Displaying publications 141 - 160 of 238 in total

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  1. Dance, drama and laughter: the best medicine
    Foong CC, Tong WT, Daniel EG, Vadivelu J
    Med Educ, 2013 May;47(5):516-7.
    PMID: 23574067 DOI: 10.1111/medu.12155
    Study site: Universiti Malaya, Phase 2 clinical students.
    Matched MeSH terms: Clinical Competence
  2. Fulltext Impact of education on ventilator-associated pneumonia in the intensive care unit
    Subramanian P, Choy KL, Gobal SV, Mansor M, Ng KH
    Singapore Med J, 2013 May;54(5):281-4.
    PMID: 23716155
    INTRODUCTION: Ventilator-associated pneumonia (VAP) is a common risk among critically ill ventilated patients. This study aimed to investigate the effects of nurse-led education on: (a) knowledge of and compliance with ventilator care bundle (VCB) practices among intensive care unit (ICU) nurses; and (b) reduction in the rates of VAP post intervention.

    METHODS: A quasi-experimental design with pretest-posttest evaluation and observation was used to investigate nurses' knowledge of and compliance with VCB practices, and the incidence of VAP. The study was conducted among 71 nurses, and the intervention involved structured education on VAP and its prevention using VCB in an ICU setting. Data were analysed using descriptive and inferential statistics.

    RESULTS: Nurse-led education significantly increased nurses' knowledge of (t[70] = -36.19; p < 0.001) and compliance with (t[65] = -21.41; p < 0.001) VCB practices. The incidence of VAP, which was 39 per 1,000 ventilator days during the two-month period before intervention, dropped to 15 per 1,000 ventilator days during the two-month period following intervention.

    CONCLUSION: Our findings show that nurse-led education on VAP and VCB significantly increased knowledge of and compliance with VCB practices among ICU nurses, and was associated with a reduction in the incidence of VAP among intubated and mechanically ventilated ICU patients. Inclusion of recent knowledge and evidence-based VCB guidelines for VAP prevention when educating anaesthetists, nurses, physiotherapists and other healthcare providers in the critical care setting is recommended.
    Matched MeSH terms: Clinical Competence
  3. Fulltext Evaluation of Community and Family Case Studies (CFCS): A Community based training of medical students
    Yadav H
    Med J Malaysia, 2013 Apr;68(2):111-4.
    PMID: 23629554
    The International Medical University has a Community and Family Case Study (CFCS) programme as part of the training for medical students. The aim of the programme is to emphasize the family and community perspective of patient care in the home environment. A cross-sectional descriptive study was done among 66 final year medical students using a questionnaire. The students were in the 10th Semester and had completed their Community and Family Case Studies (CFCS) programme. Majority (54.5%) of the students who were interviewed were Malays, 34.8% Chinese and 9.1% Indians. Majority of the students (87.9%) liked the programme because it was a good opportunity to understand the patient in their home environment; it improved their commination skills and made them understand the patient better in the community setting. The perceived problem in this programme by the students were mainly choosing an index patient initially (32.8%), patient cooperation (19.0%) and transportation to the patients' house (13.8%). They said that this programme was useful because they learnt more about the disease (45%) and understood the patient management better (15%). The programme also provided the students a wider exposure to medicine (37.9%) and the opportunity to practice clinical skills. Overall the CFCS programme in IMU was well liked by the students as it gave them an opportunity to practice some of the clinical skills in the patients' home environment and it provided an opportunity to manage the patient better. The major problem the students faced was in selecting the index patient.
    Matched MeSH terms: Clinical Competence
  4. Evolving a common surgical curriculum for ASEAN nations with a public health approach
    Lum SK
    ANZ J Surg, 2013 Mar;83(3):118-21.
    PMID: 23320799 DOI: 10.1111/ans.12055
    The Association of Southeast Asian Nations (ASEAN) Mutual Recognition Arrangement (MRA) on medical practitioners' agreement will become a reality in the year 2015. Doctors registered in one ASEAN country will be given reciprocal recognition in another country under this agreement. Rapid and excessive movement of human resources between countries in a short span of time is undesirable and can be destabilizing. The surgical fraternity in the ASEAN countries should plan for a common surgical curriculum, a common examination and an ASEAN Board of Surgery so that standards of future trainees in different countries are comparable. The curriculum should take into consideration the diversity of the countries in socio-economic development. Ideally, it should be based on a public health approach to bring affordable quality surgical care to the masses in an efficient and effective manner.
