Objective: The objective of this study was to evaluate whether students exposed to a brief stress reduction intervention would have lesser stress, anxiety and depression levels compared to their non-exposed classmates during stressful events. Methods: The Ex Post Facto design was applied in this study. Students who were exposed and not exposed to a brief stress reduction intervention were surveyed during a continuous examination and during the final examination. The Depression Anxiety Stress Scales (DASS) was used to
examine effects on anxiety, stress, and depression levels. Results: The exposed students statistically had lower anxiety and depression scores than the nonexposed students during the stressful period. Reduction of stress, anxiety and depression scores was sustained during the stressful period. Conclusion: The significant reduction of anxiety and depression scores suggested that brief intervention was effective in the enhancement of the psychological wellbeing of exposed medical students during stressful period.
Objective: In the process of growing, adolescents experience stress either good or bad depending on how they cope. School training further adds to this stressful situation. It is noteworthy that persistent over stress will impair students’ academic achievement, personal and professional development. This preliminary study is meant to obtain initial data on the stress prevalence, stressors, and coping strategies among secondary school children in Malaysia. Data gained from this preliminary study provides valuable data for subsequence research in the future. Methods: This is a cross-sectional study involving 100 secondary school students from a Malaysian government secondary school. The validated Malay version 12-item General Health Questionnaire (GHQ-12), Soalselidik Stressor Sekolah Menengah (SSSM) and Malay version of Brief COPE were used to identify stress level, stressors, and coping strategies. Results: A number of 90 (90%) students participated in this study. The prevalence of stress among secondary school students was 26.1%. It was found that the main stressors were related to academic. The top five coping strategies were religion, positive reinterpretation, active coping, planning, and use of instrumental support. Conclusion: The prevalence of stress among secondary school students in a Malaysian
stressor among the students. The most frequent coping strategies being used by the students were positive coping strategies.
Objective: Emotional Intelligence (EI) is described as the ability to perceive, express,
understand, motivate, control and regulate emotion. The USM Emotional Quotient Inventory (USMEQ-i) was designed to measure EI and it was found to be a reliable and valid tool in a sample of prospective medical students. The objective of this study is to determine stability of the USMEQ-i to measure EI at different time and occasions. Methods: A prospective cohort study was done on 196 first year medical students. It was administered to the medical students at four different intervals. The Cronbach’s alpha and intra-class correlation analysis were applied to measure the internal consistency and agreement level across the intervals. The analysis was done using Statistical Package for Social Sciences (SPSS) version 18. Results: A total of 196 first year medical students participated in this study. Its overall Cronbach’s alpha value across intervals ranged between 0.94 and 0.97. The Cronbach’s alpha values of emotional control, emotional maturity, emotional conscientiousness, emotional awareness, emotional commitment, emotional fortitude, and emotional expression scale ranged between 0.59 and 0.91. The Cronbach’s alpha value for the faking index scale ranged from 0.76 to 0.89. The ICC coefficient values for EI total score was 0.83, EI domain score ranged between 0.62 and 0.76 and the faking index score was 0.76. Conclusion: The USMEQ-i has demonstrated a good level of stability and internal consistency to measure EI at different time and occasions. It is a promising psychometric instrument that can be used to measure EI.
Objective: To determine the internal consistency and construct validity of the Adult Learning Inventory (AL-i) among first year medical students in a Malaysian medical school. Methods: Cross sectional study was done on 196 first year medical student in Universiti Sains Malaysia (USM). The Cronbach’s alpha reliability analysis, exploratory factor analysis and confirmatory factor analysis were applied to measure internal consistency and construct validity of the AL-i respectively. These analyses were done using Predictive Analytics SoftWare (PASW) version 18 and Analysis of Moment Structure (AMOS) version 19. Result: A total of 196 medical students responded to this study. Exploratory factor analysis showed that two potential constructs would be extracted from the inventory. The confirmatory factor analysis showed the two factor model with six items had a good fit with the latent constructs (X2 (df) = 25.63 (8), p = 0.048, RMR = 0.045, GFI = 0.974, AGFI = 0.933, NFI = 0.974, RFI = 0.951, IFI = 0.987, TLI = 0.975, CFI = 0.987, RMSEA = 0.07). Each domain of the final model of the AL-i has three items. The Cronbach’s alpha value of the AL-i was 0.72. The Cronbach’s alpha values of andragogy and pedagogy domains were 0.87 and 0.86 respectively. Composite Reliability and Average Variance Extracted values were more than 0.6 and 0.5 respectively indicating good construct reliability and adequate convergent validity. Conclusion: This study suggested that the two factor model with 6 items of the AL-i has a good fit and shown good psychometric values. It is a valid and reliability measurement to determine types of leaner among first year medical students.
