Author: Pei Kuan Lai

Mentoring in the clinical setting: Process, issues and challenges

Posted Pei Kuan LaiPosted in Review Articles

Author: Sivalingam Nalliah

ABSTRACT

Mentoring in academic medicine requires the trained mentor to commit time, purpose and dedication for the personal and professional development of three categories of protégés or mentees i.e. medical students, the clinician-trainee and the clinical-educator. Conventionally, assigned mentors monitor the progress of the first two categories of personnel as their career pathway is clearly defined. On the other hand the clinician–educator in academic medicine could be a scientist or a career clinician expected to contribute to medical education activities and research. The clinician-educator has grown in complexity as he multitasks in providing clinical care, assists in delivering the medical curriculum and is expected to do research and publish. Although there is dearth of research in mentoring the clinician-educator, it is clear that mentored clinical-educators are more productive by way of scientific publications. Trained mentors are expected to identify the needs of the mentee with regards to the level of his career development and his aptitude to move up the academic ladder, successfully nurturing the maturation process. Processes of mentoring in the clinical setting, attributes of the successful mentor and facilitating the mentee in overcoming challenges in academic medicine are discussed.

Keywords: Mentor, clinician-educator, clinical setting.

Citation: IeJSME 2012 : 6(1) 4-10

DOI: https://doi.org/10.56026/imu.6.1.4

Mentorship in the research setting

Posted Pei Kuan LaiPosted in Review Articles

Author: Joon-Wah Mak

ABSTRACT

The research mentorship programme is unique in that it is a planned journey undertaken by the mentor and mentee, preferably with well-defined milestones along the journey. During the journey, familiar landmarks will be pointed out by the mentor. In path-finding situations the experience and wisdom of the mentor and the critical appraisal of both mentor and mentee will contribute to learning from the encounter. In most mentor-mentee partnerships, a formal acceptance to the relationship, well-defined landmarks measuring progress in the journey, regular appraisal of the skills developed and acquired, and phased, judicious modification in the individual roles of that relationship will be required. Although there is no consensus on the elements of mentorship, there are some strategies which can contribute to the success of the relationship. Critical success factors include convergence of the research area within the broad expertise of the research mentor. The research mentor should have a proven research track record and is committed to serve in that official capacity. The research mentoring process is dynamic and characteristics of both mentor and mentee contribute to the robustness of that relationship. The mentee would have identified some attributes of the mentor that are desirable and is willing to work hard to achieve, build on, and improve upon. In the research setting endpoint measurements of success will be based on recognition of the research standing of the mentee, measurable outcomes such as number of papers in top tier journals, citation indices, etc. consultancies attracted as well as invitations to deliver plenaries in scientific conferences, patents filed and research findings translated and applied, and other measures of research productivity. In the pursuit of research excellence the mentee would have imbibed values of professionalism and ethics in research and would have constantly kept in mind that to be successful, the mentee would be able to excel beyond his mentor and that the next generation of researchers will seek mentorship from him.

Keywords: Research mentors, endpoint measurements, successful mentorship.

Citation: IeJSME 2012 : 6(1) 11-14

DOI: https://doi.org/10.56026/imu.6.1.11

Reflective writing in case summary assignments

Posted Pei Kuan LaiPosted in Review Articles

Authors: Kathiravan Chinniah, Sivalingam Nalliah.

ABSTRACT

Outcome and competency-based undergraduate and graduate medical education is the desired standard embraced by many medical educationists worldwide. Reflective capacity is an integral component of that strategy and reflective writing has shown tremendous potential as a delivery tool. But there are various challenges in the implementation of the initiative. Efficacy as a delivery tool, achievement of pedagogical outcomes, reliability issues, challenges in assessment outcomes/tools, and whether it can be taught and learnt, need to be addressed. Many questions are still not satisfactorily answered, and this review attempts to offer some perspective on the issues.

Keywords: Reflective writing, outcome-based education, reflective capacity.

Citation: IeJSME 2012 : 6(1) 15-20

DOI: https://doi.org/10.56026/imu.6.1.15

Using a Facebook Group for interactive clinical learning

Posted Pei Kuan LaiPosted in Original Article

Author: Velayudhan Menon

ABSTRACT

Background: Facebook is a popular social networking site with more than five hundred million users. This study assessed whether Facebook Groups can be used to teach clinical reasoning skills.

