Malaysian Medical School Research Articles

Medical students’ perception on their educational environment by using Dundee Ready Educational Environment Measure at a Malaysian medical school

Background Optimal educational environment in medical school has been shown to have desirable effects on medical students. In providing this environment, the input from medical students is proven to be a necessity. Objectives: The objective of this study is to obtain the perception of preclinical and clinical students on their current educational environment. Methods A cross-sectional study using self-administered Dundee Ready Education Environment Measure (DREEM) questionnaire was conducted among medical students in UiTM to measure their perception on educational environment. DREEM consisted of 50 items grouped into five subscales which addressed different aspects of educational environment: students’ perception of learning (SPoL), teachers (SPoT), atmosphere (SPoA), academic self-perception (SASP) and social self-perception (SSSP). Results A total of 894 out of 1165 students completed the questionnaire. The overall mean score of DREEM was described as more positive than negative (mean score: 131.81/200), with significant difference between pre-clinical and clinical students in SPoL and SSSP subscales. SPoL was interpreted as having a more positive perception (mean score: 33.06/48), SPoT as moving in the right direction (mean score: 30.11/44), SASP as feeling more on the positive side (mean score: 20.75/32), SPoA as having a more positive attitude (mean score: 30.72/58, and SSSP as not too bad (mean score: 17.17/28). Educators were perceived as being knowledgeable, encouraging students to participate, and wellprepared for class. Students also perceived that they have good friends, learnt a lot on empathy and the knowledge taught was relevant for future career. All students perceived that educators were authoritarian, overemphasized on factual learning, and they were unable to memorise all. Clinical students viewed educators to be angry in class, too tired to enjoy the course, stressful and lonely. Conclusion In conclusion, the educational environment was viewed positively by the students with clinical students having more areas of concern when compared to pre-clinical students. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1168-1177

Path Analysis of Factors Influencing Multiple Intelligences of Malaysian Medical Students: A Multi-institutional Study

The Multiple Intelligences (MI) Theory by Howard Gardner emphasises that individuals have a unique blend of “capabilities” (“intelligences”), differing significantly from the traditional concept of intelligence measured by conventional intelligence quotient (IQ) tests. This cross-sectional, multiinstitutional study aimed to compare the MI of medical students from three Malaysian medical schools, investigate the effects of demographic factors on the MI of students with diverse cultural and socio-economic backgrounds, and examine the effects of MI on academic performance. The MI Inventory was used to assess the MI of medical students. Path analysis was carried out using the SmartPLS software version 2.0. Inter-institutional differences in MI were observed among the students. University A students (53.51 ± 21.99) scored significantly higher than University B students (46.70 ± 20.34) in the naturalist domain (p = 0.05). University A students also scored significantly higher (58.35 ± 21.30) than University B (50.26 ± 19.49; p = 0.014) and University C students (46.90 ± 21.58; p = 0.008) in the musical/rhythmic domain. In the verbal/linguistic domain, University A students (47.94 ± 21.06) scored significantly higher than University C students (39.05 ± 19.23; p = 0.05). Path analysis highlighted a statistically significant effect of family income on the musical intelligence (β = 0.220, t = 2.005, p < 0.05), a domain closely related to verbal/linguistic intelligence. Students from all three medical schools consistently achieved the lowest score in the verbal/linguistic domain and the highest score in the intrapersonal intelligence domain. These findings suggest the need for interventions to enhance language proficiency among medical students. Emphasising MI would make medical education more comprehensive, ultimately enhancing learning in their academic pursuit.

