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Fulltext Determining the impact of pre-lecture educational video on comprehension of a difficult gross anatomy lecture

Hadie SNH, Simok AA, Shamsuddin SA, Mohammad JA

J Taibah Univ Med Sci, 2019 Aug;14(4):395-401.
PMID: 31488974 DOI: 10.1016/j.jtumed.2019.06.008

Objective: Students commonly perceive gross anatomy lectures as difficult because they contain complex information that requires three-dimensional visualisation in order to be understood. Without prior preparation, a gross anatomy topic expounded via lecture can be cognitively challenging. Hence, this study aimed to investigate the impact of a pre-lecture activity in the form of viewing a video on students' lecture comprehension.
Method: A quasi-experimental study was conducted using 254 first-year medical students with no prior exposure to the lecture topic during the 2016/17 and 2017/18 academic sessions. The students from each batch were divided into two groups and exposed to different video material. Group A watched an action movie, while Group B watched an educational video related to the lecture topic. After 15 min, both groups attended a lecture on the gross anatomy of the heart, which was delivered by a qualified anatomist. At the end of the lecture, their understanding of the material was measured through a post-lecture test using ten vetted multiple choice true/false questions.
Results: Group B's test scores were found to be significantly higher than Group A's (p > 0.001, t-stats [df] = -4.21 [252]).
Conclusion: This study concluded that the pre-lecture activity had successfully provided the students with some prior knowledge of the subject before they attended the lecture sessions. This finding was aligned with cognitive load theory, which describes a reduction in learners' cognitive load when prior knowledge is stimulated.
Fulltext Feedback from medical student on an interactive online anatomy practical using the Google Jamboard platform

Shamsuddin SA, Woon CK, Hadie SNH

J Taibah Univ Med Sci, 2023 Apr;18(2):234-243.
PMID: 36817220 DOI: 10.1016/j.jtumed.2022.08.007

OBJECTIVE: The disruption caused by COVID-19 in anatomy education has forced the transition of in-person to online learning. Despite the increasing use of technology-enhanced tools in online classes, anatomy lecturers face significant difficulty in making classes interactive. Hence, this study explored the feasibility of a web-based virtual whiteboard, Google Jamboard (GJ) for two online anatomy practical classes.
METHODS: This was a qualitative phenomenology study conducted on 116 second-year medical students from two Malaysian public universities via teleconferencing applications that allowed synchronous small-group activities. Each group was given a different link to 10 GJ slides that featured plain anatomy diagrams and instructions for the group task. Upon completion of the tasks, the students presented their tasks to the whole class. An online feedback form was distributed at the end of the practical session to explore the experience of the students when using the tool.
RESULTS: Thematic analysis of student responses generated seven themes that reflected perceived learning benefits, challenges faced by the students, and suggestions for future improvement.
CONCLUSIONS: These findings suggest that GJ is a useful tool for promoting collaborative learning in virtual anatomy education. Nevertheless, the impact of this tool on the attainment of learning outcomes remains unknown. Hence, more widescale research is needed to confirm our findings.
Fulltext The Association Between Preclinical Medical Students' Perceptions of the Anatomy Education Environment and Their Learning Approaches

Norman HH, Hadie SNH, Yaacob NM, Kasim F

Med Sci Educ, 2022 Apr;32(2):399-409.
PMID: 35528310 DOI: 10.1007/s40670-022-01517-w

This study aimed to measure medical students' perceptions of the anatomy education environment and determine its association with their learning approaches. First- and second-year undergraduate medical students (N = 234) completed the Anatomy Education Environment Measurement Inventory and the Approaches and Study Skills Inventory for Students. Results revealed that the students' perceptions of all the factors in the anatomy education environment were positive except for two areas-the anatomy learning resources and quality of histology learning facilities. The majority of students in the first year (62.3%) and second year (43.7%) adopted a deep learning approach. There was no significant association between most of the factors in the anatomy education environment and the students' learning approaches, except for the students' intrinsic interest in learning anatomy factor (p = 0.032). The anatomy education environment was positive for the medical students, and there was a prevalence of a deep learning approach among them. However, most of the factors in the anatomy education environment did not influence the students' learning approach. Given that the students' learning approach is a multifactorial construct, investigating the relationship between these two variables in longitudinal time points would provide better insight into the association between the anatomy educational climate and students' learning approaches.
Fulltext The roles of emotional intelligence, neuroticism, and academic stress on the relationship between psychological distress and burnout in medical students

