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  1. Lee SS, Samarasekera DD, Sim JH, Hong WH, Foong CC, Pallath V, et al.
    Med Sci Educ, 2020 Mar;30(1):271-280.
    PMID: 34457667 DOI: 10.1007/s40670-019-00894-z
    Purpose: Research has shown that many undergraduate students struggle with self-regulated learning (SRL) in clinical year as they are insufficiently supported by the staff in the early year to prepare them for the transition. Hence, this study aims to find out the SRL strategies and the approaches that could promote SRL among pre-clinical students in two medical schools.

    Method: This is a mixed-method study. The Motivated Strategies for Learning Questionnaire (MSLQ) was used to collect student SRL strategies while semi-structured interviews with faculty members and focus group discussions with students were used to gather data on the approaches that promote SRL. Student MSLQ was analysed using descriptive statistics while interviews were transcribed verbatim and thematically analysed.

    Results: A pilot using MSLQ with 413 students recorded a Cronbach's alpha of 0.928 for the questionnaire. The actual study involved 457 Years 1 & 2 students. Students from both institutions are motivated by the Task Value, and they use Elaboration and Organisation strategies the most in their pre-clinical year. Three themes emerged from the qualitative analysis of this study: characteristics of strategies that promote SRL, hindrance in promoting SRL, and opportunities in promoting SRL.

    Conclusions: Our findings indicate that students' intrinsic motivation is generally high in pre-clinical year. However, metacognition and critical thinking strategies will need to be enhanced among students. Despite knowing teaching and learning approaches could promote these strategies, many teachers are still not confident in doing so and hence training dang sharing best practices might be helpful in promoting SRL.

  2. Kusmiati M, Hamid NAA, Sanip S, Emilia O
    Med Sci Educ, 2019 Dec;29(4):935-940.
    PMID: 34457569 DOI: 10.1007/s40670-019-00774-6
    Background: A preceptor has a key role in evaluating medical graduate's performance in the clinical setting. This study is conducted to develop an instrument for preceptor evaluation of medical graduates' performance in the clinical setting.

    Method: A mixed-method study design, sequential exploratory approach was chosen to develop the instrument. Initial semi-structured interviews were conducted with 4 preceptors at the teaching hospitals. Five main themes emerged from the interviews. The themes were developed into a 23-item questionnaire. Nineteen Head or Assistant Head of clinical departments were asked to review the relevance of the content. The questionnaire was later sent out to 34 preceptors and 35 paramedic staffs to participate in the construct validity study by conducting exploratory factor analysis (EFA). SPSS version 21 software was used to analyze the data and Varimax rotation method was performed to simplify and describe the data structure.

    Result: Review of the factor structures suggested that the most appropriate fit was 5 factors. Most of the questionnaire items were relevant to assess performance (4.65 + 0.15), except in item 4 of the clinical skill factor. The 23 items of the evaluation instruments showed that five factors were extracted which explained 73.9% of the variance between them. Construct validity was achieved after the instrument was run for an iteration of eight times, with Cronbach's alpha of 0.951.

    Discussion: The instrument has achieved the desired content and construct validity score. It can be used by other institutions to assess their medical graduates' performance in the clinical setting.

