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An evaluation of the undergraduate teaching programme in ophthalmology in Sri Lanka and Malaysia

Dias PL

Med Educ, 1987 Jul;21(4):334-9.
PMID: 3626901

The knowledge and clinical and minor surgical skills acquired by 257 medical students in three universities in Sri Lanka and Malaysia were assessed by a questionnaire after they had completed their training period in ophthalmology. This study showed that many medical students graduating from these universities lacked the basic clinical and minor surgical skills essential for a doctor practising in a community in south-east Asia. The responses also indicated that teaching by consultants in all three universities was inadequate and due to these inadequacies the students requested that the duration of their training period be doubled. Ophthalmology is an important component of clinical practice and proper education in this subject is important. An urgent revision of the aims and objectives of the curriculum in ophthalmology is essential to place greater emphasis on this important and much neglected subject, for which very little curricular time is allotted.

Matched MeSH terms: Clinical Competence
Fulltext Knowledge of managing avulsed tooth among general dental practitioners in Malaysia

Abdullah D, Soo SY, Kanagasingam S

Singapore Dent J, 2016 Dec;37:21-26.
PMID: 27916252 DOI: 10.1016/j.sdj.2016.01.001

BACKGROUND: Dental and maxillofacial injuries are one of the areas of concern highlighted in the Malaysian National Oral Health Plan 2011-2020. General dental practitioners (GDPs) have the responsibility of diagnosing and assessing dental trauma and determining the prognosis and outcomes of trauma along with its management. The purpose of this study was to evaluate the knowledge base and preferred methods of general dental practitioners regarding the management of avulsed tooth.
METHODS: A random convenient sampling methodology was employed for sample selection. A pre-tested 11-item questionnaire was validated on the dental officers. The survey was distributed to 182 GDPs attending the annual Malaysian Dental Association conference in January 2010. The data obtained was statistically analyzed using descriptive analysis and logistic regression was employed to predict the probability of achieving high scores.
RESULTS: A total of 182 general dental practitioners participated in the study, with the majority being female (n=153, 75%). The place of practice significantly affected the knowledge score. In the group that scored more than 80 points (n=84, 46%), 76% of them worked with government hospitals. Age, work duration and number of traumatised teeth previously treated had no significant effect. The odds ratio for place of practice indicates that respondents who work in government hospitals are 3.6 times more likely to score more than 80 points compared to those who worked in private clinics (OR=3.615, P=0.001).
CONCLUSION: The knowledge level on the management of avulsed tooth among general dental practitioners in Malaysia needs to be improved. Strategies in improvement of the Malaysian dental educational system, continuous dental educational activities and utilisation of guidelines on trauma management should be recommended to increase the knowledge level of avulsed tooth management to ensure good treatment outcomes.
CLINICAL IMPLICATION: Trauma prevention and further education regarding the management of avulsed tooth is an essential requirement to improve general dental practitioners knowledge and clinical skills.

Matched MeSH terms: Clinical Competence
Fulltext How can we improve code blue training for non-paediatricians: an experience from students-conducted assessment in national clinical skills conference

Khoo, Erwin Jiayuan, Kutzsche, Stefan

Malaysian Journal of Paediatrics and Child Health, 2018;24(1):27-42.
MyJurnal

Introduction: Training of all health personnel involved in paediatric care is a key determinant of successful outcome during paediatric emergencies. We aimed to identify the need for paediatric Mock Code Blue skills training among non-paediatricians in a pre-hospital setting through checklist assessment of their performance. Methods: A paediatric septic shock and cardiac arrest Mock Code Blue pre-hospital scenarios were presented for non-paediatricians during a National Clinical Skills Conference. Eight medical student assessors and four clinical facilitators were involved in this training. Participants were expected to be able to demonstrate the skills and teamwork necessary to managepaediatric emergencies according to the learning outcomes. Results: A total of 97 delegates participated in a facilitated paediatric Mock Code Blue for multidisciplinary groups of health personnel. Outcome measures showed a significant lack of communication and team work skills, and weakness in “closing the loop” as barriers to successful resuscitation. Conclusion: We recommend Mock Code Blue simulation training to be offered regularly to all groups of healthcare providers involved in paediatric and neonatal care while not overlooking the emphasis on non-technical skills.

Matched MeSH terms: Clinical Competence
Evaluating the contribution of a wildlife health capacity building program on orangutan conservation

Unwin S, Commitante R, Moss A, Bridges E, Farmer KH, Jaya RL, et al.

