South-East Asian Journal of Medical Education

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Academic misconduct among medical students.
(South East Asia Regional Association for Medical Education., 2009-06) Tanawattanacharoen, Somchai; Nimnuan, Chaichana
Objectives: To explore attitudes and behaviour in medical students to scenarios involving academic misconduct and to determine the association between attitudes and behaviour. Methods: In August 2008, a cross-sectional survey using an anonymous, self-administered questionnaire was conducted at the Faculty of Medicine, Chulalongkorn University. All first year medical students were subjects. Completed questionnaires were collected and analyzed. Results: Of the 291 medical students, 247 (84.9%) completed the questionnaire. The majority of medical students felt that most scenarios were wrong but admitted to engaging in at least one of the scenarios. In all, 139 (56.7%) students responded that cheating should be reported. Only 22 (9.1%) of the students stated that they had or would consider cheating or had witnessed such events. Fourteen out of 22 items showed significant association between attitudes and behaviours. No scenario demonstrated a negative relationship between attitudes and behaviour. Conclusion: The proportion of first year medical students engaging in academic misconduct was high, although they considered it wrong. There were associations between students’ attitudes and behaviour in most of the scenarios.
Application of classroom good teaching practices to an online faculty development programme in India.
(South East Asia Regional Association for Medical Education., 2010-12) Vyas, Rashmi; Anshu; Lata, Hem; Burdick, William; Singh, Tejinder
Application of computer aided teaching in conventional lecture class.
(South East Asia Regional Association for Medical Education., 2011-12) Dutta, Sukhendu
Background: Computer aided teaching (CAT) became popular in medical education but there is debate among the teachers regarding application of computer in a large group lecture class. Aim of the study: The present study was aimed to find out the acceptance and use of CAT in a conventional large group lecture class along with black board assistance. Material and methods: CAT was conducted in a large group lecture class of embryology. Related lined diagrams were drawn on the blackboard in front of the students. Students were given a Likert’s type three response closed end questionnaire to express their opinion at the end of the concerned system of embryology. Result: Ninety-nine percent of the students expressed that the teacher should guide them on how to draw a lined diagram. Ninety-nine percent mentioned that emphasis should be given on the applied aspect of the topic. Ninety-six percent of students’ opinions were that at the end of each lecture, summary should be either given as a hand out or be allowed to take notes. Ninety-three percentage of the students mentioned that computer aided teaching is beneficial, 86% expressed that hybrid approach of teaching, provoked further study of embryology, 91% mentioned that the teacher should inform which books to be used as reference for further studies. Conclusion: The study result suggests that CAT is applicable in a large group lecture class. It is better to adopt hybrid approach of teaching for equal involvement of teacher and students. It is necessary to the inform students regarding the importance of concerned topics and expert teacher give the students proper guidance.
Application of digital media and information technology as an educational method in the Ophthalmology journal club.
(South East Asia Regional Association for Medical Education., 2013-06) Tulvatana, Wasee; Manassakorn, Anita; Tirakunwichcha, Suppapong; Hirunwiwatkul, Parima; Jariyakosol, Supharat; Kulvichit, Kittisak
Background: A journal club session tends to be boring after many hours of work during the week. Attendees lose their attention span shortly after the activity begins. Objectives: To introduce a new educational model, including the use of digital media devices and social media, in journal club teaching and to evaluate whether this new model could prolong attendees’ attention span. Methods: An online survey from the ophthalmology journal club was conducted to evaluate the range of attention span, the problems and suggestions. Then a team was convened to build a new educational model based on the survey results. Observations in the classroom, the information gathered from the social media, and a post-action online survey were used to evaluate the outcomes. Descriptive and analytical statistics were used for data analyses. Results: There were 20 journal club sessions during the study period. The journal club is comprised of 30 residents, 10 fellows and 19 staff members. The pre-action survey showed important information about the most boring part and the median attention span was 30 minutes. After the new educational model was introduced, the median attention span increased to 55 minutes (p<0.001, Wilcoxon signed ranks test). The status of the attendees, frequency of attendance, and frequency of falling asleep did not show statistically significant association with longer attention span. Students’ achievement scores were good. Conclusion: The new educational model increased the attendees’ attention span and provided learning achievement in the ophthalmology journal club.
Appraisal and Improvisation of Undergraduate Practical Curriculum in Physiology
(South-East Asian Journal of Medical Education, 2011-01-25) Hem Lata; Lily Walia
no abstract available
Appraisal and Improvisation of Undergraduate Practical Curriculum in Physiology.
(2010-06) Lata, Hem; Walia, Lily
Appreciative Inquiry: a discovery tool to facilitate change.
(South East Asia Regional Association for Medical Education., 2009-06) Chacko, Thomas V
An approach to integrated teaching for the subject of malnutrition.