  3. Er HM, Nadarajah VD, Hays RB, Yusoff N, Loh KLY
    Med Sci Educ, 2019 Dec;29(4):1103-1108.
    PMID: 34457589 DOI: 10.1007/s40670-019-00802-5
    Challenges in assessment implementation include assessment blueprinting, accuracy and timeliness of result processing, item analysis and personalised feedback. These challenges were addressed by an online assessment system (OAS) that translates the educational framework of outcome-based education (OBE) into an integrated platform applicable across academic programmes. OBE principles of transparency, measurability, relevance, and individualisation was feasibly addressed using technology. The system development required continuous stakeholder engagement and feedback. Its implementation involved change management at institutional level with shifts in procedures, responsibilities, staff competencies and resource allocation. This article describes approaches taken and the lessons learned in developing and implementing OAS to enhance assessment practice for medical science programmes.
  4. Kok YY, Er HM, Nadarajah VD
    Med Sci Educ, 2021 Dec;31(6):1919-1929.
    PMID: 34518785 DOI: 10.1007/s40670-021-01364-1
    The achievement of learning goals via laboratory practical depends on both extrinsic and intrinsic factors. They could be limited by laboratory time, incurred cost, safety, self-efficacy, inadequate prior preparation by learners, and different learning styles. Hence, virtual laboratory simulation (vLAB) may be an appropriate e-learning tool to overcome these restrictions. In this study, student's perception of the usefulness of vLAB was determined by using deoxyribonucleic acid (DNA) gel electrophoresis and polymerase chain reaction (PCR) as case examples. The perception of Year 2 and 3 health science undergraduate students' (N = 87) was studied using a questionnaire consisting of 12 items, rated on a 5-point Likert-scale. The attainment of learning outcomes was assessed using pre-and post-tests containing multiple-choice questions (MCQs). In addition, student's experience and learning from the vLAB were further explored using qualitative analysis. Although there was no significant difference between the mean scores of the pre-and post-tests, results showed that all participants perceived vLAB well, with a median score of 4 (Agree) for all items in the questionnaire. It provides a meaningful learning experience and an authentic environment where students feel safe to practice what they have learnt in lectures. Moreover, vLAB facilitates individualised learning and enhances self-efficacy among students. In conclusion, vLAB prepares students for physical laboratory sessions by activating the prehension dimension of Kolb's learning cycle, therefore complementing and strengthening the attainments of health sciences laboratory learning goals and outcomes.
  5. 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.
  6. Soon CSL, Tudor Car L, Ng CJ, Tan NC, Smith H
    Med Sci Educ, 2022 Dec;32(6):1405-1412.
    PMID: 36345366 DOI: 10.1007/s40670-022-01657-z
    BACKGROUND: Posters are used extensively as a mode of presentation at scientific conferences, but little is documented about their value to presenters or viewers. The study aimed to explore conference delegates' views and experiences of poster presentations, and their perceptions of the strengths and weaknesses of posters compared with oral presentations, and also to identify ways to enhance the educational value of posters.

    METHOD: This was a qualitative study using brief, semi-structured, face-to-face interviews amongst delegates at a 3-day Asia Pacific regional academic primary care conference in Singapore. Interviews were digitally recorded, transcribed verbatim, and their contents analysed thematically.

    RESULTS: Eighty-nine interviews were analysed. Respondents were mainly early career researchers (58%), and a third were presenting (poster or oral) at the conference. Many positive attributes of posters were identified. For the viewers, these included the ability to gain a rapid overview of research activity (for "benchmarking", "updating", and "inspiration"); the ability to choose who to engage with and when, in contrast to the tightly scheduled oral sessions; and opportunity to discuss content in a leisurely and detailed fashion with the presenter. Presenters considered posters "less threatening" than oral presentations and valued posters for the networking opportunities they created. However, posters were reported to be more demanding on the skills of précis and their preparation was considered arduous and more expensive than an oral presentation. Posters were also perceived to have lower academic status and dominate the presenter's time at the conference, reducing the opportunities for them to see the work of others. Suggestions for incorporating technologies to enhance the impact of posters included QR codes to access more detailed information, pre-recorded presentations, and online interactive clarification sessions with poster authors.

    CONCLUSION: Posters are perceived as a valuable mode of presentation at scientific conferences by presenters and viewers. Their unique strengths challenge the perception that posters are somehow inferior to oral presentations, suggesting a need for their advantages to be promoted by researchers and conference organisers. The incorporation of technology within the traditional display may enhance poster utility. Given the time and money spent on academic conferences there is an urgent need to evaluate the different styles of presentation used at conferences and how they differ in their ability to impact on medical science knowledge and evidence-based clinical practice.

    SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-022-01657-z.

  7. Liew SC, Naik V, Azim DHF
    Med Sci Educ, 2021 Dec;31(6):1889-1894.
    PMID: 34956703 DOI: 10.1007/s40670-021-01433-5
    Pathology teaching, an intensively image loaded discipline, poses a significant challenge in its delivery. A lot of effort has been placed into sourcing teaching methods that could effectively enhance students' understanding and knowledge retention in this discipline. We describe for the first time in the literature the use of an image-based quiz (IBQ) to deliver a neuropathology lecture. The participating medical students were randomised into either the study group (IBQ) or the control group (traditional lecture, TL). The students were asked to complete the pre- and post-multiple choice question (MCQ) test before and after attending either of the allocated interventions. In the IBQ group, the students were presented with image-based quizzes, and answers to the quizzes were projected in real-time on screen. The students in the TL group were given the usual, traditional lecture. A total of 75 third-year medical students participated in this study. The participants were recruited from third-year medical students representing two different academic years. There was no significant difference in the pre- and post-MCQ scores between the IBQ and TL groups. However, a significant improvement in the mean scores for the pre- and post-MCQ results in both the study (p = 0.001; 95% CI 0.572-1.954) and control (p 
  8. 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.
  9. 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.