A Study Protocol on Disaster Medicine Preparedness among Medical Students in a Public Military Medical School in Malaysia: Assessment of Knowledge, Attitude and Readiness to Practice

Disaster preparedness is defined as the measures taken to prepare for or decrease the impact of disaster. Medical students’ perception on disaster preparedness provides further insights into their learning needs, strengthens the disaster medicine curriculum, and improves their personal professional development. There is scarce information regarding this topic and disaster medicine education is scattered in the current medical curriculum. The aim of this study is to assess the knowledge (K), attitude (A) and readiness to practice (rP) towards disaster preparedness among medical students in a military university. A cross-sectional study will be conducted among all the medical students in Universiti Pertahanan Nasional Malaysia using a self-administered validated questionnaire via a Google Forms. The calculated minimum sample size is 176 using the twoproportion formula via Power and Sample Size (PS) software. The questionnaire consists of (a) demographic data; (b) knowledge of disaster; (c) attitude; (d) readiness to practice with responses categorised as high, moderate and low. Independent t-test and chi-square test are used to evaluate the bivariate association between demographic data with K, A and rP. Multiple linear regression is used to evaluate association of rP based on predictor variables (K, A and sociodemographic factors). A preliminary result of the study will be presented in conferences and scientific meetings. This research contributes valuable insights to the field of disaster medicine education, guiding curriculum development, and informing policy decisions within institutions.

Post-Pandemic Evaluation: Impact of Covid-19 Pandemic on Medical Students’ Mental Health, Self-Esteem, Social Interactions, and Academic Progression in Malaysia

Covid-19 pandemic has brought drastic and unprecedented challenges to the medical education and medical students, affecting them physically, mentally and emotionally. While progressing through the post-pandemic recovery phase, it is crucial to comprehensively evaluate the pandemic’s consequences and tackle the underlying problems. To investigate the impact of Covid-19 pandemic on medical students’ mental health, social well-being, and academic progression. A cross-sectional study was carried out with voluntary sampling of students from both government and private medical schools in Malaysia. A self-administered online survey form containing three validated psychological tools was distributed (Hospital Anxiety and Depression Scale HADS, Rosenberg Self-esteem Scale, NIH Toolbox Social Relationship Scales). There were also questions regarding the challenges faced by medical students and their academic performance during Covid-19 pandemic. Scores of each questionnaire were tabulated, analyzed and interpreted according to their specific cut-points. Two hundred and thirteen responses were received. 89.2% (n = 190) were domestic students while 10.8% (n = 23) were international students. Out of 32 medical universities in Malaysia, the participants were from 19 of them (9 public and 10 private universities). About half of the participants had contracted Covid-19 infection during the study period (n = 124, 58.2%). Majority had chosen “Lack of on-campus learning and training session causing incompetency” as the most relevant impact of Covid-19 on their academic progression (n = 85, 39.9%). Above 90% of participants passed their Final Academic Assessment in 2020 (91.5%) and 2021 (93.9%). About half of them (n = 86, 40.4%) were having symptoms considerable of anxiety while only 19.2% (n = 41) were having symptoms considerable of depression. Majority had normal self-esteem (n = 177, 83.1%). For social relationship, around two-third of them had great social support and companionship. However, more than half had social distress. The median for the period of time having absolute online classes, absolute physical classes and hybrid classes were 18, 4, and 9 months, respectively. Having absolute online classes of >18 months was associated significantly with higher perceived hostility (16.49vs. 14.47, p = .012). In addition, being infected with Covid-19 was associated significantly with higher self-esteem (26.88vs. 25.85, p = .009). Large proportion of students were affected by Covid-19 pandemic. Absolute online classes has huge impact on emotions of medical students especially from the aspect of perceived hostility. Hence, implementation of online medical education during Covid-19 era requires modifications and improvements.

Nascent Entrepreneurial Behaviour Among Medical Students in Malaysia: The Role of Sociodemographic Factors

Entrepreneurship is a viable option for young doctors looking for careers beyond patient care. Nascent entrepreneurial behaviour is said to predict future entrepreneurship. To understand whether medical students possess an entrepreneurial spirit, this research aimed to assess nascent entrepreneurial behaviour among students at a private medical school in Malaysia and the sociodemographic factors influencing it. A quantitative approach with a cross-sectional survey design was employed. The data were collected from 318 medical students selected by a disproportionate stratified random sampling technique. The respondents rated their nascent entrepreneurial behaviour on a 13-item selfadministered questionnaire. The responses obtained were analysed using descriptive and inferential statistical tests. Medical students in Malaysia showed moderately low levels of nascent entrepreneurial behaviour. Among the sociodemographic factors, gender and marital status significantly influenced nascent entrepreneurial behaviour among the medical students. The year of study, ethnicity and family income were insignificant. The low level of nascent entrepreneurial behaviour among medical students in Malaysia implies that they are likelier to be job seekers than job creators. Therefore, higher education institutions across the globe need to foster entrepreneurial values in all students, irrespective of their chosen field of study. An understanding of the sociodemographic factors that influence nascent entrepreneurial behaviour will help policymakers plan remedial steps to inculcate an entrepreneurial mindset among medical students.

