Abstract

Introduction: Continuing medical education and continuing professional development activities (CME/CPD) improve the practice of medical practitioners and allowing them to deliver quality clinical care. However, the systems that oversee CME/CPD as well as the processes around design, delivery, and accreditation vary widely across countries. This study explores the state of CME/CPD in the East and South East Asian region from the perspective of medical practitioners, and makes recommendations for improvement.

Methods: A multi-centre study was conducted across five institutions in Hong Kong, Indonesia, Malaysia, Singapore and Taiwan. The study instrument was a 28-item (27 five-point Likert scale and 1 open-ended items) validated questionnaire that focused on perceptions of the current content, processes and gaps in CME/CPD and further contextualised by educational experts from each participating site. Descriptive analysis was undertaken for quantitative data while the data from open-ended item was categorised into similar categories.

Results: A total of 867 medical practitioners participated in the study. For perceptions on current CME/CPD programme, 75.34% to 88.00% of respondents agreed that CME/CPD increased their skills and competence in providing quality clinical care. For the domain on pharmaceutical industry-supported CME/CPD, the issue of commercial influence was apparent with only 30.24%-56.92% of respondents believing that the CME/CPD in their institution was free from commercial bias. Key areas for improvement for future CME/CPD included 1) content and mode of delivery, 2) independence and funding, 3) administration, 4) location and accessibility and 5) policy and collaboration.

Conclusion: Accessible, practice-relevant content using diverse learning modalities offered by unbiased content providers and subject to transparent and rigorous accreditation processes with minimal administrative hassle are the main considerations for CME/CPD participants.

Keywords:           Medical Education, Health Profession Education, Continuing Professional Development, Continuing Medical Education, Accreditation

Abstract

Objectives: To compare the cut scores and pass/fail rates achieved by arbitrary 60% method and Hofstee method in an undergraduate year 4 end semester objective structured clinical examination (OSCE) and check the possibility of using Hofstee method of standard setting in future exams.

Method: 102 medical students of year 4 underwent a 10 station OSCE exam conducted in a state of art simulation lab in 3 cycles. The cut scores were calculated using arbitrary method aiming at 60% of task achievement and by Hofstee method. The student’s obtained scores were compared for cut scores and pass rates for individual stations and the entire exam.

Results: The arbitrary and Hofstee methods of standard setting leads to different cut scores. For the individual stations it was 60% vs 65-70% and for the overall score it was 60% vs 70%. The percentage of students failing the exam is 13.7% based on arbitrary scores and is 29.4% when Hofstee cut score is applied.

Conclusions: The two methods lead to different cut scores and students’ failure rates. Overall, Hofstee method is more appropriate for assessing competencies in an OSCE exam in medical schools as it leads to calculation of cut scores based on the difficulty level of the station/exam and the examiners expected level of performance by the students.

Keywords:          Objective Structured Clinical Examination, Standard Setting, Hofstee Method, Arbitrary Method

Abstract

Introduction: Maintenance of procedural skills is crucial for paediatric emergency medicine (PEM) physicians to provide high-quality care. A study by Lin-Martore et al. (2021) in the US identified key themes in conceptualising procedural skill maintenance (PSM), its motivations, and barriers to maintenance. However, the difference in culture brings into question the validity of their findings in other contexts. To determine its applicability specifically in an Asian context, this study aims to replicate the study at KK’s Women and Children Hospital (KKH), focusing on PEM physicians. While the findings are limited to a single hospital, they provide valuable insights into challenges encountered by PEM physicians.

Methods: A general qualitative approach was used through semi-structured interviews. Participants were recruited through email. Interviews were conducted via Zoom and subsequently de-identified and transcribed. The data was coded manually through thematic analysis, identifying key themes.

Results: Fifteen PEM physicians were interviewed. Participants conceptualised PSM through technical aspects and measured competence through objective and subjective measures. General motivation themes found the (1) desire to provide optimal patient care, (2) procedural competence as part of the identity of a PEM physician who teaches and performs procedures, and (3) desire for choice when alternatives are present. Barriers included limited time, support, and opportunities.

