Medicine

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IMoCC - Measure of cultural competence among medical students in the Malaysian Context.
(Informa Healthcare, 2021) Chandratilake, M.; Nadarajah, V. D.; Mohd Sani, R. M. B.
ABSTRACT:Cultural beliefs and practices impact heavily on health outcomes of patients. Doctors' ability to deal with such issues in clinical practice, i.e. cultural competence, is widely studied in the west. It has yet to be given due importance in non-western contexts. This study aimed to develop a valid and reliable measure of cultural competence in the Malaysian cultural context and to assess cultural competence among Malaysian medical students. Thirty-five cultural issues faced by Malaysian doctors were identified with a series of interviews to develop a preliminary tool. The responses of students to these cultural issues were evaluated against the extent of inquiry and advocacy based on a theoretical framework of cultural competence. The responses were subjected to statistical analysis to determine the internal structure of the tool and to reduce the number of items in the tool. The final tool (IMU Measure of Cultural Competence - IMoCC) comprised of 22 issues, which deemed to be reliable in the second round of testing. In both tools, student cohorts demonstrated an acceptable level of cultural competence with room for improvement. However, they appeared to learn how to deal with cultural issues primarily through informal means and not in the formal curriculum. KEYWORDS: Cultural competence; health professions; professionalism; undergraduate.
Identifying poor concordance between the 'planned' and the 'hidden' curricula at a time of curriculum change in a Sri Lankan medical school using the Dundee Ready Education Environment Measure
(South-East Asian Association for Medical Education, 2009) Chandratilake, M.; de Silva, N.R.
INTRODUCTION: Often there is a ‘hidden’ curriculum running alongside the planned curriculum as published in official statements of a medical school. The two aspects of the curriculum may not be in concordance, especially in a phase of change. In this study Dundee Ready Education Environment Measure (DREEM) was used as the tool to determine the level of concordance between two curricula. METHOD: The DREEM questionnaires were administered face-to-face to two batches of undergraduate medical students of Faculty of Medicine, University of Kelaniya, Sri Lanka. One batch was the first group to follow the integrated curriculum and the other was the last group to follow the discipline-based curriculum. RESULTS: The total scores of both batches indicated a reasonably positive overall perception of the education environment, but still with considerable room for improvement. The scores of third year male students for the domains of student perception of learning and teaching were significantly lower than their female colleagues and the seniors, thus indicating where interventions should be prioritised. By analysing the responses to individual items, a collection of items which were perceived negatively by both batches of students were identified. The items represented all domains with variable degree. DISCUSSION: In addition to its multiple utilities, a careful and deep interpretation of the DREEM results can be used to identify a group affected specifically by the educational environment, possibly caused by a lack of concordance between the planned and the hidden curricula of the same institution.
Medical students experiences of learning communication skills during a family medicine clerkship in Sri Lanka
(Department of Family Medicine, Aga Khan University Pakistan, 2005) de Silva, N*.
INTRODUCTION: The teaching of communication skills to medical students was introduced for the first time in Sri Lanka in 1996, during a clinical attachment in family medicine. Setting: The University Family Medicine Clinic which provides a free primary medical care service to the community. A two week family medicine clerkship for third year students in groups of 15-18. Teaching and Learning METHODS: Small group discussions and learning of communication skills through viewing of educational videos and live consultations on a TV monitor. Students received "hands on experience" in communication skills followed by constructive feedback by the teacher and peers on a video tape replay of student-patient encounters and role plays. METHOD: Qualitative research methodology was used. Students from two groups were requested to write down their experiences of learning communication skills through video tape replay and feedback during the family medicine clerkship. RESULTS: The students` narratives of their learning experiences were analyzed. The themes that emerged were: apprehension at being observed by the teacher and peers during student-patient encounters, anxiety about not remembering to ask relevant questions from the patient, enjoyment of the feeling of real doctoring, developing confidence in consulting skills and learning by watching themselves in action on video tape replay. Excerpts of the feelings expressed by the students under these themes were selected to be presented in this paper. CONCLUSION: The learning of communication skills had been an enjoyable experience for the students who appreciated the learning achieved. They had also undergone personal and professional development in the process.
Family medicine in the undergraduate curriculum : teaching and learning
(College of General Practitioners of Sri Lanka, 1997) de Silva, N*.
Recognizes the importance of family medicine in the undergraduate curriculum in UK, USA, Singapore, Malaysia and Sri Lanka. Looks at newer methods of teaching and the teaching potential of family medicine. Provides a very detailed account of the author's personal experience and educational endeavours in the teaching and learning of family medicine and the evaluations of such teaching and learning in the undergraduate curriculum.

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