Journey of an International Psychiatrist to the UK

Medicine is a global profession and doctors from the time recorded history began, have migrated between different parts of the globe bringing with them not only knowledge of different diseases and treatments but also culture and language, enriching their adopted lands as well as building bridges across nations and people. Due to the British Empire reaching across the globe, many countries that were previous dominions and are now part of the Commonwealth, share the legacy of language, culture and the British way of life. So, institutions of learning in many countries across the globe, use English as a language of instruction and inspire a desire to visit Britain in many impressionable young minds. In the last seven decades, the UK National Health Service has been held in high regard as a magic formula for universal health provision. For a doctor or a nurse in many countries, one of the career aspirations usually involves travelling to and working in the UK NHS. Hence, the UK NHS has over 47% of doctors from 200 countries and around a quarter of its 1.3 million employees have qualified overseas. 
 This blog narrates the professional trajectory of a doctor qualifying in a medical school in Malaysia to become a consultant psychiatrist in the United Kingdom. The combination of hard work, diligence and an unwavering will to pursue one’s passion in mental health, has enabled Sai Achutan to achieve his career objectives.

A Qualitative Study on the Experiences of Preclinical Students in Learning Clinical and Communication Skills at a Simulation Centre

IntroductionSimulation centres (SC) and its learning resources are now firmly established as part of medical education. In SC, medical students obtain both knowledge and skills based on a combination of theory and practice using provided resources. This study aims to explore medical students’ use of SC learning resources to learn clinical and communication skills based on Kolb’s experiential learning cycle. This is based on the research question ‘How are the SC resources useful in supporting preclinical medical students’ clinical and communication skills learning?’ The findings of the study can make a case for further enhancement of SC design and resources for medical students in the preclinical phase.MethodsA qualitative study involving 20 preclinical medical students with learning experiences in SC was conducted between December 2019 and 2020 at a medical school in Malaysia. Semi-structured interview questions were developed based on Kolb’s learning cycle. The data were thematically analysed using the six phases of Braun and Clarke’s thematic analysis.ResultsThree main themes were identified based on preclinical medical students’ experiences in SC; they were ‘preparation for authentic clinical experience’, ‘accessibility of multiple resources for learning and support’ and ‘opportunities to learn and improve’.ConclusionsThe SC’s resources have a significant and positive role in supporting preclinical medical students learn clinical and communication skills. The SC resources prepared them for authentic clinical experiences with a patient-centred care approach and self-directed learning opportunities. Social support from peers, peer tutors and academics emerged as a key finding and resource of the SC as they help preclinical students learn and improve.

Knowledge, attitude, and practice of white coat use among medical students during clinical practice (LAUNDERKAP): A cross-sectional study

Recent studies found white coats to be reservoirs for bacteria and medical students did not conform to proper hygiene measures when using these white coats. We investigated the knowledge, attitude, and practice (KAP) of medical students toward white coat use in clinical settings (LAUNDERKAP). A validated, online-based survey was disseminated to 670 students from four Malaysian medical schools via random sampling. Scores were classified into good, moderate, or poor knowledge and practice, and positive, neutral, or negative attitude. Mann-Whitney U and Kruskal-Wallis tests were used to analyze the relationship between demographic variables and knowledge, attitude, and practice scores. A total of 492/670 students responded (response rate: 73.4%). A majority showed negative attitudes (n=246, 50%), poor knowledge (n=294, 59.8%), and moderate practice (n=239, 48.6%). Senior and clinical year students had more negative attitudes. Male students had higher knowledge, while students from private medical schools and preclinical years had better practice. There was a significant relationship between attitude and practice (r=0.224, P<.01), as well as knowledge and practice (r=0.111, P<.05). The results demonstrate the need for more education to improve medical students' infection control practices. Our results can also guide decision-making among administrators on the role of white coats as part of medical student attire.