Am J Primatol, 2021 May 21.
PMID: 34018623 DOI: 10.1002/ajp.23273

One Health is increasingly being used as a tool in ecosystem protection. The Orangutan Veterinary Advisory Group (OVAG) is working to address One Health concerns in Pongo spp. (orangutan) welfare and conservation. Orangutans are vital contributors to the ecosystem health of their range areas. Strengthening national capacity is crucial to make a lasting difference in the currently bleak outlook for orangutan species survival. OVAG is a capacity strengthening and expertise network that brings together all those working with orangutans, in- and ex-situ, to share knowledge, skills, and to collectively learn. Using the One Health paradigm embedded to enhance professional development, the OVAG network is successfully supporting conservation outcomes and impact. As part of our adaptive management approach, and to assess individual and organizational change attributable to the capacity strengthening work of OVAG, we evaluated technical skill test data, program satisfaction data, and asked participants to complete a self-reflective survey. This pilot study of our work demonstrates statistically significant improvements in conservation medicine (t = 5.481, p

Matched MeSH terms: Clinical Competence
Fulltext Beginner crisis communication for nurses: an introductory module of Hospital Universiti Malaysia Sabah

Megawanah Mohd Razalee, Prisia Jibin, Sabrina Paul, Muhammad Syafiq Abdullah, Helen Benedict Lasimbang, Wendy Diana Shoesmith, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):65-0.
MyJurnal

Introduction: Crisis communication is an important skill for healthcare professionals, especially during disaster peri- od including the current 2019-nCoV pandemic. Nevertheless, the skill of crisis communication is not commonly an integral part of Malaysian nursing diploma and degree course. Methods: A half days session on how to communicate in the context of crisis was incorporated into an experiential learning workshop to 25 existing and newly recruited nurses together with 7 other healthcare professionals. The topics of nature of disaster, disease outbreak, preparation for disaster, principles and responsibility of crisis communication, preparing statement for press conference, and corporate communication were covered through brief lecture, round table discussion and tabletop simulations. Real time example of 2019-nCoV crisis communication was used to illustrate the skills required in the situation. Results: All participants confirmed that this was the first exposure to hands-on training on crisis communication and enlightening although majority of them were uncertain that they are capable to perform it during the crisis despite the ongoing 2019-nCoV issue in view of their the position that they are holding. Most nursing curriculums focus on clinical theory and clinical skill competency acquisition without addressing the need of learning how to commu- nicate beyond clinical setting in the situation of disaster and panic, which is mostly learned at job. The limitation included the practice in tabletop simulations might not be immediately translatable into real life practice. Conclu- sion: Regular reinforcement through more workshops and incorporation into disaster may potentially be a solution to improve the competency of healthcare professionals in crisis communication. Further assessment on the practice of the participants in performing crisis communication is needed to ensure the competency level has been achieved and to evaluate the efficiency of the workshop delivery method.

Matched MeSH terms: Clinical Competence
Fulltext Task Integrated Objective Structured Clinical Examination (TIOSCE): A modified version of OSCE

Shahid Hassan

Education in Medicine Journal, 2012;4(1):115-128.
MyJurnal

The impact of good assessment in medical education depends on how appropriately the tools measure the clinical performance and how reliable, valid and feasible they are to achieve the logical decision. The traditional methods of clinical examination using long and short cases and orals are often argued for its subjectivity, low reliability and inadequate context specificity. Oral test though comparatively more valid due to its face-to-face questions are considered less reliable for problems of unstandardized questions, inconsistent marking and lack of sufficient testing time. Development of an “objective structured clinical examination” (OSCE) was sought as a solution to these problems. But the fragmented representation of the context in a number of stations in OSCE makes it less authentic for an integrated judgment of performance. Yet another method to thought of, was the workplace-based assessment (WPBA) but it takes a snapshot as a predefined attribute of a more complex integrated assessment such as long case. However due to the problem of feasibility it is less likely that high stakes examination as summative assessment will ever be able to attain workplace-based assessment such as Mini-CEX and DOPS. A TOACS (task oriented assessment of clinical skills) format currently used in high stakes fellowship examination in one of the center and claimed to have more active role for examiners was analyzed and compared with OSCE. Author however, did not find a difference except the difference of acronyms of the two formats. Both have multiple, fragmented static or interactive stations of 5-10 minutes duration with or without examiners, patients or exhibits and a marking scheme comprising of checklist or global rating. In the backdrop of this context a new assessment format named the ‘task integrated objective structured clinical examination” or TIOSCE modified from OSCE is currently developed in School of Medical Sciences (SMS) at USM. However, it is a different version of OSCE in which though the principle concept is the same as that of an OSCE, the continuum of clinical skill’s work up of the same patient’s is followed through to test multiple short attributes of clinical competences. As it retains most of the favorable features, TIOSCE also addresses some of the odds features of OSCE.

