Undergraduate Medical Education Research in Malaysia: Time for a Change.

OBJECTIVE: Special Study Module (SSM) is a mandatory research module implemented in Universiti Kebangsaan Malaysia (UKM). The objective of this paper is to provide a brief overview on the student research activities and to find out the outcome measures in terms of publication. METHODS: It was a retrospective study done on SSM research projects at UKM. The SSM research is conducted from beginning of year-4 until 1(st) seven weeks of year-5. In year-4, students are assigned to a faculty-supervisor in small groups and spend every Thursday afternoon to plan and carry the research. Whole first seven weeks of year-5, students are placed with their supervisor continuously to collect data, do analysis, write report and present in the scientific conference. Outcomes of 5-years SSM research-projects starting from 2008/2009 to 2012/2013 academic session were analyzed. RESULTS: Total 257 projects were completed and presented in annual scientific meetings from which 57 (22.2%) articles were published in peer reviewed journals. CONCLUSION: Mandatory undergraduate student research project brings an opportunity to develop students' capacity building from conception to final report writing and thereby narrowing the gap between education and practice. Medical schools should implement research module to bring changes in research and publication culture of undergraduate medical education.

Comprehensive Healthcare module: medical and pharmacy students' shared learning experiences.

INTRODUCTION: The Comprehensive Healthcare (CHC) module was developed to introduce pre-clinical medical and pharmacy students to the concept of comprehensive healthcare. This study aims to explore their shared learning experiences within this module. METHODOLOGY: During this module, medical and pharmacy students conducted visits to patients' homes and to related community-based organisations in small groups. They were required to write a reflective journal on their experiences regarding working with other professions as part of their module assessment. Highly scored reflective journals written by students from the 2011/2012 academic session were selected for analysis. Their shared learning experiences were identified via thematic analysis. We also analysed students' feedback regarding the module. RESULTS: Analysis of 25 selected reflective journals revealed several important themes: 'Understanding of impact of illness and its relation to holistic care', 'Awareness of the role of various healthcare professions' and 'Generic or soft skills for inter-professional collaboration'. Although the primary objective of the module was to expose students to comprehensive healthcare, the students learnt skills required for future collaborative practice from their experiences. DISCUSSION: The CHC module provided early clinical exposure to community-based health issues and incorporated some elements of inter-professional education. The students learnt about the roles of other healthcare professions and acquired soft skills required for future collaborative practice during this module.

Emergency skills learning on video (ESLOV): A single-blinded randomized control trial of teaching common emergency skills using self-instruction video (SIV) versus traditional face-to-face (FTF) methods.

BACKGROUND: Self-instruction video (SIV) has been widely explored as a teaching mode for cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED), but not with other basic emergency skills. AIM: To evaluate the effectiveness of SIV in teaching other basic emergency skill in comparison with traditional face-to-face (FTF) methods. METHODS: Participants were randomized into SIV and FTF groups. Each group was assigned to learn basic airway management (BAM), cervical collar application (CCA), manual cardiac defibrillation (MCD), and emergency extremity splinting (EES) skills. Confidence level was assessed using questionnaires, and skills performances were assessed using calibrated-blinded assessors through an Objective Structured Clinical Examination (OSCE). RESULTS: Forty-five participants took part in the assessment exercises. There were no significant differences between both groups, on all four skill categories. The mean OSCE-score of an individual category between the FTF-group vs. the SIV-group were as follows: BAM (10.23 ± 1.04 vs. 10.04 ± 1.49; p = 0.62); CCA (7.86 ± 4.39 vs. 7.13 ± 4.12; p = 0.57); MCD (8.24 ± 0.89 vs. 7.58 ± 1.14; p = 0.39); EES (5.43 ± 2.11 vs. 4.63 ± 2.30; p = 0.23). The composite mean score for the FTF-group was 6.85, and for the SIV-group was 6.20 (p < 0.05). There was no significant different in the level of confidence for both groups. CONCLUSION: SIV is as effective as FTF in teaching and learning basic emergency skills.

An assessment of the prescribing skills of undergraduate dental students in malaysia.

Most dental schools lack a module on prescription writing in pharmacology. This study assessed the prescription writing skills of a group of Malaysian dental students at the end of their undergraduate training program. A quantitative study of a two-group posttest experiment was designed, and thirty-seven fifth-year (final-year) dental students were divided into two groups (A [n=18] and B [n=19]). Group A received a didactic lecture on how to write a complete prescription, while Group B served as a control group. For prescription writing, three standardized dental scenarios with a diagnosis of irreversible pulpitis associated with a child and a pregnant woman and periapical pulpitis for an adult man were administered. Thus, a total of 111 prescriptions (Group A [n=54] and Group B [n=57]) were collected. Twelve elements in each prescription were assessed by frequency and a chi-square test. Improvements in eight out of the twelve elements were observed in prescriptions written by students in Group A. The significantly improved elements were provision of the symbol R(x) (39.8 percent) (p<0.001), inclusion of the prescriber's signature (75.3 percent) (p<0.001), inclusion of the date with the prescriber's signature (54.6 percent) (p<0.001), and inclusion of the prescriber's registration (30.5 percent) (p<0.001). Overall, Group A gained almost a 50 percent improvement in writing complete prescriptions due to the intervening lecture. It appeared a traditional lecture led to the more accurate writing of a complete prescription. It was suggested that a module on prescription writing be added to the school's pharmacology curriculum, so that dental graduates will be competent in prescription writing for the sake of their patients' health.

Bedside teaching in undergraduate medical education: issues, strategies, and new models for better preparation of new generation doctors.

Bedside teaching is a vital component of medical education. It is applicable to any situation where teaching is imparted in the presence of patients. In teaching in the patients' presence, learners have the opportunities to use all of their senses and learn the humanistic aspect of medicine such as role modeling, which is vital but difficult to communicate in words. Unfortunately, bedside teaching has been on the decline. To investigate the reasons for the decline in bedside teaching, its importance and its revival, a review of literature was carried out using PubMed and other data bases. The review revealed that the major concerns of bedside teaching were time constraint, false preceptors' concern about patients' comfort, short stay of patients in hospitals, learner distraction by technology, lack of experience and unrealistic faculty expectation. Whatsoever the reasons, bedside teaching cannot be replaced with anything else. There are newer approaches of effective bedside teaching, and the core focus of all such approaches is educational process. A bedside teacher must learn how to involve patients and learners in the educational processes. Moreover, bedside teaching is the process through which learners acquire the skills of communication by asking patients' permission, establishing ground rules, setting time limit, introducing the team, diagnosing learner, diagnosing patient, conducting focused teaching, using simple language, asking patient if there is any question, closing with encouraging thanks, and giving feedback privately. It is most important to ensure a comfortable environment for all participants, the learner, the patient and the bedside teacher. Ongoing faculty development programs on educational processes and realistic faculty expectations may overcome the problems.