that examination was the most stressful, followed by early clinical exposure sessions (68.1%), problem·based learning sessions (62.5%), hospital visitations (59.7%), tutoriay small group sessions (49.3%), practical class (44.5%) and attending lectures (3 8.5%). Musculoskeletal System was the most stressful module among the first year students, followed by Nervous System and Gastrointestinal System with the percentage of 94.2%, 90.7% and 88.4% respectively while, 95% of the second year students felt that General, Hemopoietic ci? Lymphoid and Nervous System are the most stressful modules. This study revealed that academic sessions and lack of conducive teaching and learning environment as the main stress inducing contributors to preclinical medical students.
Rubella is an acute and contagious disease which is mainly characterized by fever, rash, and cervical lymphadenopathy. This contagious disease spreads easily through nasopharyngeal secretions, droplet or direct contact with patients. Meanwhile clinical features of scarlet fever include a sore throat, skin rash and strawberry tongue. A descriptive study was conducted to describe the epidemiological characteristic of diseases at a Training Camp in Mersing. Data obtained on demographic details, onset and time of fever and rash or contact with ill person 14 to 21 days prior to symptoms. Screening and interview conducted for all suspected cases of Rubella. 47.4% of the cases presented on 5th June 2012 followed by 15.8% on 11th June 2012 and 13.5% on 12th June 2012. Maculo papular rash was the predominant presenting symptom among students with acute infection in this outbreak (100%) followed by fever (36.8%). Measles specific IgM was not detected in the serum taken but rubella specific IgM was detected in 66.7% (6/19) of samples. 55% (11/20) were positive for ASOT. 4 trainees had Rubella and Scarlet Fever co-infection. It was found out that the outbreak occurred among 391 residents in the camp who shared common places for activities such as lecture, physical activity and meal. Rapid dissemination was due to overcrowded environment and close contact during common activities of the residents. Theoretically co-infection would be presented with severe clinical symptoms but not in this outbreak where all affected trainees only presented with mild fever and rashes.
Breast cancer is one of the most frequently encountered malignancies among young females in Malaysia, which accounts for 30.4% of newly diagnosed cancers. All women at or above the age of 20 are considered at risk of developing breast cancer. This is a cross-sectional study. The study was conducted in a private medical university in Malaysia during year 2012. Two hundred students were recruited in this study using universal sampling. Data collection was done using a selfadministration questionnaire. Chi-square test was used to assess the association between the practice of breast selfexamination and socio-demographic variables. Only 19.5% of the study sample has sufficient knowledge about BSE which is acquired mostly from local media. Having a family history of malignancy other than breast cancer seems to be the only significant variable associated with knowledge about BSE (P=0.002). Other variables such as demographic data, menstrual history and social history were also tested, but found to be not significant. Frequent community-based awareness programs are needed so that all women can know and practice BSE, which in turn helps to alert the women to any abnormal changes in the breasts so that they will be able to seek medical advice immediately.
Introduction: There is an increasing trend in smoking among rural adolescents compared to urban adolescents in Malaysia. This study was to determine the relationship between religious personality and smoking among form two students from the rural schools in Malacca. Methods: This was an unmatched case-control study conducted from May 2010 to August 2010 among form two school children from rural area in Malacca. There were 484 cases, and 444 controls selected using randomized cluster sampling. The dependent variable was smoking, and the independent factors were religious personality. Validated and reliability-tested questionnaires were used for data collection. Results: The mean age (year) at which smoking was first tried among the cases was 11.39 + 2.107. There were eleven out of twenty three significant differences between religious personality statements in the cases and control group. Those were: reciting the Quran/Holy book/Scriptures even when busy, making efforts to deepen the understanding of the religion, trying to understand the teachings of the religion in the Holy book/Quran, inviting others to perform solat/prayer/religious service, making sure all the family members are following the teachings according to the religion, referring to the learned people when feeling uncertain about the rulings/teachings of the religion, performing work duties enthusiastically because of the religion/God, making efforts to remember death and afterlife often, making efforts to internalize the ethical conduct of the religion in daily life, setting aside money every year for religious purposes and looking for opportunities to give charity. Conclusion: Religious personality is an important factor which may influence adolescents volved in smoking.