Matched MeSH terms: Clinical Competence
Fulltext Faculty development: mini-CEX as workplace-based assessment

Shahid Hassan

Education in Medicine Journal, 2011;3(1):12-21.
MyJurnal

Background: Competence-based curriculum has become the need of medical education to meet the objectives of institutions aiming to produce skilled physicians. To achieve the optimal competence and performance of graduates a number of traditional evaluation exercises have been practiced. Some of these e.g. OSCE although meet the acceptable standard of reliability and validity is the assessment done in a controlled environment. This leaves the room for performance-based assessment in real clinical situation such as mini clinical evaluation exercise (Mini-CEX). To practice and meet the challenges of Mini-CEX it is vital to undertake faculty development program with a comprehensively chalked down Mini-CEX protocol and its objectives to achieve the intended outcome. Objective: To undertake faculty development on Mini-CEX for its feasibility and acceptability as a method of formative assessment to evaluate the clinical competence of trainees in postgraduate program of Otolaryngology and Head-Neck Surgery. Method: 25 trainees from the four classes of master of surgery program of 2009 in Otolaryngology and Head-Neck Surgery (ORL-HNS) undertook Mini-CEX encounters and assessed by 9 supervisors in a 12-week period of study. Faculty development program was carried out through prior lectures deliberating on background, concept and procedure of Mini-CEX followed by demonstrations using video clip of Mini-CEX encounter recorded in own clinical environment. Students were also exposed to similar settings to take up the Mini-CEX encounter without any hesitation. Trainees were assessed in outpatient clinical setting. Program was evaluated for its feasibility and acceptability with respect to patient’s factors, clinical attributes, supervisor and trainee’s performance and their reported level of satisfaction.
Result: Faculty development and trainees orientation in Min-CEX was achieved as feasible and acceptable. Higher rating of satisfaction was reported by majority assessors and trainees as they found Mini-CEX acceptable for formative assessment. Among clinical skills highest rating was received in physical examination and lowest rating in therapeutic skills. Conclusion: A motivated faculty and organized approach towards a comprehensive knowledge on Mini-CEX for its background communication, demonstration of procedure and method to complete the rating forms is the useful guide to adopt Mini-CEX. The faculty and trainees in department of ORL-HNS found Mini-CEX as feasible and acceptable assessment tool to monitor educational activity of postgraduate program through performance-based evaluation in a real clinical situation.

Matched MeSH terms: Clinical Competence
Fulltext Faculty development: DOPS as workplace-based assessment

Shahid Hassan

Education in Medicine Journal, 2011;3(1):32-43.
MyJurnal

Background: In order to achieve the desired performance of graduates a number of traditional evaluation exercises have been practiced to assess their competence as medical students. Many of these assessments are done in a controlled environment and mostly reflect on tests of competence than performance. Mini-CEX or direct observed procedural skills (DOPS) are the real performance-based assessment of clinical skills. Increased opportunity for observation and just-in-time feedback from the role model superiors produce a positive educational impact on students learning. This also provides trainees with formative assessment to monitor their learning objectives. However, to implement assessment strategies with Mini-CEX or DOPS needs to develop institution’s clear policy for a different teaching and learning culture of workplace based assessment. It also needs to develop user friendly rating form, checklist, elaboration of clinical competence and its attributes and procedural guidelines for practice. A precise role of these tools in the assessment of postgraduate program must be established before practicing them to evaluate and monitor trainee’s progress.
Objective: To determine DOPS for its acceptability and feasibility as a method of formative assessment of clinical skills in postgraduate program of Otolaryngology and Head-Neck Surgery.
Method: A total of 25 trainees were assessed for DOPS by 8 supervisors in this 12-weeks pilot study. A faculty development program for faculty members and trainees was run for DOPS. Trainees were advised to undertake at least one DOPS encounter out of 42 shortlisted procedures. Assessors were asked to mark trainees by completing a rating form using a checklist developed for each procedure. Trainees and assessors were asked to endorse their opinion on feasibility and acceptance of DOPS for practice of formative assessment in future. Data was analyzed to determine feasibility and acceptability of DOPS in assessment program. Result: Faculty development and trainees orientation in DOPS were found satisfactory for its acceptance and feasible for its practice. Trainees were mostly assessed in outpatient clinical setting. Majority reported higher rating of satisfaction by assessors and trainees. Among clinical skills higher rating was received in procedural skills performed by the senior trainees. Conclusion: DOPS was found feasible for practice of formative assessment of trainees in postgraduate program of Otolaryngology and Head-Neck Surgery in School of Medical Sciences (SMS) at Universiti Sains Malaysia (USM). It was well accepted by the trainees to help monitor their quality of procedural skills as self-directed learning.

