1.Knowledge, attitude, and practice regarding atrial fibrillation among primary care physicians: the potential role of postgraduate training
Ooi Phaik Choo ; Gogilavendan Ramayah ; Syahril Rizwan B. Omar ; Vilasini Rajadorai ; Thatsheila Nadarajah ; Ting Chung Hui ; Teng Cheong Lieng
Malaysian Family Physician 2021;16(1):39-49
Introduction: Atrial fibrillation (AF) is known to lead to stroke and thromboembolism, causing a five-fold increase in the risk of stroke and almost doubling the mortality rate. Optimal anticoagulant therapy is effective in reducing AF-related death. However, prescription of anticoagulants in AF in East Asian countries has been low, ranging from 0.5% to 28%. This study aimed to determine whether vocational training in family medicine improves primary care physicians’ knowledge, attitude, and practice in the management of AF.
Method: This investigation was a cross-sectional study carried out during centralized workshops for two groups of trainees using a validated questionnaire: (i) junior trainees were newly enrolled postgraduate trainees in the Graduate Certificate in Family Medicine (GCFM) program, and (ii) senior trainees were postgraduate trainees in Advance Training in Family Medicine (ATFM) programs of the Academy of Family Physicians of Malaysia (AFPM).
Results: A total of 223 trainees (127 junior and 96 senior) participated in this study. Only 55.2% of the trainees passed the knowledge test; senior trainees were more likely to pass the knowledge test compared to junior trainees (69.8% vs. 44.1%, p <0.001). Female trainees were significantly more likely to pass the knowledge test than male trainees. While the attitude of senior and junior trainees was similar, more of the latter group worked in public clinic that provide better support where there is better support for outpatient anticoagulation treatment (e.g., same-day INR test, direct access echocardiogram, and warfarin in in-house pharmacy).
Conclusion: Vocational training in family medicine appears to improve primary care physicians’ knowledge regarding the management of AF. Better knowledge will help vocationally trained primary care physicians to provide anticoagulation treatment for AF within primary care clinics. More optimal AF management within primary care can take place if the identified barriers are addressed and a shared care plan can be implemented.
2.Covid-19 One Year on: Exposure to Infection, Covid-related Functional Difficulties and Concerns Among Medical Students From a Malaysian Medical School
Phaik Choo Ooi ; Nurin Qistina Subri ; Ardilla Balqis Othman ; Airin Natasha Aliya Khiril Muhyzam ; Nur Aqilah Farhana Alhamdu ; Nurul Izzati Zulkurnain ; Afiqah Hassanah Noor Ahmad Kamal
Malaysian Journal of Medicine and Health Sciences 2022;18(No.3):50-58
Introduction: The COVID-19 pandemic has forced revolutionary changes in the delivery of medical education and
imposed much stress on medical students and academicians. This study aimed at evaluating the level of exposure to
COVID-19, COVID-related functional difficulties and concerns experienced by medical students, approximately one
year after COVID-19 became significant health and socio-economic issues in Malaysia. Methods: A cross-sectional
study using self-administered online questionnaire, was conducted among the undergraduate medical students of a
private university in Malaysia. Results: A total of 243 medical students participated. They reported low level of exposure to COVID-19 infection. Majority of them demonstrate moderate level of difficulties in learning (median score of
3, highest score = 4) and high levels of COVID-related concerns (median scores of 4 to 5, highest score = 5). Lowest
household income category was a significant predictor of high level of functional difficulties (OR = 3.878, 95%CI:
1.651, 9.110); whilst female gender was a significant predictor of high level of COVID-related concerns (OR = 7.400,
95%CI: 1.920, 28.514). Conclusion: One year following the onset of COVID-19 pandemic in Malaysia, medical
students still reported significant functional difficulties in learning and demonstrated high levels of COVID-related
concern. Collaborative efforts to mitigate the problems need to be intensified with emphasis on the delivery of online
medical education and special attention to female and lower socio-economic group students to prevent detrimental
consequences to medical students and medical education. Multi-center and longitudinal studies are recommended.