    Matched MeSH terms: Clinical Competence*
  5. Fulltext Individual skills based volunteerism and life satisfaction among healthcare volunteers in Malaysia: role of employer encouragement, self-esteem and job performance, a cross-sectional study
    Veerasamy C, Sambasivan M, Kumar N
    PLoS One, 2013;8(10):e77698.
    PMID: 24194894 DOI: 10.1371/journal.pone.0077698
    The purpose of this paper is to analyze two important outcomes of individual skills-based volunteerism (ISB-V) among healthcare volunteers in Malaysia. The outcomes are: job performance and life satisfaction. This study has empirically tested the impact of individual dimensions of ISB-V along with their inter-relationships in explaining the life satisfaction and job performance. Besides, the effects of employer encouragement to the volunteers, demographic characteristics of volunteers, and self-esteem of volunteers on job performance and life satisfaction have been studied. The data were collected through a questionnaire distributed to 1000 volunteers of St. John Ambulance in Malaysia. Three hundred and sixty six volunteers responded by giving their feedback. The model was tested using Structural Equation Modeling (SEM). The main results of this study are: (1) Volunteer duration and nature of contact affects life satisfaction, (2) volunteer frequency has impact on volunteer duration, (3) self-esteem of volunteers has significant relationships with volunteer frequency, job performance and life satisfaction, (4) job performance of volunteers affect their life satisfaction and (5) current employment level has significant relationships with duration of volunteering, self esteem, employer encouragement and job performance of volunteers. The model in this study has been able to explain 39% of the variance in life satisfaction and 45% of the variance in job performance. The current study adds significantly to the body of knowledge on healthcare volunteerism.
    Matched MeSH terms: Clinical Competence*
  6. Intrinsic motivation: how can it play a pivotal role in changing clinician behaviour?
    Nantha YS
    J Health Organ Manag, 2013;27(2):266-72.
    PMID: 23802402
    In the light of an increasing healthcare burden, this paper seeks to offer insight about how intrinsic motivation could play a pivotal role in improving the pre-existing healthcare service delivery systems by altering clinician behaviour. The paper argues the case for four salient dimensions worth exploring through the lens of intrinsic motivation--non-financial incentives, positive affective states, organizational culture and prescribing quality.
    Matched MeSH terms: Clinical Competence*
  7. Communication competencies of oncology nurses in Malaysia
    Maskor NA, Krauss SE, Muhamad M, Nik Mahmood NH
    Asian Pac J Cancer Prev, 2013;14(1):153-8.
    PMID: 23534716
    This paper reports on part of a large study to identify competencies of oncology nurses in Malaysia. It focuses on oncology nurses' communications-related competency. As an important cancer care team member, oncology nurses need to communicate effectively with cancer patients. Literature shows that poor communication can make patients feel anxious, uncertain and generally not satisfied with their nurses' care. This paper deliberates on the importance of effective communication by oncology nurses in the context of a public hospital. Four focus group discussions were used in this study with 17 oncology/cancer care nurses from Malaysian public hospitals. The main inclusion criterion was that the nurses had to have undergone a post-basic course in oncology, or have work experience as a cancer care nurse. The findings indicated that nurses do communicate with their patients, patients' families and doctors to provide information about the disease, cancer treatment, disease recurrence and side effects. Nurses should have good communication skills in order to build relationships as well as to provide quality services to their patients. The paper concludes by recommending how oncology nursing competencies can be improved.
    Matched MeSH terms: Clinical Competence
  8. Importance-performance analysis of dental satisfaction among three ethnic groups in malaysia
    Dewi FD, Gundavarapu KC, Cugati N
    Oral Health Prev Dent, 2013;11(2):131-9.
    PMID: 23757453 DOI: 10.3290/j.ohpd.a29735
    PURPOSE: To find the differences in patient satisfaction related to dental services among three ethnic groups - Chinese, Indian and Malay - at AIMST University Dental Centre and analyse them with an importance-performance grid, identifying the weak and strong points, in order to provide better service.

    MATERIALS AND METHODS: This questionnaire-based study consisted of convenience samples of 174 patients of Chinese, Indian and Malay ethnicity. Importance-performance analysis for 20 attributes were compared using Likert's scale. The data obtained were statistically analysed using the Kruskal-Wallis test.

