Displaying publications 1 - 20 of 212 in total

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  1. Sunjaya DK, Herawati DMD, Indraswari N, Megawati G, Sumintono B
    J Environ Public Health, 2021;2021:5515712.
    PMID: 34603456 DOI: 10.1155/2021/5515712
    Background: Inappropriate anthropometric measurements of infants and toddlers lead to a misclassification in nutritional status and loss of important interventions. Considering the practice conducted in this program within a country, its impact on millions of children must be considered. This study assesses the ability of community health volunteers (CHVs) before and after anthropometric training on infants and toddlers. Methods. This study used a quantitative approach with a quasiexperimental and pretest-posttest design. The pre- and posttraining assessments of CHVs were conducted by standardized trainers using instruments developed according to WHO standards. There were 11 and 13 statement items for infants' and toddlers' indicators of assessment in anthropometric measurements, respectively. The result of the assessment was then analyzed using Rasch modeling with stacking and racking data analysis techniques.

    Results: The CHVs' skills before training were far from adequate. Although widely varied, all trainees improved their abilities. Stacking analysis showed that the skills of all CHVs in measuring infants and toddlers increased by 2.68 and 3.34 logits (p < 0.01), respectively. Racking analysis showed a decrease in the perceived difficulty of all items by 2.61 and 3.07 logits for infant and toddler measurements, respectively (p < 0.01). The results of the racking analysis showed that the difficulty in measuring the anthropometrics of infants decreased more than that of toddlers.

    Conclusions: CHVs' capacity to monitor child growth must be refreshed regularly. Standardized and proper training and assessment were developed to make CHVs reliable in taking anthropometric measurements of infants and toddlers.

    Matched MeSH terms: Clinical Competence*
  2. Melson E, Davitadze M, Aftab M, Ng CY, Ooi E, Blaggan P, et al.
    BMC Med Educ, 2020 Aug 18;20(1):274.
    PMID: 32811488 DOI: 10.1186/s12909-020-02190-6
    BACKGROUND: Simulation-based learning (SBL) has been increasingly used in both undergraduate and postgraduate medical training curricula. The aim of Simulation via Instant Messaging-Birmingham Advance (SIMBA) is to create a simple virtual learning environment to improve trainees' self-reported confidence in diabetes and Endocrinology.

    METHODS: This study was done as part of the continuous professional development for Health Education England West Midlands speciality trainees in diabetes and Endocrinology. Standardized transcripts of anonymized real-life endocrinology (endocrine session) and diabetes cases (diabetes session) were used in the simulation model. Trainees interacted with moderators through WhatsApp® in this model. All cases were then discussed in detail by a consultant endocrinologist with reference to local, national and international guidelines. Trainee acceptance rate and improvement in their self-reported confidence levels post-simulation were assessed.

    RESULTS: 70.8% (n = 17/24) and 75% (n = 18/24) strongly agreed the simulation session accommodated their personal learning style and the session was engaging. 66.7% (n = 16/24) strongly felt that the simulation was worth their time. In the endocrine session, there was a significant improvement in trainees' confidence in the management of craniopharyngioma (p = 0.0179) and acromegaly (p = 0.0025). There was a trend towards improved confidence levels to manage Cushing's disease and macroprolactinoma. In diabetes session, there was a significant improvement in trainees' confidence to interpret continuous glucose monitor readings (p = 0.01). There was a trend towards improvement for managing monogenic diabetes, hypoglycaemic unawareness and interpreting Libre readings. Overall, there was a significant improvement in trainees' confidence in managing cases that were discussed post-simulation.

    CONCLUSION: SIMBA is an effective learning model to improve trainees' confidence to manage various diabetes and endocrine case scenarios. More sessions with a variety of other speciality case scenarios are needed to further assess SIMBA's effectiveness and application in other areas of medical training.

