This paper describes a systematic and practical guide on manuscript writing. A step-by-step approach
as easy as learning ABC to facilitate authors to plan their manuscript writing. Research has shown that
experienced writers plan extensively, in which a writing plan is a road map, without it we will probably
lose our way in circles. Generally, authors start writing a manuscript by introduction, methods, results,
discussion and conclusion. However, this paper proposes a different approach to start writing a
manuscript based on the ABC of manuscript writing worksheet.
Item analysis (IA) is commonly used to describe difficulty and discrimination indices of multiple
true-false (MTF) questions. However, item analysis is basically a plain descriptive analysis with
limited statistical value. Item response theory (IRT) can provide a better insight into the difficulty
and discriminating ability of questions in a test. IRT consists of a collection of statistical models that
allows evaluation of test items (questions) and test takers (examinees) at the same time. Specifically,
this article focuses on two-parameter logistic IRT (2-PL IRT) model that is concerned with estimation
of difficulty and discrimination parameters. This article shows how 2-PL IRT analysis is performed in
R software environment, guides the interpretation of the IRT results and compares the results to IA on
a sample of MTF questions.
Assessment of medical professionalism is often challenged by the subjectivity of its construct and
lack of feedback practice to nurture professional growth. However transmitting professionalism alone
has not been shown to improve professional behaviour therefore professionalism need to be assessed
if it is viewed as relevant. The authors provided description and guidelines on the use of Simplified
Thematic Engagement of Professionalism Scale (STEPS) as summative and formative assessment
tool for assessing professionalism attributes. STEPS was developed based on the Professionalism
Mini-Evaluation Exercise (P-MEX) format that utilise multiple short encounter assessment and
incorporated professionalism values from a local study. The formative component has 15 attributes
that were categorised into personal, profession, patient and public. This is assessed using seven scale
rubric that promotes feedback practice using feed up, feed back and feed forward concept. The
summative component utilises global rating that will be collated longitudinally to form a more robust
evaluation of student professionalism. Current investigations are ongoing especially to ascertain the
usability and validity of STEPS as peer assessment and self-assessment tool.
Introduction: Student selection is important for selecting the best candidates into medical courses.
The Multiple Mini Interview (MMI) is a valid selection tool for the task. The School of Medical
Sciences (SMS), Universiti Sains Malaysia (USM) has employed MMI as a medical admission
tool to select potential candidates into its medical program. Objective: This paper described the
implementation of the MMI and reported the preliminary evaluation data on its validity evidence.
Method: A 9-station MMI (with 5 manned and 4 rest stations) was employed for the 2015 student
selection exercise. Interview data were analysed and questionnaire surveys were administered to both
interviewers and candidates. Validity, reliability, feasibility and acceptability were determined. Results:
Unidimensional construct on confirmatory factor analysis (CFA) and interviewer comments provided
evidence of construct validity. Overall reliability was 0.94, good enough for high-stakes decisions.
Interviewers and candidates’ comments on feasibility and acceptability were also generally positive.
The consistency of the difficulty and discrimination indices of similar stations between sessions was
identified as among the areas for improvement. Conclusions: We are cautiously optimistic regarding
the utility of the MMI in the SMS; future improvements are planned but the present implementation
seems sufficient for the stated purposes
Suboptimal management of asthma can lead to increase morbidity and mortality. Unfortunately, this has become global issue and approximately 40% of asthmatic patients received suboptimal management in emergency department. Therefore, this study aimed to develop a tool to assess knowledge and clinical reasoning of healthcare providers on acute asthmatic management in emergency setting.
Method: The tool was developed via three phases: (a) domain identification, (b) domain blueprinting based the Global Initiative of Asthma (GINA) and the British Thoracic Society (BTS) guidelines, and (c) item generation for each domain for assessing knowledge and clinical reasoning. Three forms of validity evidence related to content, response process and internal structure were appraised. Content validity index (CVI), face validity index (FVI), and intraclass correlation coefficient (ICC) estimate the content validity, response process and internal structure of the tool.
Results: A new tool was developed, named as Knowledge and Clinical Reasoning of Acute Asthma Management in Emergency Department (K-CRAMED), which assesses knowledge and clinical reasoning on three domains related to management of acute asthma – diagnosis, treatment and disposition. CVI values for the three domains were more than 0.83. FVI values for the three domains among doctors and paramedics were at least 0.83. The ICC between scores given by emergency specialists was 0.989 (CI 95% 0.982, 0.994, p-value < 0.001).
