Does simulated training improve medical students’ knowledge on cardiac life support? A study comparing simulated versus traditional teaching at the International Medical University

Authors: Thiruselvi Subramaniam, Rosalind Chi Neo Loo, Sangeetha Poovaneswaran.

ABSTRACT

Background: At the International Medical University (IMU), a half day cardiac life support teaching session was provided to fourth year medical students which included training on the use of the defibrillator machine, how to handle cardiac or respiratory arrest and drugs used for resuscitation. A new CLS (cardiac life support) training session was introduced and increased to a one-day course where students were given practical training first, which included 5 stations (airway equipment, mega codes, drugs for resuscitation, defibrillator use and cardiac rhythm identification) , MCQ (multiple choice questions) test and a mega code (practical)assessment.

Objective: To evaluate the students’ knowledge on cardiac resuscitation after a change in the delivery of the cardiac life support training (CLS).

Methodology: Group I, consisted of 82 students taught using the traditional teaching and Group II consisted of 77 students taught using hands on simulation. The students in both groups had an online manual to read prior to the session, were given an identical written exam six months after the CLS training. Group II, however, had an online pre-test.

Results: There was a statistical difference in the final mean marks between the two groups with group II scoring higher (67.3) than group 1 (62.1). No significant marks difference was noted between male and female students for both the cohorts.

Conclusion: There is a significant difference in medical  students’ knowledge when cardiac life support is taught using simulation. IMU has adopted the new teaching method with simulated training for the cardiac life support courses with plans to implement higher fidelity and technology to the existing simulated teaching in other areas of medicine.

Keywords: basic life support (BLS), cardiac life support (CLS), cardiac resuscitation, mega codes, simulation, manikins.

Citation: IeJSME 2014 8(3): 4-8

DOI: https://doi.org/10.56026/imu.8.3.4

Can learning outcomes in cognitive domain be assessed effectively using multiple choice questions? A study in an undergraduate pharmacy curriculum

Authors: Hui Meng Er, Srinivasan Ramamurthy, Peter CK Pook.

ABSTRACT

Background: The widespread use of multiple choice questions (MCQ) in examinations is attributed to its logistical advantage and broad coverage of content within a short duration. The end-of-semester examinations for several modules in the pharmacy programme previously employed a combination of written examination tools including MCQ, short answer questions (SAQ) or essays for assessing learning outcomes in the cognitive domain. Concerns regarding assessment fatigue and subjectivity in marking have led to a review of the assessment formats in the examinations. Various types of MCQ were consequently introduced as the only assessment tool. This study was conducted to evaluate the performance of students in the examinations as a result of the change.

Methodology: Analyses were carried out on the end-of-semester examination results of two cohorts of students for each module, one based on a combination of MCQ, SAQ or essay and the other based on MCQ alone. The class means were compared, and t-test was used to determine the difference between the performances.

Results: Although the difference in the mean scores of the two groups is statistically significant in 13 of the 20 modules, the difference is less than 5% in 10 modules.

Conclusion: The findings provide evidence that wellconstructed MCQ can effectively assess cognitive skills.

Keywords: Cognitive; learning outcomes; multiple choice questions; pharmacy; written examination.

Citation: IeJSME 2014 8(3): 9-18

DOI: https://doi.org/10.56026/imu.8.3.9

Mother’s mental preparedness for pregnancy : The affecting factors and its effect on birth outcomes

Authors: Sharifah Sulaiha Syed Aznal, Chee Yoong Wong, Pamela Lee Ling Tan, Vee Vee See, Chui King Wong.

ABSTRACT

Background: Increased maternal anxiety level has been reported to have detrimental effects on the physical outcome of pregnancies such as not achieving vaginal births. This study thus aims to determine the level and factors affecting mental preparedness among mothers with normal pregnancies and its correlation with birth outcomes.

Methods: Three hundred healthy mothers above 37 weeks of gestation in the early stage of labour were assessed for their level of mental preparation before birth process and outcomes after births which include general feeling (euphoria), ability to withstand labour pain and bonding with the new born. The successfulness of vaginal birth and other data on factors affecting mental preparation were also collected.