    RESULTS: Chinese and Indians both emphasised low performance on the interpersonal relationship attribute in terms of the receptionist's courtesy, whereas the Malay participants were concerned with convenience attributes. All the ethnic groups favoured maintaining existing major attributes towards technical competency, interpersonal relationship and facility factors. This study demonstrated priority differences between the ethnic groups' perception of the quality of dental services, where ethnic Chinese showed the highest gap (measure of dissatisfaction) between importance and performance compared to ethnic Malays, followed by ethnic Indians.

    CONCLUSION: The patients from the three major ethnic groups of Malaysia were generally well satisfied. Perhaps more priority should be placed on improving the interpersonal relationship attribute, especially with the receptionists.

    Matched MeSH terms: Clinical Competence
  9. Dysphagia training for speech-language pathologists: implications for clinical practice
    Kamal RM, Ward E, Cornwell P
    Int J Speech Lang Pathol, 2012 Dec;14(6):569-76.
    PMID: 22974073 DOI: 10.3109/17549507.2012.713394
    There are competency standards available in countries with established speech-language pathology services to guide basic dysphagia training with ongoing workplace mentoring for advanced skills development. Such training processes, however, are not as well established in countries where speech-language pathology training and practice is relatively new, such as Malaysia. The current study examines the extent of dysphagia training and workplace support available to speech-language pathologists (SLPs) in Malaysia and Queensland, Australia, and explores clinicians' perceptions of the training and support provided, and of their knowledge, skills, and confidence. Using a matched cohort cross-sectional design, a purpose-built survey was administered to 30 SLPs working in Malaysian government hospitals and 30 SLPs working in Queensland Health settings in Australia. Malaysian clinicians were found to have received significantly less university training, less mentoring in the workplace, and were lacking key infrastructure needed to support professional development in dysphagia management. Over 90% of Queensland clinicians were confident and felt they had adequate skills in dysphagia management; in contrast, significantly lower levels of knowledge, skills, and confidence were observed in the Malaysian cohort. The findings identify a need for improved university training and increased opportunities for workplace mentoring, training, and support for Malaysian SLPs.
    Matched MeSH terms: Clinical Competence*
  10. Fulltext Teaching medical students neonatal resuscitation: knowledge gained and retained from a brief simulation-based training workshop
    Lai NM, Ngim CF, Fullerton PD
    Educ Health (Abingdon), 2012 Nov;25(2):105-10.
    PMID: 23823593 DOI: 10.4103/1357-6283.103457
    Despite being an essential clinical skill, many junior doctors feel unprepared to perform neonatal resuscitation. We introduced a neonatal resuscitation training workshop in 2009 for our final-year medical students.
    Matched MeSH terms: Clinical Competence/standards
  11. An assessment of the prescribing skills of undergraduate dental students in malaysia
    Akram A, Zamzam R, Mohamad NB, Abdullah D, Meerah SM
    J Dent Educ, 2012 Nov;76(11):1527-31.
    PMID: 23144489
    Most dental schools lack a module on prescription writing in pharmacology. This study assessed the prescription writing skills of a group of Malaysian dental students at the end of their undergraduate training program. A quantitative study of a two-group posttest experiment was designed, and thirty-seven fifth-year (final-year) dental students were divided into two groups (A [n=18] and B [n=19]). Group A received a didactic lecture on how to write a complete prescription, while Group B served as a control group. For prescription writing, three standardized dental scenarios with a diagnosis of irreversible pulpitis associated with a child and a pregnant woman and periapical pulpitis for an adult man were administered. Thus, a total of 111 prescriptions (Group A [n=54] and Group B [n=57]) were collected. Twelve elements in each prescription were assessed by frequency and a chi-square test. Improvements in eight out of the twelve elements were observed in prescriptions written by students in Group A. The significantly improved elements were provision of the symbol R(x) (39.8 percent) (p<0.001), inclusion of the prescriber's signature (75.3 percent) (p<0.001), inclusion of the date with the prescriber's signature (54.6 percent) (p<0.001), and inclusion of the prescriber's registration (30.5 percent) (p<0.001). Overall, Group A gained almost a 50 percent improvement in writing complete prescriptions due to the intervening lecture. It appeared a traditional lecture led to the more accurate writing of a complete prescription. It was suggested that a module on prescription writing be added to the school's pharmacology curriculum, so that dental graduates will be competent in prescription writing for the sake of their patients' health.