Conclusion: The newly developed tool, named as K-CRAMED, is a valid tool to assess knowledge and clinical reasoning of healthcare providers who manage patients with acute asthma. Further validation is required to verify its validity in other setting.
Introduction: USMaP-i is an English, 66-item self-administered inventory, consisting of personality
(60 items, 5 factors) and faking (one factor) components, which was mainly developed to measure
personality traits among Malaysian students based on local cultures and values. The personality
component was based on the Big Five dimensions as suggested by numerous personality researchers.
Previous exploratory studies showed promising validity, reliability and stability of USMaP-i.
Objective: To provide further validity evidence of USMaP-i for use among medical degree program
applicants by confirmatory factor analysis (CFA). Methods: Data were collected as a part of screening
of medical degree program applicants for year 2010–2013 intakes in Universiti Sains Malaysia
(USM), of which 657 cases were suitable for analyses following a data screening measures. CFA was
performed by bootstrap maximum likelihood estimation due to non-normality of items at multivariate
level. Results: Although the revised five-factor model of personality showed good model fit (X2(df) =
144.36(55), P-value < 0.001; CFI = .944, TLI = .921; RMSEA = .050; SRMR = .032, Bollen-Stine
bootstrap P-value = 0.004), the reliability of the factors is very poor (composite reliabilities (CR) =
.483 to .650). In contrast, the unidimensional faking component exhibited good model fit (X2(df)
= 14.15(5), P-value = 0.015; CFI = .984, TLI = .968; RMSEA = .053; SRMR = .011, BollenStine
bootstrap P-value = 0.068) and factor reliability (CR = 0.731). Conclusion: The personality
component should be revised and revalidated due to poor reliability, despite showing good model fit.
In contrast, the faking component showed good model fit and reliability. Further validation studies are
recommended before its use among medical degree program applicants.
Objective: This paper describes the patterns of professional identity development (PID) among
medical graduates of a SPICES (i.e., Student-centred/teacher-centred; Problem-based/information
gathering; Integrated/discipline-based; Community based; Elective/uniform; and Systematic/
apprenticeship-based) curriculum implemented by the School of Medical Sciences, Universiti Sains
Malaysia (USM). Methods: The phenomenological study design evaluated 50 medical graduates of
USM who underwent housemanship at government hospitals in the Peninsular of Malaysia. Focus
group interviews (FGI) were conducted to explore and capture the experience of the participants
in relation to PID during medical training. Eight FGI sessions were conducted at a specific place
as agreed by both researchers and participants. A thematic analysis technique assisted by Atlas.ti
software was used to analyse the qualitative data. Results: The thematic analysis revealed that there
were two themes: self-development and professional development. The self-development theme was
represented by four categories: self-confidence, internal and external motivation, communication skills,
and problem solving. The professional development theme was represented by five categories: social
adjustment, leadership skills and management, team work, hands-on skills, and creativity. Conclusion:
The formation of professional identity among USM medical graduates was related to self-development
and professional development. This suggests that the USM medical curriculum is vital in shaping
professionalism attributes among its medical graduates that are balanced among knowledge, skills,
behaviours and values. Producing balanced medical graduates will ensure the highest quality of
healthcare sevices provided to the country. The implications of this study and recommendations are
discussed.
Educational environment is an important determinant of medical students’ behaviour. It impacts their
academic performance, motivation, and psychological well-being. Quantitative evidence have shown
that there is a decrease in the positive perception of clinical medical students towards the educational
environment. The primary focus on this study was to explore the clinical education environment
through the lived experience of clinical medical students during medical training. Using hermeneutic
phenomenology we aimed to interpret participants’ experience of personal clinical learning journey
through free text input. Thematic analysis was performed to analyse the written texts. Various
measures were taken to enhance the trustworthiness of the findings. A total of 154 (74.8%) fourth year
students and 144 (74.6%) final year students participated in the study. We identified six overarching
themes of education environment in clinical setting that are personal development, teaching and
learning, assessment for learning, facility, support and nurturing curriculum. The overlapping
relationship of the themes is illustrated in the Clinical Education Environment Framework. While
many themes were consistent with existing framework, our findings also proposed assessment as an
important component to influence perception on education environment. The themes in this study
finding conform to the definition of education environment which covers physical, social, and
psychological aspects of students learning. Medical schools should take active measures to incorporate
a nurturing education environment especially in clinical year where students struggle with the hidden
curriculum.