Yusoff MSB, Hadie SNH, Yasin MAM

BMC Med Educ, 2021 May 22;21(1):293.
PMID: 34022865 DOI: 10.1186/s12909-021-02733-5

BACKGROUND: Stress and burnout commonly threaten the mental health of medical students in Malaysia and elsewhere. This study aimed to explore the interrelations of psychological distress, emotional intelligence, personality traits, academic stress, and burnout among medical students.
METHODS: A cross-sectional study was conducted with 241 medical students. Validated questionnaires were administered to measure burnout, psychological distress, emotional intelligence, personality traits, and academic stress, respectively. A structural equation modelling analysis was performed by AMOS.
RESULTS: The results suggested a structural model with good fit indices, in which psychological distress and academic stress were noted to have direct and indirect effects on burnout. The burnout levels significantly increased with the rise of psychological distress and academic stress. Neuroticism was only found to have significant indirect effects on burnout, whereby burnout increased when neuroticism increased. Emotional intelligence had a significant direct effect on lowering burnout with the incremental increase of emotional intelligence, but it was significantly reduced by psychological distress and neuroticism.
CONCLUSION: This study showed significant effects that psychological distress, emotional intelligence, academic stress, and neuroticism have on burnout. Academic stress and neuroticism significantly increased psychological distress, leading to an increased burnout level, while emotional intelligence had a significant direct effect on reducing burnout; however, this relationship was compromised by psychological distress and neuroticism, leading to increased burnout. Several practical recommendations for medical educators, medical students, and medical schools are discussed.
A Scoping Review of Effective Teaching Strategies in Surface Anatomy

Abu Bakar YI, Hassan A, Yusoff MSB, Kasim F, Abdul Manan Sulong H, Hadie SNH

Anat Sci Educ, 2021 Mar 01.
PMID: 33650315 DOI: 10.1002/ase.2067

To become skilled physicians, medical students must master surface anatomy. However, the study of surface anatomy is less emphasized in medical and allied health science curricula, and the time devoted to direct engagement with the human body is limited. This scoping review was designed to answer one research question: "What are the elements and strategies that are effective in teaching surface anatomy?" The review was performed using a five-stage scoping review framework, including research question identification, relevant study identification, study selection, data charting, and result collating and reporting. Three databases were searched using two search terms combined with a Boolean operator: "teaching" and "surface anatomy." The initial pool of 3,294 sources was assessed for duplication, and study eligibility was evaluated using inclusion and exclusion criteria. Data were abstracted from 26 original articles by one researcher and verified by two other researchers. A thematic analysis was performed, and several elements of effective teaching strategies for surface anatomy were identified, namely contextualized teaching, embracing experiential learning, and learning facilitation. This review revealed that a multimodal approach was most commonly used in surface anatomy instruction. Hence, future research should explore the effectiveness of multimodal teaching strategies that adopt the three aforementioned primary elements of effective teaching in an authentic learning environment. It is pertinent to clarify the effectiveness of these teaching strategies by evaluating their impact on student learning, organizational changes, and benefits to other stakeholders.
Fulltext Effective Learning Behavior in Problem-Based Learning: a Scoping Review

Ghani ASA, Rahim AFA, Yusoff MSB, Hadie SNH

Med Sci Educ, 2021 Jun;31(3):1199-1211.
PMID: 33903829 DOI: 10.1007/s40670-021-01292-0

Problem-based learning (PBL) emphasizes learning behavior that leads to critical thinking, problem-solving, communication, and collaborative skills in preparing students for a professional medical career. However, learning behavior that develops these skills has not been systematically described. This review aimed to unearth the elements of effective learning behavior in a PBL context, using the protocol by Arksey and O'Malley. The protocol identified the research question, selected relevant studies, charted and collected data, and collated, summarized, and reported results. We discovered three categories of elements-intrinsic empowerment, entrustment, and functional skills-proven effective in the achievement of learning outcomes in PBL.
Fulltext Understanding the Functional Components of Technology-Enhanced Learning Environment in Medical Education: A Scoping Review

Naeem NI, Yusoff MSB, Hadie SNH, Ismail IM, Iqbal H

Med Sci Educ, 2023 Apr;33(2):595-609.
PMID: 37251205 DOI: 10.1007/s40670-023-01747-6