Objective: To determine the construct validity, convergent validity, construct reliability and internal consistency of the Medical Student Stressor Questionnaire (MSSQ) among first-year medical students in Malaysia. Methods: A multicenter cross-sectional study was done on 375 medical students of four medical schools in Malaysia. The confirmatory factor analysis and reliability analysis were applied to measure construct validity, construct reliability and internal consistency of the MSSQ. These analyses were done using Predictive Analytics SoftWare (PASW) version 18 and Analysis of Moment Structure (AMOS) version 19. The Composite Reliability and Average Variance Extracted of the final constructs were calculated manually to determine construct reliability and convergent validity. Results: A total of 359 (95.7%) medical students responded to this study. The confirmatory factor analysis showed the six factor model with 20 items had a good fit with the latent constructs (X2 (df) = 258.02 (155), p < 0.001, RMR = 0.055, GFI = 0.933, AGFI = 0.910, NFI = 0.931, RFI = 0.916, IFI = 0.971, TLI = 0.965, CFI = 0.971, RMSEA = 0.043). The Cronbach’s alpha value of the MSSQ was 0.92. The Cronbach’s alpha values of the six constructs were more than 0.7. Composite Reliability and Average Variance Extracted values of the six constructs were more than 0.6 and 0.5 respectively indicating good construct reliability and adequate convergent validity. Conclusion: This study suggested that the six factor model with 20 items of the MSSQ had a good fit and shown good psychometric values. It is a valid and reliability measurement to identify stressors among medical students across institutions in Malaysia.
Objective: To determine the internal consistency and construct validity of the Learning Approach Inventory (LA-i) among first year medical students in a Malaysian medical school. Methods: Cross sectional study was done on 196 first year medical students in Universiti Sains Malaysia (USM). The items of the LA-i were framed based on characteristics of three learning approaches. The Cronbach’s alpha reliability analysis, exploratory factor analysis and confirmatory factor analysis were applied to measure internal consistency and construct validity. These analyses were done using Predictive Analytics SoftWare (PASW) version 18 and Analysis of Moment Structure (AMOS) version 19. The Composite Reliability (CR) and Average Variance Extracted (AVE) were calculated manually to measure construct reliability and convergent validity. Result: A total of 196 medical students responded to this study. Exploratory factor analysis showed that three potential constructs were extracted from the inventory. The confirmatory factor analysis showed the three factor model with nine items had a good fit with the latent constructs (X2(df) = 26.07 (20), p = 0.163, RMR = 0.04, GFI = 0.969, AGFI = 0.93, NFI = 0.967, RFI = 0.941, IFI = 0.992, TLI = 0.985, CFI = 0.992, RMSEA = 0.04). Each domain of the final model of the LA-i has three items. The Cronbach’s alpha value of the AL-i was 0.86. The Cronbach’s alpha values of surface, strategic and deep approach domains were 0.62, 0.73 and 0.88 respectively. Most of learning approach domains had Composite Reliability and Average Variance Extracted values were more than 0.6 and 0.5 respectively indicating good construct reliability and adequate convergent validity. Conclusion: This study suggested that the three factor model with 9-items of the LA-i has a good fit and shown good psychometric values. It is a valid and reliability measurement to determine learning approaches among first year medical students.
Objective: To determine the construct validity and the internal consistency of the Postgraduate Stressor Questionnaire (PSQ) among postgraduate medical trainees hence it could be used as a valid and reliable instrument to identify stressors among them.
Methods: Items of the PSQ were derived from a review of literature on the subject and a discussion with experts in the field. It comprised of 28 items with seven hypothetical groups. The content and face validity was established through discussion with experts from field of Medical Education and Psychiatry. It was administered to all participants (N = 34) of postgraduate personal and professional development programme in a Malaysian university. Data was analysed using Statistical Package Social Sciences (SPSS) version 18. Factor analysis was applied to test construct validity whereas reliability analysis was applied to test internal consistency of the PSQ.