Results: The level of mental preparedness was found good in 78% of the mothers, mainly determined by their socioeconomic status, family support and personal ability to adjust to changes. Age (p= 0.048), parity (0.00) and income (0.01) were found to influence mental preparedness significantly. Race, occupation, education level and marital status are however not significantly related. Poor mental preparedness is associated with greater pain during labour. A correlation analysis also found a positive relationship between the level of mental preparation and mental outcomes following birth in these mothers but it did not significantly influence the mode of delivery.

Conclusion: Mental preparation before birth seems to have an effect on mental outcomes of mothers following birth process. It is vital that mothers of the younger age group with no previous obstetric experience be given more attention in preparing them mentally before they face the painful birth process.

Keywords: Affecting factors, pregnancy, mental preparedness, factors, birth outcome.

Citation: IeJSME 2014 8(3): 19-27

DOI: https://doi.org/10.56026/imu.8.3.19

The chemical, heavy metal and microbial quality of well water in an urbanised village in the Klang Valley

Authors: Stephen Ambu, Stacey Foong Yee Yong, Yvonne Ai Lian Lim, Mak Joon Wah, Donald Koh Fook Chen, Soo Shen Ooi, Sau Peng Lee, Ti Myen Tan, Mei Yen Goh, Danapridha Nyanachendram.

ABSTRACT

Background: The public health issue of consuming groundwater is a major concern because people often extract groundwater directly from the aquifers either through wells or boreholes without treating it with any form of filtration system or chlorine disinfection. Based on the Malaysian National Drinking Water guidelines the current study was designed to provide a better understanding on the variable factors that are influencing the quality of well-water in an urbanised village in Malaysia. Well water quality assessment of heavy metals, chemicals, microbial and physical parameters were carried out for Sungai Buloh Village in the Klang Valley to ensure it was safe for human consumption.

Materials and Methods: Water samples were collected from wells at four sites (Sites A,B,C,D), a river and a tap inside a house in Sungai Buloh village. Soil was sampled from the riverbed and area surrounding the wells. Samples were collected every two months over a one year duration from all sites. The water samples were processed and examined for viruses, coliforms and protozoa as well as for heavy metal contaminants.

Results: The turbidity and colour ranged in the average of 0.57-0.13 Nephelometric Turbidity (NTU) and 4.16-5.00 Total Conjunctive Use (TCU) respectively for all sites except Site C. At Site C the turbidity level was 2.56 ± 1.38 NTU. The well-water was polluted with coliforms (1.2 to 2.4 x 103 CFU/100 ml) in all sites, E. coli (0.12 – 4 x 102 CFU/100 ml CFU/ 100 ml) and Cryptosporidium oocysts (0.4 cysts/100 ml). All the heavy metals and chemical parameters were within the Malaysian Guidelines’ limits except manganese. The average pH ranged from 5.44 – 6.62 and the temperature was 28 ºC.

Conclusion: In summary, the well water at Sungai Buloh is considered unsafe for consumption due to pollution. Therefore the major thrust will be to provide better quality of drinking water to the residents of the village.

Keywords: well water, microbial, heavy metal, chemical, urbanised village, public health.

Citation: IeJSME 2014 8(3): 28-44

DOI: https://doi.org/10.56026/imu.8.3.28

Paediatric use of IV magnesium sulphate in severe asthma exacerbation: Report of a case and review of literature

Author: Davendralingam Sinniah

ABSTRACT

Nebulization with B-agonist and administration of systemic corticosteroids are standard treatments for severe asthma exacerbations, but corticosteroids take several hours to become effective. IV magnesium sulphate (MgSO4) acts faster and has both antiinflammatory and bronchodilating properties. It appears to have played a pivotal role in the successful management of a child with severe asthma exacerbation and atelectasis unresponsive to conventional therapy. A literature review reveals that the results of IV MgSO4 are much greater in children than in adults, and can avoid the need to hospitalize 25% of children presenting with severe asthma. Magnesium sulphate appears safe to use.

Keywords: intravenous magnesium sulphate, asthma exacerbation, pulmonary atelectasis.

Citation: IeJSME 2014 8(3): 45-48

DOI: https://doi.org/10.56026/imu.8.3.45