    Matched MeSH terms: Clinical Competence*
  12. Fulltext Assessing undergraduate competence in evidence based medicine: a preliminary study on the correlation between two objective instruments
    Lai NM, Teng CL, Nalliah S
    Educ Health (Abingdon), 2012 Jul;25(1):33-9.
    PMID: 23787382
    CONTEXT: The Fresno test and the Berlin Questionnaire are two validated instruments for objectively assessing competence in evidence-based medicine (EBM). Although both instruments purport to assess a comprehensive range of EBM knowledge, they differ in their formats. We undertook a preliminary study using the adapted version of the two instruments to assess their correlations when administered to medical students. The adaptations were made mainly to simplify the presentation for our undergraduate students while preserving the contents that were assessed.
    METHODS: We recruited final-year students from a Malaysian medical school from September 2006 to August 2007. The students received a structured EBM training program within their curriculum. They took the two instruments concurrently, midway through their final six months of training. We determined the correlations using either the Pearson's or Spearman's correlation depending on the data distribution.
    RESULTS: Of the 120 students invited, 72 (60.0%) participated in the study. The adapted Fresno test and the Berlin Questionnaire had a Cronbach's alfa of 0.66 and 0.70, respectively. Inter-rater correlation (r) of the adapted Fresno test was 0.9. The students scored 45.4% on average [standard deviation (SD) 10.1] on the Fresno test and 44.7% (SD 14.9) on the Berlin Questionnaire (P = 0.7). The overall correlation between the two instruments was poor (r = 0.2, 95% confidence interval: -0.07 to 0.42, P = 0.08), and correlations remained poor between items assessing the same EBM domains (r = 0.01-0.2, P = 0.07-0.9).
    DISCUSSION: The adapted versions of the Fresno test and the Berlin Questionnaire correlated poorly when administered to medical students. The two instruments may not be used interchangeably to assess undergraduate competence in EBM.
    Matched MeSH terms: Clinical Competence/standards
  13. Assessing nursing clinical skills competence through objective structured clinical examination (OSCE) for open distance learning students in Open University Malaysia
    Oranye NO, Ahmad C, Ahmad N, Bakar RA
    Contemp Nurse, 2012 Jun;41(2):233-41.
    PMID: 22800389 DOI: 10.5172/conu.2012.41.2.233
    The objective structured clinical skills examination (OSCE) has over the years emerged as a method of evaluating clinical skills in most medical and allied professions. Although its validity and objectivity has evoked so much debate in the literature, little has been written about its application in non-traditional education systems such as in distance learning. This study examined clinical skills competence among practising nursing students who were enrolled in a distance learning programme. The study examined the effect of work and years of nursing practice on nurses' clinical skills competence.
    Matched MeSH terms: Clinical Competence*
  14. Fulltext Views of Malaysian interns and their supervisors on the adequacy of undergraduate clinical skills training
    Chan SC
    Singapore Med J, 2012 Mar;53(3):196-202.
    PMID: 22434295
    This study aimed to determine the views of Malaysian interns and their supervisors on whether undergraduate clinical skills training adequately equipped them for internship and their suggestions for improvement.
    Matched MeSH terms: Clinical Competence*
  15. Exploring the knowledge of nasopharyngeal carcinoma among medical doctors at primary health care level in Perak state, Malaysia
    Balachandran R, Philip R, Avatar S, Simon R, Mann GS, Benedict CT, et al.
    Eur Arch Otorhinolaryngol, 2012 Feb;269(2):649-58.
