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  1. Abdollahimohammad A, Jaafar R, Rahim AF
    Iran J Nurs Midwifery Res, 2014 Sep;19(5):542-4.
    PMID: 25400685
    Cultural values are invisible and relatively constant in societies. The purpose of the present study is to find diversities in cultural values of Iranian and Malaysian nursing students.
  2. Yusoff MSB, Abdul Rahim AF
    MyJurnal
    Background: Tertiary education environment has always been regarded as highly stressful to students. Medical training further adds to the already stressful environment. The stress of medical training was associated with negative consequences to the mental and physical health of medical students. We describe in this article a stress-management program known as the 'Medical Student Well-Being Workshop' in our medical school.

    Methodology: The workshop was run over two half-days over a weekend. Prior to the workshop the society announced the workshop to the students and participation was voluntary. It was open to students from all years of the medical course except for first year students. A separate stress management workshop is planned for them.

    Results: A total of 55 students participated in the workshop, out of which 55 (82%) were female students. The years of study were almost equally represented; 14 students (26%) from years two and three, 20 (37%) from year four and 6 (11%) from year five. All sessions were rated as highly useful; the lowest rated, the introduction session, obtained an overall usefulness rating of 3.73 out of the possible 5 (74.6%).

    Conclusion: Medical Students Well-being Workshop is a promising intervention program in improving medical students' ability in managing stress. Perhaps similar approach can be considered relevant to be incorporated in other medical schools.
  3. Abdul Rahim AF, Norhayati MN, Zainudin AM
    PeerJ, 2021;9:e11291.
    PMID: 34123581 DOI: 10.7717/peerj.11291
    Background: Brown rice is a whole-grain food that is often assumed to have a lower glycemic index compared to white rice. A few studies have objectively confirmed the effect of a brown-rice diet on glycemic control and metabolic parameters compared to a white-rice diet. The purpose of this study is to determine the effect of brown rice on improving glycemic control and metabolic parameters in prediabetes and type 2 diabetes. The researchers conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and controlled clinical trials.

    Methods: PRISMA guidelines were used as the basis of this systematic review. Relevant studies were identified by searching the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), as well as Epistemonikos for randomized controlled trials (RCTs) and controlled clinical trials published not later than January 2021 involving adults with prediabetes and diabetes mellitus who were consuming brown rice compared to those consuming white rice. The primary outcomes measured were glycated hemoglobin (HbA1c) and fasting blood glucose (FBG) levels. The secondary outcomes were body weight, waist circumference, systolic and diastolic blood pressure levels, LDL and HDL-cholesterol levels. The mean differences (MDs) with 95% confidence intervals (CIs) between brown and white-rice-diet groups were calculated using a random-effects model.

    Results: Seven trials involving 417 adults with prediabetes or type 2 diabetes were included in this study. Brown-rice diet did not improve the glycemic control because it had no effect on the HbA1c level (p = 0.15) and the FBG level (p = 0.95) compared to white-rice diet. Brown-rice diet reduced body weight (p 