THE LEVEL OF KNOWLEDGE, ATTITUDE AND PRACTICE TOWARDS COVID-19 IMMUNISATION AMONG MEDICAL STUDENTS IN PUBLIC MEDICAL SCHOOLS IN MALAYSIA

COVID-19 is a highly contagious disease that caused a worldwide pandemic in 2020. Medical students are public advocates for COVID-19 vaccination to achieve herd immunity. Our objective is to ascertain the level of knowledge, attitude, and practice toward COVID-19 immunisation among medical students in Malaysia. The online study included four public universities in Peninsular Malaysia: Universiti Putra Malaysia, International Islamic University Malaysia, Universiti Sains Malaysia and Universiti Sains Islam Malaysia. Data collected include sociodemographic characteristics, history of COVID-19 infection, knowledge, attitude and practice towards COVID-19 immunisation. Analytical statistics were analysed with IBM Statistical Package Statistical Package for the Social Science (SPSS) v27.0 using Pearson chi-square or Fisher’s exact test (significant if p &lt; 0.05). From the total of 427 respondents, 60.2% had good knowledge whereby clinical students 67.0% had a higher proportion of good knowledge as compared to preclinical students 53.5% (p = 0.004). Respondents in the age group of 21 to 24 years old (p &lt; 0.001) and 25 to 29 years old (p = 0.016), and Indian ethnicity (p = 0.006) were more likely to have good knowledge. Respondents registered in Malaysia’s National COVID-19 vaccination program were considered as having a positive attitude (n = 264, 61.8%). A vaccination rate of 100% was observed. In conclusion, 60.2% of medical students had good knowledge, 61.8% had a positive attitude and 100% were vaccinated in these four public medical schools in Malaysia. Sociodemographic factors (age group and Indian ethnicity) have an association with only good knowledge but none with the level of attitude and practice towards COVID-19 immunisation.

Surviving the COVID-19 Pandemic: Lessons Learnt and Experience of a Private Medical School in Malaysia

As a small group of academicians in a private medical university in Malaysia, we observed, in 2020, how the COVID-19 pandemic, changed our lives and the lives of our students. We would like to share our experiences in this commentary. It describes the contingency plans taken by the School of Medicine at International Medical University (IMU) to ensure that the delivery of the medical curriculum and its assessments has the best possible outcome in these tumultuous times, with plans to improve the delivery of teaching and learning, with an emphasis on technology-enhanced learning (TEL). We hope that this commentary is beneficial to those reading and that the contingency plans developed by IMU will help other institutions in the country and in this region navigate safely through the COVID-19 storm.

Cultural Competency of Medical Students: An Asian Context

Introduction: People of different cultures perceive health and disease differently. A culturally competent healthcare team is needed to provide quality healthcare. In Asian medical schools, less emphasis is laid on cultural competency training. In this context, the study aims to assess the cultural competency of medical students in Malaysia and to fathom the demographic factors influencing it. Methods: A cross sectional survey was conducted on students from all five years of a Malaysian medical school using an adapted version of Clinical Cultural Competency Questionnaire (CCCQ) to tap the self-perceived knowledge, skills, comfort level in cross-cultural encounters and attitude towards cultural competency. Descriptive and inferential statistics was used to analyse the data. Results: Among the 291 respondents, the cultural competency was found to be significantly different among medical students of different year of study, age, and ethnicity. However, with regards to gender, country of birth or the number of languages spoken, the difference was insignificant. The clinical year students had significantly higher scores on the knowledge, skills, comfort level and attitude domains of cultural competency when compared to the preclinical students. Chinese students’ perception on cultural competence was significantly distinct from Indian and Malay students. Conclusion: Exposure to cross cultural encounters in clinical settings and personal experiences seem to influence cultural competency of the medical students. It provides valuable data to plan for interventions, training and self-development strategies aimed at providing culturally attuned patient centred care.