(South East Asia Regional Association for Medical Education., 2013-06) Kalaiselvan, Ganapathy; Dongre, Amol R; Mahalakashmy, T
Are final-year medical students satisfied with placement-based training in Obstetrics and Gynaecology.
(South East Asia Regional Association for Medical Education., 2009-12) Sen, Sujan; Lumsden, Mary Ann
Assessment of perception of first professional MBBS students in India about a teaching learning activity in Biochemistry.
(South East Asia Regional Association for Medical Education., 2009-12) Bhowmick, Kaushik; Mukhopadhyay, Mousumi; Chakraborty, Sandip; Sen, Pradyut K; Chakraborty, Indranil
Objectives: To obtain feedback from the 1st Professional MBBS students on their perception of the existing method of lecture classes in Biochemistry. Method: A semi-structured questionnaire based study was conducted at the Department of Biochemistry, Medical College and Hospital, Kolkata, West Bengal, India, under the West Bengal University of Health Sciences. The subjects were the 1st Professional MBBS students in the 1st semester of the academic year 2008 – 2009. Results: Three items with the highest and least Satisfaction Index were segregated and compared against an ‘average satisfaction’ of 66.67%. The summary of the consolidated observation on the most appreciated and least appreciated aspects and suggestions for improvements were taken into consideration and discussed. Further, Interpretation of the feedback reflected that the learners still preferred to be taught in a predominantly individualized care-based environment. Conclusion: Feedback from the students facilitates a change in preconceived notions about teachinglearning principles on the part of the faculty. At the same time, it is evident from the feedback obtained that the students still prefer to be taught in an individualized care-based environment which reflects their lack of or incomplete attitudinal shift towards the more institutionalized care-based environment of a medical education institution.
Attrition of Medical Students in International Medical University - 2002 to 2007.
(South East Asia Regional Association for Medical Education., 2012-06) Yadav, Hematram; Yusoff, Noraidah; Tan, Kok Leong
Objectives: To estimate the attrition rate and identify common characteristics of medical students who withdrew from an undergraduate medical programme. Methods: This study retrospectively analysed records of students who withdrew from medical programme among 10 student cohorts between 2002 and 2007 in the pre-clinical phase at the International Medical University (IMU), Malaysia. Data on student gender, pre-university entry, banding and English qualification (Malaysian University English Test [MUET] or International English Language Testing System [IELTS]) were studied and compared with all students entering the university during the same study period. Results: Among the 10 student cohorts between 2002 and 2007, a total of 112 out of 1,890 students withdrew from medical programme with more male than female students. Attrition was more common among students with Australian University Foundation, Canadian Pre-University and Ministry of Education Malaysia pre-university entry qualifications. Students with ‘high’ academic banding of entry qualifications and poor English qualification grades exhibited higher rates of attrition. Conclusion: The attrition rate among medical students in IMU between 2002 and 2007 was 5.9%. IMU needs to review the minimum academic criteria for admission into the medical programme in order to reduce the attrition rate. It is suggested to select students of ‘lower banding’ with better English grades while reducing the intake among students from ‘higher banding’ and lower English grades.
Basic sciences in South Asia now and then: A personal perspective.
(2008-06) Shankar, P Ravi
The late 1980s was a period of change and continuity. The preclinical subjects of Anatomy, Physiology and Biochemistry were taught during the first one and half years of the course. Dissection, histology, osteology, animal experiments, hematology practicals, biochemistry practicals were the different exercises. The internet and computers were still in the future during my student days and traditional anatomical specimens were used to study the subject. These days a number of simulations and computer programs are available. Multimedia has made the learning of the subject easier and online support websites are a great help to both students and teachers. Animal experiments and pharmacy practicals were carried out in pharmacology during my student days. Pathology and Microbiology practicals were microscope based. Community Medicine was not taught in the community. Nepal is a relatively new entrant to medical education. In Nepal, the basic science subjects are taught in an integrated, organ system-based manner during the first four semesters. Teaching and learning rational use of medicines is emphasized in pharmacology in our institution. Assessment has become more structured and is carried out using checklists. Adult learning strategies are more commonly used and the student-teacher relationship is becoming more democratic and egalitarian. Technology has invaded the classroom. The number of private medical schools has increased and the importance of the undergraduate medical degree (MBBS) has decreased. The next twenty years will definitely see more changes and promises to be an exciting time in medical education. The late 1980s were a period of change and continuity. India was firmly wedded to socialist principles but a young prime minister was just beginning to initiate change. Medical schools were still traditional places of learning. Massive buildings, overcrowded hospitals, milling crowds.
Blended Learning in Emergency Medicine: Implementing the E-Learning component.
