MyMedR

Displaying publications 161 - 180 of 238 in total

Abstract:

Sort:

Use of the Gynecare Prolift system in surgery for pelvic organ prolapse: 1-year outcome

Vaiyapuri GR, Han HC, Lee LC, Tseng LA, Wong HF

Int Urogynecol J, 2011 Jul;22(7):869-77.
PMID: 21479713 DOI: 10.1007/s00192-011-1400-9

INTRODUCTION AND HYPOTHESIS: This retrospective study reports the 1-year outcome in women who underwent mesh-augmented Prolift surgery performed from 2006 to 2008. There were a total of 254 patients, with 128, 106 and 20 patients receiving total, anterior and posterior Prolift, respectively.
METHODS: Incidence of thigh pain was lower in 2008 compared to 2006 and 2007 (p < 0.0001). The percentage of patients requiring blood transfusions (p = 0.09), duration of IDC ≥ 7 days (p = 0.27), wound dehiscence and re-operation rate were lower in 2008 in contrast to 2006 and 2007 (p = 0.43). Only 209 patients (82.3%) were available for review at 1 year. There were two (1.0%) cases of recurrent vault prolapse.
RESULTS: The subjective and objective cure rates at 1 year after this mesh implant surgery in 2006, 2007 and 2008 were 92.1% and 92.1%; 97.0% and 92.4% and 100% and 97%, respectively. The mesh erosion rate was remarkably lower in 2008 as compared to 2007 and 2006 (p < 0.001).
CONCLUSIONS: This synthetic mesh-augmented implant surgery is effective and safe, and surgical outcome appears related to the learning curve of the surgeon.

Matched MeSH terms: Clinical Competence
Fulltext Initial management of spontaneous pneumothorax--role of the thoracic surgeon

Sachithanandan A, Badmanaban B

Med J Malaysia, 2011 Jun;66(2):164.
PMID: 22106707
Matched MeSH terms: Clinical Competence*
Impact of interventional nephrology on outcome and penetration rate of a CAPD program

Wong CM, Ng KP, Keng TC, Lim SK, Tan SY

Perit Dial Int, 2011 3 24;31(2):194-6.
PMID: 21427247 DOI: 10.3747/pdi.2009.00237
Matched MeSH terms: Clinical Competence
Fulltext Self-perceived competence correlates poorly with objectively measured competence in evidence based medicine among medical students

Lai NM, Teng CL

BMC Med Educ, 2011;11:25.
PMID: 21619672 DOI: 10.1186/1472-6920-11-25

BACKGROUND: Previous studies report various degrees of agreement between self-perceived competence and objectively measured competence in medical students. There is still a paucity of evidence on how the two correlate in the field of Evidence Based Medicine (EBM). We undertook a cross-sectional study to evaluate the self-perceived competence in EBM of senior medical students in Malaysia, and assessed its correlation to their objectively measured competence in EBM.
METHODS: We recruited a group of medical students in their final six months of training between March and August 2006. The students were receiving a clinically-integrated EBM training program within their curriculum. We evaluated the students' self-perceived competence in two EBM domains ("searching for evidence" and "appraising the evidence") by piloting a questionnaire containing 16 relevant items, and objectively assessed their competence in EBM using an adapted version of the Fresno test, a validated tool. We correlated the matching components between our questionnaire and the Fresno test using Pearson's product-moment correlation.
RESULTS: Forty-five out of 72 students in the cohort (62.5%) participated by completing the questionnaire and the adapted Fresno test concurrently. In general, our students perceived themselves as moderately competent in most items of the questionnaire. They rated themselves on average 6.34 out of 10 (63.4%) in "searching" and 44.41 out of 57 (77.9%) in "appraising". They scored on average 26.15 out of 60 (43.6%) in the "searching" domain and 57.02 out of 116 (49.2%) in the "appraising" domain in the Fresno test. The correlations between the students' self-rating and their performance in the Fresno test were poor in both the "searching" domain (r = 0.13, p = 0.4) and the "appraising" domain (r = 0.24, p = 0.1).
CONCLUSIONS: This study provides supporting evidence that at the undergraduate level, self-perceived competence in EBM, as measured using our questionnaire, does not correlate well with objectively assessed EBM competence measured using the adapted Fresno test.
STUDY REGISTRATION: International Medical University, Malaysia, research ID: IMU 110/06.