Malaysian Medical Students' Attitudes and Readiness Toward AI (Artificial Intelligence): A Cross-Sectional Study.

The Malaysian health ministry has started introducing artificial intelligence (AI) technology to aid local healthcare delivery. This study aims to survey Malaysian medical students' attitudes toward AI and evaluate their readiness to work with medical AI technology. An online questionnaire on Google Forms was distributed to all 31 medical schools in Malaysia. The questionnaire consists of 3 sections: the first part surveyed the participants' demographics, the second assessed the participants' attitudes toward AI, and the final part utilizes the Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS) scale to evaluate their AI readiness. Three hundred and one students from 17 universities in Malaysia responded to the questionnaire. 87.36% of students agreed that AI will play an essential role in healthcare; 32.55% of students were less likely to consider a career in radiology due to the advancement of AI. The majority of students (71%) felt that teaching in AI will benefit their careers, while 69.44% agreed that all students should receive teaching in AI. Around 44.5% of students felt that they will possess the knowledge required to work with AI upon graduation. On the MAIRS-MS scale, students had a mean score of 21 of 40 for the cognitive factor, 25 of 40 for the ability factor, 10 of 15 for the vision factor, and 11 of 15 for the ethics factor. Overall, Malaysian students had a mean total score of 67±14.8out of 110. Malaysian medical students have demonstrated awareness of AI and a willingness to learn more about it. More work needs to be done to improve students' AI readiness, particularly their knowledge and application of AI technology. Malaysian universities should start to work on incorporating AI teaching into their curricula.

Students’ perception of peer learning: A study in a private Malaysian medical school

Students’ perception of peer learning: A study in a private Malaysian medical school

Clinical students’ reflections on the preclinical anatomy learning experience

ObjectivesAnatomy is a fundamental pillar of medical knowledge that bridges basic medical science knowledge and clinical practice. However, integrated modern medical curricula have reduced the anatomy teaching content, and cadaveric dissection is no longer conducted. Medical graduates who lack anatomy knowledge are anticipated to be inadequately equipped for safe clinical practice. This study was aimed at exploring clinical year students' experiences regarding their anatomy learning during the preclinical phase in Malaysian medical schools. The findings reflect how the students’ preclinical anatomy training prepared them for their clinical years of study. MethodsA qualitative phenomenology study using the focus group discussion method was conducted on 30 final-year students from four public universities. Four focus group discussion sessions were conducted, and students’ responses were transcribed and converted to electronic formats. The transcripts were analyzed thematically with ATLAS.ti software. ResultsThe first-cycle coding of the text analysis generated 157 open codes based on the phrases used by the participants. The subsequent coding cycle produced 16 axial codes—groups of open codes with similar features. During the final coding cycle, the content and interrelations between the axial codes were categorized into six codes: (1) preclinical anatomy learning experience, (2) anatomy content and teaching, (3) anatomy-related competency, (4) the importance of anatomy knowledge in clinical practice, (5) the importance of early exposure to applied clinical anatomy, and (6) suggestions for future anatomy education. ConclusionsThe six identified themes reflected students’ perceptions of their anatomy learning experience, the challenges that they faced during their preclinical years, and their opinions regarding the anatomy knowledge and skills that are functionally relevant during the clinical years. Their responses also echoed the need to improve anatomy teaching and learning, thereby emphasizing the importance of early clinical integration and application.

Role-playing in medical education: An experience from public role-players

ObjectiveWe aim to explore the lived experiences of public role-players from the aspects of benefits, barriers, and enablers of role-playing in a medical school in Malaysia. MethodsA mixed-method study was performed involving 15 community dwellers who been engaged as role-players with Newcastle University Medicine in Malaysia. Participants answered a brief questionnaire followed by taking part in semi-structured interview. The interviews were audio-recorded, transcribed verbatim, and analyzed using thematic approach. Results86.7% of the participants strongly agreed that they had better medical knowledge after participating. Seven themes emerged under the three categories of perceived benefits, challenges, and recommendations: understanding and medical knowledge, and practical application, other benefits of role-playing, emotional upheaval, understanding medical jargons, improving the role-playing quality, and translating the experience gained into the community setting. ConclusionThe public role-players acknowledged their role positively and recognized refinement in their interpretation of medical knowledge and health. The public role-players were enthusiastic in using their knowledge acquired by upskilling themselves for community health programs and initiatives.

