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Fulltext Evaluation of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Epidemiology, clinical characteristics, and outcomes in the older patients in a tertiary teaching hospital in Malaysia

Hasmukharay K, Ngoi ST, Saedon NI, Tan KM, Khor HM, Chin AV, et al.

BMC Infect Dis, 2023 Apr 18;23(1):241.
PMID: 37072768 DOI: 10.1186/s12879-023-08206-y

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is a major concern in the global healthcare system. However, data from Asian regions dealing with the singularity of this infection in older persons is lacking. We aimed to identify the differences in the clinical characteristics and outcomes of MRSA bacteremia between adults aged 18-64 and ≥ 65 years.
METHODS: A retrospective study cohort was conducted at the University Malaya Medical Centre (UMMC) on cases of MRSA bacteremia from 2012 to 2016. Patient demographic and clinical data were collected for risk factors analyses.
RESULTS: New cases of MRSA bacteremia showed a trend of increase from 0.12 to 100 admissions in 2012 to 0.17 per 100 admissions in 2016 but a drop was observed in 2014 (0.07 per 100 admissions). Out of the 275 patients with MRSA bacteremia, 139 (50.5%) patients were aged ≥ 65 years old. Co-morbidities and severity at presentation were significantly higher among older adults, including diabetes mellitus (p = 0.035), hypertension (p = 0.001), and ischemic heart disease (p

Matched MeSH terms: Hospitals, Teaching
Fulltext Knowledge, attitude, and practice of virtual consultation among outpatients at a teaching hospital in Malaysia

Liew SC, Pallath V, Rasali Y, Foong CC, Hong WH, Tan MP

PLoS One, 2023;18(12):e0289176.
PMID: 38117842 DOI: 10.1371/journal.pone.0289176

INTRODUCTION: During the coronavirus disease 2019 (COVID-19) pandemic, the use of virtual consultations has accelerated to ensure continued access to healthcare despite lockdowns and physical distancing measures. We aimed to determine the knowledge (awareness) of, attitude (acceptability) to, and practice (exposure) [KAP] of virtual consultations (VC), the demographic factors associated with poor KAP, and the correlation between the three KAP domains.
METHODS: A cross-sectional study, using a convenience sampling technique, was conducted from 13 September, 2021 to 28 November, 2021. We designed a 45-item VC KAP questionnaire. This was distributed to outpatient users attending cardiovascular, dermatology, geriatrics, haematology, endocrine, respiratory, gastroenterology, rheumatology, or neurology clinics at the University Malaya Medical Centre. It was completed during face-to-face, online, or telephone interviews. The data were analysed using SPSS version 24.0. Binary logistic regression was used to determine the demographic factors associated with KAP. Correlation between KAP domains was determined using Spearman's rho (r). A p-value of <0.05 was considered statistically significant.
RESULTS: A total of 366 questionnaires were completed. Knowledge (awareness), attitude (acceptability), and practice (exposure) were considered good in 69.7%, 80.9%, and 24.6% of participants, respectively. There were no significant relationships between age, gender, ethnicity, and duration of hospital attendance (years) with knowledge (awareness), attitude (acceptability), and practice (exposure). A moderate positive correlation was seen between knowledge (awareness) and attitude (acceptability) (Attitude total [Atotal]) (r = 0.48, p<0.001), with no significant correlation between knowledge (awareness) and practice (exposure) (r = 0.04, p = 0.45), and attitude (acceptability) (Atotal) and practice (r = 0.01, p = 0.82).
CONCLUSION: Overall, outpatient clinic users had good knowledge (awareness) of and were receptive towards VC but had poor practice (exposure). More opportunities for VC use in healthcare can increase exposure and subsequent utilisation. Interventions to increase the effectiveness of VC use should be explored in future studies.

Matched MeSH terms: Hospitals, Teaching
Fulltext Deep Brain Stimulation (DBS) for Movement Disorders: An Experience in Hospital Universiti Sains Malaysia (HUSM) Involving 12 Patients

Hooi LL, Fitzrol DN, Rajapathy SK, Chin TY, Halim SA, Kandasamy R, et al.