    Matched MeSH terms: Clinical Competence
  3. Ming CH
    Physiologist, 2015 Nov;58(6):279, 284-5.
    PMID: 26669041
    Matched MeSH terms: Clinical Competence*
  4. Sachithanandan A, Badmanaban B
    Med J Malaysia, 2011 Jun;66(2):164.
    PMID: 22106707
    Matched MeSH terms: Clinical Competence*
  5. Barman A
    Ann Acad Med Singap, 2005 Sep;34(8):478-82.
    PMID: 16205824
    INTRODUCTION: The main aim of medical education is to foster the development of clinical competence in students at all levels. Differences in experiences, methods of instruction and ambiguous forms of assessment are obstacles to attaining this goal. Dissatisfaction with the conventional methods of clinical assessment on the part of teachers and students led assessors to search for appropriate alternatives and in 1975, Harden and his colleagues introduced the objective structured clinical examination (OSCE). It is nearly impossible to have a test that satisfies all the criteria of a good test. Sometimes, a compromise has to be made between the available resources (in terms of man, money and time), and the method and quality of assessment (in terms of reliability, validity, objectivity and practicability).

    METHODS: This critique on the OSCE is based on the published findings of researchers from its inception in 1975 to 2004.

    RESULTS: The reliability, validity, objectivity and practicability or feasibility of this examination are based on the number of stations, construction of stations, method of scoring (checklists and/ or global scoring) and number of students assessed. For a comprehensive assessment of clinical competence, other methods should be used in conjunction with the OSCE.

    CONCLUSION: The OSCE can be a reasonably reliable, valid and objective method of assessment, but its main drawback is that it is resource-intensive.

    Matched MeSH terms: Clinical Competence*
  6. Muhamad Z, Ramli A, Amat S
    Sultan Qaboos Univ Med J, 2015 May;15(2):e266-74.
    PMID: 26052461
    OBJECTIVES: The aim of this study was to determine the content validity, internal consistency, test-retest reliability and inter-rater reliability of the Clinical Competency Evaluation Instrument (CCEVI) in assessing the clinical performance of physiotherapy students.
    METHODS: This study was carried out between June and September 2013 at University Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia. A panel of 10 experts were identified to establish content validity by evaluating and rating each of the items used in the CCEVI with regards to their relevance in measuring students' clinical competency. A total of 50 UKM undergraduate physiotherapy students were assessed throughout their clinical placement to determine the construct validity of these items. The instrument's reliability was determined through a cross-sectional study involving a clinical performance assessment of 14 final-year undergraduate physiotherapy students.
    RESULTS: The content validity index of the entire CCEVI was 0.91, while the proportion of agreement on the content validity indices ranged from 0.83-1.00. The CCEVI construct validity was established with factor loading of ≥0.6, while internal consistency (Cronbach's alpha) overall was 0.97. Test-retest reliability of the CCEVI was confirmed with a Pearson's correlation range of 0.91-0.97 and an intraclass coefficient correlation range of 0.95-0.98. Inter-rater reliability of the CCEVI domains ranged from 0.59 to 0.97 on initial and subsequent assessments.
    CONCLUSION: This pilot study confirmed the content validity of the CCEVI. It showed high internal consistency, thereby providing evidence that the CCEVI has moderate to excellent inter-rater reliability. However, additional refinement in the wording of the CCEVI items, particularly in the domains of safety and documentation, is recommended to further improve the validity and reliability of the instrument.
    KEYWORDS: Clinical Competence; Malaysia; Physiotherapy Speciality; Validity and Reliability
    Matched MeSH terms: Clinical Competence*
  7. Fathil SM, Mohd Mahdi SN, Che'man Z, Hassan A, Ahmad Z, Ismail AK
    Int J Emerg Med, 2010;3(4):233-7.
    PMID: 21373289 DOI: 10.1007/s12245-010-0201-0
    BACKGROUND: Airway management is an important part of the management of the critically ill and injured patients in the Emergency Department (ED). Numerous studies from developed countries have demonstrated the competency of emergency doctors in intubation. To date there have been no published data on intubations performed in EDs in Malaysia.
    METHODS: Data on intubations from 7 August 2007 till 28 August 2008 were prospectively collected.
    RESULTS: There were 228 intubations included in the study period. Cardiopulmonary arrest was the main indication for intubation (35.5%). The other indications were head injury (18.4%), respiratory failure (15.4%), polytrauma (9.6%) and cerebrovascular accident (7.0%). All of the 228 patients were successfully intubated. Rapid sequence intubation (RSI) was the most frequent method (49.6%) of intubation. A total of 223 (97.8%) intubations were done by ED personnel. In 79.8% of the cases, intubations were successfully performed on the first attempt. Midazolam was the most common induction agent used (97 patients), while suxamethonium was the muscle relaxant of choice (109 patients). There were 34 patients (14.9%) with 38 reported immediate complications. The most common complication was oesophageal intubation.
    CONCLUSION: Emergency Department UKMMC personnel have a high competency level in intubation with an acceptable complication rate. RSI was the most common method for intubation.
    KEYWORDS: Airway; Intubation; Orotracheal intubation; Rapid sequence intubation
    Matched MeSH terms: Clinical Competence*
  8. Abdullah BJ, Ng KH
    Br J Radiol, 2001 Aug;74(884):675-6.
    PMID: 11511489
    Matched MeSH terms: Clinical Competence*
  9. Teoh TG
    Singapore Med J, 1997 Aug;38(8):323-5.
    PMID: 9364883
    The aim of this study was to find out the effect of learning curve on the outcome of external cephalic version (ECV) at term, using tocolytics. The effect of various factors affecting the outcome of ECV was also studied in relation to the learning curve.
    Matched MeSH terms: Clinical Competence*
  10. Rahman AR, Noor AR, Hassan Y
    Med J Malaysia, 1994 Dec;49(4):364-8.
    PMID: 7674972
    The training of doctors in therapeutics has created interesting discussions internationally. A survey of senior hospital pharmacists currently practising throughout West Malaysia was embarked on during a recent postgraduate seminar. About sixty per cent said prescribing errors were common amongst doctors. Sixteen per cent of the prescribing errors were potentially serious. Most of the time errors were due to carelessness, lack of knowledge on drug action or a combination of both. Nearly 35% of prescribing errors were not acknowledged by doctors. Most doctors did not give reasons for not acknowledging pharmacists' intervention. About half (46.5%) of the respondents thought that doctors were not adequately trained in the use of drugs.
    Matched MeSH terms: Clinical Competence*
  11. Tan K, Chong MC, Subramaniam P, Wong LP
    Nurse Educ Today, 2018 May;64:180-189.
    PMID: 29500999 DOI: 10.1016/j.nedt.2017.12.030
    BACKGROUND: Outcome Based Education (OBE) is a student-centered approach of curriculum design and teaching that emphasize on what learners should know, understand, demonstrate and how to adapt to life beyond formal education. However, no systematic review has been seen to explore the effectiveness of OBE in improving the competencies of nursing students.