  4. Yusoff MS, Abdul Rahim AF, Yaacob MJ
    Malays J Med Sci, 2010 Jan;17(1):30-7.
    PMID: 22135523 MyJurnal
    Being in medical school has always been regarded as highly stressful. Excessive stress causes physical and mental health problems. Persistent stress can impair students' academic achievement and personal or professional development. The aim of this study is to explore the nature of stress among medical students by determining the prevalence, sources and pattern of stress and the factors affecting it.
  5. Rahim AF, Hitam WH, Alwi MN, Ghazali G, Rahim SZ
    Malays J Med Sci, 2000 Jul;7(2):9-12.
    PMID: 22977384
    To aid future curriculum revision and planning, a batch of newly graduated medical students were surveyed using a questionnaire containing items representing possible areas of concern during house-officership. Students rated items representing communication issues as areas of concern. They did not agree that areas concerning responsibilities as a doctor, continuing medical education, theoretical and practical skills and potentially stressful working conditions were problem areas. Communication skills should remain among the priority areas for undergraduate training. Students should also be given more information about the house-officership period prior to graduation. Further study is needed to confirm perceived strengths of the USM curriculum suggested by the study, which are skills in finding resources for further learning and skills in leadership. A task-analysis of the house-officership period is also needed.
  6. Yusoff MS, Esa AR, Mat Pa MN, Mey SC, Aziz RA, Abdul Rahim AF
    Educ Health (Abingdon), 2013 Jan-Apr;26(1):39-47.
    PMID: 23823672 DOI: 10.4103/1357-6283.112800
    CONTEXT: There is considerable evidence that emotional intelligence, previous academic achievement (i.e. cumulative grade point average (GPA)) and personality are associated with success in various occupational settings. This study evaluated the relationships of these variables with psychological health of first year medical students during stressful periods.
    METHODS: A 1-year prospective study was done with students accepted into the School of Medical Sciences, Universiti Sains Malaysia. Information on emotional intelligence, GPA and personality traits were obtained prior to admission. The validated Universiti Sains Malaysia Emotional Quotient Inventory and Universiti Sains Malaysia Personality Inventory were used to measure emotional intelligence and personality traits, respectively. Stress, anxiety and depression were measured by the 21-item Depression Anxiety Stress Scale during the end-of-course (time 1) and final (time 2) examinations.
    RESULTS: At the less stressful period (time 1), stress level was associated with agreeableness and the final GPA, anxiety level was associated with emotional control and emotional conscientiousness and depression level was associated with the final GPA and extraversion. At the more stressful period (time 2), neuroticism associated with stress level, anxiety level was associated with neuroticism and emotional expression, and depression level was associated with neuroticism.
    CONCLUSIONS: This study found that neuroticism was the strongest associated factor of psychological health of medical students during their most stressful testing period. Various personality traits, emotional intelligence and previous academic performance were associated factors of psychological health during a less stressful period. These data suggest that early identification of medical students who are vulnerable to the stressful environment of medical schools might help them maintain psychological well-being during medical training.
  7. Yusoff MS, Abdul Rahim AF, Baba AA, Ismail SB, Mat Pa MN, Esa AR
    Psychol Health Med, 2013;18(4):420-30.
    PMID: 23140393 DOI: 10.1080/13548506.2012.740162
    Many studies have shown that the prevalence of psychological distress among medical students during medical training is higher than that in general population. A few studies have shown that the prevalence of psychological distress among medical students before the onset of medical training was similar to general population. This study aimed to investigate psychological health of medical students before and during medical training. A one-year prospective study was done on successful applicants who undergo the first year of medical training for 2010/2011 academic session. The stress, anxiety and depression were measured by the DASS-21 at five intervals; during interview (Time 0), two months (Time 1), four months (Time 2), six months (Time 3) and final examination (Time 4) of the first year medical training. The prevalence of unfavourable stress, anxiety and depression before the onset of medical training was 4.1%, 55.6% and 1.8%, respectively. The prevalence of unfavourable stress during medical training ranged between 11.8% and 19.9%. The prevalence of anxiety during medical training ranged between 41.1% and 56.7%. The prevalence of depression during medical training ranged between 12% and 30%. Mean scores of stress and depression before (Time 0) and during medical training (Time 1-4) were significantly different (p 
