Displaying all 8 publications

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  1. Pai DR, Ram S, Madan SS, Soe HH, Barua A
    Natl Med J India, 2014 Jul-Aug;27(4):192-7.
    PMID: 25668162
    It is known that simulation training is associated with stress for the trainees, at all levels of trainee experience. We explored the factors which were perceived by the trainees to cause them the maximum stress related to their simulation experience and their temporal changes over three simulation sessions.
  2. Mathiharan K
    Natl Med J India, 2014 Jan-Feb;27(1):39-42.
    PMID: 25403126
    The concept of informed consent specific to medical research and treatment is still alien to many medical researchers and practitioners and to millions of Indians. The doctor-patient relationship in India is governed more by trust where the doctor is the authoritative person. Therefore, the benefit of informed consent does not reach all patients in day-to-day medical practice. To complicate the issue, the Indian law is not specific about the age at which a person can give valid consent. The Indian Penal Code is silent about the legal validity of consent given by persons between 12 and 18 years of age. Similarly, the age at which the 'Right to Confidentiality' begins is yet to be defined either by the statute or by the courts. Hence, there is a need for a clear statutory provision to remove the anomalies and ambiguities regarding the age of consent to undergo invasive therapeutic or investigative procedures, participate in clinical trials, as well as define the age at which a person's right to medical confidentiality begins.
  3. Salam A, Mohamad N, Siraj HH, Kamarudin MA, Yaman MN, Bujang SM
    Natl Med J India, 2014 Nov-Dec;27(6):350.
    PMID: 26133346
  4. Jegasothy R, Sen M
    Natl Med J India, 2020 3 5;32(3):161-166.
    PMID: 32129312 DOI: 10.4103/0970-258X.278687
    When students enrol in a medical school, they are not introduced to any ethical issues until later in the curriculum. The Hippocratic/physician's oath is taken upon graduation. A student oath is important to introduce students to the solemnity of the education they are dedicating themselves to. This oath is analysed and compared with the doctor's oath upon graduation and a few other oaths.
  5. Nagandla K, Gupta ED, Motilal T, Teng CL, Gangadaran S
    Natl Med J India, 2019 7 4;31(5):293-295.
    PMID: 31267998 DOI: 10.4103/0970-258X.261197
    Background: Assessment drives students' learning. It measures the level of students' understanding. We aimed to determine whether performance in continuous assessment can predict failure in the final professional examination results.

    Methods: We retrieved the in-course continuous assessment (ICA) and final professional examination results of 3 cohorts of medical students (n = 245) from the examination unit of the International Medical University, Seremban, Malaysia. The ICA was 3 sets of composite marks derived from course works, which includes summative theory paper with short answer questions and 1 of the best answers. The clinical examination includes end-of-posting practical examination. These examinations are conducted every 6 months in semesters 6, 7 and 8; they are graded as pass/fail for each student. The final professional examination including modified essay questions (MEQs), 1 8-question objective structured practical examination (OSPE) and a 16-station objective structured clinical examination (OSCE), were graded as pass/fail. Failure in the continuous assessment that can predict failure in each component of the final professional examination was tested using chi-square test and presented as odds ratio (OR) with 95% confidence interval (CI).

    Results: Failure in ICA in semesters 6-8 strongly predicts failure in MEQs, OSPE and OSCE of the final professional examination with OR of 3.8-14.3 (all analyses p< 0.001) and OR of 2.4-6.9 (p<0.05). However, the correlation was stronger with MEQs and OSPE compared to OSCE.

    Conclusion: ICA with theory and clinical examination had a direct relationship with students' performance in the final examination and is a useful assessment tool.

  6. Vashe A, Devi V, Rao KR, Abraham RR
    Natl Med J India, 2021 8 17;34(1):40-45.
    PMID: 34397005 DOI: 10.4103/0970-258X.323445
    Background: . The relevance of curriculum mapping to determine the links between expected learning outcomes and assessment is well stated in the literature. Nevertheless, studies confirming the usage of such maps are minimal.

    Methods: . We assessed links through curriculum mapping, between assessments and expected learning outcomes of dental physiology curriculum of three batches of students (2012-14) at Melaka-Manipal Medical College (MMMC), Manipal. The questions asked under each assessment method were mapped to the respective expected learning outcomes, and students' scores in different assessments in physiology were gathered. Students' (n = 220) and teachers' (n=15) perspectives were collected through focus group discussion sessions and questionnaire surveys.

