Clinical skills program as a laboratory method is a valuable adjunct to other forms of undergraduate medical training. This article describes the process of developing a core curriculum in clinical skills based on the Dundee model for a clinical skills centre. The School of Medical Sciences, in Universiti Sains Malaysia (USM) has been provided with a well equipped skills centre. However, the PBL curriculum in the undergraduate medical program in the school needs to be integrated with a clinical skills lab program. This is to counter the general feeling that the contribution of PBL is insignificant in terms of building clinical competency in an integrated system such as that used in USM compared to the traditional curricula of other medical teaching institutions in Malaysia. Integrating clinical skills laboratory training with the PBL curriculum will provide evidence of PBL as an effective and innovative method for teaching and learning in Malaysia.
skills ; Clinical ; curriculum aspects ; Malaysia ; Teaching aspects

The question vetting is an ongoing process that essentially is a teamwork represented by right combination of experts from within the teaching faculty. It is considered mandatory to maintain quality standard of any examination. Vetting sessions are not only used for screening of questions towards technical and language problems but vetting is also used to generate the content-related validity of assessment questions. The role of vetting committee has been emphasized in literature. However, implementation of question vetting in specially convened meetings is not without errors and problems are encountered if the faculty indulged in vetting does not adheres to an appropriately set vetting protocol. The objective of the study was to identify the percentage of errors to improve the quality of examination questions and to appraise the protocol of vetting at Faculty of Medicine, Universiti Sultan ZainalAbidin Percentage errors in current practice of question vetting were recorded and the need of adequately practiced vetting using a protocol was identified. A protocol based on different level of question evaluation was established. Two levels of vetting committee were identified with chairpersons and members selected from within the faculty. The role of committee members in vetting was established. However, a third level of vetting was exclusively practiced considering FM (UniSZA) a new medical school. Each level of vetting observed 10-30% changes suggested in originally structured questions by the experts with consensus of entire members of the vetting committee. This error was the initiative factor to subsequently design the formation of vetting committee with duly represented members. The vetting of question practiced with appropriate committees and prescribed guidelines was found important to improve the quality of items in assessment employed in second professional examination of MBBS program in Faculty of Medicine at Universit Sultan ZainalAbidin, Malaysia.

Multiple-choice question as one best answer (OBA) is considered as a more effective tool to test higher order thinking for its reliability and validity compared to objective test (multiple true and false) items. However, to determine quality of OBA questions it needs item analysis for difficulty index (PI) and discrimination index (DI) as well as distractor efficiency (DE) with functional distractor (FD) and non-functional distractor (NFD). However, any flaw in item structuring should not be allowed to affect students’ performance due to the error of measurement. Standard error of measurement (SEM) to calculate a band of score can be utilized to reduce the impact of error in assessment. Present study evaluates the quality of 30 items OBA administered in professional II examination to apply the corrective measures and produce quality items for the question bank. The mean (SD) of 30 items OBA = 61.11 (7.495) and the reliability (internal consistency) as Cronbach’s alpha = 0.447. Out of 30 OBA items 11(36.66%) with PI = 0.31-0.60 and 12 items (40.00%) with DI = ≥0.19 were placed in category to retain item in question bank, 6 items (20.00%) in category to revise items with DI ≤0.19 and remaining 12 items (40.00%) in category to discard items for either with a poor or with negative DI. Out of a total 120 distractors, the non-functional distractors (NFD) were 63 (52.5%) and functional distracters were 57 (47.5%). 28 items (93.33%) were found to contain 1- 4 NFD and only 2 (6.66%) items were without any NFD. Distracter efficiency (DE) result of 28 items with NDF and only 2 items without NDF showed 7 items each with 1 NFD (75% DE) and 4 NFD (0% DE), 10 items with 2 NFD (50% DE) and 4 items with 3 NFD (25% DE). Standard error of measurement (SEM) calculated for OBA has been ± 5.51 and considering the borderline cut-off point set at ≥45%, a band score within 1 SD (68%) is generated for OBA. The high frequency of difficult or easy items and moderate to poor discrimination suggest the need of items corrective measure. Increased number of NFD and low DE in this study indicates difficulty of teaching faculty in developing plausible distractors for OBA question. Standard error of measurement (SEM) should be utilized to calculate a band of score to make logical decision on pass or fail of borderline students.