  8. Yusoff MS, Rahim AF, Noor AR, Yaacob NA, Hussin ZA
    Med Educ, 2009 Nov;43(11):1106.
    PMID: 19874517 DOI: 10.1111/j.1365-2923.2009.03459.x
  9. Yusoff MS, Abdul Rahim AF, Baba AA, Ismail SB, Mat Pa MN, Esa AR
    Asian J Psychiatr, 2013 Apr;6(2):128-33.
    PMID: 23466109 DOI: 10.1016/j.ajp.2012.09.012
    Many studies have reported that the prevalence of psychological distress among medical students during medical training was high. However, there are very few studies exploring on the psychological health of prospective medical students. This study aimed to determine the prevalence and associated factors for stress, anxiety and depression symptoms among the prospective medical students. A cross-sectional study was done on two cohorts of applicants to a public medical school. A total of 839 applicants were invited to participate in the study. The 21-item Depression Anxiety Stress Scale was administered to the applicants after they completed interviews. A total of 743 (92.2%) applicants took part in the study. The prevalence of moderate to extremely severe level of stress, anxiety and depression were 3.6%, 54.5% and 1.9%, respectively. Stress was significantly associated with extra-curricular activity (p<0.001) and race (p<0.001). Anxiety was associated with extra-curricular activity (p<0.001), race (p<0.001), mother education level (p=0.002) and CGPA group (p=0.034). Depression was associated with academic performance in class (p<0.001) and race (p=0.004). Prevalence of stress and depression among entering medical students was low; however prevalence of anxiety was high which could be due to worry about the interviews to enter medical course. The associated factors of psychological distress among prospective medical students were related to academic, non-academic, parent education and cultural backgrounds.
  10. Mat Pa MN, Ab Rahman A, Abdul Rahim AF, Yusoff MSB, Yaacob NA
    MyJurnal
    The community placement programme was first introduced to our medical students in 2007. The objectives of this community service programme are to enable students to explore and understand the importance of various skills such as leadership, teamwork and interest towards community services, as well as to improve their skills in those areas for becoming better students and future doctors. The first year medical students were tasked to plan, organize and implement activities in selected communities such as disabled people, orphans, neglected elderly, the poor, HIV positive single mothers and children. Amongst the activities conducted were sharing experiences and thoughts, games, donation and ‘gotong-royong’. The objective of this study was to evaluate the students’ perception on the successfulness of the community placement programme in building their professional qualities. A cross-sectional study was conducted among the first year medical students using a self-administered questionnaire. The questionnaire consists of 5 elements of professional qualities such as leadership and team work skills, interest towards community services, volunteerism and empathy. Self-reflection sessions were also held to explore the learning points gained. A total of 147 students answered the questionnaires. The students rated the overall programme as highly useful (80.6%) and as achieving the objectives (80.1%). They perceived that this programme helped them to improve their personal and professional skills such as leadership (70.0%), team work (71.4%), interest towards community services (87.1%), volunteerism (85.0%), and empathy (89.1%). Self-reflection revealed that the programme made them realize the role of doctors in a community, appreciate the spirit of teamwork and helped them to understand the need of vulnerable groups. As a conclusion, this programme was well-accepted and perceived as assisting medical students to build professional qualities to become caring and competent doctors.
  11. Wadi MM, Yusoff MSB, Taha MH, Shorbagi S, Nik Lah NAZ, Abdul Rahim AF
    BMC Med Educ, 2023 Apr 05;23(1):213.
    PMID: 37016407 DOI: 10.1186/s12909-023-04177-5
    BACKGROUND: Burnout and depression among health professions education (HPE) students continue to rise, leading to unwanted effects that ultimately jeopardise optimal medical care and patient health. Promoting the resilience of medical students is one solution to this issue. Several interventions have been implemented to foster resilience, but they focus on aspects other than the primary cause: the assessment system. The purpose of this study is to develop a framework to promote resilience in assessment planning and practice.