Malays J Med Sci, 2017 Mar;24(2):87-93.
PMID: 28894408 MyJurnal DOI: 10.21315/mjms2017.24.2.11

Deep brain stimulation (DBS) was first introduced in 1987 to the developed world. As a developing country Malaysia begun its movement disorder program by doing ablation therapy using the Radionics system. Hospital Universiti Sains Malaysia a rural based teaching hospital had to take into consideration both health economics and outcomes in the area that it was providing neurosurgical care for when it initiated its Deep Brain Stimulation program. Most of the patients were from the low to medium social economic groups and could not afford payment for a DBS implant. We concentrated our DBS services to Parkinson's disease, Tourette's Syndrome and dystonia patients who had exhausted medical therapy. The case series of these patients and their follow-up are presented in this brief communication.

Matched MeSH terms: Hospitals, Teaching
Fulltext Hospital outcomes of adult respiratory tract infections with extended-spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae

Loh LC, Abdul Samad NIH, Mohd Sani RM, Raman S, Thayaparan T, Kumar S

Malays J Med Sci, 2007 Jul;14(2):36-40.
PMID: 22993489 MyJurnal

Klebsiella pneumoniae ranks high as a cause of adult pneumonia requiring hospitalization in Malaysia. To study whether extended-spectrum b-lactamase (ESBL) producing K. pneumoniae was linked to hospital outcomes, we retrospectively studied 441 cases of adult respiratory tract infections with microbial proven K. pneumoniae from an urban-based university teaching hospital between 2003 and 2004. 47 (10.6%) cases had ESBL. Requirement for ventilation and median length of hospital stay, were greater in 'ESBL' than in 'non-ESBL' group [34% vs. 7.4%, p<0.001; 14 days vs. 5 days, p<0.001 respectively] but not crude hospital mortality rate [21.3% vs. 12.4%, p=0.092]. There was a four-fold increased risk of requiring ventilation [4.61 (2.72-7.85)] when ESBL was present. Our findings support the association of ESBL producing K. pneumoniae with adversed hospital outcomes and reiterate the need for vigilance on the part of treating clinicians.

Matched MeSH terms: Hospitals, Teaching
Antimicrobial Susceptibility Patterns of an Emerging Multidrug Resistant Nosocomial Pathogen: Acinetobacter baumannii

Tewari R, Chopra D, Wazahat R, Dhingra S, Dudeja M

Malays J Med Sci, 2018 May;25(3):129-134.
PMID: 30899194 DOI: 10.21315/mjms2018.25.3.13

Multidrug-resistant (MDR) Acinetobacter baumannii (A. baumannii) bacterium, a nosocomial pathogen associated with a high mortality rate and limited therapeutic options have emerged as a serious problem throughout the world. The present study aimed to assess the current levels of antibiotic susceptibility among the isolates of Acinetobacter species. The sensitivity patterns were analysed from various clinical specimens obtained from both in-patients and outpatients of a teaching hospital. Isolation was performed on 5% sheep blood agar and MacConkey agar. Urine samples were inoculated into CLED agar. Antibiotic susceptibility was performed by the disc diffusion method. A total of 16,452 samples were collected. The total number of samples positive for Acinetobacter species was 67 (0.4%). The highest number of isolates 26 (38.8%) were obtained from urine. Majority 80.3% of the isolates exhibited resistance to three or more classes of antibiotics. All isolates were susceptible to colistin (100%). The susceptibility rate of A. baumannii isolates was 80% for tigecycline and 53.3% for carbapenem. Combination therapies including colistin and tigecycline seem to be the rational treatment for MDR A. baumannii until new alternatives come forward.

Matched MeSH terms: Hospitals, Teaching
Blood pre-donation deferrals--a teaching hospital experience

Rabeya Y, Rapiaah M, Rosline H, Ahmed SA, Zaidah WA, Roshan TM

Southeast Asian J Trop Med Public Health, 2008 May;39(3):571-4.
PMID: 18564700

Blood donor selection contributes to the safety of both the donor and the recipient. The objective of this study was to identify the number and causes of blood pre-donation deferrals at the Hospital Universiti Sains Malaysia (HUSM). A retrospective study was carried out to retrieve data regarding deferred blood donors at the HUSM in the year 2006. A total of 4,138 blood donors donated blood at the Transfusion Medicine Unit, of whom 231 were deferred or rejected as donors. The percentage of deferred donors was 5.6%. The main reason for deferral was a low hemoglobin (40.7%), with females constituting the majority of those deferred. This was followed by high blood pressure (29.4%) and male donors were predominant in this group. Medical illness caused 15.6% of donor deferrals. The majority of deferred donors were regular donors (64.1%). We recommend setting new hemoglobin criteria for donor deferral according to the reference range obtained for the particular population. Most of the other deferrals were preventable by proper health care education and awareness.