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 Do we need certified medical teachers in medical schools: an educator’s self-reflective questionnaire-based survey at Universiti Sains Malaysia

Shahid Hassan, Zafar Ahmed, Ahmad Fuad Abdul Rahim

Education in Medicine Journal, 2011;3(2):53-64.
MyJurnal

Background: Faculty’s role as educators is over looked in clinical education, even though the teaching has a direct reflection of performance of clinical competence and professional development of graduating doctors. Two major problems of clinical education are the lack of uniform teaching and learning strategies in postgraduate as well as later years of undergraduate clinical teaching and the professional development of faculty in teaching in medical institutions. Objective: The survey has two major objectives. First objective was to know about the faculty response to a survey on teaching while trying to create awareness for teaching and research in teaching. The second objective was to know the faculty members’ understanding with principles of learning and teaching with strengths and weaknesses of respondents’ performance in clinical teaching on completing The Educator’s Self-Reflective Inventory (ESRI). Method: The ESRI was administered to approach 214 faculty members in SMS at USM. Appraisal of self-reflection inventory as medical teacher and personal development with respect to challenges, opportunities, innovations and need assessment of teaching were explored in response to 35 items grouped in 5 clusters through a questionnaire-based survey utilizing ESRI. Result: Statistical analysis of respondent’s data indicates a mixed response with lab-based disciplines 54.54% followed by surgical-based disciplines 50% and medical-based disciplines 30%. Individual discipline best response is received from Plastic Surgery and ORL-HNS (100%) and Hematology (77.77%). A result of individual item response in each cluster WAS also analyzed. Conclusion: The survey evaluated the faculty’s response to ESRI and concern shown to develop their abilities as teachers and researchers in clinical teaching. However, the initial response suggested the need for more survey to continue creating the awareness for faculty development and research in teaching. Conclusion drawn from analysis of each items in inventory is encouraging for teaching in medical education.

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 Performance of the final year medical students in Universiti Malaysia Sabah in the end surgical senior posting (SSP) examination

Almothafar, B., Chee, F.T.

JUMMEC, 2011;14(2):1-6.
MyJurnal

The present study reports the performance of final year medical students from the Universiti Malaysia Sabah (UMS) in the end of the senior surgical posting examination (SSP) with the aim to demonstrate the medical students graduating from this newly established university are of good standing and of improving quality. A study on the outcome of the method of teaching conducted on this study was performed by measuring the students’ performance continuously and at the end of their posting. The present data analyses demonstrate that there have been improvements in the medical students’ performance between the last two batches of students graduating from UMS. However, the students appear to be weaker in their MCQs, demonstrating a decline in theoretical knowledge. The analyses also demonstrate that there is a poor positive correlation between theoretical knowledge, clinical skills and/or continuous assessments, demonstrating the importance of emphasis in these 3 areas amongst medical students. Further studies may be required to determine the reason for this poor correlation since these may lead to better understanding on how to improve the overall performance of future medical student. CONCLUSION: The present study demonstrates that UMS medical student appears to continue to improve in their SSP performance although there are concerns about the decline in theoretical knowledge.

Matched MeSH terms: Clinical Competence
Fulltext Successive objective long-case assessment as a driver of clerkship learning - evaluation through perception questionnaire

Toh, Peng Yeow, Wai, Sun Choo, Amir S. Khir, Li, Cher Loh

International e-Journal of Science, Medicine & Education, 2011;5(2):3-11.
MyJurnal

Background: Clinical clerkship in a busy hospital environment forms an important part of undergraduate medical training. Regular objective assessment of this activity with feedback would be expected to improve outcome.

Methods: We implemented fortnightly clinical assessments using modified OSLER (Objective Structured Long Examination Record), and over a 6-week clinical rotation. Modifications included provision of individualized feedback. The assessment process was evaluated by both students and teachers via a questionnaire measuring their perceived educational impact, feasibility and acceptability.

Results: Students agreed that the patient spectrum was appropriate and fair, resulting in improved history taking and presentation skills (96.6%), clinical examination skills (89%) and clinical reasoning skills (90.7%). It was graded to have helped learning “tremendously” and “moderately” by 64.7% and 32.8% of students respectively. Perceived improvement was attributable mainly to the repetitive nature of the assessments since only 63% of students were provided with feedback. 96.6% of students and 94.1% of assessors perceived the format created a stressful but positive learning environment. 52.9% of assessors agreed that the exercise consumed significant time and resources but 88.2% rated it as manageable and supported its continuation.

