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

Introduction: Simulation 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. Methods: A 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. Results: Three 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'. Conclusions: The 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.

Communication skills in primary care settings: aligning student and patient voices.

INTRODUCTION: Effective communication is essential for patient-centred relationships. Although medical graduates acquire communication skills during undergraduate training, these have been shown to be inadequate in early practice. Both students' and patients' perspectives are required to improve readiness for the workplace, patient satisfaction, and health outcomes. Our research question was: to what extent are medical students prepared with patient-centred communication skills in primary care settings? METHODS: A qualitative descriptive research study using in-depth semi-structured interviews was conducted with Year 3 medical students and patients to study their experiences at a primary care clinic, over two weeks. Data were transcribed verbatim and analysed using Braun and Clark's thematic analysis. Both students' and patients' views on communication skills were obtained. RESULTS: Three themes were established based on student-patient communication in primary care settings: socio-cultural elements in student-patient communication; cognitive and emotional challenges for effective communication; and enablers for effective student-patient communication. The themes and sub-themes describe both students and patients valuing each other as individuals with socio-cultural beliefs and needs. CONCLUSION: The findings can be used to structure new approaches to communication skills education that is patient-centred, culturally sensitive, and informed by patients. Communication skills training should encourage students to prioritise and reflect more on patient perspectives while educators should engage patients to inform and assess the outcomes.

An exploratory study on the challenges faced and coping strategies used by preclinical medical students during the COVID-19 crisis.

PURPOSE: The impact of the coronavirus disease 2019 crisis on medical education includes reduced clinical training, a significant loss of learning time and a probable decline in confidence of being a doctor. These recent changes will have significant effect on the well-being of medical students and interventional support needs to be given early. This study explores the challenges faced and coping strategies used by preclinical medical students during the crisis. METHODS: A qualitative study involving 13 preclinical medical students was conducted between August and September 2020 at a medical school in Malaysia. An in-depth individual interview via Microsoft Teams (Microsoft Corp.) with semi-structured questions was conducted. The recorded interview data were thematically analyzed using the six phases of Braun and Clarke's Thematic Analysis. RESULTS: The challenges faced were identified under three themes: psychosocial impact of lockdown, significant lifestyle changes, and impact on professional progression. Meanwhile, four themes emerged in coping strategies that include behavioral strategies, re-appraisal of the uncertainties of situation, active coping mechanisms, and regulation of emotion with coping reserve. There are indications that personality traits determine strategies to cope with challenges faced during the crisis which may either lead to resilience building or experiencing burnout. CONCLUSION: The findings of the study highlighted the urgent need to develop early preventive and intervention strategies to address the mental health of medical students to mitigate stress and promote positive well-being in times of crisis.

Mind your language: the importance of english language skills in an International Medical Programme (IMP).

BACKGROUND: Language proficiency is crucial for doctors as they communicate with patients, peers and other healthcare professionals. Although proficiency in English is part of admission requirements, there is a gap in the knowledge of medical students' perception of factors enhancing English language (EL) skills during training in international medical programmes (IMPs). The gap prevents educators and policy makers from helping students who struggle with communication skills during medical training. This study therefore explores the importance of English language skills from medical students' perspectives. METHODS: Six focus group interviews with 24 medical students were conducted in an IMP. Data were analysed using Braun and Clarke's framework of thematic analysis. RESULTS: Results established three themes that constitute the importance of EL skills, namely the use of EL in medical training and practice, influence of university culture in EL mastery and individual EL proficiency as perceived by medical students. CONCLUSIONS: Findings of this study demonstrate how students perceived the importance of EL skills as a professional and social requirement during medical training and for future practice. It also informs that setting English language admission pre requisites needs to be complemented with opportunities to practice context specific communication skills. Thus, international medical programmes should embed diverse and inclusive strategies to support and develop medical students' English language skills.

The effect of transactional analysis training on emotional intelligence in health professions students.

BACKGROUND: Emotional intelligence (EI) is considered to present a significant predictor of work performance whereas Transactional analysis (TA) is the relational perspective in communication in managing emotions. We evaluated the effect of psycho-educational training in EI and TA (TEITA) on EI among health professions undergraduates, with post-training, and at 1-month follow-up. METHODS: A total of 34 participants participated in the study where 17 participants were in the TEITA group and another 17 were in the control group. A quasi-experimental non-randomised, controlled cohort study was conducted, in which participants in the TEITA group were introduced to EI and TA concepts on a weekly basis for four weeks, at 90 min each time, and provided with opportunities for experiential sharing of emotions and coping mechanisms experienced in the previous week. Both TEITA and control groups received weekly EI and TA reading materials. All completed the 16-item Wong and Law EI Scale at baseline and post-training. The training group also completed the questionnaire at a 1-month follow-up. Wilcoxon Signed Ranks and Mann Whitney tests were used to analyse within a group and between group changes in EI scores. RESULTS: Baseline EI scores in the TEITA group were lower than the control group. On completion of TEITA, EI scores in the TEITA group increased, and differences were not detected between groups. Within the TEITA group, paired increases in all domains were statistically significant, whereas, in the control group, the paired increase was only detected in the domain addressing regulations of emotion (ROE). Pre to post-training increases in EI scores were statically significantly greater in TEITA compared to control groups. At the 1-month follow-up, EI scores were sustained. CONCLUSION: The psycho-educational training based on EI and TA is effective in enhancing EI among health professions undergraduates. Future research should investigate the effect of such training on observable inter-personal and socio-economic behaviours.