  10. Sam CP, Nathan JL, Aroksamy JA, Ramasamy N, Mamat NHB, Nadarajah VD
    Med Sci Educ, 2023 Oct;33(5):1127-1137.
    PMID: 37886265 DOI: 10.1007/s40670-023-01851-7
    INTRODUCTION: Simulation centres (SC) and its learning resources are now firmly established as part of medical education. In SC, medical students obtain both knowledge and skills based on a combination of theory and practice using provided resources. This study aims to explore medical students' use of SC learning resources to learn clinical and communication skills based on Kolb's experiential learning cycle. This is based on the research question 'How are the SC resources useful in supporting preclinical medical students' clinical and communication skills learning?' The findings of the study can make a case for further enhancement of SC design and resources for medical students in the preclinical phase.

    METHODS: A qualitative study involving 20 preclinical medical students with learning experiences in SC was conducted between December 2019 and 2020 at a medical school in Malaysia. Semi-structured interview questions were developed based on Kolb's learning cycle. The data were thematically analysed using the six phases of Braun and Clarke's thematic analysis.

    RESULTS: Three main themes were identified based on preclinical medical students' experiences in SC; they were 'preparation for authentic clinical experience', 'accessibility of multiple resources for learning and support' and 'opportunities to learn and improve'.

    CONCLUSIONS: The SC's resources have a significant and positive role in supporting preclinical medical students learn clinical and communication skills. The SC resources prepared them for authentic clinical experiences with a patient-centred care approach and self-directed learning opportunities. Social support from peers, peer tutors and academics emerged as a key finding and resource of the SC as they help preclinical students learn and improve.

  11. Tang KS, Maher S, Lee SWH
    Med Sci Educ, 2023 Feb;33(1):83-89.
    PMID: 37008431 DOI: 10.1007/s40670-022-01703-w
    Interdisciplinary learning combining foundational science concepts and clinical practice applications is important in many healthcare-related programmes, including pharmacy. The coherent, structured interdisciplinary curricula designed by specialists may not always be perceived as integrated by students. Team teaching, an education approach where two or more instructors share teaching responsibilities within a classroom setting, may help eliminate this perception. This study aims to explore whether team teaching can improve Asian students' experience of learning in an undergraduate pharmacy programme in Malaysia. A single 2-h interactive lecture session was delivered using a team-based approach to year 4 undergraduate pharmacy students enrolled at the School of Pharmacy, Monash University Malaysia, from 2015 to 2017. All students who attended the team-based teaching lectures were provided with an anonymous link, which requested responses on their views towards team-based teaching. Fifty out of 104 participants from three different cohorts responded to the survey of this study. Over 75% of students reported that they learnt better with the team teaching approach compared to traditional lectures delivered by one lecturer and that the team teaching approach was superior to private study. About 60% of the participants agreed that the team-based teaching approach helped develop their information-synthesising and problem-solving skills. This study provides evidence for using team teaching for design and delivery in an Asian context. The approach was well received by the participants.
  12. Subramaniam T, Aznal SSS, Ikram MA
    Med Sci Educ, 2024 Feb;34(1):201-208.
    PMID: 38510413 DOI: 10.1007/s40670-023-01916-7
    In many universities, simulation-based learning has finally been inducted as a member of 'the accepted teaching modality community'. This paper is to share the challenges and successes in the journey towards the inclusion of simulation-based learning in the medical curriculum at the authors' university which saw a steep surge during the COVID-19 pandemic. Our teaching and learning that was heavily traditional based went through a dramatic change to adapt to the new norm when the actual environment and patients became out of reach. We followed five factors (5 Fs) that significantly influenced the successful change: fast, force, fellowship, flexibility, and favourable reception.
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