abstract - mahidol university

The 20th Thai Medical Education Conference: Educational disruption in medical schools

Abstract


Factors Associated with Improved Microsurgical Learning in a Plastic Surgery Training

Program

Nutthawut Akaranuchat

*

Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University,

Bangkok, Thailand

*Corresponding Author’s E-mail: [email protected]

Abstract

Background: Microsurgery lab training is one of the best ways to learn and improve microsurgical skill. We

explored factors that facilitate positive and efficient development of microsurgical skills during plastic surgery

training.

Methods: An open questionnaire examining factors potentially associated with microsurgical learning was

administered to residents and fellows and six factors were identified. These factors included duration and

frequency of assessment, clarity of assessment tools and topics, knowledge gained during assessment, validity

and reliability of the assessor, and evolution of microsurgical skills after assessment. Senior surgeons also

assessed student’s microsurgical skills. Finally, a satisfaction survey about the microsurgery program was given

to students. Using findings from these tools, a reorganization of the microsurgical training program was

implemented. Six months later, the survey was administered again and the results were compared with the initial

assessment. Student lab participation rates and laboratory costs were measured.

Results: Six months following program reorganization, student satisfaction significantly increased in 5 of 6

parameters; duration for assessment (from 1.73 to 2.87; p=0.019), frequency for assessment (1.27 to 2.93;

p=<0.001), clarity of tools and topics (2.60 to 3.13; p=0.045), knowledge gained (1.93 to 3.20; p=<0.001), and

validity and reliability of the assessor (1.20 to 2.87; p=0.001). Overall trainee satisfaction improved from 2.40 to

3.00 (p=0.028). The average microsurgical skill of students increased from 1.77 to 2.35 (p=0.001)

Microsurgery lab participation increased from 46 (July to December 2018) to 105 (January to June 2019).

This was three times higher than during previous academic year. The new training protocol reduced the average

cost per microsurgery lab session from more than 4500 baht (145 USD) to 1468.34 baht (46.4 USD).

Conclusions: Five factors associated with an improved microsurgical learning experience were identified and

used to guide program reorganization. Six months later, we measured increased rates of lab participation,

improved student satisfaction and reduced program costs.


Physical Activity of Pre-clinical and Clinical Medical Students in Mae Fah Luang University

Kawinchaya Poolsombat*, Phumyanee Changchit Variya Tangpanitansook, Punyapapha Changchit, Paween

Tangchitphisut and Chitlada Utaipiboon

School of Medicine, Mae Fah Luang University, Chiang Rai, Thailand


Abstract

Background: Pre-clinical medical students nowadays often study for more than 6-9 hours per day, and 45-90

hours in clinical training is considered 1 credit. Sedentary behavior also increases in clinical students due to their

long hours spent in the hospital. Thus this accounts for a decrease in physical activities (PA) of medical students

of Mae Fah Luang University, which could lead to reduced overall health and may increase the risk of diseases

in the future. Therefore, it is important to improve the level of physical activity in medical students.

Objective: To compare the levels of physical activity between pre-clinical and clinical medical students of Mae

Fah Luang University. To compare the levels of physical activity in each school year.

Method: A cross-sectional analytic study was conducted by distributing a global physical activity questionnaire

to all Mae Fah Luang medical students, currently studying in the academic year of 2019, via social media.

Results: A total of 156 (response rate 81.25%) medical students participated. 67.74% Pre-clinical students had

moderate to high levels of PA (n=63). The median Metabolic equivalent value (MET) was 1908.73 MET-

minute/week (range 0-11,520). 52.99% of Clinical medical students had moderate to high levels of PA (n=36).

The median Metabolic equivalent value (MET) was 1,339.05 MET-minute/week (range 0-7,280). Pre-clinical

medical students were more likely to have higher levels of PA (p=0.03).

Conclusion: One-third of the medical students were reported with low levels of physical activity. Clinical

medical students had reduced levels of physical activity compared with Pre-Clinical students. Therefore,

physical activity should be promoted to help increase the overall health of medical students.

Keyword: Physical activity, Medical Students, Mae Fah Luang University, Clinic, Pre-clinic

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Empathy Enhancement among Medical Residents by Dialogue Workshop: RCT

Chitrawina Mahagita1,2*

, Jirattakarn Pongpakatien3, Thitisak Kitthaweesin

4, and Cherdsak Iramaneerat

5

1 Physiology Department, Phramongkutklao College of Medicine, Bangkok, Thailand

2 Master of Science Program in Health Science Education, Faculty of Medicine Siriraj Hospital, Mahidol

University, Bangkok, Thailand 3 Contemplative Education Center, Mahidol University, Nakhon Pathom, Thailand

4 Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand

5 Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

* Corresponding Author’s E-mail: [email protected]

Abstract

Empathy plays a significant role regarding physician humanity, doctor-patient relationship, clinical

competence, and clinical outcomes. Nevertheless, many studies have reported empathy erosion among both

medical students and residents. Therefore, any learning promoting empathy, would be valuable. This research

focused on “dialogue”, regarding David Bohm. The four principles of dialogue are deep listening, respect,

suspending judgment and voicing. This is the first research studying the role of dialogue workshop

concerning empathy level. The method was experimental design using randomized pretest-posttest control

groups. Voluntary participants constituted first-year medical residents of Phramongkutklao Hospital (n=96). The

positive control group comprised 2.5-hour communication skills focused on counselling (n=47). The dialogue

group comprised a 2.5-hour dialogue workshop (n=49). The empathy level was measured by the Jefferson Scale

of Empathy, Health Professional Version (JSE-HP), reporting the total JSE and its 3-domain: perspective taking,

compassionate care and standing in the patient’s shoes. No significant difference was found regarding sex and

specialties among groups. Every baseline level of JSE did not significantly differ between groups. After the

workshops, the mean change scores of the pre- and post-test JSE scores in the dialogue group were significantly

higher than the control group; total JSE: 5.36, p=0.005, perspective taking: 3.01, p=0.019 and compassionate

care: 2.51, p=0.023, but without significant difference for the third domain (-0.14, p=0.759). Hence, the dialogue

workshop significantly enhanced empathy among medical residents. This study provides a substantial scientific

contribution to medical education and suggests the possibility to apply a dialogue workshop to cultivate medical

learners in well-rounded aspects.