    Results: . More than 75% of students were successful (≥50% scores) in majority of the assessments. There was moderate (r=0.4-0.6) to strong positive correlation (r=0.7-0.9) between majority of the assessments. However, students' scores in viva voce had a weak positive correlation with the practical examination score (r=0.230). The score in the assessments of problem-based learning had either weak (r=0.1-0.3) or no correlation with other assessment scores.

    Conclusions: . Through curriculum mapping, we were able to establish links between assessments and expected learning outcomes. We observed that, in the assessment system followed at MMMC, all expected learning outcomes were not given equal weightage in the examinations. Moreover, there was no direct assessment of self-directed learning skills. Our study also showed that assessment has supported students in achieving the expected learning outcomes as evidenced by the qualitative and quantitative data.

  7. Devi V, Abraham RR
    Natl Med J India, 2021 3 24;33(2):102-106.
    PMID: 33753639 DOI: 10.4103/0970-258X.310920
    Background: . Undergraduate research experience has become increasingly relevant for today's medical students, considering the professional requirements of their challenging future.

    Methods: . In the mentored student project (MSP) programme at Melaka Manipal Medical College, students undertake a short-term group research project under the guidance of their mentor. After data collection and analysis, students are required to write an abstract, present a poster and also write individual reflective summaries of their research experience. We evaluated the MSP programme using reflective summaries of a batch of undergraduate medical students. Data from 41 reflective summaries were analysed using the thematic analysis approach. The learning outcomes at the third and fourth levels of the Kirkpatrick evaluation model were determined from the summaries.

    Results: . Students' reflective summaries indicated that they were satisfied with the MSP experience. In all the summaries, there was a mention of an improvement in teamwork skills through MSP. Improved relations with mentors were another relevant outcome. Improvement in communication skills and a positive change related to research attitude were also reported by students.

    Conclusions: . Reflective summaries as a means to evaluate the MSP programme was found to be an easy, feasible and cost-effective method. The qualitative approach adopted for data analysis enabled the programme coordinators to assess the strengths and barriers of the programme.

  8. Thambiah SC, George E, Samsudin IN, Hong LH, Chuo LL, Ramli N, et al.
    Natl Med J India, 2016 May-Jun;29(3):136-140.
    PMID: 27808061
    BACKGROUND: The principal cause of iron overload in patients with haematological malignancies is recurrent red cell transfusions for anaemia. The serum ferritin level reflects the iron burden in the body, in the absence of inflammation or liver disease. In Malaysia, data are lacking on the association between pre-transplant serum ferritin levels and outcome after allogeneic haemopoietic stem cell transplant.

    METHODS: We did a cross-sectional study using retrospective data of 106 post-allogeneic haemopoietic stem cell transplant patients (HLA-matched sibling) with haematological malignancies at Hospital Ampang to determine the relationship between pre-transplant serum ferritin levels and post-transplant outcome, post-transplant complications and survival time. Patients were divided into two groups according to the iron status: serum ferritin level >1000 μg/L (iron overload) and <1000 μg/L.

    RESULTS: The median age for patients was 30.5 (18-58) years. The median pre-transplantation serum ferritin level and the prevalence of pre-transplantation iron overload were 2423 (408.2-7664) μg/L and 87.5%, respectively. No significant association was found between iron status and demographic factors, type of haematological malignancy and post-transplant complications. Although insignificant, patients with iron overload had a shorter survival time (36 months) compared to those with no iron overload (40 months). There was also no significant association between the iron status and post-transplant outcome. Significant post-transplant complications associated with post-transplant outcome were the need for total parenteral nutrition (TPN) (p=0.014) and chronic graft-versus-host disease (GVHD) (p=0.008). Similarly, significant associations were found between age group (p=0.003), TPN (p=0.035) and chronic GVHD (p=0.012) with survival time using Kaplan-Meir analysis. However, after Cox regression, only age group was found to be significantly associated with survival time (p=0.014).

    CONCLUSION: Serum ferritin is an acute phase reactant and its levels increase in the presence of tissue necrosis and inflammation. Both these events occur in haematological malignancies. Although serum ferritin level is a non-invasive, relatively cost-effective, widely available and practical indicator of iron status, it is not specific to iron overload. Therefore, a true association between the serum ferritin level and iron burden is problematic in patients with haematological malignancies.
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