Background: Gastrointestinal illnesses and respiratory-related illnesses are common among
young children in Malaysia, especially those who are attending day care. During administration of
probiotic, the occurences of gastrointestinal and respiratory-related illnesses can be reduced. These
were observed by evaluation through a single questionnaire. However, currently no single tool exists
to simultaneously evaluate the domains of gastrointestinal and respiratory-related illnesses among
these young children. The current study aimed to develop a source questionnaire in English, translate
and validate into the Malay. Methods: Relevant domains of gastrointestinal and respiratory-related
illnesses were identified to generate items and formed a screening tool through literature reviews,
focus groups and opinions of experts. Results: The developed Basic Demographic and Lifestyle
Questionnaire (BDLQ) and Monthly Healthy Questionnaires (MHQ) showed item-level content
validity index (I-CVI) of 0.99 and 0.97, respectively, while the translated Malay versions showed I-CVI
of 1.00 and 0.99, respectively. Item-level face validity index (I-FVI) of 1.00 for both questionnaires
were obtained from 30 respondents showing that the items were clear and comprehensible.
Conclusion: This study showed good level of I-CVI and I-FVI in both developed questionnaires and
their Malay translated versions. These tools in English and Malay were valid and thus reliable to be
used for assessing gastrointestinal and respiratory-related illnesses in young children.
This study aimed to translate Oldenburg Burnout Inventory (OLBI) into Malay language, and test its
response process (face validity) and internal structure (factor structure and internal consistency). To
the author’s knowledge, OLBI is not yet validated in Malay language, thus this study aimed to produce
a validated Malay version of OLBI (OLBI-M) in order to measure burnout among the healthcare
learner population in Malaysia. OLBI has great potentials mainly due to its accessibility and free of
any cost to use it, thus might promote more researchers to conduct burnout research in Malaysia. The
forward-backward translation was performed as per standard guideline. The OLBI-M was distributed
to 32 medical students to assess face validity and later to 452 medical students to assess construct
validity. Data analysis was performed by Microsoft Excel, Statistical Package for the Social Sciences
(SPSS), and Analysis of Moment Structures (AMOS). The face validity index of OLBI-M was more
than 0.70. The two factors of CBI-M achieved good level of goodness of fit indices (Cmin/df = 3.585,
RMSEA = 0.076, GFI = 0.958, CFI = 0.934, NFI = 0.912, TLI = 0.905) after removal of several
items. The composite reliability values of the two factors ranged from 0.71 to 0.73. The Cronbach’s
alpha values of the three factors ranged from 0.70 to 0.74. This study shows OLBI-M is a reliable
and valid tool to measure burnout in medical students. Future burnout studies in Malaysia are highly
recommended to utilise OLBI-M. However, it is crucial for further validity to be carried out to verify
the credential of OLBI-M.
Lecturers are expected to teach effectively and evaluating their teaching effectiveness are essential to
ensure students get the best learning experience. A systematic evaluation of teaching behaviours with a
proper feedback mechanism will help to improve their teaching effectiveness. Improvement of teaching
effectiveness will result in better students’ learning experience, and thus attaining the intended
educational outcomes. This study aimed to evaluate teaching effectiveness among lecturers by
assessing their teaching behaviours during lectures. A cross-sectional study was conducted on lecturers
in a Malaysian public medical school. Their teaching behaviours were rated by 30 trained pre-clinical
medical students using Teacher Behaviour Inventory (TBI) on seven aspects – organisation, speechpacing,
clarity, enthusiasm, interaction, rapport, and disclosure. A total of 55 lecturers were rated
by the medical students. The organisation and speech-pacing aspects were highly rated as the mean
scores were 4.02 and 4.15, respectively. The clarity, enthusiasm, interaction, and rapport aspects
attained satisfactory level as the mean scores ranged from 3.10 to 3.59. The disclosure aspect was
poorly rated as the mean score was 2.20. Eventhough all lecturers in this school are considered expert
in their area, findings from this study suggest that some teaching behaviour need some improvement.
Findings from this study also provide useful data for the medical school to chart direction of faculty
development activities to improve their lecturers’ teaching effectiveness during lectures.