Matched MeSH terms: Hospitals, Teaching
Clinical audit teaching in record-keeping for dental undergraduates at International Medical University, Kuala Lumpur, Malaysia

Chong JA, Chew JK, Ravindranath S, Pau A

J Dent Educ, 2014 Feb;78(2):206-12.
PMID: 24489028

This study investigated the impact of clinical audit training on record-keeping behavior of dental students and students' perceptions of the clinical audit training. The training was delivered to Year 4 and Year 5 undergraduates at the School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. It included a practical audit exercise on patient records. The results were presented by the undergraduates, and guidelines were framed from the recommendations proposed. Following this, an audit of Year 4 and Year 5 students' patient records before and after the audit training was carried out. A total of 100 records were audited against a predetermined set of criteria by two examiners. An email survey of the students was also conducted to explore their views of the audit training. Results showed statistically significant improvements in record-keeping following audit training. Responses to the email survey were analyzed qualitatively. Respondents reported that the audit training helped them to identify deficiencies in their record-keeping practice, increased their knowledge in record-keeping, and improved their record-keeping skills. Improvements in clinical audit teaching were also proposed.

Matched MeSH terms: Teaching/methods*
Fulltext Qualities of an effective teacher: what do medical teachers think?

Singh S, Pai DR, Sinha NK, Kaur A, Soe HH, Barua A

BMC Med Educ, 2013;13:128.
PMID: 24044727 DOI: 10.1186/1472-6920-13-128

Effective teaching in medicine is essential to produce good quality doctors. A number of studies have attempted to identify the characteristics of an effective teacher. However, most of literature regarding an effective medical teacher includes student ratings or expert opinions. Furthermore, interdisciplinary studies for the same are even fewer. We did a cross-sectional study of the characteristics of effective teachers from their own perspective across medicine and dentistry disciplines.

Matched MeSH terms: Teaching/standards*
Structured student-generated videos for first-year students at a dental school in Malaysia

Omar H, Khan SA, Toh CG

J Dent Educ, 2013 May;77(5):640-7.
PMID: 23658411

Student-generated videos provide an authentic learning experience for students, enhance motivation and engagement, improve communication skills, and improve collaborative learning skills. This article describes the development and implementation of a student-generated video activity as part of a knowledge, observation, simulation, and experience (KOSE) program at the School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. It also reports the students' perceptions of an activity that introduced first-year dental students (n=44) to clinical scenarios involving patients and dental team aiming to improve professional behavior and communication skills. The learning activity was divided into three phases: preparatory phase, video production phase, and video-watching. Students were organized into five groups and were instructed to generate videos addressing given clinical scenarios. Following the activity, students' perceptions were assessed with a questionnaire. The results showed that 86 percent and 88 percent, respectively, of the students agreed that preparation of the activity enhanced their understanding of the role of dentists in provision of health care and the role of enhanced teamwork. In addition, 86 percent and 75 percent, respectively, agreed that the activity improved their communication and project management skills. Overall, the dental students perceived that the student-generated video activity was a positive experience and enabled them to play the major role in driving their learning process.

Matched MeSH terms: Teaching/methods*
Clinical pairing revisited: a study at the University of Malaya, Malaysia

Ahmad NA, Naimie Z, Lui JL, Aziz AA, Abdullah M, Abu Kasim NH, et al.