Results: Thirty three postgraduate medical trainees participated in this study. Factor analysis found that the 28 items of the PSQ were loaded nicely into the seven pre-determined groups as their factor loading values were more than 0.3. The reliability analysis showed that the Cronbach's alpha value for The PSQ was 0.95. Whereas, The Cronbach's alpha values for academic, poor relationship with superior, bureaucratic constraints, work-family conflicts, poor relationship with colleagues, performance pressure, and poor job prospect domains were 0.63, 0.84, 0.81, 0.65, 0.73, 0.78, and 0.70 respectively.
Conclusion: This study showed that the PSQ is a reliable and valid instrument to identify stressors of postgraduate medical trainees. It is a promising instrument that can be used in future to explore further on this area.
Introduction: The LA-i was found to be valid, reliable, simple and easy to be administered and consumed minimal time. However, to author knowledge, none of articles reported its stability across multiple observations. Realising its potential, continued research is required to optimize its role, usefulness and applicability as a tool to help educators to understand their students’ learning approaches. Objective: To determine stability of the LA-i to measure characteristics of students’ learning approaches at different time and occasions in a sample of medical students.Method: A prospective cohort study was done on 177 first year medical students. It was administered to a cohort of medical students at four different intervals. The Cronbach’s alpha and intra-class correlation analysis were applied to measure internal consistency and agreement level across the
intervals. The analysis was done using SPSS 18. Result: A total of 157 (88.7%) first year medical students responded completely to the inventory. The overall Cronbach’s alpha value of the LA-i at different intervals ranged between 0.79 and 0.92, The Cronbach’s alpha values for surface learning
approach subscale ranged between 0.65 and 0.80. The Cronbach’s alpha value for strategic learning approach subscale ranged between 0.76 and 0.84. The Cronbach’s alpha value for deep learning approach subscale ranged between 0.83 and 0.95. ICC values for the three learning approach subscales ranged between 0.46 and 0.50. Conclusion: This study reflected that the LA-i had high level of internal stability to measure students’ learning approaches at different time and occasions. Continued research is required to optimize its role, usefulness and applicability at various educational settings.
Introduction: There is lacking of evidence available in literatures on faking good in personality and emotional intelligent (EI) tests among medical school applicants. Thus more research is required to address the faking good issues in medical context specifically related to student admission. Objective: This study aimed to estimate the prevalence of faking good in personality and EI tests during a high stake situation which was during student selection process. Method: A one-year prospective study was carried out on a cohort of medical school applicants. Data collection was carried out at five different intervals; one measurement at pre-selection (Time 1) and four measurements at post-selection (Time 2 to Time 5). The USMaP-i and USMEQ-i were used to measure personality and EI. Faking good was positive if the scores at Time 1 beyond the 95% CI of average scores of Time 2 to Time 5.Result: The highest prevalence of faking good among personality traits was in conscientiousness (83.1%) and the lowest was in openness (74.1%). The highest prevalence of faking good among EI constructs was in emotional conscientiousness (77%) and the lowest was in emotional awareness (51.7%). About 1.7% of applicants were not faking good at any of the personality dimensions while 11.5% of them were not faking good at any of the EI constructs. About 47.4% faked good at all the personality dimensions and 33.9% faked good at all the EI constructs. Conclusion: The prevalence of faking good in the self-reporting personality and EI tests was high. Certain personality traits and EI constructs were more susceptible to faking good. The personality test was more susceptible to faking good than the EI test. Considering the potential positive impacts of personality and EI on individual performance, alternative ways should be designed to address the faking good issues.
Objective: To determine association between academic performance and absenteeism in classroom among first year medical students.
Methods: A one-year prospective study was conducted on 196 first year medical students. Academic performance was measured by examination scores at four examinations. Absenteeism score was measured by the cumulative number of absence in an academic session of each student recorded by academic office at the end of the first year of medical training. The academic performance was categorized into pass and fail for analysis purpose. Data was analyzed by SPSS version 20.
Results: The independent-t analysis showed that, in all examinations, students who passed the examinations had significantly lower absenteeism scores than those who failed (p < 0.001).
Conclusion: This study found significant associations between academic performances and absenteeism scores among first year medical students. Medical schools should pay more attention on this matter since it may result in poor academic performances.
There are five sources of validity evidence that are content, response process, internal structure, relation to other variables, and consequences. Content validity is the extent of a measurement tool represents the measured construct and it is considered as an essential evidence to support the validity of a measurement tool such as a questionnaire for research. Since content validity is vital to ensure the overall validity, therefore content validation should be performed systematically based on the evidence and best practice. This paper describes a systematic approach to quantify content validity in the form of content validity index based on the evidence and best practice.