Conclusion: Frequent and regular in-course clinical assessments with emphasis on individual feedback is feasible, acceptable and has significant positive educational impact.

Matched MeSH terms: Clinical Competence
Malaysian dental graduates' competence in holistic care: what do graduates and employers think?

Yusof ZY, Jaafar N, Jallaludin RL, Abu-Hassan MI, Razak IA

J Dent Educ, 2010 Dec;74(12):1380-7.
PMID: 21123505

The purpose of this study was to explore the University of Malaya (UM) dental graduates' competence in holistic care in real settings from the employers' and graduates' perspectives. A self-administered questionnaire consisting of ten domains was sent to thirty senior dental officers of the Ministry of Health (MOH) and 164 UM graduates. In this article, nineteen major competencies that best represent the graduates' competence in the provision of holistic care are discussed. Each competency was rated on a scale of 1 (very poor) to 4 (very good) and was categorized as "poor and of major concern" (if less than 60 percent of respondents scored good or very good), "satisfactory and of minor concern" (60-69 percent), or "excellent" (70 percent and above). One hundred and six out of 164 graduates (64.6 percent) and twenty-nine out of thirty employers (96.7 percent) responded. Overall, the employers rated the graduates lower than what the graduates rated themselves on all items. While the graduates felt they were excellent and satisfactory in sixteen out of nineteen items (84.2 percent), the employers felt they were poor in fourteen out of nineteen (73.7 percent). Both groups agreed that the graduates were excellent in communication, but poor in life-saving skills, obtaining patient's family and psychosocial histories, and recognizing signs and symptoms (not intraoral) indicating the presence of a systemic disease. In conclusion, although the graduates felt competent in the majority of the holistic care competencies, the employers had some reservations over such claims. Outcomes of the study led to recommendations to incorporate longer community-based learning hours, an improved behavioral science component, a module for special care patients, and multidepartmental collaborative teachings in the new integrated program aimed for implementation in 2011.

Matched MeSH terms: Clinical Competence*
Satisfaction with school dental service provided by mobile dental squads

Othman N, Razak IA

Asia Pac J Public Health, 2010 Oct;22(4):415-25.
PMID: 20462854 DOI: 10.1177/1010539510370794

Feedback on satisfaction with dental care is vital for continuous improvement of the service delivery process and outcome. The objective of this study was to assess the satisfaction with school dental service (SDS) provided via mobile dental squads in Selangor, Malaysia, under 4 domains of satisfaction: patient-personnel interaction, technical competency, administrative efficiency, and clinic setup using self-administered questionnaires. Among the 607 participants who had received treatment, 62% were satisfied with the services provided. In terms of domains, technical competency achieved the highest satisfaction score, whereas clinic setup was ranked the lowest. As for items within the domains, the most acceptable was "dental operator did not ask personal things which were not dentally related," whereas privacy of treatment was the least acceptable. In conclusion, whereas children were generally satisfied with the SDS, this study indicates that there are still areas for further improvement.

Matched MeSH terms: Clinical Competence
Fulltext A survey on the initial management of spontaneous pneumothorax

Ismail T, Anshar MF, How SH, Hashim CW, Mohamad WH, Katiman D

Med J Malaysia, 2010 Sep;65(3):187-91.
PMID: 21939165

Spontaneous pneumothorax (SP) is a common medical condition but continues to be a frequent management problem among doctors. Despite the availability of guidelines on management of SP, studies have shown that the compliance with the guidelines is low. The various treatment options available in treating this condition further confuse doctors on the right approach in managing SP. The objective of this study is to investigate the awareness of the availability of these existing guidelines and to investigate how the doctors involved in the initial management of SP would manage this condition. A self completed questionnaire which included three case scenarios were distributed among doctors in two teaching university hospitals and two large Ministry of Health hospitals. This study showed that there is a lack of awareness of the existing guidelines even among the senior doctors and there is a variation in the initial management of SP. Therefore a locally produced guideline may be beneficial to standardise and improve the management of SP.

Matched MeSH terms: Clinical Competence*
Prospective randomized controlled trial evaluating cap-assisted colonoscopy vs standard colonoscopy

Tee HP, Corte C, Al-Ghamdi H, Prakoso E, Darke J, Chettiar R, et al.