J Dent Educ, 2012 Oct;76(10):1377-83.
PMID: 23066138

This study is part of ongoing educational research conducted by the Department of Conservative Dentistry, University of Malaya, Malaysia, to evaluate the perception of clinical pairing. A thirteen-question survey was distributed to 148 dental students after they had experienced four-handed dentistry. The objectives were to identify the advantages, disadvantages, and the acceptance of the implementation of clinical pairing from the students' point of view. The responses from the open-ended questions were categorized into six main themes (areas of interest): quality-related (Q), patient-related (PT), partner-related (P), lecturer-related (T), infection control (IC), and learning environment (L). Data analysis was done using SPSS version 18. Results indicated that the students perceived they possessed enough knowledge regarding clinical pairing. However, it was found that they still preferred to work independently as compared to working in pairs. The benefits of clinical pairing may not be viewed in the same vein by both dental students and teachers. The quality-related theme was perceived by students as the main advantage of clinical pairing, whilst the partner-related theme was perceived otherwise. The study also revealed that students may have some preconceived notions about pairing that may have impaired their acceptance. As a consequence, some reluctance was seen in their responses.

Matched MeSH terms: Teaching/methods
Teaching engineering ethics using BLOCKS game

Lau SW, Tan TP, Goh SM

Sci Eng Ethics, 2013 Sep;19(3):1357-73.
PMID: 23065541 DOI: 10.1007/s11948-012-9406-3

The aim of this study was to investigate the use of a newly developed design game called BLOCKS to stimulate awareness of ethical responsibilities amongst engineering students. The design game was played by seventeen teams of chemical engineering students, with each team having to arrange pieces of colored paper to produce two letters each. Before the end of the game, additional constraints were introduced to the teams such that they faced similar ambiguity in the technical facts that the engineers involved in the Challenger disaster had faced prior to the space shuttle launch. At this stage, the teams had to decide whether to continue with their original design or to develop alternative solutions. After the teams had made their decisions, a video of the Challenger explosion was shown followed by a post-game discussion. The students' opinion on five Statements on ethics was tracked via a Five-Item Likert survey which was administered three times, before and after the ethical scenario was introduced, and after the video and post-game discussion. The results from this study indicated that the combination of the game and the real-life incident from the video had generally strengthened the students' opinions of the Statements.

Matched MeSH terms: Teaching/methods*
Fulltext Student perceptions regarding the usefulness of explicit discussion of "Structure of the Observed Learning Outcome" taxonomy

Prakash ES, Narayan KA, Sethuraman KR

Adv Physiol Educ, 2010 Sep;34(3):145-9.
PMID: 20826769 DOI: 10.1152/advan.00026.2010

One method of grading responses of the descriptive type is by using Structure of Observed Learning Outcomes (SOLO) taxonomy. The basis of this study was the expectation that if students were oriented to SOLO taxonomy, it would provide them an opportunity to understand some of the factors that teachers consider while grading descriptive responses and possibly develop strategies to improve scores. We first sampled the perceptions of 68 second-year undergraduate medical students doing the Respiratory System course regarding the usefulness of explicit discussion of SOLO taxonomy. Subsequently, in a distinct cohort of 20 second-year medical students doing the Central Nervous System course, we sought to determine whether explicit illustration of SOLO taxonomy combined with some advice on better answering descriptive test questions (to an experimental group) resulted in better student scores in a continuous assessment test compared with providing advice for better answering test questions but without any reference to SOLO taxonomy (the control group). Student ratings of the clarity of the presentation on SOLO taxonomy appeared satisfactory to the authors, as was student understanding of our presentation. The majority of participants indicated that knowledge of SOLO taxonomy would help them study and prepare better answers for questions of the descriptive type. Although scores in the experimental and control group were comparable, this experience nonetheless provided us with the motivation to orient students to SOLO taxonomy early on in the medical program and further research factors that affect students' development of strategies based on knowledge of SOLO taxonomy.