Keywords: empathy/ dialogue workshop/ deep listening/ reflection/ soft skills


Changes of the VARK Learning Style from the First to the Second Preclinical Year

Punyapat Maprapho1, Chantacha Sitticharoon

2*, Vasu Lertsiripatarajit

2, Issarawan Keadkraichaiwat

2, Pailin

Maikaew2, Nipith Charoenngam

3

1Department of Medical education, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,

Thailand

2Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

3Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand


Abstract

VARK, visual(V)-auditory(A)-reading/writing(R)-kinesthetic(K), is one of the most used learning style

models. This study aimed to 1) determine changes of the VARK learning style from the 1st (Preclinic1) to the 2

nd

(Preclinic2) preclinical year and 2) compare academic factors and stress level between students who changed

and did not change their learning style. The study questionnaire and VARK questionnaire version 7.8 were sent

to students at the end of Preclinic1 and Preclinic2 with 87.20% (286/328) and 92.99% (305/328) being returned,

respectively. Students who changed and did not change their learning preference from Preclinic1 to Preclinic2

were allocated into 2 groups, the “change” (69.3%) and “no-change” (30.7%) groups, respectively. Most of

students were multimodal learners (65.03% in Preclinic1 and 69.51% in Preclinic2). In Preclinic1 and Preclinic2,

GPA and percentile of GPA of the no-change group were significantly higher than the change group (p<0.01

all). GPA of the change group in Preclinic2 was significantly lower than theirs in Preclinic1 (p<0.001).

Achievement of study targets and stress level of the change group in Preclinic2 were lower than the change

group in Preclinic2 and lower than theirs in Preclinic1 (p<0.05 all). The change group might need self-adaptation

as their Preclinic1 learning style might not fit to the Preclinic2 learning environments or did not help them reach

the academic performance at their level of expectation or satisfaction. In conclusion, the students who changed

their learning preference might need to adapt to a new learning preference probably leading to lower academic

capability but less stress.

Keywords: VARK, Preclinic, Learning preference, Academic achievement, Stress

mailto:[email protected]


A Study of Attitudes Relating to Home Health Visit among Applied Thai Traditional Medical

Students

Athippat Tantiwongsekunakorn

1*, Suprapath Sonjaipanich

2, and Worapant Kriengsoontornkij

2

1 Master of Science Program in Health Science Education, Faculty of Medicine Siriraj Hospital, Mahidol

University, Bangkok, Thailand, 2,3

Department of Pediatrics Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.


Abstract

This research aimed to study the attitudes relating to home health visits (HHV) before and after

professional practice experience (PPE) of applied Thai traditional medical (ATM) students at the Faculty of

Medicine Siriraj Hospital, Mahidol University. Forty-eight 4th year ATM students have participated in this study.

Data was collected using a questionnaire, which was assessed for validity and reliability by three experts.

Descriptive statistics and pair t-test were used to analyze the data. The aspects of attitudes that had statistically

significant changes after PPE were the relationship with patients and their relatives, working with the

multidisciplinary team and the role of ATM practitioners (p < 0.001). Whereas the attitudes relating to practice

in HHV had the least mean difference and were not statistically significant. Nevertheless, to promote some

particular aspects of learners’ attitudes relating to HHV, instructors and supervisors could select the appropriate

teaching methods to enhance empathy and associated skills such as deep listening, the practice of reflectivity for

self-awareness. These can effectively increase the positive attitudes of students, resulting directly in their

performance toward HHV as well as from health care providers.

Keywords: attitude, home health visit


Effects of Using Audience Response Systems (Kahoot and google form and sheets) on

Learning of Medical Students in a Large Class

Vasu Lertsiripatarajit1, Chantacha Sitticharoon

1*, Punyapat Maprapho2, Issarawan Keadkraichaiwat

1

1 Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,

Thailand, 2 Department of Medical education, Faculty of Medicine Siriraj Hospital, Mahidol University,

Bangkok, Thailand


Abstract

Audience response system (ARS), an electronic tool, is used to collect responses from

students. In this study, many formats of ARS were used including Kahoot used as individuals

(Kahoot-I) or team (Kahoot-T); and other formats created by combining Google Form and Google

sheet to ask multiple choice questions (Google-MCQ) and open-ended questions (Google-OEQ). This

study aimed to compare students’ perspective in using each ARS format in many aspects including

augmenting students’ ‘participation’, ‘attention’, ‘understanding’, ‘enthusiasm’, ‘happiness’, liking of

ARS (‘liking’), friendly competition, courage to ask/answer questions, capturing concept, feeling

interested in teaching content, and following content with or without subgroup analysis into quartiles

of their summative scores (Q1(lowest)-Q2-Q3-Q4(highest)). Students were asked to rate their opinion

whether ARS could enhance their learning compared to traditional lectures in a Likert scale,

1(strongly disagree)-2(disagree)-3(neutral)-4(agree)-5(strongly agree), with 86.22% (269/312)

respondents. For all ARS formats, students rated scores ≥4 for almost all aspects except ‘

understanding’ (3.98) for Kahoot-I. Scores for Kahoot-T were rated highest in all aspects (4.35-

4.48) except ‘understanding’ (4.09). Q4 students rated significantly higher scores for ‘enthusiasm’

than Q1 and Q2 students for Kahoot-I (P<0.05 all). Scores for ‘happiness’ and ‘liking’ were rated

higher in Q2-4 students than Q1 students for Kahoot-T (P<0.05 all). In conclusion, students agreed

that ARS could promote their learning in many aspects. Low academic-achieved students rated lower

scores than their peers in many aspects. Thus, types of ARS should be appropriately selected to match

activities in each class and students’ background.