Validity evidence can be supported by five sources that are content, response process, internal structure, relation to other variables, and consequences. Response process validity measures the thought processes of users of the tested inventory as they respond to the assessment tool. These are commonly evaluated in the form of clarity of instructions and language used in the assessment tool, as well as the comprehension of instruction after training or an observation session. Response process validity contributes to the overall validity of an assessment tool; therefore, it should be quantified systematically based on the evidence and best practice. This paper describes a systematic approach to quantify response process validity in the form of face validity index based on the evidence.
Feedback and students’ perception towards it has gained increasing attention in the educational literature recently, yet it is an underresearched area. The importance of feedback has not been perceived in a positive manner among medical students. This may be due to students’ lack of knowledge on the concept of feedback and their awareness of the benefits of feedback. This study focused on students’ knowledge on the concept of feedback and their perception towards the feedback system practiced in School of Medical Sciences, University Sains Malaysia. Methods: This was a cross-sectional study involving 433 numbers of students from year 1, 3 and 5 medical students. The variables that were included in this were the gender and their year of study. A validated questionnaire was used to perform this study. School and ethical committee clearance were obtained prior to the start of the study. Data obtained was analysed using Statistical Package for Social Sciences (SPSS) version 20. Results: Findings revealed that students have an average level of knowledge on the concept of feedback and have a neutral perception towards the feedback system that is practiced in School of Medical Sciences, USM. There was no association between students’ knowledge level on feedback and their perception with their year of study and gender differences. However, although there was not much difference in students’ perception level about feedback with their year of study but it was found those students’ perception level decreases as their year of study progresses. It was also found that there was a poor correlation between medical students’ knowledge level on feedback with their perception towards the feedback system in School of Medical Sciences, USM. Conclusions: The area in which it raised concern in students’ perception about feedback was the factors that are involved in feedback practice, which are the givers of feedback, timing of feedback and the mode of feedback. Further study addressing students’ poor engagement and involvement in feedback can be done and issues identified from this study can be included in together for further improvements of the feedback system.
Objective: Missing values is commonly encountered in data analysis in all types of research. Various methods were introduced to handle this matter. This study aims to compare the result of using complete data analysis, missing indicator method, means substitution and single imputation in dealing with this issue. Methods: 202 patients who were discharged from the psychiatric ward, University Malaya Medical Centre (UMMC) from 27th August 2007 to 15th April 2008 were recruited. The general psychopathology was measured with Brief Psychiatric Rating Scale (BPRS-24). The information on age, gender, race, marital status and psychiatric diagnosis were collected. On follow up, the patients who had early readmission (
Introduction: Various studies had been done on medical students stress, but there is yet no comparative study done between universities in Asia and Europe. Universiti Sains Malaysia (USM) and Universiteit Maastricht (UM) share a lot in common in terms of medical education as both actively apply PBL-oriented education into their curriculum. It will be interesting to find out the effect of differing culture, one Eastern and another Western, on the prevalence of stress and stressors among medical students of both universities.
Method: A comparative study was conducted on medical students from USM and UM. Psychological distress was measured by the 12 item General Health Questionnaire and stressors were measured by the 40 item Medical Student Stressor Questionnaire. The calculated sample size was 215 per university. The collected data was analyzed using Statistical Package for Social Sciences (SPSS) version 20.
Result: Results showed that the overall prevalence of psychological distress among medical students of USM and UM was 25.9% and no significant difference was found between the two universities. Binary logistic regression test showed that medical students in pre-clinical phase were 1.84 times more likely to develop psychological distress than medical students in clinical phases (B = 0.612, odd ratio (CI95%) = 1.84 (1.16, 2.93), p = 0.010). The major stressors were related to academic requirements, UM medical students perceived the stressors as causing less stress than USM medical students (t-stat (df) = 5.33 (380), p-value < 0.001).
Conclusion: Psychological health among medical students in the two universities was comparable. Academic requirements were the most stressful events as perceived by the students, but UM medical students had more positive perception toward the stressors than USM medical students. Pre-clinical students experienced higher psychological pressures than the clinical students. The medical schools should provide more attention to pre-clinical students because they might need psychological support from them.
Journal business models are basically classified based on the source of income to cover publication costs and in general there are two main journal business models which are the toll-access and open-access. These leading to a question that still remains around the ethics of publishing academic work across the different journal business models in terms of (a) editorial decision-making and (b) the dissemination of research that has not been appropriately peer-reviewed for quality and rigor. This paper discussed about these two areas based on the literature and the authors' observations.