World J Gastroenterol, 2010 Aug 21;16(31):3905-10.
PMID: 20712051

AIM: To study the significance of cap-fitted colonoscopy in improving cecal intubation time and polyp detection rate.
METHODS: This study was a prospective randomized controlled trial conducted from March 2008 to February 2009 in a tertiary referral hospital at Sydney. The primary end point was cecal intubation time and the secondary endpoint was polyp detection rate. Consecutive cases of total colonoscopy over a 1-year period were recruited. Randomization into either standard colonoscopy (SC) or cap-assisted colonoscopy (CAC) was performed after consent was obtained. For cases randomized to CAC, one of the three sizes of cap was used: D-201-15004 (with a diameter of 15.3 mm), D-201-14304 (14.6 mm) and D-201-12704 (13.0 mm). All of these caps were produced by Olympus Medical Systems, Japan. Independent predictors for faster cecal time and better polyp detection rate were also determined from this study.
RESULTS: There were 200 cases in each group. There was no significant difference in terms of demographic characteristics between the two groups. CAC, when compared to the SC group, had no significant difference in terms of cecal intubation rate (96.0% vs 97.0%, P = 0.40) and time (9.94 +/- 7.05 min vs 10.34 +/- 6.82 min, P = 0.21), or polyp detection rate (32.8% vs 31.3%, P = 0.75). On the subgroup analysis, there was no significant difference in terms of cecal intubation time by trainees (88.1% vs 84.8%, P = 0.40), ileal intubation rate (82.5% vs 79.0%, P = 0.38) or total colonoscopy time (23.24 +/- 13.95 min vs 22.56 +/- 9.94 min, P = 0.88). On multivariate analysis, the independent determinants of faster cecal time were consultant-performed procedures (P < 0.001), male patients (P < 0.001), non-usage of hyoscine (P < 0.001) and better bowel preparation (P = 0.01). The determinants of better polyp detection rate were older age (P < 0.001), no history of previous abdominal surgery (P = 0.04), patients not having esophagogastroduodenoscopy in the same setting (P = 0.003), trainee-performed procedures (P = 0.01), usage of hyoscine (P = 0.01) and procedures performed for polyp follow-up (P = 0.01). The limitations of the study were that it was a single-center experience, no blinding was possible, and there were a large number of endoscopists.
CONCLUSION: CAC did not significantly different from SC in term of cecal intubation time and polyp detection rate.

Matched MeSH terms: Clinical Competence
CUSUM: a dynamic tool for monitoring competency in cataract surgery performance

Salowi MA, Choong YF, Goh PP, Ismail M, Lim TO

Br J Ophthalmol, 2010 Apr;94(4):445-9.
PMID: 19951939 DOI: 10.1136/bjo.2009.163063

AIMS: To apply cumulative sum (CUSUM) in monitoring performance of surgeons in cataract surgery and to evaluate the response of performance to intervention.
METHOD: A CUSUM analysis was applied to 80 phacoemulsification performed by three ophthalmic trainees and one consultant, for the occurrence of posterior capsular rupture and postoperative refracted vision of worse than 6/12 among patients without pre-existing ocular comorbidity. The CUSUM score of each consecutive procedure performed by an individual surgeon was calculated and charted on CUSUM chart. When trainees' CUSUM charts showed an unacceptable level of performance, their supervisors would give feedback and impose closer monitoring of subsequent surgeries.
RESULTS: CUSUM charts of the trainees demonstrated an initial upward followed by flattening trend. This reflects learning curves in their process of acquiring competency in phacoemulsification. In contrast, the consultant showed a flat curve indicating an ongoing maintenance of competence.
CONCLUSION: The CUSUM analysis is able to monitor and promptly detect adverse events and trends of unacceptable outcomes in cataract surgery. This objective and dynamic monitoring makes CUSUM a useful audit tool for individual surgeons, but more so for busy consultants who need to supervise trainees.

Matched MeSH terms: Clinical Competence/standards*
Developing a practice-based master in clinical pharmacy program at the Universiti Teknologi MARA, Malaysia

Hadi MA, Ming LC, Leng LW, Shaharuddin S, Adam A

Am J Pharm Educ, 2010 Mar 10;74(2):32d.
PMID: 20414448
Matched MeSH terms: Clinical Competence*
Malaysian pharmacy students' assessment of an objective structured clinical examination (OSCE)