Keywords: Audience response system, Preclinic, Large Class, Academic achievement, Kahoot


Laboratory Integrated Case-Based Learning (Li-Cbl) for Infectious Diseases

Nitchatorn Sungsirin1*

, and Veerachai Watanaveeradej1

1 Department of Microbiology, Phramongkutklao College of Medicine,

Bangkok, Thailand


Abstract

Case study learning as a patient base integrated with laboratory practices (Lab-integrated

case-based learning: LI-CBL) for teaching medical students in pre-clinical course has been first

conducted in academic year 2018. This is a novel active learning of various organ systems aiming at

common infectious diseases in Thailand, integrating with the practice of Microbiology laboratory

skills.

The learning process consists of 3 parts. Part 1 (25 minutes): A clinical experienced physician

presents a case study and uses questions to guide students to ask additional history and physical

examinations. The students give their differential diagnosis, likely causative pathogens and discuss

about clinical specimen collections and laboratory tests for diagnosis. Part 2 (30-40 minutes):

Students are divided into small groups of 9-10 to work in the lab focusing on gathering the correct

diagnosis, pathogen identification and drug susceptibility tests. Each group has its own laboratory

experienced technicians as an instructor. Part 3 (25 minutes): The clinical experienced physician

summarizes the diagnosis of pathogens with the students, discussing about patient care, prevention,

prognosis as well as knowledge about the epidemiology of this important infectious diseases in

Thailand and around the world (Global health). A pharmacologist can discuss about treatment

guidelines and rational drug uses. After completing these 3 parts, there is a learning evaluation by

using the Constructed Response Questions (CRQ).

Students s' satisfaction with LI-CBL is assessed by 95 students. Most of students (more than

80%) satisfy as very good or excellent satisfaction in all 19 asked topics. The evaluation of

satisfaction from 16 instructors shows very good or excellent grade in more than 80% of 10 asked

topics. In summary, the major advantages of LI-CBL are to stimulate students' interest in learning,

promote problem solving skills, integrate basic knowledge in microbiology lab with their future

clinical practices and makes learning more efficient.

Keywords: Lab-integrated case-based learning (LI-CBL), Constructed Response Questions (CRQ)


Barriers and Facilitating Factors to Pass National License Examinations: Suggestions

from International Medical Graduates

Chananya Hokierti

1*, Kasana Raksamani

2, Tripop Lertbunnaphong

3

1Master of Science Program in Health Science Education, Faculty of Medicine Siriraj Hospital,

Mahidol University, Bangkok, Thailand, 2Anesthesiology Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,

Thailand, 3Obstetrics and Gynecology Department, Faculty of Medicine Siriraj Hospital, Mahidol University,

Bangkok, Thailand,


Abstract

Only 10.7% of Thai international medical graduates pass national license examinations every

year. Knowing the barriers and facilitating factors of national license examinations may improve the

passing rate, leading to more certified doctors to serve Thai healthcare system. This study was to

understand the international medical graduates’ perspectives of barriers and facilitating factors

affecting the passing rate of national license examinations. Fifteen participants having experience in

the internship program at Nopparat Rajathanee Hospital were selected through purposive sampling in

this phenomenology, qualitative study. Eight participants were divided into 2 focus groups, while 7

participants were individually interviewed using semi-structure questions. The audio data were

transcribed verbatim and analyzed with thematic analysis. The results showed that barriers of the

international curriculum comprised teaching methods, less attention from teacher, difficulties in

foreign language, different scope of the study and national license examination, and lack of facilities.

Individual barriers included less perceived barriers, low capacity to change, and less preparedness for

practice. Differences of examination methods, disasters and pollution, parenting supports were also

identified. Facilitating factors were non cultural related factors in the individual level. In conclusion,

barriers to national license examinations were non-cultural related factors in both training and

individual levels, whilst, facilitating factors were non-cultural related factors in the individual level.

All participants suggested early preparation for national license examinations and strongly

recommended domestic electives in early clinical year.

Keywords: international medical graduates, barriers, facilitating factors, national license

examinations


Medical Education Taking the Learning Beyond the Individual: How Reflection

Informs Change in Practice

Fiona Muir, Mairi Scott*, McConville K, Watson K, Behbehani K, Sukkar F.


Abstract

Introduction; The UK General Medical Council explicitly states that undergraduate training must

enable graduates to be aware of the need to maintain their personal physical and mental well-being

and inocorate compassionate self-care into their personal and professional life. Traditional teaching

methods have failed to deliver these skills in a systematic way however in a Masters level Diabetes

Care Education and Management (DCEM) programme in Kuwait, reflective practice was embedded

into the curriculum to enhance student skills in self-awareness and compassionate self-care.