    OBJECTIVE: To appraise and synthesize the best available evidence that examines the effectiveness of OBE approaches towards the competencies of nursing students.

    DESIGN: A systematic review of interventional experimental studies.

    DATA SOURCES: Eight online databases namely CINAHL, EBSCO, Science Direct, ProQuest, Web of Science, PubMed, EMBASE and SCOPUS were searched.

    REVIEW METHODS: Relevant studies were identified using combined approaches of electronic database search without geographical or language filters but were limited to articles published from 2006 to 2016, handsearching journals and visually scanning references from retrieved studies. Two reviewers independently conducted the quality appraisal of selected studies and data were extracted.

    RESULTS: Six interventional studies met the inclusion criteria. Two of the studies were rated as high methodological quality and four were rated as moderate. Studies were published between 2009 and 2016 and were mostly from Asian and Middle Eastern countries. Results showed that OBE approaches improves competency in knowledge acquisition in terms of higher final course grades and cognitive skills, improve clinical skills and nursing core competencies and higher behavioural skills score while performing clinical skills. Learners' satisfaction was also encouraging as reported in one of the studies. Only one study reported on the negative effect.

    CONCLUSIONS: Although OBE approaches does show encouraging effects towards improving competencies of nursing students, more robust experimental study design with larger sample sizes, evaluating other outcome measures such as other areas of competencies, students' satisfaction, and patient outcomes are needed.

    Matched MeSH terms: Clinical Competence*
  12. Abd-Rahman ANA, Baharuddin IH, Abu-Hassan MI, Davies SJ
    J Dent Educ, 2021 Jul;85(7):1210-1216.
    PMID: 33792052 DOI: 10.1002/jdd.12600
    BACKGROUND: The outcome of assessments is determined by the standard-setting method used. Standard setting is the process of deciding what is good enough. A cutoff score of 50% was commonly used in dental schools in Malaysia. This study aims to compare the conventional, norm-referenced, and modified-Angoff standard-setting methods.