Student evaluation of the learning environment in an undergraduate pharmacy programme: Lessons for educators.

BACKGROUND: Student evaluation of the learning environment is important to enhance learning experiences. Programs such as Pharmacy use feedback from the evaluation to identify teaching-learning issues and use it to improve the quality of the learning experiences. The article aims to explore the general observations from the evaluation; to identify how the feedback is used to improve the learning environment and to identify lessons for educators in managing and using the feedback. METHODS: A cross-sectional data analysis of Pharmacy students' learning environment from 2011-2015 based on data from module, faculty, IMU-REEM and Student Barometer Survey was applied. Feedback obtained from the data was triangulated to establish commonalities/differences of the issues. RESULTS: Based on the analysis, issues affecting Pharmacy student learning experiences were identified. The identified issues included teaching by subject matter experts, pedagogical delivery and physical learning environment. Seven lessons were presented for educators to assess the practicality of the feedback. CONCLUSIONS: The feedback serves as a means to improve the Pharmacy program. Nonetheless, the challenges lie between the ideal and realistic expectations of students in optimizing the learning experiences. Lessons acquired from the evaluation of the learning environment are essential for educators in managing and using the information.

Educating universal professionals or global physicians? A multi-centre study of international medical programmes design.

Introduction: Medical schools increasingly offer curricula that specifically aim to prepare students for an international medical career. This is challenging as well as controversial: curriculum designers must balance specific local healthcare requirements with global health competencies doctors need in our globalised world. By investigating how international medical programme designers experience this balancing act, this study aims to contribute insights to the debate on local versus global medical education.Methods: We conducted a multi-centre instrumental case study across three universities with international medical programmes in three countries. The study involved 26 semi-structured interviews with key curriculum designers recruited through purposive sampling. Additionally, we performed a curriculum document analysis. Data were thematically analysed within a multidisciplinary team.Results: Participants described two profiles of international medical programme graduates: 'a global physician', equipped with specific competencies for international practice, and 'a universal professional', an overall high-level graduate fit for future practice anywhere. These perspectives presented different curriculum design challenges.Conclusions: International medical programmes teach us how we can rethink graduate profiles in a globalising world. Yet, educational standardisation poses risks and securing equity in global health education is challenging, as is preparing students to be adaptable to the requirements of a rapidly changing future local healthcare context.

A cross-cultural study investigating body features associated with male adolescents' body dissatisfaction in Australia, China, and Malaysia.

This study investigated how dissatisfaction with particular aspects of the body was associated with overall body dissatisfaction among male adolescents in Western and Asian cultures. One hundred and six Malaysian Malays, 55 Malaysian Chinese, 195 Chinese from China, and 45 non-Asian Australians aged 12 to 19 years completed a questionnaire assessing dissatisfaction with their overall body and dissatisfaction with varying aspects of their body. Dissatisfaction with the face, height, and hair was positively correlated with overall body dissatisfaction among Malaysian Malays after body mass index, age and dissatisfaction with body areas typically included in measures (weight/shape, upper, middle, and lower body, and muscles) had been controlled for. Dissatisfaction with the face was positively correlated with overall body dissatisfaction among Malaysian Chinese. These findings demonstrate the differences in body focus for males from different cultures and the importance of using assessment measures that address all possible areas of body focus.

Which body features are associated with female adolescents' body dissatisfaction? A cross-cultural study in Australia, China and Malaysia.

This study investigated how dissatisfaction with various aspects of the body is associated with overall body dissatisfaction among female adolescents in Western and Asian cultures. Data used in the study were obtained from 58 Malaysian Malays, 95 Malaysian Chinese, 242 Chinese from China, and 81 non-Asian Australians aged 12-19 years (M=15.72, SD=1.72) who were recruited from high schools. Participants completed a questionnaire assessing dissatisfaction with their body overall, and dissatisfaction with varying aspects of their body. Malaysian Chinese were the most dissatisfied with their bodies. After controlling for body mass index (BMI), age and dissatisfaction with weight/shape, upper, middle and lower body, and muscles, dissatisfaction with the face was positively correlated with overall body dissatisfaction among Malaysian Malays and Australians. These findings demonstrate the importance of using assessment measures that address all possible areas of body focus as well as being tailored to the relevant culture.