Objectives; The purpose of this research was to explore the value of critical reflection in student

learning within the DCEM Masters programme, and its ability to enhance self-care and long-term

well-being. Methods; A small scale, exploratory case study using a qualitative approach was

conducted. Seventeen participants (DCEM students) were interviewed in focus groups and an

inductive approach to thematic analysis, examining themes within data, was performed. Results; The

results indicate that participants valued the opportunity to study through organized, structured taught

and assessed reflection. The learning provided increased self-awareness which led to enhanced self-

care and professional resilience. The embedded nature of skills acquisition in a clinical medicine

programme increased immediate relevance leading to consolidation into daily practice for students

and their colleagues. Conclusion; The significance of reflection is currently seen in the literature as

an important quality for professional competence and resilience. This research has highlighted the

value of reflection as a key component within an educational programme and confirmed the

effectiveness of the teaching approach.

Keywords: Reflection, Self-care, Resilience, Professionalism


Influence of Teaching and Learning Factors on Happiness of Preclinical Students

Chantacha Sitticharoon1*, Nipith Charoenngam

2, Issarawan Keadkraichaiwat

1, Pailin Maikaew

1, Vasu

Lertsiripatarajit1

1Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,

Thailand

2Department of Internal medicine, Faculty of Medicine Siriraj Hospital, Mahidol University,

Bangkok, Thailand


Abstract

Stressful medical study leads to high stress levels and decreased happiness in students. This

study aimed to determine factors influencing happiness in preclinical students especially in aspects of

teaching and learning, students’ motivation, study habits, and academic achievement. Questionnaires

were sent to students of class of 2018 when they were in the second preclinical year and students of

class of 2019 when they were in the first and second preclinical years with 83.54% (274/328), 85.11%

(280/329), 86.32% (284/329) being returned, respectively. From open-ended questions, the first top 5

ranking factors increasing students’ happiness were teaching of instructor, content satisfaction,

content understanding, free time, and handouts. Factors that had positive influences/associations with

happiness of preclinical students were happiness in learning subjects taught in a particular year;

satisfaction of content, study outcomes, materials, handouts, teaching motivating desire to learn, and

applicability of content to medical profession; high motivation to study medicine, expected score, and

the percentage of achievement of study targets; less amount of time spent on recorded-e-lecture study

and internet for non-academic use; and low stress levels. Thus, happiness of preclinical students was

influenced by satisfaction in teaching and learning, their attitude, study habits, and academic

achievement. Good students’ attitude and study habits; effective teaching and learning environments;

as well as activities increasing students’ motivation should be promoted to maintain or enhance

students’ happiness during preclinical studies. Study habits and academic achievement might be used

as tools to monitor students’ happiness throughout their study.

Keywords: preclinic, happiness, academic achievement, teaching, learning


Outcome-Based Curriculum: Perspectives from Medical Students Towards Curricular

Management

Natthapong Suthammopasut1, Nattapatra Manakitsirisuthi

1, Setabud Srijaiin

1, and Adisak

Tantiworawit2*

1 Medical Student, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,

2 Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai,

Thailand


Abstract

The curriculum of Chiang Mai University was re-evaluated every 5 years. The outcome-based

curriculum was established in 2015 aimed to improve student outcome in research skill and individual

clinical skill by elective course. This study aimed to determine the perceptions from our students

regarding those outcomes. A questionnaire with self-rating scales detailed about research courses and

elective in clinical skills was sent to 198 medical students in 2nd

to 5th year. All participants considered

research skills were necessary with a mean score 7.4±1.6 of 10, and their confidence was significantly

increased from the score 4.1±2.0 to 7.1±1.8 of 10 after attended the curriculum. The faculty

curriculum on research framework, ethics, and statistics correlated with the students’ confidence to

perform their own research. Forty-seven medical students attended elective course in other hospitals.

The mean score was 8.6±1.5 of 10. Our study showed elective course in community hospital was

significantly correlated with the clinical skill improvement in the students while the curriculum in the

university hospital revealed no significance. Outcome-based curriculum on research skills and clinical

skill by elective course promoted the self-confidence for the future career in medical students.

Keywords: medical student perspectives, medical school curriculum, researching skill, clinical

training


Outcome of The Faculty Development Workshop in Simulation-Based Medical

Education Using Kirkpatrick’S Model

Poom Tritrakarn 11*

, Phongthara Vichitvejpaisal 21, and Suprapath Sonjaipanich 3

2

1Department of anesthesia, Faculty of Medicine Siriraj hospital, Mahidol university, Bangkok,

Thailand,

2Department of pediatrics, Faculty of Medicine Siriraj hospital, Mahidol university, Bangkok,

Thailand.


Abstract

The Faculty of Medicine, Siriraj Hospital, Mahidol University has realized the potential

of Simulation-Based Medical Education (SBME) and has established a workshop to promote SBME

among its medical staff, nurse instructors, and educational officer since 2012. There are doubts in the

workshop’s management regarding its procedure for improvement. This prospective mixed qualitative

and quantitative evaluation-based study, applied the Kirkpatrick Model up to level III to assess the

outcome of the training in order to plan for future improvement. Twenty eight healthcare educators

who completed the whole workshop were included in this study. Level I (Reaction) was assessed by

using questionnaires consisting of participants’ feedback, the Likert’s scale on participants’

satisfaction, and a willingness to recommend the workshop to others. Level II (Learning) was

assessed by pretest-posttest design using MCQ tests. Level III (Behavior) was assessed by using semi-

structured interviews to ask about behavioral change of the participants, 2-3 months after attending

the workshop.The study showed a satisfactory successful outcome (81.8% satisfaction), a highly

significant posttest-pretest difference (P < 0.001), and a satisfactory rate of behavioral change

(84.6%). Along with the results, useful feedbacks from participants were also obtained. The overall

data suggested that debriefing and multi-professional setting of the workshop were the major areas for

improvement.