Methods: Sixty-seven final year medical students from the International Medical University, Malaysia, were exposed to interactive online learning through a Facebook Group for a period of six months in this study. The purpose was to determine if supervised interactive online learning could be used to augment the deep learning that comes from learning medicine at the bedside of patients. The interactive online discussions were entirely triggered by clinical problems encountered in the medical wards of the general hospital to which these students were attached.

Results: A total of 10 topics were discussed in this forum during the duration of this study and an example of one such discussion is provided to illustrate the informal nature of this kind of learning. The results showed a high degree of student involvement with 76 percent of students actively participating in the discussions.

Conclusion: The high degree of voluntary participation in the clinical discussions through the Facebook Group in this study tells us that Facebook Groups are a good way of engaging students for learning and can be used in medical education to stimulate creative clinical thinking.

Keywords: e-learning, interactive learning, online learning, medical students.

Citation: IeJSME 2012 : 6(1) 21-23

DOI: https://doi.org/10.56026/imu.6.1.21

Risk factors of peripheral venous catheterization thrombophlebitis

Posted Pei Kuan LaiPosted in Original Article

Authors: Wilkinson Yoong Jian Tan, Jo Wearn Yeap, Sharifah Sulaiha Syed Aznal.

ABSTRACT

Background: Peripheral venous catheterisation is indispensable in modern practise of medicine. The indications of venous access should be weighed against the risk of complications, the commonest being thrombophlebitis. Thrombophlebitis causes patient discomfort and the need for new catheter insertion and risk of developing further widespread infections.

Methodology: This observational study was conducted on adult patients admitted to the surgical and medical ward of a tertiary hospital in Negeri Sembilan Malaysia in 2011. Four researchers visited patients daily and examined for signs of thrombophlebitis; warmth, erythema, swelling, tenderness or a palpable venous cord. Risks factors that were studied in this research were patient/s age and gender, duration of catheterization, use of catheter for infusion, size of catheter, site of catheter insertion and types of infusate. Thrombophlebitis was graded using a scale adapted from Bhandari et al. (1979).

Results: In total, 428 patients were recruited with an incidence rate of thrombophlebitis of 35.2%. Among those who developed thrombophlebitis, 65% had mild thrombophlebitis, 19% moderate and 8% severe thrombophlebitis. Results showed that female patients had a significant increased risk of developing thrombophlebitis. Also risk increased significantly with increased duration of catheterization and usage of the catheter for infusion. The age of a patient, types of infusate use, size of catheter and site of catheter insertion did not significantly influence the development of thrombophlebitis.

Conclusion: The study showed that risk of developing thrombophlebitis is significantly increased among female patients, and also with increased duration of catheterization and use of the peripheral venous catheter for infusion. We recommended elective replacement of catheter every 72 hours and daily examination of catheters for signs of thrombophlebitis by a healthcare personnel.

Keywords: Thrombophlebitis, Catheter, Catheter-Related Infections, Intravenous Infusions, Patient Care.

Citation: IeJSME 2012 : 6(1) 24-30

DOI: https://doi.org/10.56026/imu.6.1.24

Concept of professional socialization in nursing

Posted Pei Kuan LaiPosted in Research Note

Authors: Pei Kuan Lai, Pek Hong Lim.

ABSTRACT

Each nursing student comes to nursing with a lay image of nursing portrayed by nurses they have seen. This lay perception of nursing that a nursing student holds is transformed to a more professional understanding that is acquired in nursing schools. This process is known as professional socialization. It is a process of learning the norms, attitudes, behaviours, skills, roles, and values of the profession. It involves the internalization of the values and norms of the profession in the individual’s own behaviour and self-concept. The ultimate goal of professional socialization is to internalize a professional identity of the profession. Professional socialization sets in to reduce the tension from the scenario of reality shock and facilitate adaptation during the transition process. This paper serves as a concept paper with the main purpose of introducing and explaining the concept of professional socialization in nursing to help the readers in gaining further understanding of the concept, especially within the local context. The first author has also incorporated her own personal reflections with regards to her socialization process to nursing.

Keywords: Nurse, nursing education, profession, values, socialization.

Citation: IeJSME 2012 : 6(1) 31-35

DOI: https://doi.org/10.56026/imu.6.1.31

Evaluating a weekly face-to-face informal discussion forum for final year medical students

Posted Pei Kuan LaiPosted in Research Note

Authors: Samuel Easaw, Toh Peng Yeow, Li Ching Lee, Wai Sun Choo, Tow Shung Tan, Amir Sharifuddin Mohd Khir, Li Cher Loh.

