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  1. Fulltext Students’ feedback on effectiveness of combined flipped classroom and high fidelity simulated teaching on airway and ventilation during accident and emergency posting
    Subramaniam T, Valuyeetham PS, Tay JS
    Education in Medicine Journal, 2018;10(2):5-13.
    MyJurnal DOI: 10.21315/eimj2018.10.2.2
    Simulation-based medical education enables knowledge, skills and attitudes to be taught in a safe,
    realistic manner. Flipped classroom teaching encourages self-learning. Emergency medicine exposes
    students to diverse group of patients and physicians’ decision making. This study aims to determine
    students’ perception on knowledge, skills and confidence after combined flipped classroom and
    simulated teaching. Two cohorts of Semester 7 students Group 1 (n = 120) and Group 2 (n = 78)
    completed a 5-point Likert scale questionnaire. Group 1 completed the questionnaire after a lapse
    of six months while Group 2 at the end the posting. Responses from both cohorts were compared
    using the Mann-Whitney U test. Of 198 (Groups 1 and 2) students, 91.41% (n = 181) felt the
    simulated sessions helped better understand care of emergency patients. The sessions helped identify
    knowledge gaps (89.90%; n = 178), improve knowledge and understanding of oxygen therapy devices
    (85.35%; n = 169), and airway equipment (90.91%; n = 180). They prepared better for the flipped
    classroom teaching than traditional sessions (80.81%; n = 160). They felt that their communication
    skills (82.32%; n = 163) and confidence (63.64%; n = 126) improved. Significant differences noted
    to questions (p = 0.006, p = 0.005, p = 0.041 respectively) targeting knowledge on oxygen therapy
    devices, confidence, and identification of gaps in knowledge respectively. Combined simulation and
    flipped classroom teaching was well received by students though this requires more preparation.
  2. Empathy amongst doctors: an observational study
    Subramaniam TS, Valuyeetham PS, Kamaru Ambu V
    Med J Malaysia, 2023 May;78(3):344-349.
    PMID: 37271844
    INTRODUCTION: Empathy is the ability to put oneself in another's emotional space and experience what they feel. Either due to lack of experience or mundaness of practice, a state of empathy can become premised, and individuals become indifferent or detached. We aimed to explore the level of empathy among doctors at different levels of practice, age, gender, academics, non-academics and discipline.

    MATERIALS AND METHODS: This was a cross-sectional, observational study on empathy among doctors practicing in the private, public hospital sector and faculty at a medical university in Negeri Sembilan, Malaysia that utilised convenience sampling for data collection. The Toronto Empathy Questionnaire (TEQ) a validated tool was used to measure empathy.

    RESULTS: The questionnaire was completed by 127 doctors, 52% (n= 66) were males and 48% (n=61) females. There was no significant difference in empathy between male (M=46.44; SD=6.01) and female (M=45.05, SD=5.69) doctors; t (123) = 1.326, p=0.187. Pearson correlation coefficient was computed to assess the linear relationship between age and empathy and revealed no correlation between the two variables: r (125) =0.15, p=0.099. Medical-based doctors (M= 47.47, SD=5.98) demonstrated more empathy than surgicalbased (M=44.32, SD=5.41); t (123) =-3.09, p=0.002. Those already specialised in their fields (M=47.38, SD=4.57) had more empathy than those who had not (M= 44.36, SD=6.52); t (123) =-2.96, p = 0.004. Doctors in the university (M=47.97, SD=4.31) tended to have more empathy than those in the public hospitals (M= 44.63, SD=6.27); t (117) =-2.91, p=0.004. Academicians had more empathy than non-academicians but there was no difference between those who were in clinical practice and not.

    CONCLUSION: Our findings indicate that medical-based doctors demonstrate more empathy than surgical-based doctors, and there appeared to be no correlation between age and empathy. However, clinical experience and growth within the specialty seem to improve empathy. Doctors teaching in the university setting demonstrated more empathy than those practicing in the hospital setting. Inclusion of empathy-related sessions in the undergraduate and post-graduate curriculum could bridge the gap in empathy noted with age, discipline, and experience in practice. Further research on empathy among doctors using a wider population in Malaysia and a TEQ questionnaire validated to the Asian population would provide better insight regarding this area of medical practice. Future research on outcomes of inclusion of programmes targeted at improving empathy to create awareness during practice would support patient satisfaction and safety.

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