    METHODS: The norm-referenced method of standard setting was applied to the real scores of 40 final-year dental students on a multiple-choice question (MCQ), a short answer question (SAQ), and an objective structured clinical examination (OSCE). A panel of 10 judges set the standard using the modified-Angoff method for the same paper in one sitting. One judge set the passing score of 10 OSCE questions after 2 weeks. A comparison of the grades and pass/fail rates derived from the absolute standard, norm-referenced, and modified-Angoff methods was made. The intra-rater and inter-rater reliabilities of the modified-Angoff method were assessed.

    RESULTS: The passing rate for the absolute standard was 100% (40/40), for the norm-referenced method it was 62.5% (25/40), and for the modified-Angoff method it was 80% (32/40). The modified-Angoff method had good inter-rater reliability of 0.876 and excellent test-retest reliability of 0.941.

    CONCLUSION: There were significant differences in the outcomes of these three standard-setting methods, as shown by the difference in the proportion of candidates who passed and failed the assessment. The modified-Angoff method was found to have good reliability for use with a professional qualifying dental examination.

    Matched MeSH terms: Clinical Competence*
  13. Mohd Mydin FH, Wan Yuen C, Othman S, Mohd Hairi NN, Mohd Hairi F, Ali Z, et al.
    J Interpers Violence, 2022 01;37(1-2):NP719-NP741.
    PMID: 32394780 DOI: 10.1177/0886260520918580
    Elder abuse and neglect (EAN) goes largely unrecognized and underreported globally by health care professionals. Despite acknowledging their role to intervene elder abuse, health care professionals lacked knowledge and skills in this issue. This is a single-blinded, three-armed, cluster randomized controlled trials aimed to evaluate the effectiveness of the face-to-face Improving Nurses' dEtection and managEment of elDer abuse and neglect (I-NEED) intensive training program and I-NEED educational video in improving primary care nurses' knowledge, attitude, and confidence to intervene EAN; 390 primary care nurses were randomized equally into two intervention groups-ITP group (intensive training program) and ITP+ group (intensive training program and educational video)-and a control group. The knowledge, attitudes, and confidence to intervene EAN were measured using questionnaires at four intervals during 6-month follow-up. A total of 269 primary care nurses participated in this study. There was a significant increase in knowledge, attitude, and confidence to intervene EAN immediately post intervention observed in both intervention groups compared to the control group (p < .001). At the end of sixth month, there was an increase of knowledge favoring ITP group than the ITP+ group (p < .001). There is, however, no significant difference in attitude score between ITP and ITP+ group. There is a significant difference of confidence to intervene among the participants between both intervention groups with ITP+ participants reporting higher scores post intervention (p < .05). An intensive training module improved the knowledge, attitude, and confidence to intervene EAN. Other co-existing barriers for abuse victims getting help, resources, policy, and law of EAN need further highlights.
    Matched MeSH terms: Clinical Competence*
  14. McKay DA
    Med J Malaysia, 1979 Mar;33(3):198-200.
    PMID: 522722
    Matched MeSH terms: Clinical Competence
  15. Hassan S
    Malays J Med Sci, 2007 Jul;14(2):4-10.
    PMID: 22993486 MyJurnal
    Clinical skills program as a laboratory method is a valuable adjunct to other forms of undergraduate medical training. This article describes the process of developing a core curriculum in clinical skills based on the Dundee model for a clinical skills centre. The School of Medical Sciences, in Universiti Sains Malaysia (USM) has been provided with a well equipped skills centre. However, the PBL curriculum in the undergraduate medical program in the school needs to be integrated with a clinical skills lab program. This is to counter the general feeling that the contribution of PBL is insignificant in terms of building clinical competency in an integrated system such as that used in USM compared to the traditional curriculi of other medical teaching institutions in Malaysia. Integrating clinical skills laboratory training with the PBL curriculum will provide evidence of PBL as an effective and innovative method for teaching and learning in Malaysia.
    Matched MeSH terms: Clinical Competence
  16. Chan, S.C., Sandheep, S., Lee, S.L.
    MyJurnal
    Introduction: The Royal College of Medicine Perak under Universiti Kuala Lumpur started its own undergraduate medical degree programme in 2007. As part of the review and evaluation of communication skills (CS) training, the performance of the two pioneer batches of final year students in CS Objective Structured Clinical Examinations (OSCEs) stations in the 2012 and 2013 were analysed.