(South East Asia Regional Association for Medical Education., 2014-06) Lateet, Fatimah
Blended learning (BL) refers to the combination of approaches to learning and teaching using a variety of delivery modes. It is playing an increasingly prominent role in medical education. Its strategy includes the combination of traditional face to face learning with e-learning, multimedia videos, online discussions and computer-based assessments. This paper discusses the steps undertaken in implementing an e-learning model through the utilization of a Blackboard system. The phases involved in the implementation include: 1) Training and Familiarisation: introductory learning session with hands-on trial and explanation of the system and its capabilities; 2) Deepening Understanding: formal training with real time trials and demonstration, as well as more complex problem handling; 3) Feedback: trainees and supervisors present and share experience of using the system and how to improve/ enhance it; 4) Assimilation and integration: final stage where knowledge and skills learnt are blended into clinical applications in daily practice. In combining e-learning with other forms of learning under the umbrella of BL, there could be a notable shift from a teacher-oriented model to an active learner- centred one. The whole process emphasizes active learning, with collaboration between learners and supervisors, for the eventual delivery of best clinical care to patients.
Challenges of Problem Based Learning.
(South East Asia Regional Association for Medical Education., 2009-12) Salam, Abdus; Mohamad, Nabishah; Siraj, Harlina Halizah Hj; Latif, Azian Abd; Soelaiman, Ima Nirwana; Omar, Baharuddin Hj; Ngah, Wan Zurinah Wan; Moktar, Norhayati
Background: The cornerstone of problem-based learning (PBL) tutoring is its facilitation skills and is vital to student learning. PBL is a major component in the undergraduate medical curriculum at the Univeristi Kebangsaan Malaysia (UKM). Objectives: The objective of this study was to identify the knowledge, attitudes and skills of PBL tutors of different status and backgrounds. Methods: A cross sectional study was carried out on 55 tutors with medical and non-medical backgrounds, of various academic positions, who conducted 94 tutorials. Respondents were 240 semester-1, year-1, UKM medical students of the academic session of 2007-2008. Data was collected at the end of last session of each PBL case tutorial, utilizing an evaluation form. Results: The majority of tutors possessed knowledge on PBL process and showed positive attitudes towards students learning. Facilitation skills varied among the tutors. However, no significant difference was found between tutors of medical and non-medical backgrounds. Conclusion: Problem processing or facilitation is a challenging task. This also depends on problem structure or designing of the problem. Every PBL tutor irrespective of their background and status must have adequate training on PBL facilitation skills and designing of problem based on critical evaluation of educational theory.
The changing face of medical education in the SEARO region and the need to adapt.
(South East Asia Regional Association for Medical Education., 2011-06) Karunathilake, Indika
Clinical diagnosis by junior doctors - How confident and accurate are they.
(South East Asia Regional Association for Medical Education., 2014-06) Sudusinghe, D H; Indrakumar, J
Background: Accurate diagnosis is necessary for effective treatment. Over the past few years it has been noticed that the junior doctors are not confident enough to make a diagnosis after initial history and examination. Aim of this study is to determine the ability of junior doctors to document a clinical diagnosis and accuracy of the diagnosis. Method: This single centre study included case records of patients admitted to Professorial Medical Unit (PMU) and Emergency Treatment Unit (ETU) at Colombo South Teaching Hospital (CSTH). The junior doctors‘ on admission diagnosis is compared with the medical consultants‘ diagnosis. Only case records of patients belonging to four common specialty domains were studied. Results: In the PMU out of 200 case records no diagnosis or symptom as a diagnosis was documented in 99(49.5%) cases and a diagnosis was documented in 68(34.0%) case records of which 53(77.9%) diagnoses were concordant with the medical consultants‘ diagnosis. When case records of patients admitted to ETU considered, no diagnosis or symptom as a diagnosis was documented in 56(56.0%) case records and a diagnosis was documented in only 21(21.0%) case records of which 15(71.4%) diagnoses were concordant with the medical consultants‘ diagnosis. Documentation of correct diagnosis improved with the grade of the doctor, from intern medical officer (IMO) to medical registrar (MR) in both study settings and also with the order of clerking. Conclusion: Recording of symptom based diagnosis or no diagnosis remains high among most of the junior doctors in all specialty domains and at all grades.
Clinical reasoning of Indonesian medical students as measured by diagnostic thinking inventory.
(South East Asia Regional Association for Medical Education, 2008-06) Rahayu, Gandes Retno; McAleer, Sean
Introduction: Clinical reasoning skill is one of the most important skills for a good physician. A number of instruments have been developed to measure this skill, including the Diagnostic Thinking Inventory (DTI). Several studies have been carried out to measure its reliability and validity; however, evidence of its construct validity is still limited. This study aims to explore the construct validity of the DTI and to measure the clinical reasoning skills of Indonesian medical students. Method: The subjects were 1135 medical students and 60 general practitioners. They were asked to complete the Indonesia version of DTI. Results: Overall reliability of the DTI was .74 and .50 for the flexibility in thinking scale and .70 for the evidence of knowledge structure scale. A one way unrelated ANOVA showed that there were significant differences in the DTI score (F = 7.097, p = .000), flexibility of thinking subscale (F = 6.111, p = .000), and the evidence of knowledge structure subscale (F = 5.306, p = .000) with the scores increasing over the period of medical training and practical experiences. The biggest proportion of subjects in all groups reached the highest level (scored between 171-246/level 5). Conclusion: This study has shown the construct validity of DTI in a different linguistic context. It also has shown the level of clinical reasoning skills of Indonesian medical students varied with year of study.