Conclusion: The study found that the themes from the original study are applicable in KKH, featuring SDT concepts prominently. Practical recommendations for KKH were proposed. Future research can focus on the challenges and gaps in maintaining procedural skills and develop strategies to improve PSM in PEM physicians.

Keywords:         Procedural Skill Maintenance, Singapore, Emergency Medicine, Qualitative, Paediatric Medicine

Abstract

Introduction: From the late 1960s to the present, physicians’ dress codes have been actively studied in Western countries. Until the early 21st century, patients tended to prefer a conservative dress style, such as “shirt and tie or skirt” with white coats for physicians. However, as attitudes toward dress codes have changed, knowledge regarding this issue needs to be updated. A variety of colours of scrubs are currently commonly used by medical professionals, but it is not known whether all colours are acceptable to patients. The current study sought to investigate the acceptability of various dress codes for physicians from the patients’ perspective, to inform medical education.

Methods: Outpatients and their family members at a university hospital and a small-to-medium-sized hospital were surveyed. We inquired about which of the different styles of white coats and different colours of scrubs were most desirable for male and female physicians. We used Scheffe’s paired comparison method to determine rankings.

Results: Patients and their family members expected their physicians to wear white coats rather than scrubs. Furthermore, a more traditional and formal dress code was preferred. The least preferred colour of scrubs was yellow.

Conclusion: The current results indicated that patients’ preference for a traditional, conservative appearance has not changed over time. This finding does not match current perspectives on infection prevention. Both patient preferences and infection prevention are important for informing education and gaining patient trust.

Keywords:           White Coat, Scrub Colour, Physicians’ Appearance, Medical Education, Doctor-Patient Communication

Abstract

Introduction: The Singapore Institute of Technology-University of Glasgow (SIT-UofG) Nursing Programme has traditionally taken a didactic teaching approach in the delivery of the Evidence-Based Practice (EBP) module.  A hybrid approach was introduced using Game-Based Learning (GBL) to encourage active learning through gameplay. 

Methods: A Randomised Controlled Trial (RCT) was undertaken encompassing a cohort of 100 Nursing students taking the EBP module in their first year at the Singapore Institute of Technology (SIT) in the 2021/22 academic year. The experimental group (n=27) worked through the online GBL intervention and the EBP module, while the control group (n=27) took the EBP module alone. The GBL included five Learning Quests and three case studies.

Results: High levels of satisfaction were reported by both the experimental group (n=22) and the control group (n=15) on the traditional content and delivery of the EBP module. High levels of engagement were reported by the experimental group on the GBL intervention; a one-sample statistics analysis confirming a significant level of engagement (p<0.001). A Mann-Whitney U Test, however, found no significant difference in the Continuous Assessment (CA) scores of the two groups (p=0.507 and 0.461). 

Conclusion: The introduction of GBL designed to deliver educational content directly associated with the learning outcomes increased the nursing student engagement in the EBP module. These findings and discoveries can be utilised to improve the GBL intervention to the EBP module to have a more positive impact the student CA scores and therefore on student learning.

Keywords:           Evidence-Based Teaching, Evidence-Based Practice (EBP), Nursing Education, Game-Based Learning (GBL), Teaching and Learning EBP, Nursing Students, Gamification

Abstract

Introduction: We frequently associate microbes with infection, rarely expounding on their usefulness and importance to healthy development. For humanity to leverage these microbial “super powers”, learners from all backgrounds need to appreciate their utility and consider how microbes could help solve some of the most critical problems we face. However, learners are frequently uninterested or intimidated by microbiology. The card game “No Guts No Glory” was created to engage students by piquing curiosity and encouraging informal learning to change perceptions and advocate the value of microbes to good health.

Methods: Undergraduates from various faculties in the National University of Singapore were invited to play and give feedback on accessibility, engagement and self-reported learning gains.