Matched MeSH terms: Teaching*
Fulltext Knowledge and behavior regarding breast cancer screening among female teachers in Selangor, Malaysia

Parsa P, Kandiah M, Mohd Zulkefli NA, Rahman HA

Asian Pac J Cancer Prev, 2008 Apr-Jun;9(2):221-7.
PMID: 18712963

A cross-sectional study was carried out to determine the knowledge and practices of 425 female secondary school teachers from 20 selected secondary schools in Selangor, Malaysia on breast cancer screening (BCS). A self-administered, structured questionnaire was used for data collection. This study showed moderate to low knowledge on breast cancer (BC) and BCS among teachers. Only 19%, 25% and 13.6% eligible women performed breast self-examination (BSE), clinical breast examination (CBE) and mammography respectively, on a regular basis. Level of breast cancer knowledge was significantly associated with BSE (p<0.001). Having heard/ read about BCS, and regular visit with a physician were associated with BCS behaviors (P<0.05). There was no association between BCS behaviors (P>0.05) and age, family history of breast cancer, marital status or having health insurance. Efforts are needed to increase knowledge and remove misconceptions about breast cancer and screening practices among Malaysian women.

Matched MeSH terms: Teaching*
Fulltext Tetanus in adults--a continuing problem: an analysis of 217 patients over 3 years from Delhi, India, with special emphasis on predictors of mortality

Anuradha S

Med J Malaysia, 2006 Mar;61(1):7-14.
PMID: 16708728

Tetanus is still widely prevalent in many parts of the world especially in the developing countries. This study was conducted to assess the demographic and clinical features, treatment and outcome of tetanus in adults with a special emphasis on identification of predictors of mortality. This was a retrospective study of all adult patients admitted with tetanus over a three-year period from 1998 to 2000 at Lok Nayak Hospital, New Delhi, India. The demography, clinical features, treatment and complications of the patients were assessed and were evaluated against two possible outcomes- survival or death, to identify the predictors of mortality. There were 217 adults (148 males, 69 females) admitted with generalized tetanus during the study period. The mean age of the patients was 36.08 +/- 18.84 years. In most instances (63.5%), wounds / injuries served as the source of infection. Overall 31.8% had mild, 21.7% had moderate and 46.5% had severe disease at presentation. Respiratory failure and dysautonomia were the frequently observed complications. Of the 217 patients, 82 died - a mortality rate of 37.78%. Parameters that were significantly associated with increased mortality were: age (especially > 60 years); shorter duration of symptoms - trismus, rigidity and dysphagia; severe disease at presentation and shorter period of onset. Tetanus is a preventable disease associated with a high fatality rate. Universal coverage of immunization programme and appropriate wound prophylaxis is the corner stone of tetanus eradication. The treatment of tetanus is difficult and requires specialized and intensive care. The presence of parameters indicating an adverse outcome at the beginning in the patients will help identify the subset of patients that need more intensive management especially in resource poor nations.

Matched MeSH terms: Hospitals, Teaching/utilization
An assessment of the prescribing skills of undergraduate dental students in malaysia

Akram A, Zamzam R, Mohamad NB, Abdullah D, Meerah SM

J Dent Educ, 2012 Nov;76(11):1527-31.
PMID: 23144489

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.

Matched MeSH terms: Teaching/methods
Cytopathology whole slide images and adaptive tutorials for postgraduate pathology trainees: a randomized crossover trial

Van Es SL, Kumar RK, Pryor WM, Salisbury EL, Velan GM

Hum Pathol, 2015 Sep;46(9):1297-305.
PMID: 26093936 DOI: 10.1016/j.humpath.2015.05.009

To determine whether cytopathology whole slide images and virtual microscopy adaptive tutorials aid learning by postgraduate trainees, we designed a randomized crossover trial to evaluate the quantitative and qualitative impact of whole slide images and virtual microscopy adaptive tutorials compared with traditional glass slide and textbook methods of learning cytopathology. Forty-three anatomical pathology registrars were recruited from Australia, New Zealand, and Malaysia. Online assessments were used to determine efficacy, whereas user experience and perceptions of efficiency were evaluated using online Likert scales and open-ended questions. Outcomes of online assessments indicated that, with respect to performance, learning with whole slide images and virtual microscopy adaptive tutorials was equivalent to using traditional methods. High-impact learning, efficiency, and equity of learning from virtual microscopy adaptive tutorials were strong themes identified in open-ended responses. Participants raised concern about the lack of z-axis capability in the cytopathology whole slide images, suggesting that delivery of z-stacked whole slide images online may be important for future educational development. In this trial, learning cytopathology with whole slide images and virtual microscopy adaptive tutorials was found to be as effective as and perceived as more efficient than learning from glass slides and textbooks. The use of whole slide images and virtual microscopy adaptive tutorials has the potential to provide equitable access to effective learning from teaching material of consistently high quality. It also has broader implications for continuing professional development and maintenance of competence and quality assurance in specialist practice.