Objective: Medical housemanship training has always been regarded as a highly stressful environment to doctors. This article described findings on stress, stressors and coping strategies among house officers in a Malaysian hospital. Methods: A cross-sectional study was conducted on house officers in a Malaysian hospital. The 12 items General Health Questionnaire (GHQ-12), General Stressors Questionnaire (GSQ) and Brief COPE inventory were administered to measure perceived stress, sources of stress and coping strategies among house officers respectively. Data was analysed using SPSS version 12. Results: Forty two house officers participated in this study. This study found that approximately 31% of the house officers were in distress. The top five stressors were fears of making mistakes that can lead to serious consequences, work overload, working with uncooperative colleagues, doing
work that mentally straining and feeling of being underpaid. The most frequent coping strategies used by house officers were religion, acceptance and self-distraction. Conclusion: This study found that there was a high percentage of distressed house officers. It also found that major stressors were related to performance pressure. The main coping strategy used by house officer was emotion-focused coping.
Objective: Medical training has always been regarded as a highly stressful environment to students. This article described a preliminary data on impact of a stress-management programme on medical students’ stress level. Methods: This is a quasi-experimental before after comparison study design. The programme was run over half-day and convenient sampling method was applied. Sample size as calculated for this preliminary study was 38. The 12 items General Health Questionnaire (GHQ-12) was administered prior to the
programme and four months later. Data was analysed using SPSS version 12. Results: 34 participants were involved in this study. This study found that there was a significant difference in participants’ GHQ-12 scores before and after the programme (p
Objective: Postgraduate medical training has always been regarded as a highly stressful environment to students. This article described an initial finding on prevalence and sources of stress among postgraduate students. Method: This is a cross-sectional study conducted on postgraduate students in the School of Medical Sciences, Universiti Sains Malaysia. Sample size as calculated for this preliminary study was 38 and convenient sampling method was applied. The 12 items General Health Questionnaire (GHQ-12) and Postgraduate Stressors Questionnaire (PSQ) were administered during a workshop involving postgraduate students. Data was analysed using SPSS version 12. Results: Thirty three participants participated in this study. This study found that the prevalence of distressed postgraduate students was 36.4%. The top ten stressors were tests and examinations, large amount of content to be learnt, time pressure to meet deadlines, doing work beyond
ability, work overload, unfair assessment by superior, fears of making mistakes that can lead to serious consequences, doing work that mentally straining, work demands affect my personal and home life, and lack of time to review what have been learnt. Conclusion: This study found that there was a high prevalence of distressed postgraduate students. It also found that the major stressors were related to academic and performance pressure.
Background: Summative assessment in postgraduate examination globally employs multiple measures. A standard-setting method decides on pass or fail based on an arbitrarily defined cut-off point on a test score, which is often content expert’s subjective judgment. Contrary to this a standard-setting strategy primarily practices two approaches, a compensatory approach, which decides on overall performance as a sum of all the test scores and a conjunctive approach that requires passing performance for each instrument. However, the challenge using multiple measures is not due to number of measurement tools but due to logic by which the measures are combined to draw inferences on pass or fail in summative assessment. Conjoint University Board of Examination of Masters’ of Otolaryngology and Head-Neck Surgery (ORL-HNS) in Malaysia also uses multiple measures to reach a passing or failing decision in summative assessment. However, the standard setting strategy of assessment is loosely and variably applied to make ultimate decision on pass or fail. To collect the evidences, the summative assessment program of Masters’ of ORL-HNS in School of Medical Sciences at Universiti Sains Malaysia was analyzed for validity to evaluate the appropriateness of decisions in postgraduate medical education in Malaysia. Methodology: A retrospective study was undertaken to evaluate the validity of the conjoint summative assessment results of part II examination of USM candidates during May 2000-May 2011. The Pearson correlation and multiple linear regression tests were used to determine the discriminant and convergent validity of assessment tools. Pearson’s correlation coefficient analyzed the association between assessment tools and the multiple linear regression compared the dominant roles of factor variables in predicting outcomes. Based on outcome of the study, reforms for standard-setting strategy are also recommended towards programming the assessment in a surgical-based discipline. Results: The correlation coefficients of MCQ and essay questions were found not significant (0.16). Long and short cases were shown to have good correlations (0.53). Oral test stood as a component to show fair correlation with written (0.39-0.42) as well as clinical component (0.50-0.66). The predictive values in written tests suggested MCQ predicted by oral (B=0.34, P