Matched MeSH terms: Clinical Competence
Fulltext The relationship between alvarado score and pain score in managing adult acute appendicitis in the Emergency Department

Ahmad, K.I., Shamsul, A.S., Ismail, M.S.

Journal of Surgical Academia, 2011;1(1):15-24.
MyJurnal

Acute appendicitis is one of the most common differential diagnoses for acute abdominal pain made by emergency doctors. Suspected cases require surgical referral for observation or definitive intervention to prevent complications. A high index of suspicion and good clinical skills with the aid of scoring systems allows early decision making, which includes optimal pain control. The objective of this study was to identify the pain score and is relationship to the cut-off points of the Alvarado scoring system so that justifies early surgical referral or discharge for suspected acute appendicitis from the Emergency Department of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This was a cross sectional study of acute abdominal pain from June 2007 to September 2008. All patients who fulfilled the criteria and consented to the study were assessed for Alvarado score, verbal numerical pain score (VNRS) and their subsequent management. Patients with an Alvarado score of ≥7 were likely to have acute appendicitis (80.1% sensitivity and 52.63% specificity) and those with the score of ≤3 were unlikely to have acute appendicitis. The median pain score was 7.00 (IQR: 5.00-8.50) but 72.5% did not receive any analgesia. There was no direct relationship between the pain score with Alvarado score. Oligoanalgesia in patients with acute appendicitis still exist in Emergency Department of UKMMC.

Matched MeSH terms: Clinical Competence
Fulltext Dental undergraduates’ self-assessed confidence in paediatric dentistry

Wong, S.W.Y., Wong, X.Q., Vaithilingam, R.D., Rajan, S.

Ann Dent, 2015;22(2):1-9.
MyJurnal

Aim: Self-assessment based on benchmarked professional standards is an excellent tool to assist in improving the dental curriculum. Areas of strength and weaknesses can be identified. It can also act as a baseline standard when significant changes are introduced to the dental curriculum. The aims of this prospective cross-sectional study was to investigate self-assessed confidence of final year dental undergraduates in paediatric dentistry enrolled at University of Malaya in 2013. Methods: 65 undergraduates completed anonymised questionnaires which were formulated based on expected professional competencies in three domains namely clinical skills, patient management, and professional development and clinical governance. Visual analogue score (VAS) represented by a 10cm line with score ‘0’ no confidence at all and ‘10’ complete confidence was used to measure the level of confidence. Results: The overall analysis of self-assessed confidence was very positive with median VAS ≥ 5cm in; clinical skills, 7.66±1.31cm (range=2.41–9.97cm: n=62; 95.4%), patient management 7.73±1.27cm (range=5.09–9.95cm: n=64; 100.0%), and professional development and clinical governance, 8.13±1.21cm (range=5.22–10.00cm: n=64; 100.0%). High confidence was reported for routine dental care (fillings and preventive care) while lower confidence reported for basic life support (median VAS=5.65cm) and pulp therapy for immature permanent teeth (median VAS=5.95cm). Conclusions: The final year dental undergraduate students of the University of Malaya appear to have good overall self-assessed confidence in core areas in paediatric dentistry.

Matched MeSH terms: Clinical Competence
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
Cochrane Rehabilitation: Organization and Functioning

Negrini S, Arienti C, Gimigliano F, Grubišić F, Howe T, Ilieva E, et al.