    METHODS: We followed the guidelines suggested by Whetten for constructing a theoretical model for framework development. There were four phases in the model development. In the first phase, different literature review methods were used, and additional students' perspectives were collected through focus group discussions. Then, using the data, we constructed the theoretical model in the second phase. In the third phase, we validated the newly developed model and its related guidelines. Finally, we performed response process validation of the model with a group of medical teachers.

    RESULTS: The developed systematic assessment resilience framework (SAR) promotes four constructs: self-control, management, engagement, and growth, through five phases of assessment: assessment experience, assessment direction, assessment preparation, examiner focus, and student reflection. Each phase contains a number of practical guidelines to promote resilience. We rigorously triangulated each approach with its theoretical foundations and evaluated it on the basis of its content and process. The model showed high levels of content and face validity.

    CONCLUSIONS: The SAR model offers a novel guideline for fostering resilience through assessment planning and practice. It includes a number of attainable and practical guidelines for enhancing resilience. In addition, it opens a new horizon for HPE students' future use of this framework in the new normal condition (post COVID 19).

  12. Hadie SNH, Abdul Manan Sulong H, Hassan A, Mohd Ismail ZI, Talip S, Abdul Rahim AF
    J Taibah Univ Med Sci, 2018 Apr;13(2):162-172.
    PMID: 31435319 DOI: 10.1016/j.jtumed.2017.11.001
    OBJECTIVE: There is a need to create a standard interactive anatomy lecture that can engage students in their learning process. This study investigated the impact of a new lecturing guideline, the Cognitive Load Theory-based Lecture Model (CLT-bLM), on students' cognitive engagement and motivation.

    METHODS: A randomised controlled trial involving 197 participants from three institutions was conducted. The control group attended a freestyle lecture on the gross anatomy of the heart, delivered by a qualified anatomist from each institution. The intervention group attended a CLT-bLM-based lecture on a similar topic, delivered by the same lecturer, three weeks thereafter. The lecturers had attended a CLT-bLM workshop that allowed them to prepare for the CLT-bLM-based lecture over the course of three weeks. The students' ratings on their cognitive engagement and internal motivation were evaluated immediately after the lecture using a validated Learners' Engagement and Motivation Questionnaire. The differences between variables were analysed and the results were triangulated with the focus group discussion findings that explored students' experience while attending the lecture.

    RESULTS: The intervention group has a significantly higher level of cognitive engagement than the control group; however, no significant difference in internal motivation score was found. In addition, the intervention group reported having a good learning experience from the lectures.

    CONCLUSION: The guideline successfully stimulated students' cognitive engagement and learning experience, which indicates a successful stimulation of students' germane resources. Stimulation of these cognitive resources is essential for successful cognitive processing, especially when learning a difficult subject such as anatomy.

  13. Wadi M, Yusoff MSB, Abdul Rahim AF, Lah NAZN
    BMC Psychol, 2022 Jan 06;10(1):8.
    PMID: 34991718 DOI: 10.1186/s40359-021-00715-2
    BACKGROUND: Medical students are vulnerable to test anxiety (TA), which impacts their professional lives and jeopardizes the optimal health care of their patients. The qualitative exploration of TA among medical students is crucial to understanding the problem. Hence, this study examined medical students' insights into TA and their suggestions on how to reduce it.

    METHODS: We conducted a phenomenological study on medical students at a public university. We utilized focus group discussions (FGDs) to investigate their experiences of TA. The FGDs were transcribed verbatim, and these transcripts were analyzed using Atlas.ti software. The thematic analysis followed the recommended guidelines.

    RESULTS: Seven FGD sessions were conducted with 45 students. Three major themes emerged: the students, their academic resources, and the examiner. Each theme comprised mutually exclusive subthemes. The "students" theme was divided into negative vs. positive thoughts and self-negligence vs. self-care, "academic recources" into heavy curriculum vs. facilitative curricular aids, and "examiner" into criticism vs. feedback and strict vs. kind approaches.

    CONCLUSION: This study provides a solid foundation for policymakers and decision makers in medical education to improve current assessment practices and student well-being. Medical students will be able to significantly alter and reduce TA if they are provided with additional psychological support and their examiners are trained on how to deal with examinees.

  14. Yusoff MS, Rahim AF, Baba AA, Ismail SB, Esa AR
    Malays J Med Sci, 2012 Jul;19(3):29-35.
    PMID: 23610547 MyJurnal
    Medical training is often regarded as a stressful period. Studies have previously found that 21.6%-50% of medical students experience significant psychological distress. The present study compared the prevalence and levels of psychological distress between 2 cohorts of first-year medical students that underwent different admission selection processes.
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