Comparable selection methods based on interview as one of the selection criteria are used in many countries globally however; procedure of interview and its reliability has been of varying nature. A semi-structured interview procedure was developed by the Faculty of Medicine at Universiti Sultan ZainalAbidin to finally select the shortlisted candidates seeking to studying medicine in this institution as the new intake of 2015-2016 sessions of MBBS program. Multiple panels comprising of two members each to independently select the candidate held interview. Inter-ratter reliability of quality assessment was investigated. Current article investigates the inter-ratter reliability of interviewers in quality assessment of candidates seeking to join the Faculty of Medicine at Universiti Sultan ZainalAbidin, Malaysia. An observational study, conducted across all the candidates, who were shortlisted on merit for formal selection through interview procedure. Data reflecting candidates’ characteristics and qualities were collected as quantitative score. Inter-ratter reliability using intra class coefficient was calculated for interpretation. A moderate difference of mean (SD) among the interviewer varying from 37.61 (3.48) to 42.12 (0.60) was observed. The reliability of score varied between 0.50- 0.65, significant at p = < 0.05 with majority assessors. However, among the 4 panels of assessors’ intra-class correlation coefficient was between 0.70-0.0.90 (p = < 0.001). Assessment of candidates’ performance based on observation did not achieve the satisfactory level of intraclass correlation coefficient (ICC ≥ 0.70). However for higher discrepancy in inter-ratter scores in some cases, continuing faculty development program in interviewing skills and calibration workshops are recommended to improve the reliability and validity of quality selection through interview procedure in future.

Aims: The aim of the present work was to evaluate the effect of various cryoprotective agents on the survival of freezedried probiotic Lactobacillus rhamnosus. Methodology and results: Investigation was done on the viability and stability of probiotics L. rhamnosus. The effect of different cryoprotective agents (namely, sodium chloride, sucrose, dextran, sorbitol, monosodium glutamate, glycerol, skim milk and skim milk with malt extract) with modified De-Man Rogosa Sharpe (MMRS) medium were examined. Commercial De-Man Rogosa Sharpe (MRS) medium was proved to be more expensive than the modified MRS medium with relatively low yield of probiotics L. rhamnosus. Significantly high viable counts were achieved with monosodium glutamate, skim milk and skim milk with malt extract, with optimum concentration at 0.3% w/v. There was a reduction in cell viability at concentration above 0.5% w/v, which could be attributed to cell shrinkage associated with osmotic pressure changes. The cells were found to be stable at room temperature (28 °C) for eight weeks. A significant growth of probiotics was produced from skim milk. Conclusions: Modified MRS medium with skim milk is suggested for the remarkable growth and yield of probiotic lactobacilli.

This study aims at exploring the correlation between coping strategies and thinking styles. Methods: The study sample consisted of 62 students (30 females and 32 males) from the Medical Science College in Hodeidah University, Yemen. They responded to the Scale of Coping styles and Inventory of Thinking styles quetionnaire. Results: Active coping strategy was affected significantly by legislative, local and hierarchical thinking styles, while avoidance strategy was affected significantly by oligarchic thinking styles, behavioral conducts by judicial, global and anarchic thinking styles. Significant gender differences were found in behavioral conducts (from coping strategies), anarchic and internal thinking styles with advantage with females. Conclusion: Coping strategies are not independent of thinking styles. These results offer justification and support for future research in larger samples. Potential implications of the impact of thinking styles on coping strategies are also considered.
Adaptation, Psychological ; Thinking ; Students ; Universities

Introduction: Despite general acknowledgement of the importance in assessing family needs in critical care patients, there is no psychometric instrument to measure the family needs within Malaysian settings. This study aimed to perform factorial validation and establish psychometric properties of Malay translated Critical Care Family Need Inventory (CCFNI-M) for Malaysians. Methods: This study consisted of four protocols: Forward-Backward translation, validity, internal reliability and inter domain correlations phases. The factorial validation of the CCFNI-M was based on its administration to 109 family members of critical care patients admitted to the Intensive Care Unit of Hospital Universiti Sains Malaysia, Kelantan, Malaysia. At validity phase, factorial validation was performed using Exploratory Factor Analysis using Principal Component Analysis with Varimax rotation. The internal consistency and inter domain correlations were calculated using Cronbach’s alpha and Pearson correlation coefficient respectively. Results: Preliminary analyses reported the suitability of data for factorial validation. With reference to the original CCFNI, five factors were extracted which explained 49.4% of the total variance. After removal of several items for different reasons, the final items in CCFNI-M were 42. The internal consistency values for five dimensions ranged from 0.72 to 0.87 with inter domain correlation values (r) among the dimensions ranged between 0.36 and 0.61. Conclusion: The high measures of factorial validity, internal consistency and inter domain correlations values of the CCFNI-M make it suitable measure for assessing the family needs of critical care patients.

A late adolescent patient presented with a Class III malocclusion on a skeletal Class III base, complicated by severe upper arch and moderate lower arch crowding, reverse overjet, anterior and bilateral posterior crossbites with displacement, proclined upper incisors, retroclined lower incisors, distally tipped lower canines and non-coincident centrelines. Treatment was undertaken on an extraction basis by employing the use of an upper removable appliance with Z-springs and posterior bite blocks to correct the anterior crossbite, quad helix and jockey arch for arch expansion, and pre-adjusted edgewise fixed appliance to level and align, space closure and achieve a mutually protective functional occlusion. This paper discussed the rational and evidences behind the treatment employed.

Erythrocyte Sedimentation Rate ; Viscosity ; Plasma Proteins ; Plasma ; Fibrinogen

paradigm ; seconds ; Injury inflicted to the body by an external force ; therapeutic aspects ; Capital