Applying the Kirkpatrick Model has given the researcher a deeper insight of the methods

used in the workshop, thus, plans have been created for its future improvement. These findings have

encouraged the faculty to continue in conducting training for its personnel and improve the standards

of the SBME in Thailand.

Keywords: Simulation, Faculty development, Outcome, Program evaluation, Kirkpatrick’s model


Learning Style Preferences and the Perceived Usefulness for Social Media in Pre-

clinical Medical Students

Adisak Nartthanarung1*

, Umaporn Udomsubpayakul2

1 Ramathibodi Medical School, Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand

2 Research Center, Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand


Abstract

At present, social media is popular a channel of communication based on information

technology. Studies have found that social media is used for exchanging information for everyday life

and for academic purposes among students including medical students. Although, there is some data

that shows the benefits of using social media for learning, but there is not enough information to

prove its efficiency for medical students. Students with different styles of learning may prefer

different types of social media for their studies. This research was therefore conducted to study the

various types of learning styles according to Kolb’s Learning Styles among preclinical medical

students from the Faculty of Medicine, Ramathibodi Hospital, to discover the types of social media

students use to learn, and to find the relationships between learning styles and perceived usefulness in

each type of social media. The results showed that the medical students had a variety of learning

styles. Social media that are commonly utilized include video or audio sharing, social networks, and

wikis. There are existing relationships between perceived usefulness and social media that they use to

gather and present their knowledge.

Keywords: social media, learning styles, Kolb’s Learning Styles, perceived usefulness


Efficiency of BMP Gamification and Effectiveness on Learning Achievement for

Medical Students of Phramongkutklao College of Medicine

Montalee Theeraapisakkun1*

, Thanakrit Vichasilp1, Unchalee Visawapoka1, Nattaprapa Suriyamontol1,

Prakarn Rudeekulthamrong1, Charin Cheungsirakulvit1, and Alisa Sanamontre1

1 Department of Biochemistry, Phramongkutklao College of Medicine, Bangkok, Thailand


Abstract

The application of game elements and game techniques were used in the e-Learning of

Biochemistry and Molecular biology (BMB) course in last academic year. It was found to improve e-

learning participation and engagement in medical students of Phramongkutklao College of Medicine

(PCM). The purposes of this research were to determine the efficiency of the BMB gamification and

effectiveness on students’ learning achievement. BMB gamification was improved and studied by 99

of the second year PCM medical students. The BMB contents were comprised of biomolecules,

metabolism and molecular biology. The achievement test was used before and after the learning

experience. During studying, 3 formative tests should also be done. The data were collected and

statistically analysed by SPSS. We found that the efficiency of the BMB gamification E1/E2 was

85.19/80.77. The students’ learning achievement at posttest was significantly higher than the one at

pretest at 0.001 level. When grouping by number of formative tests which were done during studying,

all groups showed posttest scores were higher than pretest scores while the group which completed 3

formative tests had the highest score in posttest. The attitude towards the learning by BMB

gamification was at the good to excellent level. The BMB gamification was very effective and could

develop the student’s learning achievement. It can indirectly help learners improve their learning

outcome by making them more participation in learning activity.

Keywords: Gamification, E-learning, Efficiency


Does Learning Pre-Medical Sciences During First Year is Still Important?: an

Evaluation from Medical Students’ Perspectives

Sakarn Charoensakulchai1*

, Anupong Kantiwong2

1 Phramongkutklao College of Medicine, Bangkok, Thailand

2 Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, Thailand


Abstract

Pre-medical course usually spans over the first year of medical curriculum. The subjects

involve pure sciences such as calculus, chemistry and physics. However, some of these subjects are

seemingly unnecessary for medical professionalism. To plan a better curriculum, students’ perspectives are required. This study aimed to evaluate students’ perspectives on pre-medical and pre-clinical courses. A cross-sectional study was conducted in 95 sixth-year and 95 fourth-year medical

students at Phramongkutklao College of Medicine. The questionnaire included two 5-Likert rating

scales on perspectives of curriculum and commentaries for improvement. Independent T-test was used

to analyse differences in perspectives. There was significant difference in perspectives between sixth-year and fourth-year students on pre-medical course (t=2.177,p=0.031), but not on pre-clinical course. Majority of both sixth-year (Median=3;N=44;46.315%) and fourth-year (Median=3;N=38;40.000%) rated

average for application of pre-medical knowledge to basic medical sciences. Most

(Median=4;N=39;41.052%) of sixth-year rated good on selective subjects in pre-medical course while

most (Median=3;N=37;38.947%) of fourth-year rated average. Students suggested adding selective

subjects in general education and social sciences to promote soft skills professionalism. The score was

lower than other items. Both years concerned that subjects in pre-medical course had low

correlation to pre-clinical course and suggested replacement with medical sciences e.g. biochemistry, biostatistics and cell biology. It could be concluded that there should be more

openly selective subjects to allow freedom of idea and living and the current first year course is still

inapplicable and unnecessary for medical science.