Increasing use of technology in medical education has caused concerns to medical teachers pertaining to the quality of digital learning environments. Thus, this review aimed to unearth the functional components of effective technology-enhanced learning environment in the undergraduate medical education context. The revised Arksey and O'Malley protocol was utilized that include identification of research question and relevant studies, selection of studies, data charting and collection, and collating, summarizing, and reporting results after consultation. We discovered nine components with 25 subcomponents of 74 functional elements found to be present in effective online learning environments. The nine components include cognitive enhancement, content curation, digital capability, technological usability, pedagogical practices, learner characteristics, learning facilitator, social representations, and institutional support. There is an interplay between these components, influencing each other in online learning platforms. A technology-enhanced learning in medical education (TELEMEd) model is proposed which can be used as a framework for evaluating online learning environment in medical education.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-023-01747-6.
Fulltext Creating an engaging and stimulating anatomy lecture environment using the Cognitive Load Theory-based Lecture Model: Students' experiences

Hadie SNH, Abdul Manan Sulong H, Hassan A, Mohd Ismail ZI, Talip S, Abdul Rahim AF

J Taibah Univ Med Sci, 2018 Apr;13(2):162-172.
PMID: 31435319 DOI: 10.1016/j.jtumed.2017.11.001

OBJECTIVE: There is a need to create a standard interactive anatomy lecture that can engage students in their learning process. This study investigated the impact of a new lecturing guideline, the Cognitive Load Theory-based Lecture Model (CLT-bLM), on students' cognitive engagement and motivation.
METHODS: A randomised controlled trial involving 197 participants from three institutions was conducted. The control group attended a freestyle lecture on the gross anatomy of the heart, delivered by a qualified anatomist from each institution. The intervention group attended a CLT-bLM-based lecture on a similar topic, delivered by the same lecturer, three weeks thereafter. The lecturers had attended a CLT-bLM workshop that allowed them to prepare for the CLT-bLM-based lecture over the course of three weeks. The students' ratings on their cognitive engagement and internal motivation were evaluated immediately after the lecture using a validated Learners' Engagement and Motivation Questionnaire. The differences between variables were analysed and the results were triangulated with the focus group discussion findings that explored students' experience while attending the lecture.
RESULTS: The intervention group has a significantly higher level of cognitive engagement than the control group; however, no significant difference in internal motivation score was found. In addition, the intervention group reported having a good learning experience from the lectures.
CONCLUSION: The guideline successfully stimulated students' cognitive engagement and learning experience, which indicates a successful stimulation of students' germane resources. Stimulation of these cognitive resources is essential for successful cognitive processing, especially when learning a difficult subject such as anatomy.
Fulltext Development and validation of Digi-MEE Instrument measuring online learning environments in medical education

Naeem NI, Hadie SNH, Ismail IM, Yusoff MSB

Pak J Med Sci, 2023;39(6):1573-1583.
PMID: 37936768 DOI: 10.12669/pjms.39.6.8430

OBJECTIVES: To develop and validate Digital Medical Education Environment (Digi-MEE) Instrument for measuring online learning environment in medical education.
METHODS: This series of studies involved 696 participants from May 2022 to December 2022. Following scoping review, invited modified e-Delphi experts developed consensus on the components and related items for measuring online learning environments. A panel of content experts and a group of medical students carried out content and response-process validation to determine Content Validity Index (CVI) and Face Validity Index (FVI) respectively. This was followed by exploratory and confirmatory factor analysis and reliability analysis to determine Digi-MEE's factorial structure and internal consistency using SPSS version 26.0 and AMOS 26.0.
RESULTS: Delphi experts agreed upon nine components with 73 items of initial Digi-MEE version. CVI of Digi-MEE 2.0 was more than 0.90. with FVI of Digi-MEE 3.0 of 0.87. Exploratory factor analysis yielded 46 items with 57.18% variance. Confirmatory factor analysis led to the final Digi-MEE version containing 28 items within nine components with acceptable levels of goodness of fit indices. Overall Cronbach alpha of the final Digi-MEE was more than 0.90, and for the nine components ranged between 0.62 and 0.76.
CONCLUSION: Digi-MEE is a promising valid and reliable instrument to evaluate online education environment in medical education. Content, response-process, factorial structure, and internal consistency evidence support the validity of Digi-MEE. Medical schools can use Digi-MEE as an evaluation tool for the continuous quality improvement of online learning environments.
From generosity to gratitude: Exploring Islamic views on body donation, human dissection, and honoring the gift of life