Matched MeSH terms: Teaching/methods*
Understanding of Coronavirus Disease 2019 (COVID-19) and the practice of preventive measures among doctors and nurses in a university teaching hospital- A cross-sectional study

Ng BH, Low HJ, Nik Nuratiqah NA, Faisal AH, Soo CI, Periyasamy P, et al.

Med J Malaysia, 2021 07;76(4):454-460.
PMID: 34305104

INTRODUCTION: Knowledge and adequate practice of preventive measures among health care workers (HCWs) are important to reduce the risk of COVID-19 transmission.
METHODS: A cross-sectional study was conducted among doctors and nurses in the medical department in Pusat Perubatan Universiti Kebangsaan Malaysia between November 18, 2020 and December 18, 2020 during the third wave of COVID-19 epidemic in Malaysia. We studied the knowledge and practice of preventive measures of COVID-19 among doctors and nurses in the COVID-19 or sudden acute respiratory infection (SARI) wards and general medical wards. Data was collected using a validated self-designed google form online-questionnaire.
RESULTS: A total of 407 subjects completed the study and 80.8% were females; 55.8% were aged between 30-39 years; 46.4% were medical doctors. The main source of COVID-19 knowledge was the Ministry of Health Malaysia (MOH) website (35.1%). Majority (97%) had sufficient knowledge and 82% practiced proper preventive measures. Doctors had a higher mean knowledge score compared to nurses (p < 0.001). HCWs working in COVID-19 or SARI wards scored higher in knowledge questions compared to those in the general medical wards (p = 0.020). Nurses practiced better preventive measures (p < 0.001). Good knowledge could not be predicted based on professions (OR: 0.222, 95% CI: 0.048 - 1.028, p = 0.054). Majority were unable to recall the proper steps of donning (85.8%) and doffing (98.5%).
CONCLUSIONS: Although majority had good knowledge and practiced proper preventive measures, there was a poor recall in donning and doffing steps regardless of place of practice. The MOH website is a useful platform for tailored continuous medical education and regular updates on COVID-19. Regular training and retraining on donning and doffing of PPE is needed to bridge this gap.

Matched MeSH terms: Hospitals, Teaching/statistics & numerical data
Fulltext An international survey of medical ethics curricula in Asia

Miyasaka M, Akabayashi A, Kai I, Ohi G

J Med Ethics, 1999 Dec;25(6):514-21.
PMID: 10635508

SETTING: Medical ethics education has become common, and the integrated ethics curriculum has been recommended in Western countries. It should be questioned whether there is one, universal method of teaching ethics applicable worldwide to medical schools, especially those in non-Western developing countries.
OBJECTIVE: To characterise the medical ethics curricula at Asian medical schools.
DESIGN: Mailed survey of 206 medical schools in China, Hong Kong, Taiwan, Korea, Mongolia, Philippines, Thailand, Malaysia, Singapore, Indonesia, Sri Lanka, Australia and New Zealand.
PARTICIPANTS: A total of 100 medical schools responded, a response rate of 49%, ranging from 23%-100% by country.
MAIN OUTCOME MEASURES: The degree of integration of the ethics programme into the formal medical curriculum was measured by lecture time; whether compulsory or elective; whether separate courses or unit of other courses; number of courses; schedule; total length, and diversity of teachers' specialties.
RESULTS: A total of 89 medical schools (89%) reported offering some courses in which ethical topics were taught. Separate medical ethics courses were mostly offered in all countries, and the structure of vertical integration was divided into four patterns. Most deans reported that physicians' obligations and patients' rights were the most important topics for their students. However, the evaluation was diverse for more concrete topics.
CONCLUSION: Offering formal medical ethics education is a widespread feature of medical curricula throughout the study area. However, the kinds of programmes, especially with regard to integration into clinical teaching, were greatly diverse.