Keywords: Application, Perspectives, Pre-Clinic, Pre-Medical, Students


Massive Open Online Courses for Teaching Basic Trauma Procedures: A Pilot Project

Pasurachate Samorn 1*

1 Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand


Abstract

Massive open online courses(MOOC) is a popular learning platform globally. There are some

available courses in health and medicine, and most of them are in English. Chulalongkorn University

has its MOOC called Chula MOOC, free-of-charge and open-registration online lessons in Thai, to

serve the country variety of classes, and this is the first course in medicine. The author hypothesised

medical students, physicians and healthcare personnel would participate in the lessons widely after

Chula MOOC has distributed this basic-trauma-procedure course. The author collected data after the

class had launched for 3 months. There were 2,628 registrants including 619 physicians, 519 medical

students and 1,490 healthcare personnel. Among these, 820 participants finished the lessons and

passed all the tests. For conclusion, MOOC is available learning material for sending inter-

occupational knowledge about managing trauma patients all over the country.

Keywords: Massive open online courses, MOOC, Trauma


Factors Influencing Academic Achievement in Preclinical Students

Yanint Raksadawan1, Chantacha Sitticharoon

1*, Issarawan Keadkraichaiwat

1, Nipith Charoenngam

2,

Pailin Maikaew1

1Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,

10700, Thailand

2Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University,

Bangkok, 10700, Thailand


Abstract

Academic achievement is a major concern of preclinical students. This study aimed to

determine factors influencing academic achievement in preclinical years. Questionnaires were sent to

students of the 2019 class at the 1st (2019/1) and 2nd preclinical years (2019/2) and the 2018 class at

the 2nd preclinical year (2018/2), with 85.11% (280/328), 86.32% (284/328), and 83.54% (274/328)

being returned, respectively. Students were divided into Q1 (lowest)-Q2-Q3-Q4 (highest) according to

quartiles of their GPA. Q4 students had higher examination expectation and achievement of study

targets in all classes and more time spent on non-recorded-e-lecture study in the 2018/2 and 2019/2

classes; but lower time spent on recorded-e-lecture study in the 2019/1 class and non-academic-

internet use in the 2019/2 and 2018/2 classes than other groups. In contrast, Q1 students had higher

instances of lateness and absence/year in the 2019/2 and 2018/2 classes but lower happiness scores in

the 2018/2 class compared to other groups. Obese and overweight students had significantly lower

GPA than normal weight and underweight students of the 2019/2 class (p<0.05 all). The current year

GPA had significantly positive correlations with the previous year GPA, examination expectation,

achievement of study targets, and time spent on non-recorded-e-lecture study; but had significantly

negative correlations with time spent on recorded-e-lecture study and non-academic internet use,

instances of lateness and absence/year, and BMI (p<0.05 all). Collectively, students with more self-

regulation strategies in many aspects of self-regulated learning, including time management, learning

strategies, emotion control, motivation, and self-efficacy, had better academic outcomes.

Keyword: academic achievement, preclinical students, GPA, SRL, time management


Spiral Curriculum Development to Establish Individual Medical Research Competency

During the 3rd

Year to the 6th

Year Medical Students

Boonsub Sakboonyarat1, Mathirut Mungthin

2, Panadda Hatthachote

3, Wisit Kaewput

1, Sarawut

Jindarat2, Phunlerd Piyaraj

4, Picha Suwannahitatorn

4, Pongsom Luanghirun

1, Ram Rangsin

1*

1Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok,

Thailand 2Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, Thailand

3Department of Physiology, Phramongkutklao College of Medicine, Bangkok, Thailand

4Department of Parasitology, Phramongkutklao College of Medicine, Bangkok,

Thailand


Abstract

Lifelong learning is one of the competencies for graduate doctor which help to continue development

and improve needed knowledge and skills. Both principle of medical research and biostatistics are

important for development of this competency. According to the competency based medical

curriculum, Phramongkutklao College of Medicine has designed spiral curriculum to establish

individual medical research competency during the 3rd

year to the 6th

year medical students. Firstly,

MC301 provides foundation knowledge in several aspects including epidemiological study,

biostatistics, study design, data analysis and public health intervention. Medical students practice in

rural community to perform community health survey and uncover health problems. After that, when

they study in MC401, medical students have a chance to develop individual medical research

proposal. Each part of the research proposal is sequentially submitted via online system. The advisors

access the individual research proposal to perform the feedback. After the feedback, medical students

could adjust their research proposal and resubmit to their advisor to complete its. Moreover, medical

students are grouped into 8 groups to establish community-based research. Finally, 6th year medical

students have a chance to practice in community hospitals for 4 weeks. Medical students gain

experiences in medical skills, communication skills, and professionalism. Additionally, they conduct a

hospital-based research and inform the results to improve medical care in community hospital setting.

Eventually, our medical students are highly potential that they can present their medical research in

international conferences and publish their study in peer-reviewed medical journals.

Keywords: spiral curriculum, medical research competency, community medicine


Validity and Reliability of Stages of Metacognition in Anesthesia to Evaluate Critical

Thinking Skill in Anesthesia Residents

Taniga Kiatchai*, Kasana Raksamani, and Suwannee Suraseranivonse

Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University,

Bangkok, Thailand


Abstract

Introduction: Critical thinking is a crucial skill in anesthesia practice yet there is no specific

tool to evaluate such skill in anesthesia training. We developed a tool to evaluate critical thinking skill

by ranking learners into 5 stages of metacognition ranging from unreflective thinker to accomplished

critical thinker. Objectives: To measure validity, reliability and practicality of a tool to measure stages

of metacognition in anesthesia. Methods: Content validity was validated by 5 experts. Concurrent

validity, discriminant validity, reliability, and practicality were tested by 2 evaluators. We

retrospectively random 47 long-essay assignments (full score 100) written by 1st-3

rd year anesthesia

residents. Assignments were, then, blindly evaluated by 2 researchers in terms of stage of

metacognition, rationale, and decision making. Results: Tool’s items were adjusted for content

validity until item-objective congruence > 0.5. Concurrent validity between score and stage of

metacognition showed positive correlation by both evaluators (evaluator1 r=0.574, p<0.001;

evaluator2 r=0.294, p=0.045). Learners with higher rank of metacognition (3-4-5) had higher scores

than lower rank (1-2). Scores presented in mean (SD) between higher vs lower metacognition ranks

are evaluator1 77.4 (9.0) vs 62.4 (15.2), p=0.001; evaluator2 76.0 (12.9) vs 68.2 (13.7), p=0.050.

