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  1. Solarsh G, Lindley J, Whyte G, Fahey M, Walker A
    Acad Med, 2012 Jun;87(6):807-14.
    PMID: 22643380 DOI: 10.1097/ACM.0b013e318253226a
    The learning objectives, curriculum content, and assessment standards for distributed medical education programs must be aligned across the health care systems and community contexts in which their students train. In this article, the authors describe their experiences at Monash University implementing a distributed medical education program at metropolitan, regional, and rural Australian sites and an offshore Malaysian site, using four different implementation models. Standardizing learning objectives, curriculum content, and assessment standards across all sites while allowing for site-specific implementation models created challenges for educational alignment. At the same time, this diversity created opportunities to customize the curriculum to fit a variety of settings and for innovations that have enriched the educational system as a whole.Developing these distributed medical education programs required a detailed review of Monash's learning objectives and curriculum content and their relevance to the four different sites. It also required a review of assessment methods to ensure an identical and equitable system of assessment for students at all sites. It additionally demanded changes to the systems of governance and the management of the educational program away from a centrally constructed and mandated curriculum to more collaborative approaches to curriculum design and implementation involving discipline leaders at multiple sites.Distributed medical education programs, like that at Monash, in which cohorts of students undertake the same curriculum in different contexts, provide potentially powerful research platforms to compare different pedagogical approaches to medical education and the impact of context on learning outcomes.
  2. Suleiman AB
    Acad Med, 1999 Aug;74(8 Suppl):S45-52.
    PMID: 10495743
    This case study of medical schools in Malaysia addresses their role in meeting the demands of a young nation. Throughout the growth and development of these medical schools, there have been efforts to coordinate and cooperate with providers of health care. The treatment of illness must mesh with the changing paradigm of health and wellness as an achievable and indeed desirable goal, not only for the individual but also for society. The scientific basis of medicine is being emphasized with the advent of evidence-based medicine and outcome measures. Innovations have been made to bring the schools in closer contact with the service providers. Malaysia has prepared farsighted plans to become a developed nation by the year 2020. Accordingly, its health services will use advances in information technology and will introduce telemedicine in various strategic applications to extend the reach of the health care team. It is incumbent on the medical schools to move in concert with the Ministry of Health to realize goals of the nation and the society.
  3. Chur-Hansen A, Vernon-Roberts J
    Acad Med, 1999 Jul;74(7):829-34.
    PMID: 10429593
    PURPOSE: To explore the use of standardized patients for evaluating medical student's proficiency in speaking English.

    METHOD: In 1995, using a language rating scale constructed by the authors, six standardized patients evaluated the English-language proficiencies of 127 second-year medical student undergraduates enrolled at the University of Adelaide, Australia, many of whom were from a non-English speaking background.

    RESULTS: An earlier standardized test (Screening Test for Adolescent Language) had identified approximately one third of the students as potentially experiencing difficulties in using English in their training. Students so identified were rated lower than were their peers by the standardized patients.

    CONCLUSION: The study proved useful both in identifying aspects of speech that can be reasonably rated by standardized patients and also in identifying students who might benefit from language interventions. Replication studies with the new instrument are required to further establish its reliability, validity, and generalizability across different student cohorts.

  4. Zaharias G, Piterman L, Liddell M
    Acad Med, 2004 Feb;79(2):148-55.
    PMID: 14744716
    BACKGROUND: Much research on gender differences in medicine has centered on women as better communicators, more egalitarian, more patient-centered, and more involved with psychosocial problems, preventive care, and female-specific problems. Hardly any research has examined the interaction between the doctor's gender and the patient's gender. The authors examined students' perceptions and comfort levels regarding patients' gender during consultation.

    METHOD: This cross-sectional study used a questionnaire to survey final-year medical students at one school in 1999. It tested students' patient-centeredness, "patient-care" values, and degree of comfort in performing certain intimate physical examinations.