Results: The game was well-received across disciplinary backgrounds with positive feedback (5-point scale) on game mechanics being fun (4.17±0.63), attractive artwork (3.83±1.00) and scientific snippets (3.79±1.04), positive re-playability (3.46±0.84), player engagement for those without foundational knowledge in microbiology (3.63±1.04), and usefulness of knowledge taught (3.54±1.10). Areas for improvement evidenced from feedback included unclear instructions (2.74±0.98), limited content taught (2.76±0.93), not generating interest to attend formal microbiome classes (2.88±1.17) and not prompting lifestyle changes (1.98±1.11).

Conclusion: This pilot study provided valuable insights from the target demographic, with concrete ideas on how to improve the educational potential of “No Guts No Glory”. Findings further lay the groundwork for the design of future instruments to objectively quantify learning gains from gameplay.

Keywords:           Game-based Learning, Microbiome, Microbiology, Card Game, No Guts No Glory

I. INTRODUCTION

Risk management is a skillset that is embedded within clinical practice. Clinicians use protective equipment to safeguard themselves from pathogens carried by patients, learn de-escalation techniques to manage violent patients, and learn to ask for help. Patients of course are also at risk, because they present with illness or injury that may get worse despite our best efforts, and because there’s always a chance of iatrogenic injury or disease. Healthcare providers dedicate themselves to healing injury and illness, and to not causing further harm. In contrast, risk management is rarely considered with regards to teaching and learning, as they are not commonly understood to involve risk. When a teaching or learning experience feels risky, but we don’t think it should, then we don’t talk about it, and this can create cognitive dissonance and discourage us from engaging in teaching and learning.

I. INTRODUCTION

Neonatology is considered a ‘niche’ paediatric subspecialty. Most junior doctors posted to the department have limited prior exposure to the neonatal population, and require quick and effective training to help them function safely on the clinical floor. In recent years, postgraduate medical teaching has found the use of blended learning to be effective (Liu et al., 2016). Blended learning is defined as a combination of classroom face-time with online teaching approaches, and there is currently paucity of literature on its efficacy in ‘up-skilling’ relatively inexperienced healthcare professionals in a subspecialty setting. Hence, the aim of this study was to design and evaluate the efficacy of a blended-learning orientation programme in improving neonatal clinical knowledge and procedural skills amongst junior doctors.

I. INTRODUCTION

The COVID-19 epidemic has prompted the spread of ICT-based education, with many university classes being conducted remotely. Some education systems use asynchronous tools such as learning management systems (LMSs); others use synchronous tools such as web conference systems. This trend has affected not only lectures but also exercises among students and clinical practice. Game-based education is no exception, and classes that require direct face-to-face interaction have become difficult to implement. Escape rooms (ERs) are one example of game-based education.

I. INTRODUCTION

In preclinical years, histology, which is the study of the microscopic structures of tissue and organs, aids students in understanding the normal morphology of cell and tissue organisation in organs and differentiating their pathological changes (Hussein & Raad, 2015). The study of histology is important as it provides the fundamental basis of anatomical knowledge. Students have adapted to a new learning environment, particularly after the COVID-19 outbreak, by utilising autonomous learning strategies, including online and digital learning, as histology requires visual interpretation that is developed by continuous practice (Yohannan et al., 2019). Given this, we have created a virtual histology platform using our existing tool: the National University of Singapore – Human Anatomy Learning resOurce (NUS-HALO). NUS- HALO is an online platform with digital images and videos and has emerged as a novel tool in transforming anatomy teaching and learning. By integrating cutting-edge, high-definition histology images and relevant learning materials, the histology component of NUS-HALO offers a platform that aids students to excel in histology (Darici et al., 2021).

I. INTRODUCTION

The landscape of health profession education, particularly dental education, is evolving to equip students with essential contemporary knowledge and skills for competent dental practice. Within this context, dental materials science plays a pivotal role in undergraduate dental programs, providing the foundation for understanding the materials used in clinical dentistry. However, traditional teaching approaches relies on didactic lectures, often rendering this multidisciplinary subject seem dry and challenging (Soni et al., 2021). Students also face difficulties in grasping the practical applications of materials science in clinical dentistry within the confines of passive didactic lectures.