Awaisu A, Abd Rahman NS, Nik Mohamed MH, Bux Rahman Bux SH, Mohamed Nazar NI

Am J Pharm Educ, 2010 Mar 10;74(2):34.
PMID: 20414449

OBJECTIVE: To implement and determine the effectiveness of an objective structured clinical examination (OSCE) to assess fourth-year pharmacy students' skills in a clinical pharmacy course.
DESIGN: A 13-station OSCE was designed and implemented in the 2007-2008 academic year as part of the assessment methods for a clinical pharmacy course. The broad competencies tested in the OSCE included: patient counseling and communication, clinical pharmacokinetics (CPK), identification and resolution of drug-related problems (DRPs), and literature evaluation/drug information provision.
ASSESSMENT: Immediately after all students completed the OSCE, a questionnaire containing items on the clarity of written instructions, difficulty of the tasks, perceived degree of learning gained and needed, and the suitability of the references or literature resources provided was administered. More than 70% of the students felt that a higher degree of learning was needed to accomplish the tasks at the 2 DRP stations and 2 CPK stations and the majority felt the written instructions provided at the phenytoin CPK station were difficult to understand. Although about 60% of the students rated OSCE as a difficult form of assessment, 75% said it should be used more and 81% perceived they learned a lot from it.
CONCLUSION: Although most students felt that the OSCE accurately assessed their skills, a majority felt the tasks required in some stations required a higher degree of learning than they had achieved. This may indicate deficiencies in the students' learning abilities, the course curriculum, or the OSCE station design. Future efforts should include providing clearer instructions at OSCE stations and balancing the complexity of the competencies assessed.

Matched MeSH terms: Clinical Competence*
Identification of competencies for Malaysian occupational safety and health professionals

Daud R, Ismail M, Omar Z

Ind Health, 2010;48(6):824-34.
PMID: 20616464

Competencies of occupational safety and health (OSH) professionals have become a concern due to the significance of safety management in the field of safety engineering. The purpose of this article is to identify competencies needed by OSH professionals. These competencies are required by professionals in administrating and enforcing legislations related to OSH in Malaysia. This study used Delphi technique in three rounds of data collection. The benefits of this research approach are the use of experts in gaining opinions without time and geographical restraints. The results show 25 generic competencies with combinations of cognitive, interpersonal and intrapersonal competencies and 33 functional or specific competencies including knowledge and skills needed by OSH professionals. Both generic and functional competencies are also divided into threshold and differentiating competencies that would be used to differentiate average and excellent performance of OSH professionals.

Matched MeSH terms: Clinical Competence/standards*; Clinical Competence/statistics & numerical data
Fulltext A prospective study of tracheal intubation in an academic emergency department in Malaysia

Fathil SM, Mohd Mahdi SN, Che'man Z, Hassan A, Ahmad Z, Ismail AK

Int J Emerg Med, 2010;3(4):233-7.
PMID: 21373289 DOI: 10.1007/s12245-010-0201-0

BACKGROUND: Airway management is an important part of the management of the critically ill and injured patients in the Emergency Department (ED). Numerous studies from developed countries have demonstrated the competency of emergency doctors in intubation. To date there have been no published data on intubations performed in EDs in Malaysia.
METHODS: Data on intubations from 7 August 2007 till 28 August 2008 were prospectively collected.
RESULTS: There were 228 intubations included in the study period. Cardiopulmonary arrest was the main indication for intubation (35.5%). The other indications were head injury (18.4%), respiratory failure (15.4%), polytrauma (9.6%) and cerebrovascular accident (7.0%). All of the 228 patients were successfully intubated. Rapid sequence intubation (RSI) was the most frequent method (49.6%) of intubation. A total of 223 (97.8%) intubations were done by ED personnel. In 79.8% of the cases, intubations were successfully performed on the first attempt. Midazolam was the most common induction agent used (97 patients), while suxamethonium was the muscle relaxant of choice (109 patients). There were 34 patients (14.9%) with 38 reported immediate complications. The most common complication was oesophageal intubation.
CONCLUSION: Emergency Department UKMMC personnel have a high competency level in intubation with an acceptable complication rate. RSI was the most common method for intubation.
KEYWORDS: Airway; Intubation; Orotracheal intubation; Rapid sequence intubation

Matched MeSH terms: Clinical Competence*
The BigSib students' peer group mentoring programme

Yusoff MS, Rahim AF, Noor AR, Yaacob NA, Hussin ZA

Med Educ, 2009 Nov;43(11):1106.
PMID: 19874517 DOI: 10.1111/j.1365-2923.2009.03459.x
Matched MeSH terms: Clinical Competence

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links