Method: A cross-sectional study was carried out on a sample of medical students in their final year at Universiti Sains Malaysia. Confirmatory factor analysis (CFA) was performed using AMOS 22 to assess construct validity. Reliability analysis was performed using SPSS 22 to assess internal consistency.
Results: A total of 159 final year medical students participated. CFA showed that the original four-factor model with 15 items achieved acceptable values for the goodness of fit indices, suggesting a good model fit (X2 = 198.295, ChiSq/df = 2.418, RMSEA = 0.095, GFI = 0.867, CFI = 0.953, NFI = 0.923, TLI = 0.940). The Cronbach's alpha values of the mentoring relationship structure, engagement, and competency support domains were 0.96, 0.90 and 0.88, respectively. For autonomy support, the Cronbach's alpha value was 0.62.
Conclusion: MBS demonstrates a satisfactory level of construct validity and a high level of internal consistency in measuring supportive mentor behaviours in a medical school setting. This result suggests that MBS can be used as a mentorship evaluation tool for feedback in the context of a Malaysian medical school.
Aim: To consolidate the literature regarding the barriers faced by primary care physicians in making house calls.
Design of the study: Literature review.
Method: Studies were sourced from PubMed and Embase.
Results: 7 studies were selected to be in the literature review. Barriers to making house calls by primary care physicians include inadequate remuneration, lack of time and training, unconducive home environment, concerns with professional liability and safety, and perceived low value-added in the patient's quality of care.
Conclusion: While primary care physicians do recognize the value of house calls in patient care, the perceived limited standard of care that can be achieved in the home setting, busy clinic practice (large patient loads), coupled with inadequate remuneration make house calls unrealistic for many doctors. These barriers must be addressed to ensure accessibility to primary health care services for the immobile, frail, and sick is not being compromised. One of the solutions may be to expose medical students and residents to house calls early through mentorship.
METHODOLOGY: A cross-sectional survey using selfadministered questionnaires was conducted among all specialists working in government specialist hospitals in the northern states of Malaysia.
RESULTS: Out of 733 questionnaires distributed, 467 were returned giving a response rate of 63.7%. Ninety-nine percent of the respondents believed that research benefits patients while 93.3% think research helps in their professional development. However, 34.8% think that under their present working conditions, it is unlikely they will participate in research. The major barriers identified were lack of funds for research (81%); lack access to expertise, software or statistical analysis (78.4%); interference with daily work schedule (75.1%) and inconsistent manpower in their department (74.2%). There are three barriers with statistically significant difference between hospitals with CRC compared to hospitals without CRC; lack of funds, mentors and access to expertise, software or statistical analysis. The demographic factors, attitudes and barriers contributing to involvement in research also investigated. The main facilitators for the conduct of research are potential to benefit patients and potential for professional development.
CONCLUSION: Taking note of the findings, the Ministry of Health can implement appropriate strategies to improve specialist participation in research.
METHODS AND ANALYSIS: The pre-HO intervention is the 'Medicorp' module that includes clerkship, experience sharing, hands-on skills training, common clinical cases and introduction of the local healthcare system. This is a pre-post quasi-experimental study lasting 1 year, with three assessment time points-at pretraining, immediately after training and 1 month into the participants' HO-ship. The study is currently ongoing and involves 208 participants who attended the course in Malaysia. Participants with known psychiatric illness, working HOs and medical students are excluded. A pretested, self-administered questionnaire that includes baseline sociodemography, adaptation of the International Medical University (IMU) Student Competency Survey and the Depression Anxiety Stress Scale has been adopted, and 1 month follow-up will be conducted by telephone. Data will be analysed using SPSS V.24. The primary outcome is change in confidence level, while the secondary outcomes are changes in the readiness and psychological well-being of the participants.
ETHICS AND DISSEMINATION: This study protocol has received ethics approval from Ethics Committee for Research Involving Human Subjects Universiti Putra Malaysia and the National Medical Research Registry Malaysia. Written informed consent has been obtained from each participant. Results will be disseminated through journals and conferences, especially those involved in medical education specifically looking into the training of medical doctors.
TRIAL REGISTRATION NUMBER: NCT03510195.