ABSTRACT

Realising possible unmet needs of final year medical students we initiated a weekly informal face-to-face discussion forum between them and the teaching faculty of the department of medicine. Various academic and non-academic topics, as dictated by the students, were discussed in 19 weekly sessions. Evaluation by the students was subsequently done by means of an on-line questionnaire after the final examinations. The aim of this study was to evaluate this forum, undertaken for the first time in our institution, by assessing student feedback. We conclude that although the number of attendees and responders were small, feedback was generally positive. This type of forum can be improved upon and serve as another portal for benefitting students.

Keywords: medical students, unmet needs, academic and non-academic topics, informal face-to-face discussion.

Citation: IeJSME 2012 : 6(1) 36-37

DOI: https://doi.org/10.56026/imu.6.1.36

Omega-6 and omega-3 fatty acid nutrition amongst Malaysians are far from desirable

Posted Pei Kuan LaiPosted in Review Articles

Authors: Tony Kock Wai Ng, Sivalingam Nalliah, Azlinda Hamid, Siew Rong Wong, Sim Ling Chee, Cheryl Andrea Augustine.

ABSTRACT

This paper reviews available reports on the omega-6 (linoleic acid, LA) and omega-3 fatty acid [alpha-linolenic acid (ALA) + eicosapentaenoic acid (EPA) + docosahexaenoic acid) intakes amongst Malaysians against Malaysian Recommended Nutrient Intakes (RNI), focussing particularly on pregnant and lactating women because of the availability of data for these latter vulnerable groups. Overall, the omega-6 and omega-3 fatty acid nutrition amongst Malaysians are poor and far from desirable. The nutritional situation regarding these long-chain polyunsaturated fatty acids (LCPUFA) amongst Malaysian pregnant and lactating women is alarming and warrants urgent attention in nutrition promotion activities/counselling. Daily consumption of LA by these women and other Malaysians studied ranged from 3.69 – 5.61 % kcal with 38-60% of individuals not meeting their RNIs. Daily intakes of omega-3 fatty acids faired worse, averaging 0.21-0.33% kcal with as high as 92% of subjects in one study not meeting their RNIs. The omega-6 to omega-3 fatty acid ratios obtained in the studies reviewed are about 20:1, which is way above the World Health Organisation-recommended ratio of 5-10:1. Dietary sources of these omega- fatty acids in the subjects studied are chicken, fish and milk. Since local foods are not particularly rich in LCPUFA such as EPA and DHA, the options to improve EPA/DHA nutrition amongst Malaysians are the greater consumption of omega-3 enriched foods and in the case of pregnant and lactating women, LCPUFA supplementation may warrant serious consideration.

Keywords: Omega-6 and omega-3 fatty acids, Malaysians intake.

Citation: IeJSME 2012 6(2): 4-9

DOI: https://doi.org/10.56026/imu.6.2.4

The influence of admission qualifications on the performance of first and second year medical students at the International Medical University

Posted Pei Kuan LaiPosted in Original Article

Authors: Ammu Kutty Radhakrishnan, Nagarajah Lee, Mei-Ling Young.

ABSTRACT

Background: Medical schools have long been concerned with establishing a suitable process of admission. The criteria used to select students have traditionally focussed on high academic achievement.

Method: The International Medical University (IMU) accepts students from a wide range of pre-university entry qualifications for admission into the medical programme. The criteria for the various pre-university entry qualifications used by the IMU were agreed and accepted by the IMU Academic Council (AC), which consist of deans of the IMU’s partner medical schools (PMS). In this study, the various entry qualifications were first grouped into five categories based on the educational pedagogy. Then, this was aligned with the entry qualification data of all students who had been admitted into the IMU medical programme for the period of December 1993 to March 2000. During this period 1,281 students were enrolled into the IMU medical programme. The relationship between the five groups of pre-university entry qualifications and the students’ academic achievement in three end-of-semester (EOS) examinations namely EOS 1, EOS 3, and EOS 5 were analysed.

Results: Students with better grades in their pre-university examinations showed better performance in their EOS examinations, regardless of the subjects that they took at the pre-university level. Cluster analysis revealed that students who came in with certain pre-university qualifications generally performed poorly than the more conventional qualifications. However, after their first year in medical school, there were no significant differences in the clustering of the students.

Conclusion: Students with better grades in their pre-university examinations showed better performance in their EOS examinations, regardless of the science subjects that they took at the pre-university level.

Keywords: pre-university, entry qualifications, examinations, criteria for entry.

Citation: IeJSME 2012 6(2): 10-17

DOI: https://doi.org/10.56026/imu.6.2.10