    PMID: 21691719 DOI: 10.1007/s00405-011-1665-0
    Nasopharyngeal carcinoma (NPC) is among the commonest cancers in Malaysia. The prognosis for NPC like most other head and neck cancer is dependent on its staging. Majority of patients in Malaysia at the time of diagnosis are either at stage III or IV (27 and 47%, respectively). The lack of knowledge among primary care medical doctors regarding NPC may contribute to this delay in diagnosis. The aim of this study was to assess the knowledge of the primary care doctors in the state of Perak on the various aspects of NPC. The doctors at the primary care level in the state of Perak were recruited to take part in this study on a voluntary basis. A total number of 154 out of 198 doctors participated in this survey. They were given a questionnaire to fill in to test their knowledge on different aspects of NPC and its treatment. The overall respondents' score was poor with a score of 67.5% on all sections. The doctors appear to be able to identify common presenting features of NPC with a mean score of 85.3% but for the uncommon presentations of NPC, the scores were poorer with 61.8%. In addition, 54.1% of the participants answered that they would refer a patient with symptoms suspicious of NPC after a period of 1 month from the onset of symptom. However, only 34% would refer within 2 weeks. Based on the results of this study, the authors feel that it is clear that the doctors posted in the primary care hospitals and clinics appear to have inadequate knowledge to diagnose and refer patients with suspected NPC. As early diagnosis can often lead to a better prognostic outcome, steps must be taken to raise the awareness among these doctors.
    Matched MeSH terms: Clinical Competence*
  16. Fulltext International patients with congenital heart disease: what brings them to India?
    Maheshwari S, Animasahun BA, Njokanma OF
    Indian Heart J, 2012 Jan-Feb;64(1):50-3.
    PMID: 22572426 DOI: 10.1016/S0019-4832(12)60011-X
    Factors that have led to the increasing popularity of medical travel include the high cost of healthcare, long wait times for certain procedures, the ease and affordability of international travel, and improvements in both technology and standards of care in many countries.
    Matched MeSH terms: Clinical Competence
  17. Fulltext Dysfunctional problem-based learning curricula: resolving the problem
    Lim WK
    BMC Med Educ, 2012;12:89.
    PMID: 23009729 DOI: 10.1186/1472-6920-12-89
    Problem-based learning (PBL) has become the most significant innovation in medical education of the past 40 years. In contrast to exam-centered, lecture-based conventional curricula, PBL is a comprehensive curricular strategy that fosters student-centred learning and the skills desired in physicians. The rapid spread of PBL has produced many variants. One of the most common is 'hybrid PBL' where conventional teaching methods are implemented alongside PBL. This paper contends that the mixing of these two opposing educational philosophies can undermine PBL and nullify its positive benefits. Schools using hybrid PBL and lacking medical education expertise may end up with a dysfunctional curriculum worse off than the traditional approach.
    Matched MeSH terms: Clinical Competence/standards
  18. Fulltext Using a Facebook group for interactive clinical learning
    Menon V
    International e-Journal of Science, Medicine & Education, 2012;6(1):21-23.
    MyJurnal
    Background: Facebook is a popular social networking site with more than five hundred million users. This study assessed whether Facebook Groups can be used to teach clinical reasoning skills.
    Methods: Sixty-seven final year medical students from the International Medical University, Malaysia, were exposed to interactive online learning through a Facebook Group for a period of six months in this study. The purpose was to determine if supervised interactive online learning could be used to augment the deep learning that comes from learning medicine at the bedside of patients. The interactive online discussions were entirely triggered by clinical problems encountered in the medical wards of the general hospital to which these students were attached.
    Results: A total of 10 topics were discussed in this forum during the duration of this study and an example of one such discussion is provided to illustrate the informal nature of this kind of learning. The results showed a high degree of student involvement with 76 percent of students actively participating in the discussions.
    Conclusion: The high degree of voluntary participation in the clinical discussions through the Facebook Group in this study tells us that Facebook Groups are a good way of engaging students for learning and can be used in medical education to stimulate creative clinical thinking.
    Matched MeSH terms: Clinical Competence
  19. 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
  20. Implant dentistry in undergraduate dental curricula in South-East Asia: forum workshop at the University of Hong Kong, Prince Philip Dental Hospital, 19-20 November 2010
    Lang NP, Bridges SM, Lulic M
    J Investig Clin Dent, 2011 Aug;2(3):152-5.
    PMID: 25426784 DOI: 10.1111/j.2041-1626.2011.00085.x
    This paper reports on the discussions arising from a 2-day forum on implant dentistry education in South-East Asia. The 10 institutions present represented undergraduate and postgraduate dental curricula from seven countries, including Hong Kong, Indonesia, Malaysia, Taiwan, Thailand, the Philippines, and Singapore. While not aiming to reach consensus as in other such conferences, the outcome was positive in establishing realistic goals in university education in implant dentistry for curriculum leaders and developers.
    Matched MeSH terms: Clinical Competence
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