Hadie SNH, Gasmalla HEE, Wadi MM, Zainul Abidin MA, Yusoff MSB

Anat Sci Educ, 2024 Feb 08.
PMID: 38332675 DOI: 10.1002/ase.2393

Human dissection is an ancient pedagogical method that is still relevant in modern anatomy curricula. The body procurement process for dissection purposes has undergone significant evolution from the medieval era until now, whereby body donation has become the main source for human bodies in medical education. The appreciation ceremony for body donors is an excellent way to promote a body donation program, whereby both dissection and appreciation ceremonies are effective in inculcating professional behaviors and altruism among medical students. Despite the benefits of dissection and such ceremonies, conflicting ideas about the acceptability of these methods exist among Muslim scholars and students. Hence, this article provides a theological Islamic interpretation of human dissection, body donation, and appreciation ceremonies from four sources of Islamic law-the Qur'an, Hadith, Idjmaa, and Qiyas-to justify Muslims' involvement in the aforementioned. It is important to note that the fundamentals of Islam are submission to the will of the one and only God, Allah Subhanahu wa ta'ala (SWT) and recognition of Prophet Muhamad (peace be upon him) as the last messenger of God. Therefore, the actions of a Muslim are strongly based on faith and virtue.
Fulltext Discovering the Potential of Natural Antioxidants in Age-Related Macular Degeneration: A Review

Wong KH, Nam HY, Lew SY, Naidu M, David P, Kamalden TA, et al.

Pharmaceuticals (Basel), 2022 Jan 14;15(1).
PMID: 35056157 DOI: 10.3390/ph15010101

Age-related macular degeneration (AMD) is a multifactorial disease associated with anatomical changes in the inner retina. Despite tremendous advances in clinical care, there is currently no cure for AMD. This review aims to evaluate the published literature on the therapeutic roles of natural antioxidants in AMD. A literature search of PubMed, Web of Science and Google Scholar for peer-reviewed articles published between 1 January 2011 and 31 October 2021 was undertaken. A total of 82 preclinical and 18 clinical studies were eligible for inclusion in this review. We identified active compounds, carotenoids, extracts and polysaccharides, flavonoids, formulations, vitamins and whole foods with potential therapeutic roles in AMD. We evaluated the integral cellular signaling pathways including the activation of antioxidant pathways and angiogenesis pathways orchestrating their mode of action. In conclusion, we examined the therapeutic roles of natural antioxidants in AMD which warrant further study for application in clinical practice. Our current understanding is that natural antioxidants have the potential to improve or halt the progression of AMD, and tailoring therapeutics to the specific disease stages may be the key to preventing irreversible vision loss.
Fulltext The potential neuroprotective effects of stingless bee honey

Zulkifli NA, Hassan Z, Mustafa MZ, Azman WNW, Hadie SNH, Ghani N, et al.

Front Aging Neurosci, 2022;14:1048028.
PMID: 36846103 DOI: 10.3389/fnagi.2022.1048028

Tropical Meliponini bees produce stingless bee honey (SBH). Studies have shown beneficial properties, including antibacterial, bacteriostatic, anti-inflammatory, neurotherapeutic, neuroprotective, wound, and sunburn healing capabilities. High phenolic acid and flavonoid concentrations offer SBH its benefits. SBH can include flavonoids, phenolic acids, ascorbic acid, tocopherol, organic acids, amino acids, and protein, depending on its botanical and geographic origins. Ursolic acid, p-coumaric acid, and gallic acid may diminish apoptotic signals in neuronal cells, such as nuclear morphological alterations and DNA fragmentation. Antioxidant activity minimizes reactive oxygen species (ROS) formation and lowers oxidative stress, inhibiting inflammation by decreasing enzymes generated during inflammation. Flavonoids in honey reduce neuroinflammation by decreasing proinflammatory cytokine and free radical production. Phytochemical components in honey, such as luteolin and phenylalanine, may aid neurological problems. A dietary amino acid, phenylalanine, may improve memory by functioning on brain-derived neurotrophic factor (BDNF) pathways. Neurotrophin BDNF binds to its major receptor, TrkB, and stimulates downstream signaling cascades, which are crucial for neurogenesis and synaptic plasticity. Through BDNF, SBH can stimulate synaptic plasticity and synaptogenesis, promoting learning and memory. Moreover, BDNF contributes to the adult brain's lasting structural and functional changes during limbic epileptogenesis by acting through the cognate receptor tyrosine receptor kinase B (TrkB). Given the higher antioxidants activity of SBH than the Apis sp. honey, it may be more therapeutically helpful. There is minimal research on SBH's neuroprotective effects, and the related pathways contribute to it is unclear. More research is needed to elucidate the underlying molecular process of SBH on BDNF/TrkB pathways in producing neuroprotective effects.
Fulltext COVID-19 Disruptions in Health Professional Education: Use of Cognitive Load Theory on Students' Comprehension, Cognitive Load, Engagement, and Motivation