Association Between Level of Knowledge Gained, Confidence, Motivation and Flexibility on Types of Learning for Bedside Teaching Among Clinical Students in Four Malaysian Medical Schools During COVID-19 Pandemic

Introduction: With the arise of the COVID-19 pandemic, higher institutions are forced to change the method of delivery for bedside teaching sessions from face-to-face to online learning. However, online learning was found not effective in delivering practical knowledge and skills to students. Hence, the objective of this study was to determine the association between level of knowledge gained, confidence, motivation and flexibility on types of learning for bedside teaching sessions among clinical students in four Malaysian medical schools during COVID-19 pandemic. Methods: A cross-sectional study involving medical students from Universiti Putra Malaysia (UPM), Universiti Sains Islam Malaysia (USIM), Universiti Islam Antarabangsa (UIA) and Universiti Sains Malaysia (USM) were conducted from 1st March 2021 until 6th June 2021. An online questionnaire was distributed and it consisted of 5 sections which cover sociodemographic information, level of knowledge gained, confidence, motivation, and flexibility from bedside teaching session. The data was analysed by using SPSS software program. Results: There is a significant association between the level of knowledge gained, level of confidence, level of motivation and level of flexibility with the type of learning (online or face-to-face) during bedside teaching sessions. Results revealed that students gained a higher level of knowledge (84.9%), higher level of confidence in physical examination (93.3%), higher motivation (82.2%) and higher flexibility (64.1%) during face-to-face bedside teaching sessions compared to online learning. Conclusion: Most of the medical students in four Malaysian medical schools prefer face-to-face learning compared to online learning for bedside teaching sessions.

Now You See Me, Now You Don’t: Exploring Medical Students’ Cognitive, Emotional and Behavioural Engagement with Emergency Remote Learning During the COVID-19 Pandemic

The COVID-19 pandemic had forced medical students to study at home, transitioning to an emergency remote learning mode of instruction. Its impact on students was unknown and likely to be of concern. Therefore, this study assessed cognitive, emotional and behavioural engagements of medical students during emergency remote learning, and examined its associations with regard to their age, gender, stages of study and ethnic groups. A self-administered questionnaire was distributed to undergraduate medical students at one public medical school in Malaysia. Emergency remote learning was conducted via Microsoft Teams (synchronous) and web resources (asynchronous). The questionnaire consisted of four sections: demographic background, emotional, behavioural, and cognitive engagements with emergency remote learning. Three hundred twenty-nine students (n = 329) completed the questionnaire. The three engagement dimension scores were 3.36/4.00 (behaviour – act), 3.16 (cognition – think) and 3.07 (emotion – feel), respectively. There was a significant difference between the engagement dimension scores (paired data), implying that what students feel, think and act on emergency remote learning did not seem to align. Next, engagements of these students were not significantly associated with their age, stages of study, and ethnic groups, but male students had higher dimension mean scores for cognitive and emotional engagements. Emergency remote learning had a considerable impact on student engagements. The study calls for continuing efforts in improving effectiveness and equity in learning engagements among medical students in the post-pandemic era.

Exploring the Domains of Faculty Development Programmes for Malaysian Medical School Lecturers: A Qualitative Study