Discriminant validity was demonstrated by higher rank of metacognition in senior residents,

evaluator1 p=0.038 and evaluator2 p=0.026. Interrater reliability, using Spearman’s correlation, was

moderately correlated (r=0.469, p=0.001). Both evaluators were satisfied with the tool’s practicality.

Conclusion: The tool to evaluate stages of metacognition in anesthesia is valid, reliable, and practical

in assessing the critical thinking skill of anesthesia residents.

Keywords: critical thinking, stage of metacognition, anesthesia, residency training


Teaching Critical Thinking Skill in Anesthesia Residents Using Serial Constructed

Response Questions

Taniga Kiatchai*, Suwannee Suraseranivonse, Kasana Raksamani, Manee Raksakietisak,

Naiyana Aroonpruksakul, Pranee Rushatamukayanunt, Sahatsa Mandee, Naruenart Lomarut,

Pichaya Waitayawinyu, and Pavinee Sareenun Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University.

2 Wanglang road, Bangkok Noi, Bangkok, 10700, Thailand


Abstract

Introduction: Critical thinking, the ability to be deliberate about thinking, is a crucial skill in

medical education. There are few evidences to support the best way to teach critical thinking in post-

graduate training. Objectives: To evaluate whether using serial constructed response questions could

improve critical thinking skill in anesthesia residents. Methods: Three serial constructed response

questions (long essay cases, full score 100) were assigned to 1st-3

rd year anesthesia residents in 4-

week interval. Each assignment was individually corrected, feedback returned to residents, and key

answer explained before the subsequent case was assigned. Written assignments were retrospectively

collected. Only residents with three-retrieved assignments were further blindly assessed by 2

evaluators for critical thinking skill: stages of metacognition (ranging from 1 to 5), rationale, and

decision making. Results: Seventy-eight residents completed the written assignments. Mean (SD)

scores for the first, second, and third assignments were 63.0 (15.5), 73.4 (10.1), and 73.8 (9.3),

p<0.001, respectively. Forty-one residents returned all 3 assignments for critical thinking skill

evaluation. Their median scores showed an improvement in stages of metacognition from stage 2

(beginning critical thinker) to stage 3 (practicing critical thinker). Both evaluators (evaluator1,

evaluator2) observed increases in stages of metacognition (p<0.001, p=0.082), rationale (p=0.001,

p<0.001), and decision making (p=0.040, p=0.015). Self-comparison between pre-post learning by

residents showed an improvement in thinking ability, writing ability, and confidence to handle real

situation (p<0.001). Conclusion: Teaching anesthesia residents using three serial constructed response

questions improved critical thinking skill in terms of stages of metacognition, rationale and decision

making.

Keywords: critical thinking, stage of metacognition, constructed response question, anesthesia,

residency training


Depression, Quality of Life and Coping Style among Doctors Before Their First Year of

Residency Training

Pornjira Pariwatcharakul1, Woraphat Ratta-apha

1,2*, Thanayot Sumalrot

1, Julaluck Wankaew

1

1 Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,

Thailand 2 Siriraj Center of Research Excellence Management (SiCORE-M) Unit, Faculty of Medicine Siriraj

Hospital, Mahidol University, Bangkok, Thailand


Abstract

The aim of this study is to assess coping style, depression and quality of life of residents prior

to the beginning of residency training. This was a cross-sectional study at the Faculty of Medicine

Siriraj Hospital, Mahidol University, Thailand in 2016. A set of online questionnaires including Thai

versions of Proactive Coping Inventory, Patient Health Questionnaire (PHQ-9) and Pictorial Thai

Quality of Life (PTQL) scale was emailed to all of the first-year residents in Academic Year 2015 just

1 week before the beginning of their residency training programme. Among 277 doctors, 102 of them

(36.8%) responded to the survey. The respondents aged 25-33 years (mean=26.8, SD=1.2) and 69.6%

were female. Most doctors (99.0%) had moderate-to-high overall scores on quality of life. However,

depression was found in 9.8% of the respondents. Depression severity was negatively correlated with

proactive coping and quality of life. Proactive coping (r=.509, p<0.001), reflective coping (r=.266,

p=0.007), strategic planning (r=.347, p<0.001), preventive coping (r=.298, p=0.002), and emotional

support seeking (r=.252, p=0.011) were positively correlated with quality of life. Furthermore,

proactive (r=-.303, p=0.002) and strategic coping (r=-.195, p=0.050) were correlated with less

depressive symptom severity and higher quality of life before the beginning of residency training.

Although most doctors had moderate-to-high quality of life, positive screening for depression was not

uncommon among young doctors even before the beginning of their residency training programme.

The residency training programme should have mental health promotion policy to help their residents

throughout the specific training programme.

Keywords: depression, quality of life, coping, doctors, residents, residency training.