Objectives: This paper reports the outcome of Session With Carer, one of the activities in the Year 4 Personal and Professional Development (PPD) module in the new integrated curriculum of the Undergraduate Medical Programme at the Faculty of Medicine,
Universiti Kebangsaan Malaysia (UKM). Methods: This activity involves groups of 14 – 15 students sitting in with family members of individuals with mental illness. The session starts with the carer giving his or her perspective of patient’s care and the challenges involved. This is followed by a question and answer session. Finally, the carer provides a written feedback by way of scoring certain items as well as brief comments. After the session, each student is required to prepare an individual report in the form of reflective writing. Results: Out of a total of 224 students, the reflections of 126 students were reviewed to assess what they had learnt from the Session With Carer. Among the more significant findings were: 100% learnt about the various challenges faced by carers. 31.7% learnt the importance of
faith/spirituality of the carer in caring for a mentally ill family member. 29.4% learnt the importance of family and others’ support. An equal number, that is, 26.2% learnt that it helps for the carer to have good mental health and a positive attitude, as well as good
knowledge of the illness. Those who became aware of the benefits of the carer having patience and determination made up 23.8% of the total reflections reviewed. Conclusion: The findings show that the Session With Carer is very educational, and helps create more
awareness of the importance of the carer’s role in patient management and support. In other words, carers can act as teachers in creating more public awareness about mental illness and
ultimately, help in gradually removing the stigma associated with mental illness. Therefore, carers should be utilized for this purpose.
Adolescents who overestimate the prevalence of smoking among their peers or other teens are at higher risk to take up smoking. The purpose of this study is to elucidate the factors which are related to adolescents’ overestimation of smoking. We surveyed form four (16 years old) students in Petaling District, Selangor. A sample was selected using two-stage stratified sampling, and data were collected using standardised, self-administered questionnaires. A response rate of 80.4% (n=1045/1298) was obtained, and a total of 943 students were included in the final analysis. About 73 percent (n=688/943) of the respondents overestimated the prevalence of smoking among their peers. The odds of overestimating increased as the number of close friends who smoke increased [Two close friends, OR=3.10(1.67-5.75), three close friends OR=10.81(4.44-26.3) and four-five close friends OR= 12.91(5.31-31.43)]. Those who had an elder brother who smoked (OR=1.95 (1.18-3.24)) and females [2.08(1.37-3.33) were more likely to overestimate peer smoking prevalence. Intervention programmes to correct the misperception of peer smoking prevalence are recommended, in addition to measures to modify the other factors that are amenable to intervention, so as to reduce the risk of smoking initiation among adolescents.
Comparison of rates of smoking across countries revealed that students are more likely to begin smoking in medical school than to give it up and increase their cigarette consumption rather than decrease it. A cross-sectional survey of all consenting medical students in a private medical university in north Malaysia was conducted in 2008 to determine the prevalence and smoking habits among them. A self administered questionnaire which was returned to the investigators in a sealed envelope was used. Results were tabulated and analysed with SPSS version 13.0 software. The response rate was 83.3% (508/610). The prevalence rate for current smokers was 5.3% (27/508) and for ever smokers 9.3% (47/508). Factors significantly associated with smoking were gender (p<0.001), age group (p<0.001) and family income (p=0.003). The odds of being a smoker was 14 folds high when a family member smoked and the odds of being an ever smoker was almost 6 folds more when a family member smoked. Friends were the most common influence to start smoking and the most common reason to stop smoking among ever smokers. The reasons for not smoking among the never smokers were health concerns and the distasteful smell of cigarettes. A module on how to help medical students to stop smoking should be included in the curriculum of every medical school. This will not only help them become good educators but will prevent them from picking up the habit. Educational intervention should also include family members who smoke.
Key words: smoking, medical students, university, Malaysia
Participation and adherence to the law and cultivation of anti-tobacco culture became the important issues for reducing the tobacco use prevalence in the community. Measuring the perception of tobacco policy indirectly measures the acceptability of the law. This study aims to determine the perception of students on anti-tobacco policy in terms of tobacco free school environment and factors that support or deter them. A two-stage cluster samplingtechnique was used for selection of schools with probability proportional to enrolment size followed by stratified random sampling of government and private schools. Data were collected from 6563 secondary school students using
structured questionnaire. Analysis showed that 66.2% of the female students and 33.8% of the male student have strong supportive attitude towards tobacco free school environment. Logistic regression analysis revealed that class grade IX and above, father’s occupation as service, family size less than 6, higher economic status, non smoker, non exposure to second hand smoking in the house and discussion of dangers of smoking appeared to have important influencing factors for tobacco free school environment (p
Health system reform has been a major concern for different countries. The aim of this research was to develop a reliable and valid questionnaire suitable to assess the consequences of health reform process from people's perspective. An extensive literature review used to extract a set of statements as possible indicators for health system reform. Expert panel used to determine the content validity rate (CVR) and the content validity index (CVI). The first version produced in Turkish language and pre-piloted with 20 heads of household. Qualified committee used to translate the Turkish version to English version. Group of eighteen academics and graduate students recruited to tests both versions for parallel test validity. The construct validity of the questionnaire was determined using principal components analysis with Varimax rotation method (PCA). Internal consistency and questionnaire's reliability were calculated by Cronbach's alpha and the test–retest reliability test. A 17- items questionnaire was developed through the qualitative phase. The Bartlett's test was significant (p < 0.001), and the KMO value (0.842) showed that using principal component analysis (PCA) was suitable. Eigenvalues equal or higher than 1 were considered significant and chosen for interpretation. By PCA, 4 factors were extracted (accessibility, attitude and preference, quality of care and availability of resources) that jointly accounted for 85.2% of observed variance. The Cronbach's alpha coefficient showed excellent internal consistency (alpha=0.97), and test-retest of the scale with 2-weeks intervals indicated an appropriate stability for the scale (Intra-class coefficient = 0.96). The findings showed that the designed questionnaire was valid and reliable and can be used easily to assess the consequences of health reform process by comparing the situation before and after the reform from people's perspective.