Hadie SNH, Tan VPS, Omar N, Nik Mohd Alwi NA, Lim HL, Ku Marsilla KI

Front Med (Lausanne), 2021;8:739238.
PMID: 34671622 DOI: 10.3389/fmed.2021.739238

This study explored the impact of online lectures that were developed using principles of cognitive load theory (CLT) and cognitive theory of multimedia learning (CTML) on health profession students' lecture comprehension, cognitive load, cognitive engagement, and intrinsic motivation in learning. A total of 215 first-year undergraduate students in medical, dentistry, and nutrition programs participated in this pre-post quasi experimental study. The students attended a typical face-to-face lecture on Day-1 of the intervention, followed by a CLT-based online lecture 8 weeks thereafter. Their comprehension of the lecture topics was measured through pre- and post-lecture assessments, and their cognitive load, cognitive engagement, and motivation were measured immediately after each lecture session. The analysis revealed that the CLT-based online lectures promoted the students' comprehension of the lecture content (p < 0.001), self-perceived learning (p < 0.001), engagement toward the learning material, and motivation to learn (p = 0.025). It was also effective at reducing the students' intrinsic and extraneous cognitive loads (p < 0.001). Hence, designing online lectures using CLT and CTML principles could be an effective method to promote students' knowledge and comprehension, cognitive engagement, and learning motivation. However, further research is needed to investigate the applicability and impact of CLT-based online lectures in non-health profession disciplines.
Anatomy education environment measurement inventory: A valid tool to measure the anatomy learning environment

Hadie SNH, Hassan A, Ismail ZIM, Asari MA, Khan AA, Kasim F, et al.

Anat Sci Educ, 2017 Sep;10(5):423-432.
PMID: 28135037 DOI: 10.1002/ase.1683

Students' perceptions of the education environment influence their learning. Ever since the major medical curriculum reform, anatomy education has undergone several changes in terms of its curriculum, teaching modalities, learning resources, and assessment methods. By measuring students' perceptions concerning anatomy education environment, valuable information can be obtained to facilitate improvements in teaching and learning. Hence, it is important to use a valid inventory that specifically measures attributes of the anatomy education environment. In this study, a new 11-factor, 132-items Anatomy Education Environment Measurement Inventory (AEEMI) was developed using Delphi technique and was validated in a Malaysian public medical school. The inventory was found to have satisfactory content evidence (scale-level content validity index [total] = 0.646); good response process evidence (scale-level face validity index [total] = 0.867); and acceptable to high internal consistency, with the Raykov composite reliability estimates of the six factors are in the range of 0.604-0.876. The best fit model of the AEEMI is achieved with six domains and 25 items (X2 = 415.67, P
Fulltext Clinical students' reflections on the preclinical anatomy learning experience

Syed Abd Halim SA, Yusoff MSB, Yaman MN, Razali SA, Tengku Muda TFM, Ramli RR, et al.

J Taibah Univ Med Sci, 2023 Aug;18(4):757-770.
PMID: 36852241 DOI: 10.1016/j.jtumed.2022.12.007