Matched MeSH terms: Teaching/organization & administration
Fulltext Association of psychological distress and work psychosocial factors with self-reported musculoskeletal pain among secondary school teachers in Malaysia

Zamri EN, Moy FM, Hoe VC

PLoS One, 2017;12(2):e0172195.
PMID: 28234933 DOI: 10.1371/journal.pone.0172195

BACKGROUND: Musculoskeletal pain is common among teachers. Work-related psychosocial factors are found to be associated with the development of musculoskeletal pain, however psychological distress may also play an important role.
OBJECTIVES: To assess the prevalence of self-reported low back pain (LBP), and neck and/or shoulder pain (NSP) among secondary school teachers; and to evaluate the association of LBP and NSP with psychological distress and work-related psychosocial factors.
METHODS: This was a cross-sectional study conducted among teachers in the state of Penang, Malaysia. The participants were recruited via a two stage sampling method. Information on demographic, psychological distress, work-related psychosocial factors, and musculoskeletal pain (LBP and NSP) in the past 12 months was collected using a self-administered questionnaire. Poisson regression was used to estimate the prevalence ratio (PR) for the associations between psychological distress and work-related psychosocial factors with LBP and NSP.
RESULTS: The prevalence of self-reported LBP and NSP among 1482 teachers in the past 12 months was 48.0% (95% Confidence Interval (CI) 45.2%, 50.9%) and 60.1% (95% CI 57.4%, 62.9%) respectively. From the multivariate analysis, self-reported LBP was associated with teachers who reported severe to extremely severe depression (PR: 1.71, 95% CI 1.25, 2.32), severe to extremely severe anxiety (1.46, 95% CI 1.22, 1.75), high psychological job demand (1.29, 95% CI 1.06, 1.57), low skill discretion (1.28, 95% CI 1.13, 1.47) and poorer mental health (0.98, 95% CI 0.97, 0.99). Self-reported NSP was associated with mild to moderate anxiety (1.18, 95% CI 1.06, 1.33), severe to extremely severe anxiety (1.25, 95% CI 1.09, 1.43), low supervisory support (1.13, 95% CI 1.03, 1.25) and poorer mental health (0.98, 95% CI 0.97, 0.99).
CONCLUSIONS: Self-reported LBP and NSP were common among secondary school teachers. Interventions targeting psychological distress and work-related psychosocial characteristics may reduce musculoskeletal pain among school teachers.

Matched MeSH terms: Teaching*
Gatekeeper Suicide Training's Effectiveness Among Malaysian Hospital Health Professionals: A Control Group Study With a Three-Month Follow-Up

Siau CS, Wee LH, Ibrahim N, Visvalingam U, Yeap LLL, Wahab S

J Contin Educ Health Prof, 2018;38(4):227-234.
PMID: 30036213 DOI: 10.1097/CEH.0000000000000213

INTRODUCTION: There is a lack of suicide-related training in the nonpsychiatric health professional's basic education. We suggest that a continuing education through a brief gatekeeper suicide training program could be a suitable platform to improve suicide-related knowledge, self-efficacy, and attitudes. This study aimed at examining the effectiveness of the Question, Persuade, Refer gatekeeper program on improving the knowledge, self-efficacy in suicide prevention, and understanding of/willingness to help suicidal patients of Malaysian hospital health professionals.
METHODS: The Question, Persuade, Refer program materials were translated and adapted for implementation in the hospital setting for nonpsychiatric health professionals. There were 159 (mean age = 35.75 years; SD = 12.26) participants in this study. Most participants were female (84.9%), staff/community nurses (52.2%), who worked in the general medical department (30.2%) and had no experience managing suicidal patients (64.2%). Intervention participants (n = 53) completed a survey questionnaire at pretraining, immediately after training, and after three months. Control participants (n = 106) were not exposed to the training program and completed the same questionnaire at baseline and three months later.
RESULTS: Significant improvement occurred among intervention participants in terms of perceived knowledge, self-efficacy, and understanding of/willingness to help suicidal patients immediately after training and when compared with the control participants 3 months later. Improvements in declarative knowledge were not maintained at the 3-month follow-up.
DISCUSSION: This study confirmed the short-term effectiveness of the gatekeeper training program. Gatekeeper suicide training is recommended for implementation for nonpsychiatric health professionals nationwide.

Matched MeSH terms: Teaching/standards*

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