Am J Phys Med Rehabil, 2018 01;97(1):68-71.
PMID: 28953033 DOI: 10.1097/PHM.0000000000000832
Matched MeSH terms: Clinical Competence
Preparedness of recent dental graduates and final-year undergraduate dental students for practice amidst the COVID-19 pandemic

Pandarathodiyil AK, Mani SA, Ghani WMN, Ramanathan A, Talib R, Zamzuri AT

Eur J Dent Educ, 2023 Feb;27(1):78-86.
PMID: 35100466 DOI: 10.1111/eje.12779

INTRODUCTION: Dental education involves performing clinical procedures on patients under expert supervision. The COVID-19 pandemic has disrupted routine face-to-face teaching-learning-assessment dynamics world over. This study assessed the self-perceived preparedness of dental undergraduate students for practice, whose clinical training was interrupted by the COVID-19 pandemic from dental schools across Malaysia.
MATERIALS AND METHODS: This cross-sectional web-based questionnaire survey was done among new dental graduates of the academic year 2019-2020 and the final year undergraduate students (academic year 2020-2021) from dental schools in Malaysia, using the Dental Undergraduates Preparedness Assessment Scale (DU-PAS), from 6th to 26th April 2021. The questionnaire addressed clinical skill competence, and cognitive and behavioral attributes. The number of respondents needed to achieve a confidence level of 95% with margin of error of 5% was 306.
RESULTS: A total of 453 (243 final year students and 210 new graduates) responded from dental schools nationwide, with a response rate of 30.6%. The overall mean score for preparedness for dental practice was 76.3±14.7, for clinical skills 39.7±7.3, and behavioral and cognitive attributes 36.5±9.1. New graduates had significantly higher mean preparedness score (78.6±14.4) as compared to students in their final year (74.2±14.7). Performing endodontic treatment on multi-rooted teeth had the lowest perceived competency (29.8%), followed by assessing treatment needs of patients requiring orthodontics (37.1%), prescribing drugs (46.6%) and providing crowns using principles of tooth preservation (48.1%).
CONCLUSIONS: Satisfactory scores were obtained for most attributes. The final-year cohort was significantly less prepared for dental practice compared to the newly graduated cohort.

Matched MeSH terms: Clinical Competence
Physical assessment skills practised by critical care nurses: A cross-sectional study

Rosli SN, Soh KL, Ong SL, Halain AA, Abdul Raman R, Soh KG

Nurs Crit Care, 2023 Jan;28(1):109-119.
PMID: 35023244 DOI: 10.1111/nicc.12748

BACKGROUND: Physical assessment skills are essential to clinical decision-making in nursing as they help nurses to identify and respond to patients' deterioration. Nurses develop confidence and can detect any out-of-range parameters in diagnosing and treating patients. Prior studies surveyed 120 skills but did not explicitly assess critical care.
AIM: To determine the range of physical assessment skills practised by critical care nurses and their adoption factors.
STUDY DESIGN: This study uses a cross-sectional survey design. A self-administered questionnaire evaluating 40 physical assessment skills was conducted with 133 staff nurses (response rate: 96.4%) in three critical care units at a Malaysian government hospital between November 2019 and January 2020.
RESULTS: Most nurses applied 32 (80%) skills during every working shift, involving the vital signs and all body systems except the gastrointestinal system. Five skills (12.5%) were occasionally applied, while three skills (7.5%) were rarely applied or not part of most nurses' clinical practice. About 20% of the nurses did not routinely check the respiration rate. Medical and surgical intensive care unit nurses (U = 1129, p

Matched MeSH terms: Clinical Competence
Evaluation of dental students' clinical communication skills from three perspective approaches: A cross-sectional study

Ab Ghani SM, Mohd Khairuddin PNA, Lim TW, Md Sabri BA, Abdul Hamid NF, Baharuddin IH, et al.

Eur J Dent Educ, 2024 Feb;28(1):106-113.
PMID: 37253116 DOI: 10.1111/eje.12925

INTRODUCTION: The communication skills of clinicians are very crucial in providing better health outcomes for patients. Therefore, this study aimed to assess undergraduate dental students' communication skills in relation to their demographics and clinical setting using a three-perspective approach; the student, the patient and the clinical instructor perspective.
METHODS: A cross-sectional study was conducted using validated modified-communication tools; Patient Communication Assessment Instruments (PCAI), Student Communication Assessment Instruments (SCAI) and Clinical Communication Assessment Instruments (CCAI) which included four communication domains. One hundred and seventy-six undergraduate clinical year students were recruited in this study whereby each of them was assessed by a clinical instructor and a randomly selected patient in two settings: Dental Health Education (DHE) and Comprehensive Care (CC) clinic.
RESULTS: Comparing the three perspectives, PCAI yielded the highest scores across all domains, followed by SCAI and CCAI (p

Matched MeSH terms: Clinical Competence
Fulltext Malaysian pharmacy students' perspectives on the virtual objective structured clinical examination during the coronavirus disease 2019 pandemic