Medical students are future doctors who are trained to treat all kinds of diseases including people living with HIV/AIDS (PLWHA) without prejudice. Teaching basic scientific knowledge and technical skills is no longer adequate for today’s medical students. There is also a need for them to be provided with high personal and professional values. This study examined stigmatizing attitude towards people living with HIV/AIDS (PLWHA) among the medical students in a public medical school. The participants were stratified to preclinical-year (year 1 and year 2) and clinical-year (year 3 and year 4) medical students. Simple random sampling was carried out to select 170 participants from each category of students. Self-administered questionnaires captured socio-demographic data, HIV/AIDS knowledge and stigmatisation attitudes towards PLWHA. Multiple linear regression was used to assess the relationship between ethnic groups and stigmatization attitude. Three hundred and forty participants were recruited. Malay medical students who did not have previous encounter with PLWHA were associated with stigmatizing attitude towards HIV/AIDS patients, whereas clinical-year medical students who had no clinical encounter with PLWHA were more likely to feel uncomfortable with PLWHA. Malay ethnicity and medical students in clinical years who had not encounter a PLWHA were more likely to have stigmatizing attitude towards PLWHA.
Background: Social support is the perception that one is cared for, has assistance available from friends and significant others. Social support can be measured by The Multidimensional Scale of Perceived Social Support. This scale has been widely used and validated in different languages. Objective: To determine the factor structure of The Multidimensional Scale of Perceived Social Support scale and find its reliability. Method: The study was conducted in one of the Universities in Malaysia. The undergraduate students who volunteered to participate in the study were explained about the purpose of the study and implications. The English version of Multidimensional Scale of Perceived Social Support scale (MSPSS) that was administered. In all 313 undergraduate students were studied. Exploratory factor analysis, with varimax rotation, was applied to the data Results: The three factor solution accounted for 80.51 % of the total variance. The procedure output has an overall alpha of 0.921. Conclusion: The MSPSS appears to be good enough to be used in Malaysia however more studies are required.
This case report highlights on the dilemma in making a decision for termination of pregnancy (TOP) for a muslim rape victim in Malaysian setting. We report a case of 17 year-old student at 7 weeks of pregnancy after being gang-raped, who, together with her parents, had requested for a TOP. Psychiatric assessment showed that the patient suffered from a major depressive disorder and post-traumatic stress disorder which justified termination of pregnancy on a psychological and clinical basis. However the available Malaysian Islamic fatwa had caused some uncertainties on the final decision making. This case demonstrated on the needs to understand the relevant issues beyond clinical judgment in relation to TOP in our setting which encompasses the legal provision, ethical obligation as well as the needs for a clear religious understanding and stand to support the medical decision.
Objective: Literatures on factors influencing performance of the Stroop interference have been elusive on coping styles. Past investigations of coping influence on Stroop test have been indirect and inconclusive due to variability of multidimensional coping models and application of different Stroop test. The concept of constricted versus flexible or broad cognitive style have linked personality and coping styles to Stroop performance. The objective of this study was to determine the associations of coping styles with Stroop resistance towards interference (Stroop RI) and subsequently determine the predictors of Stroop performance. Methods: This was a cross-sectional community research design study with purposive sampling. In this study, the self-administered Brief COPE inventory questionnaires and Stroop Test were performed among 205 undergraduate medical students. Results: Findings revealed that behavioural disengagement (r=-0.361), dysfunctional coping (r=-0.355), self-blame (r = 0.222), and substance abuse (r = -0.173) showed negative correlation and proven strong association with Stroop RI. Further multiple regression analyses identified behavioural disengagement (R2 = 0.13), and dysfunctional coping (R2 = 0.024) as significant predictors for interference. Conclusion: Coping styles have implication on Stroop test exhibited in varied cognitive styles. Integrating coping styles factor on Stroop test has glimpsed the future direction of other neuropsychological assessment batteries on the importance of profiling individualistic baseline norms. ASEAN Journal of Psychiatry, Vol. 16 (1): January – June 2015: XX XX.