Clinical teachers working in hospitals: a New Zealand perspective.
(2012-06) Henning, Marcus; Pinnock, Ralph; Bagg, Warwick; Shulruf, Boaz; Hawken, Susan J
Introduction: The perceptions and actions of clinical teachers working in hospitals influence their teaching, how their students’ learn and the clinical learning environment. The research question was, “what are the views of clinical teachers in relation to what needs to be changed in the School of Medicine?” Materials and methods: A total of 80 hospital clinical teachers involved in teaching general medicine, obstetrics and genecology, paediatrics, psychiatry, and surgery contributed to this study. The teachers were self-selected and expressed their perceptions in response to an open-ended question, ‘If you could change three things about medical school - what would they be?’ To derive meaning from the open-ended comments the Colaizzi phenomenological method was adapted. Additionally, six items were constructed to allow teachers to rate their level of agreement on key areas of teaching. Results: The clinical teachers’ commentaries indicated that the main themes were in areas of curriculum and selection of students, teaching, service and research commitments, and professional development. The level of agreement data supported the commentaries and showed no differences across the clinical disciplines.Discussion: The findings of this study affirmed the need for further cohesion between the medical programme and the hospitals in terms of directing and integrating the curriculum. It is imperative that non-faculty clinician teachers have allocated time to teach and are rewarded for their work. Teach the teacher initiatives need to be developed to assist clinical teachers in meeting their teaching responsibilities in their hospital settings.
Communication as the crucial aspect of collaboration among three established medical schools in Indonesia: curriculum evaluation process.
(South East Asia Regional Association for Medical Education., 2014-06) Findyartini, Ardi; Felaza, Estivana; Soemantri, Diantha; Sakiman, F X Bambang; Aswiyanti; Indrama, Erly
Aligned with the effort to increase and maintain the quality of medical institutions, three well-established schools of medicine in Indonesia formed a collaboration framework comprising areas of medical education, research, and services. The undergraduate medical curriculum was identified as one of the main areas for collaboration, with curriculum evaluation as the first step taken. This article emphasizes the reflection of each institution on the collaboration process. The focuses were on the positive impacts, disadvantages or negative impacts, obstacles and solutions for further improvement in the collaboration. Semi-structured interviews with each faculty leader and collaborator were conducted to obtain a comprehensive view of the current collaboration process. Although some advantages resulting from the collaboration were widely acknowledged, many obstacles were also identified. Ineffective communication between and within each collaborating institution became one of the potential hurdles in the process of collaboration. Despite the obstacles in collaborating, the stakeholders involved felt the benefits of the process, in which each institution was encouraged to review the existing curriculum and evaluation program, identify any weaknesses and determine further plans.
Communication Skills Appropriate to Context: Our Approach to Meeting the Training Needs of Interns.
(South East Asia Regional Association for Medical Education., 2014-12) Rahim, A A; Govindaraj, G M; Thekkekara, R J; Anitha, P M; Laila, K V
Objectives: To identify the core competency areas for teaching and training interns in communication skills followed by evaluating effectiveness of the training subjectively, based on student perception. Methods: At the outset we identified five key areas where doctors faced difficulty in communication in their routine clinical practice. This was followed by a two day training programme to 160 interns consisting of videos, hand-outs, lectures and role plays with emphasis on deliberate practice of skills. At the end of the training, Intern‘s perception about the effectiveness of the programme and their selfperceived improvement in skills were assessed. Results: The core competency areas listed by the doctors were: breaking bad news; dealing with a parent resistant to immunisation; communicating with the distressed patient and irritated bystander in casualty, explaining risks and procedures; and dealing with a patient with psychosomatic complaints. Interns responses to the training methodology based on the core competencies were overwhelming with 91% rating the training as effective. Role play was the most appreciated learning technique. Increased self-perceived immediate improvement in Communication skills was reported by 85% of Interns. Conclusions: This exercise has helped us identify the key areas to be focused in communication skills training for interns in our setting, as well as design appropriate teaching learning methods to achieve the objectives. A systematic approach in developing a teaching-learning methodology stressing on the content and process of communication skills training relevant to the local context using a mix of experiential problem based and didactic methods should be stressed while framing a communication skill curriculum.

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