    Methods: The CS OSCE stations were analysed based on the percentage of students obtaining a satisfactory performance in each CS component. Overall performance in each CS component was considered satisfactory, if ≥ 50% of students achieved satisfactory performance or unsatisfactory, if < 50% of students achieved satisfactory performance. The two cohorts were compared for any significant statistical difference (p < 0.05) in their performance.
    Results: Satisfactory performance was obtained in basic CS (courtesy, appropriate non-verbal and verbal CS), stating intention of session, recognizing patient’s cues, checking and addressing patient’s perceptions and concerns, checking patient’s understanding, breaking bad news and maintaining a professional attitude. The performance was unsatisfactory in assessing prior knowledge, discussing patient management and checking patient’s coping skills. Both the two cohorts’ performance did not differ significantly.
    Conclusion: Overall the students’ performance was satisfactory except for assessing prior knowledge, discussing management and checking patients’ coping skills.
    Matched MeSH terms: Clinical Competence
  17. Sharma A, U V, Dong V, Raut A, Tawfik GM, Ng SJ, et al.
    Clin Med (Lond), 2021 Mar;21(Suppl 2):25-26.
    PMID: 34078684 DOI: 10.7861/clinmed.21-2-s25
    Matched MeSH terms: Clinical Competence
  18. Sim JH, Abdul Aziz YF, Mansor A, Vijayananthan A, Foong CC, Vadivelu J
    Med Educ Online, 2015;20:26185.
    PMID: 25697602 DOI: 10.3402/meo.v20.26185
    INTRODUCTION: The purpose of this study was to compare students' performance in the different clinical skills (CSs) assessed in the objective structured clinical examination.
    METHODS: Data for this study were obtained from final year medical students' exit examination (n=185). Retrospective analysis of data was conducted using SPSS. Means for the six CSs assessed across the 16 stations were computed and compared.
    RESULTS: Means for history taking, physical examination, communication skills, clinical reasoning skills (CRSs), procedural skills (PSs), and professionalism were 6.25±1.29, 6.39±1.36, 6.34±0.98, 5.86±0.99, 6.59±1.08, and 6.28±1.02, respectively. Repeated measures ANOVA showed there was a significant difference in the means of the six CSs assessed [F(2.980, 548.332)=20.253, p<0.001]. Pairwise multiple comparisons revealed significant differences between the means of the eight pairs of CSs assessed, at p<0.05.
    CONCLUSIONS: CRSs appeared to be the weakest while PSs were the strongest, among the six CSs assessed. Students' unsatisfactory performance in CRS needs to be addressed as CRS is one of the core competencies in medical education and a critical skill to be acquired by medical students before entering the workplace. Despite its challenges, students must learn the skills of clinical reasoning, while clinical teachers should facilitate the clinical reasoning process and guide students' clinical reasoning development.
    KEYWORDS: OSCE; clinical skills; student performance
    Matched MeSH terms: Clinical Competence*
  19. Mathialagan A, Nagalinggam P, Mathialagan S, Kirby BP
    Int J Pharm Pract, 2015 Oct;23(5):320-6.
    PMID: 25582973 DOI: 10.1111/ijpp.12170
    The objective of this study was to examine the relationship between performance barriers and competency, and implementation of an expanded public health role for community pharmacists.
    Matched MeSH terms: Clinical Competence*
  20. Madan SS, Pai DR
    Simul Healthc, 2014 Apr;9(2):127-35.
    PMID: 24096921 DOI: 10.1097/SIH.0b013e3182a86165
    Arthroscopy uses a completely different skill set compared with open orthopedic surgery. Hitherto, arthroscopy had not been given enough emphasis in the core orthopedic curricula. Simulation has been seen as an excellent way to teach the skills required in arthroscopy. The simulators used for arthroscopy training can be broadly classified into physical simulators such as cadavers, animals, models and box trainers, virtual-reality simulators, and hybrid simulators that combine virtual-reality simulation with physical components that allow real tactile feedback. The advantages and disadvantages of each of these types have been described in this article. The factors that determine skill acquisition using these simulators have been highlighted. In conclusion, simulation seems to be a valuable tool for arthroscopy training, although further studies are needed to state whether this translates into better operative skill on real patients.
    Matched MeSH terms: Clinical Competence*
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