Background: One of important educational climate roles is to provide an environment that promotes positive development of medical students' psychological wellbeing during training. Unfortunately, many studies have reported that educational climate in medical education are not favourable to them. Therefore, it is a real need for a simple, valid, reliable and stable tool that will help medical schools to screen psychological wellbeing of their students so that early intervention could be done.
Objective: This study aimed to explore the psychometric properties of the Medical Student Wellbeing Index (MSWBI) to measure psychological wellbeing at different interval of measurements in a cohort of medical students.
Method: A prospective study was done on a cohort of medical students. MSWBI was administered to the medical students at five different intervals. The confirmatory factor analysis, Cronbach's alpha and intra-class correlation analysis were applied to measure construct validity, internal consistency and agreement level at different interval of measurements.
Result: A total of 153 (89.5%) medical students responded completely to the MSWBI. The MSWBI showed that the one-factor model had acceptable values for most of the goodness of fit indices signified its construct was stable across multiple measurements. The overall Cronbach's alpha values for the MSWBI at the five measurements ranged between 0.69 and 0.78. The ICC coefficient values for the MSWBI total score was 0.58 to 0.59.
Conclusion: This study found that the MSWBI had stable psychometric properties as a screening tool for measuring psychological wellbeing among medical students at different time and occasions. Continued research is required to refine and verify its psychometric credentials at different educational settings.
Introduction: Just-in-Time Teaching (JiTT) is a novel method of teaching-learning used in various disciplines of science and humanities. It is a technique that scaffolds the students learning process by reducing the cognitive load which is the load related to the executive control of working memory. Just in time teaching underpins the concept that expertise in learning originates from the knowledge already stored in long term memory and with subsequent interaction between the learner and teacher motivates enhanced active learning and optimizes the intellectual performance.
Objective: The objective of the study is to assess the acceptability of JiTT over traditional lecture teaching among the medical students.
Method: In a cross sectional pilot study, three hundred thirty five students participated in a questionnaire based study that grades the various aspects of the traditional lecture series. After the implementation of JiTT method for a period of four months, three hundred two students completed the questionnaire, grading the same variables for JiTT. The analysis was done by using SPSS version 11 applying Paired t test and McNemar's Test.
Result: The results of our study highlighted that JiTT technique was perceived superior to traditional teaching with statistically significant outcomes in the clarity of the topic (p=0.003,) duration of the session (p=0.002), knowledge gained and orientation for exams (p=0.044). The students perceived JiTT method as less monotonous (p=0.005) increasing their alertness during these sessions (p=0.002).
Conclusion: We therefore propose that Just-in-Time Teaching method is a more interactive and acceptable teaching-learning tool shifting the nature of teaching to a more student-centric approach as perceived by the medical students. This is the first pioneer study on JiTT to be performed on undergraduate medical students so far.
Introduction: Medical and allied health educators around the globe agreed that an optimal educational climate is a vital aspect for effective learning to take place. Without a doubt, appraisal of the educational climate has been emphasized as a key to the delivery of high quality medical education. In addition, the appraisal provides useful feedback to particular institution to improve their curriculum.
Objective: This study was employed as part of the School of Medical Sciences (SMS) Universiti Sains Malaysia curriculum review process. It aimed to explore the strengths and weaknesses of the current medical curriculum thus could provide useful information to guide the curriculum review committee during the review process.
Method: A cross sectional study was conducted on a total of 656 medical students from the first, third and fifth year of study. Purposive sampling method was applied. DREEM was administered to the medical students to evaluate the educational climate in the studied medical school.
Result: A total of 511 (77.9%) medical students completely responded to the 50 statements of DREEM. The mean global score across phases of medical training was 128.36/200. The global scores for year 1, year 3 and year 5 were 138.94/200, 122.27/200 and 125.49/200 respectively. Results showed that; 1) the medical school had reasonably level of educational climates across phases of medical training; 2) the medical teachers were knowledgeable and well prepared for the teaching; 3) the students were overloaded with factual knowledge; 4) the medical teachers were quite harsh to students during teaching session especially in clinical phase; 5) students experienced a significant amount of stress that led to poor memory; 6) the learning process was inclined toward teacher-centered rather than student-centered learning; 7) students had a considerable healthy social relationships with peers as well as others; and 8) academic dishonesty became more apparent in the clinical phase.
Conclusion: The medical school's educational environment across different phases of study was more positive than negative. However, there are plenty of rooms for improvement as perceived by the medical students. The medical school should address various important issues highlighted in this article during the curriculum review process.