Elnaem MH, Akkawi ME, Nazar NIM, Ab Rahman NS, Mohamed MHN

J Educ Eval Health Prof, 2021;18:6.
PMID: 33910270 DOI: 10.3352/jeehp.2021.18.6

PURPOSE: This study investigated pharmacy students' perceptions of various aspects of virtual objective structured clinical examinations (vOSCEs) conducted during the coronavirus disease 2019 pandemic in Malaysia.
METHODS: This cross-sectional study involved third- and fourth-year pharmacy students at the International Islamic University Malaysia. A validated self-administered questionnaire was distributed to students who had taken a vOSCE a week before.
RESULTS: Out of the 253 students who were approached, 231 (91.3%) completed the questionnaire. More than 75% of the participants agreed that the instructions and preparations were clear and helpful in familiarizing them with the vOSCE flow. It was found that 53.2% of the respondents were satisfied with the flow and conduct of the vOSCE. However, only approximately one-third of the respondents believed that the tasks provided in the vOSCE were more convenient, less stressful, and easier to perform than those in the conventional OSCE. Furthermore, 49.7% of the students favored not having a vOSCE in the future when conducting a conventional OSCE becomes feasible again. Internet connection was reported as a problem hindering the performance of the vOSCE by 51.9% of the participants. Students who were interested in clinical pharmacy courses were more satisfied than other students with the preparation and operation of the vOSCE, the faculty support, and the allocated time.
CONCLUSION: Students were satisfied with the organization and operation of the vOSCE. However, they still preferred the conventional OSCE over the vOSCE. These findings might indicate a further need to expose students to telehealthcare models.

Matched MeSH terms: Clinical Competence
Fulltext Clinical Skill: The Ebbing Art of Medicine

Datta A

Malays J Med Sci, 2021 Feb;28(1):105-108.
PMID: 33679226 DOI: 10.21315/mjms2021.28.1.13

Clinical history taking and physical examination are the essence of clinical medicine. However, the glare of modern diagnostic tools and techniques has overshadowed these basic but indispensable steps of diagnosis. Deterioration of clinical skills is a burning issue in this era due to over-reliance on high-end technology. Poor clinical judgment not only leads to mismanagement but also results in over-utilisation of health care resources. Moreover, with lesser time at the bedside, the physician-patient relationship is also getting compromised.

Matched MeSH terms: Clinical Competence
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*
Intervention to improve intensive care nurses' knowledge of sedation assessment and management

Ramoo V, Abdullah KL, Tan PS, Wong LP, Chua PY

Nurs Crit Care, 2016 Sep;21(5):287-94.
PMID: 25271143 DOI: 10.1111/nicc.12105

BACKGROUND: Sedation management is an integral component of critical care practice. It requires the greatest attention of critical care practitioners because it carries significant risks to patients. Therefore, it is imperative that nurses are aware of potential adverse consequences of sedation therapy and current sedation practice recommendations.
AIMS AND OBJECTIVES: To evaluate the impact of an educational intervention on nurses' knowledge of sedation assessment and management.
DESIGNS AND METHODS: A quasi-experimental design with a pre- and post-test method was used. The educational intervention included theoretical sessions on assessing and managing sedation and hands-on sedation assessment practice using the Richmond Agitation Sedation Scale. Its effect was measured using self-administered questionnaire, completed at the baseline level and 3 months following the intervention.
RESULTS: Participants were 68 registered nurses from an intensive care unit of a teaching hospital in Malaysia. Significant increases in overall mean knowledge scores were observed from pre- to post-intervention phases (mean of 79·00 versus 102·00, p < 0·001). Nurses with fewer than 5 years of work experience, less than 26 years old, and with a only basic nursing education had significantly greater level of knowledge improvement at the post-intervention phase compared to other colleagues, with mean differences of 24·64 (p = 0·001), 23·81 (p = 0·027) and 27·25 (p = 0·0001), respectively. A repeated-measures analysis of variance revealed a statistically significant effect of educational intervention on knowledge score after controlling for age, years of work and level of nursing education (p = 0·0001, ηp (2) = 0·431).
CONCLUSION: An educational intervention consisting of theoretical sessions and hands-on sedation assessment practice was found effective in improving nurses' knowledge and understanding of sedation management.
RELEVANCE TO CLINICAL PRACTICE: This study highlighted the importance of continuing education to increase nurses' understanding of intensive care practices, which is vital for improving the quality of patient care.

Matched MeSH terms: Clinical Competence/standards
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*

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