MyMedR

Displaying all 4 publications

Abstract:

Sort:

Fulltext Perception of the usability and implementation of a metacognitive mnemonic to check cognitive errors in clinical setting

Chew KS, van Merrienboer JJG, Durning SJ

BMC Med Educ, 2019 Jan 10;19(1):18.
PMID: 30630472 DOI: 10.1186/s12909-018-1451-4

BACKGROUND: Establishing a diagnosis is a complex, iterative process involving patient data gathering, integration and interpretation. Premature closure is a fallacious cognitive tendency of closing the diagnostic process before sufficient data have been gathered. A proposed strategy to minimize premature closure is the use of a checklist to trigger metacognition (the process of monitoring one's own thinking). A number of studies have suggested the effectiveness of this strategy in classroom settings. This qualitative study examined the perception of usability of a metacognitive mnemonic checklist called TWED checklist (where the letter "T = Threat", "W = What if I am wrong? What else?", "E = Evidence" and "D = Dispositional influence") in a real clinical setting.
METHOD: Two categories of participants, i.e., medical doctors (n = 11) and final year medical students (Group 1, n = 5; Group 2, n = 10) participated in four separate focus group discussions. Nielsen's 5 dimensions of usability (i.e. learnability, effectiveness, memorability, errors, and satisfaction) and Pentland's narrative network were adapted as the framework to study the usability and the implementation of the checklist in a real clinical setting respectively.
RESULTS: Both categories (medical doctors and medical students) of participants found that the TWED checklist was easy to learn and effective in promoting metacognition. For medical student participants, items "T" and "W" were believed to be the two most useful aspects of the checklist, whereas for the doctor participants, it was item "D". Regarding its implementation, item "T" was applied iteratively, items "W" and "E" were applied when the outcomes did not turn out as expected, and item "D" was applied infrequently. The one checkpoint where all four items were applied was after the initial history taking and physical examination had been performed to generate the initial clinical impression.
CONCLUSION: A metacognitive checklist aimed to check cognitive errors may be a useful tool that can be implemented in the real clinical setting.

Matched MeSH terms: Prejudice/psychology*
Fulltext Beliefs and attitudes of medical students from public and private universities in Malaysia towards individuals with HIV/AIDS

Koh KC, Teh JR, Khan SA

ScientificWorldJournal, 2013;2013:462826.
PMID: 24285935 DOI: 10.1155/2013/462826

We describe the findings from a survey assessing the beliefs regarding testing, confidentiality, disclosure, and environment of care and attitudes towards care of people with HIV/AIDS (PLHWA), in 1020, 4th and 5th year medical students, from public and private medical universities in Malaysia. A self-administered validated questionnaire based on the UNAIDS Model Questionnaire with a 5-point Likert scale (5, strongly disagree; 4, disagree; 3, neutral; 2, agree; 1, strongly agree) was used as a survey tool. The survey included demographic data and data on undergraduate training received on HIV/AIDS. Statistical significance in the demographic data and training received by respondents was evaluated using the chi-square test while the independent Student's t-test was used for comparison of means between public and private universities. A P value of <0.05 was considered statistically significant with 95% confidence interval. Our study revealed less than 20% of medical students received adequate training to care for PLHWA. They had prevalent negative beliefs regarding testing, confidentiality, disclosure and environment of care towards PLHWA although in giving care to PLHWA, their attitudes were largely positive and nondiscriminatory.
Study site: 7 public and private universities in Malaysia

Matched MeSH terms: Prejudice/psychology
Prevalence and factors associated with HIV/AIDS-related stigma and discriminatory attitudes: a cross-sectional nationwide study

Wong LP

Prev Med, 2013;57 Suppl:S60-3.
PMID: 23583477 DOI: 10.1016/j.ypmed.2013.03.013

OBJECTIVE: The prime purpose of this study is to assess HIV/AIDS-related self-stigma and discrimination (S&D) attitudes and associated factors using multivariate analysis of data from the 2010-11 National Survey of Understanding the Root of HIV/AIDS Related Stigma and Discrimination.
METHOD: A national telephone survey was carried out with 2271 of the Malaysian public aged 18-60 years. The sample was contacted by random digit dialing covering the whole of Peninsular Malaysia from December 2010 to May 2011. The HIV-transmission knowledge, HIV-related self-stigma, and public stigma were investigated.
RESULTS: Despite high level of HIV-transmission knowledge [mean (SD)=10.56 (2.42), mean score at 70th percentile] the respondents in this study had moderate levels (mean scores near midpoints) of self-stigma and public stigma attitudes. HIV-transmission knowledge score was not significantly correlated with self-stigma score, but showed a significantly small positive effect (r<0.2) for public stigma scores. Ethnicity is the strongest correlate of HIV-transmission knowledge, self-stigma, and public stigma attitudes in the multivariate analyses. Other significant correlates were age, socioeconomic group, and urban-rural setting.
CONCLUSIONS: The root causes of HIV stigma and discriminatory attitudes were not associated with knowledge deficiency. Interventions should be oriented towards promoting de-stigmatization of HIV/AIDS, and tailored socio-culturally.
KEYWORDS: Discriminatory; HIV/AIDS; Knowledge; Stigma

Matched MeSH terms: Prejudice/psychology
Fulltext Multi-ethnic perspective of uptake of HIV testing and HIV-related stigma: a cross-sectional population-based study

Wong LP

AIDS Care, 2013;25(11):1356-69.
PMID: 23406514 DOI: 10.1080/09540121.2013.766302

The objective of this study was to identify demographic characteristics and correlates of the uptake of HIV testing, willingness to be tested and perceived HIV-related stigma of Malaysian lay public. A cross-sectional computer-assisted telephone interview survey of a representative sample of multiracial Malaysians aged 18 years and above was conducted between December and July 2011. The survey collected information on demographics, knowledge about HIV transmission and religious beliefs on attitudes to HIV/AIDS. A total of 2271 households were successfully interviewed. The response rate was 48.65%. The HIV transmission knowledge score ranged from 0 to 15 (mean =10.56; SD±2.42). Three of the most common misconceptions about HIV transmission were mosquito bite (42.8%), eating in a restaurant where the cook is HIV positive (20.4%) and using a public toilet (20.1%). Only 20.6% reported ever having been tested for HIV, 49.1% reported a willingness to be tested for HIV and 30.3% had no intention of getting an HIV test. Low-risk perception (63.7%) constitutes a major barrier to HIV testing. Being Malay and Chinese (relative to Indian) were the strongest predictors of low-risk perception. Other significant predictors of low-risk perception were being male, being married and living in an urban locality. Perceived self-stigma if tested positive for HIV was prevalent (78.8%). Multivariate findings showed that being female, Malay, low income, living in rural localities and public stigma were significant correlates of self-stigma. These findings warrant interventions to reduce the disproportionate HIV transmission misconception, barriers to HIV testing and stigma and discriminative attitudes to involve considerations of sociocultural economic and demographic characteristics.

Matched MeSH terms: Prejudice/psychology