    RESULTS: Women students were more patient-centered than were men students. Both genders were more attuned to the concerns of patients of their own gender, were more comfortable with personal rather than sexual issues, and were more uncomfortable with performing more intimate examinations upon the opposite gender. Using comparable case studies, it was also shown that the female student-female patient dyad had significantly greater "patient-care" values than did the male student-male patient dyad.

    CONCLUSION: Medical students did not behave in a gender-neutral way in the consultation. There is a powerful interaction between a student's gender and a patient's gender. This warrants further investigation in the real clinical situation because it has implications on the outcomes of the consultation.

  5. Jacob SA, Palanisamy UD, Napier J, Verstegen D, Dhanoa A, Chong EY
    Acad Med, 2021 May 25.
    PMID: 34039854 DOI: 10.1097/ACM.0000000000004181
    There is a need for culturally competent health care providers (HCPs) to provide care to deaf signers, who are members of a linguistic and cultural minority group. Many deaf signers have lower health literacy levels due to deprivation of incidental learning opportunities and inaccessibility of health-related materials, increasing their risk for poorer health outcomes. Communication barriers arise because HCPs are ill-prepared to serve this population, with deaf signers reporting poor-quality interactions. This has translated to errors in diagnosis, patient nonadherence, and ineffective health information, resulting in mistrust of the health care system and reluctance to seek treatment. Sign language interpreters have often not received in-depth medical training, compounding the dynamic process of medical interpreting. HCPs should thus become more culturally competent, empowering them to provide cultural- and language-concordant services to deaf signers. HCPs who received training in cultural competency showed increased knowledge and confidence in interacting with deaf signers. Similarly, deaf signers reported more positive experiences when interacting with medically certified interpreters, HCPs with sign language skills, and practitioners who made an effort to improve communication. However, cultural competency programs within health care education remain inconsistent. Caring for deaf signers requires complex, integrated competencies that need explicit attention and practice repeatedly in realistic, authentic learning tasks ordered from simple to complex. Attention to the needs of deaf signers can start early in the curriculum, using examples of deaf signers in lectures and case discussions, followed by explicit discussions of Deaf cultural norms and the potential risks of low written and spoken language literacy. Students can subsequently engage in role plays with each other or representatives of the local signing deaf community. This would likely ensure that future HCPs are equipped with the knowledge and skills necessary to provide appropriate care and ensure equitable health care access for deaf signers.
  6. Coombs CM, Shields RY, Hunt EA, Lum YW, Sosnay PR, Perretta JS, et al.
    Acad Med, 2017 04;92(4):494-500.
    PMID: 27680320 DOI: 10.1097/ACM.0000000000001387
    PROBLEM: Because reported use of simulation in preclinical basic science courses is limited, the authors describe the design, implementation, and preliminary evaluation of a simulation-based clinical correlation curriculum in an anatomy course for first-year medical students at Perdana University Graduate School of Medicine (in collaboration with Johns Hopkins University School of Medicine).

    APPROACH: The simulation curriculum, with five weekly modules, was a component of a noncadaveric human anatomy course for three classes (n = 81 students) from September 2011 to November 2013. The modules were designed around major anatomical regions (thorax; abdomen and pelvis; lower extremities and back; upper extremities; and head and neck) and used various types of simulation (standardized patients, high-fidelity simulators, and task trainers). Several methods were used to evaluate the curriculum's efficacy, including comparing pre- versus posttest scores and comparing posttest scores against the score on 15 clinical correlation final exam questions.

    OUTCOMES: A total of 81 students (response rate: 100%) completed all pre- and posttests and consented to participate. Posttest scores suggest significant knowledge acquisition and better consistency of performance after participation in the curriculum. The comparison of performance on the posttests and final exam suggests that using simulation as an adjunctive pedagogy can lead to excellent short-term knowledge retention.

    NEXT STEPS: Simulation-based medical education may prove useful in preclinical basic science curricula. Next steps should be to validate the use of this approach, demonstrate cost-efficacy or the "return on investment" for educational and institutional leadership, and examine longer-term knowledge retention.

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