Faculty development programmes (FDPs) are recognised to be effective mechanisms by which to enhance medical education. They cover various domains of both the clinical and non-clinical environments; however, the available data on these programmes are insufficient. The aim of this study was to explore the domains covered in FDPs conducted in Malaysian public medical schools. A qualitative approach was used for this study, which involved 30 participants from five Malaysian medical schools in 2019. The inclusion criteria for the study were (a) participants were lecturers who had served at least five years, (b) participants had experience with FDPs, and (c) participants were medical doctors. Trainee lectures were excluded from the study. Document analysis and focus group discussions were utilised for the collection of data. The data were analysed using the ATLAS.ti software and the inductive thematic analysis approach. The data analysis indicated three themes (personal attributes, professional attributes and curriculum management); six categories (communication skills, teaching and learning methods, e-learning, student management, assessment and research methodology) and 13 sub-categories namely, interpersonal communication, intrapersonal communication, adult learning, instructional models, problem-based learning (PBL), clinical-based learning (CBL), team-based learning (TBL), multiple-choice question (MCQ), single best answer (SBA), objective structured clinical examination (OSCE), standard setting, qualitative research and quantitative research. This study demonstrates the significant role played by FDPs in Malaysian public medical schools. Medical faculties are advised to incorporate all these domains into their development programmes.

Assessment Modalities That Provoke Test Anxiety Among Medical Students

The prevalence of distress among medical students continues to rise. Studies have shown that stressrelated to examinations – test anxiety (TA) – is the most frequently reported source of distress. Research on the relationship between TA and assessment modalities is thus critical for determining the potential ramifications of this problem. This study aimed to explore assessment modalities that aggravate TA among medical students in a Malaysian medical school. A cross-sectional study was conducted among medical students at the School of Medical Sciences (SMS) of Universiti Sains Malaysia (USM). Students rated TA for each assessment modality used in the school. Each modality was scored from 1 to 10, with 1 indicating no TA and 10 representing extreme TA. Forty-five students participated in the study. The group was divided almost equally in terms of sex. The assessment modalities that provoked the most TA were the objective structured clinical examination (OSCE), the short case, the short essay question (SEQ) and the long case, with mean scores of 7.9, 7.8, 7.7 and 7.7, respectively. The case write-up, the problem-based learning (PBL) assessment, the multiple true-false (MTF) questions and the Simplified Thematic Engagement of Professionalism Scale (STEPS) were the assessment methods that induced the least TA, with mean scores of 5.1, 5.0, 4.4 and 4.0, respectively. This study found that the worst assessment modalities in terms of TA were the OSCE, the short and long cases, and the short essay question, while the case write-up, the PBL assessment, the MTF questions, and the STEPS induced the least TA. Most students reported that memorisation difficulties and facing examiners were the most common causes of TA. Remedial measures include examiner training on how to deal with examinees during assessments, evaluating the distribution of marks according to assessment modality and student training focused on study skills and exam preparation.

Flipped Classroom for Pharmacology Teaching in a Malaysian Medical School using Online Tools during the COVID-19 Pandemic: Knowledge Gained and Student Perception

Introduction: The usage of a flipped classroom to instruct medical students is becoming more common. During the COVID-19 epidemic, this method of teaching and learning proved to be effective. This study aims to analyse the knowledge gained and perceptions of medical students who were taught pharmacology in a flipped classroom utilising online tools.&#x0D; Methodology: A total of 50 second-year medical students took part in the research. Local anaesthetics and adverse drug reactions were the two topics covered in the flipped classroom. A few weeks before the session, pre-reading materials were distributed, which included voice-over PowerPoint videos and AMBOSS links. Students were given pre and post-tests using Microsoft forms to assess their knowledge gained during the face-to-face session. Higher-order thinking questions were uploaded as a Kahoot session, and the questions were also posted using Microsoft PowerPoint in an interactive session. A validated questionnaire was used to collect feedback, and the responses were graded on a 4-point Likert scale. Descriptive statistics were used to analyse the data.&#x0D; Results: There were 18 females and 32 males among the 50 students. The students' average age was 21.4±0.6 years. When the pre and post-test scores were compared, statistically significant results were obtained (P-value .000). The students had a favourable attitude about flipped classrooms. Most students said that the flipped classroom increased their understanding of the subject (mean score 3.760.44). They also thought the flipped classroom was a fun way to learn (mean score 3.710.47). The overall perception of the flipped classroom was excellent (53%).&#x0D; Conclusion: The knowledge gained by the students during the flipped classroom session in pharmacology was significant. The students had a favourable opinion of the flipped classroom method of teaching pharmacology.