OBJECTIVES: Anatomy is a fundamental pillar of medical knowledge that bridges basic medical science knowledge and clinical practice. However, integrated modern medical curricula have reduced the anatomy teaching content, and cadaveric dissection is no longer conducted. Medical graduates who lack anatomy knowledge are anticipated to be inadequately equipped for safe clinical practice. This study was aimed at exploring clinical year students' experiences regarding their anatomy learning during the preclinical phase in Malaysian medical schools. The findings reflect how the students' preclinical anatomy training prepared them for their clinical years of study.
METHODS: A qualitative phenomenology study using the focus group discussion method was conducted on 30 final-year students from four public universities. Four focus group discussion sessions were conducted, and students' responses were transcribed and converted to electronic formats. The transcripts were analyzed thematically with ATLAS.ti software.
RESULTS: The first-cycle coding of the text analysis generated 157 open codes based on the phrases used by the participants. The subsequent coding cycle produced 16 axial codes-groups of open codes with similar features. During the final coding cycle, the content and interrelations between the axial codes were categorized into six codes: (1) preclinical anatomy learning experience, (2) anatomy content and teaching, (3) anatomy-related competency, (4) the importance of anatomy knowledge in clinical practice, (5) the importance of early exposure to applied clinical anatomy, and (6) suggestions for future anatomy education.
CONCLUSIONS: The six identified themes reflected students' perceptions of their anatomy learning experience, the challenges that they faced during their preclinical years, and their opinions regarding the anatomy knowledge and skills that are functionally relevant during the clinical years. Their responses also echoed the need to improve anatomy teaching and learning, thereby emphasizing the importance of early clinical integration and application.
Fulltext Probiotic Improves Skin Oxidation, Elasticity, and Structural Properties in Aging Rats

Lee BK, Xu P, Mageswaran UM, Jeong WS, Engku-Husna EI, Muhammad-Nashriq K, et al.

Prev Nutr Food Sci, 2023 Sep 30;28(3):293-301.
PMID: 37842246 DOI: 10.3746/pnf.2023.28.3.293

Skin aging, which affects all living organisms, is associated with oxidative stress. Probiotics exhibit antioxidant properties by producing reactive metabolites that counter oxidative stress. We hypothesized that Limosilactobacillus fermentum USM 4189 (LF 4189) has antioxidative properties and may prevent skin aging. In the present study, we used a D-galactose senescence-induced rat model to evaluate the potential antioxidative capability of LF 4189. The results indicated that rats administered LF 4189 exhibited increased plasma antioxidative activity (P=0.004), lipid peroxidation capacity (P=0.007), and skin elasticity compared with untreated aged rats (P=0.005). LF 4189 prevented telomere length shortening (P<0.05), indicating the potential to prevent senescence. A higher apoptotic activity was observed in old rats compared with young rats, whereas LF 4189 reduced the expression of four antioxidative enzyme genes that function as radical scavengers (all P<0.05), suggesting that the LF 4189 group had a reduced need to scavenge free radicals. Our findings indicate the potential of probiotics, such as LF 4189, as an anti-aging dietary intervention with antioxidant potential to improve skin health.
Fulltext Sustainable Medical Teaching and Learning During the COVID-19 Pandemic: Surviving the New Normal

Yusoff MSB, Hadie SNH, Mohamad I, Draman N, Muhd Al-Aarifin I, Wan Abdul Rahman WF, et al.

Malays J Med Sci, 2020 May;27(3):137-142.
PMID: 32684814 MyJurnal DOI: 10.21315/mjms2020.27.3.14

During the first phase of the Movement Control Order, many medical lecturers had difficulty adapting to the online teaching and learning methods that were made compulsory by the institutional directives. Some of these lecturers are clinicians who need to juggle between clinical work and teaching, and consider a two-week adaptation during this period to be not enough. Furthermore, converting traditional face-to-face learning to online formats for undergraduate and postgraduate clinical programmes would reduce the learning outcomes, especially those related to clinical applications and the acquisition of new skills. This editorial discusses the impact that movement restrictions have had on medical teaching and learning, the alternatives and challenges and the way forward.
Fulltext Anatomy Education Environment Measurement Inventory (AEEMI): a cross-validation study in Malaysian medical schools

Hadie SNH, Yusoff MSB, Arifin WN, Kasim F, Ismail ZIM, Asari MA, et al.

BMC Med Educ, 2021 Jan 14;21(1):50.
PMID: 33446203 DOI: 10.1186/s12909-020-02467-w

BACKGROUND: The Anatomy Education Environment Measurement Inventory (AEEMI) evaluates the perception of medical students of educational climates with regard to teaching and learning anatomy. The study aimed to cross-validate the AEEMI, which was previously studied in a public medical school, and proposed a valid universal model of AEEMI across public and private medical schools in Malaysia.
METHODS: The initial 11-factor and 132-item AEEMI was distributed to 1930 pre-clinical and clinical year medical students from 11 medical schools in Malaysia. The study examined the construct validity of the AEEMI using exploratory and confirmatory factor analyses.
RESULTS: The best-fit model of AEEMI was achieved using 5 factors and 26 items (χ 2 = 3300.71 (df = 1680), P

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