Rater Scoring Variability Assisted by Video-Recorded Long Case Objective Structured

Clinical Examination

Nattapol Sathavarodom*, Worawong Chueansuwan, Anupong Kantiwong, Bancha Satirapoj,

Ouppatham Supasyndh, Pongthorn Narongrauknavin, Aumnart Chaiprasert

Department of Medicine, Phramongkutklao Hospital and College of Medicine


Abstract

Background: Whenever multiple observers provide ratings, even of the same performance, inter-

rater variation is prevalent. Long case objective structured clinical examination (OSCE) had many

limitations and poses challenges for how we were to adequately analyze performance assessment

ratings.

Objective: In this study, we explored rater variability using video-recorded clinical performances and

test reliability of long case assessment form.

Material and Method: 19 physician raters viewed 2 video-recorded clinical performances and

provided ratings through our long case OSCE assessment form dividing in 7 learning outcome

categories. Inter-raters scoring variability was tested. In addition, reliability of assessment form was

done.

Results: In our study, rating-score variability were 11.8%, 16.8%, 14.1%, 15.0%, 15.6%, 13.4%, and

12.4%, in according to the part of method of history taking (Hx) and physical examination (PE), the

results of Hx and PE, clinical assessment, laboratory interpretation, plan of management,

communication skill, and attitude of examinee respectively. Raters scoring were homogeneity

(Levene test = 0.771, p = 0.730). Assessment of both between groups and within groups variability

were not significant (F = 1.117, p = 0.345). Our long case assessment form was reliability

(Cronbach’s alpha = 0.784).

Conclusion: This was the first video-recorded clinical performances for evaluating inter-rater

variability in our military medical college. Our 19 raters scoring were homogeneity and long case

assessment form were also valid. Further video-recorded clinical performance study might be helpful

in standardization long case OSCE examination and development of standard case scenarios for raters

practice simulation.

Keywords: Inter-raters scoring variability, video-recorded clinical performances, long case OSCE

assessment


Social Media Addiction and Academic Performance among Medical Cadets at

Phramongkutklao College of Medicine, 2019

Pannawat Chanpongsang1*

, Phunlerd Piyaraj2

1Phramongkutklao College of Medicine

2Department of Parasitology, Phramongkutklao College of Medicine

* Corresponding Author’s E-mail: [email protected]

Abstract

Introduction: To date social media have had a major influence on students' academic

performance. These platforms create many opportunities and threats for medical students in various

fields. Information of addiction to social media and its impact on medical students' academic

performance is limited in Thailand. Objectives: The purpose of this study was to investigate the

prevalence of social media addiction (SMA) and its relationship with academic performance of

medical cadets in Phramongkutklao College of Medicine. Methods: In this cross-sectional study was

conducted in October 2019. The Thai version of Bergen Social Media Addiction Scale was used and

the students' overall grade point average (GPAX) obtained in previous educational term was

considered as the indicator of academic performance. Results: The total of 190 medical cadets were

enrolled into the study, where males constituted (58.95%). The prevalence of SMA was 44.7%. The

independent factors associated with SMA were included female students (Odds ratio (OR) = 2.20,

95% confidence interval (CI) = 1.12-4.29) and GPAX score (OR = 0.31, 95%CI = 0.15-0.65).

Conclusion: The SMA of the medical cadets was at moderate level and the female students had a

higher level of addiction compared to the male students. There was an inverse and significant

relationship between the SMA and academic performance of medical students. Therefore, it is

imperative that the educational planner of medical school take interventional steps to support their

students who are dependent on these networks and inform them about the negative consequences of

addiction to social networks.

Keywords: Social media addiction, Medical student


Study on Sastisfaction & Functionality Assessment of Padlet to Preclinical Laboratory

Teaching in Phramongkutklao College of Medicine: Students and Instructors Aspect

Au-krit Luangpattarawong

1*, Nichatorn Sungsirin

2, Panadda Hatthachote

1, Anupong Kantiwong

3

1Department of Physiology,

2Microbiology,

3Phamacology, Phramongkutklao College of Medicine,

Thailand


Abstract

Preclinical teaching by using the Padlet, an online application for gathering, sharing and

discussing idea onto virtual board, was first introduced for learning in microbiology laboratory

lessons among the 3rd

year medical cadets during August to September 2019. A focus group interview

of the usability of this application was carried out in instructors (based on Rubric for eLearning Tool

Evaluation by Lauren M. Anstey & Gavan P.L. Watson, copyright 2018 Centre for Teaching and

Learning, Western University). The satisfaction evaluation was also done in the students and

instructors of Phramongkutklao College of Medicine

According to the evaluation of the satisfaction of the students (n=81) and instructors (n=5)

(Score level 1 to 5, Cronbach’s alpha 0.881, explained by means) found that the student and

instructors had an overall score with scores 4.18 + 0.68 and 3.73 + 1.38 Respectively, which were not

statistically significant differences. For the instructors, they commented that the program worked well

in terms of functionality, technical aspect, mobile design, privacy, social presence and teaching

presence. However, the student still had some problems about accessibility because it was a new

application that need basic instruction on how to use it. In addition, the instructors also commented

that this application requires expertise in teaching design in order to further develop student higher

thinking. Finally, for student engagement, document delivery system should be designed on this

application. This will be the way to develop this application in the future.

Keywords: Padlet, Technology, medical students, education.


Characteristics of Depression in Preclinical Medical Students at Faculty of Medicine

Siriraj Hospital

Tattiya Wisanuyothin1, Chinnawudh Sawee

1, Lakkana Thongchot

1, Nattha Saisavoey

1,

and Yodying Dangprapai1*

1 Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,


Abstract

Depression is one of the most important mental health problems, which has recently been

more recognized. Therefore, it is crucial to determine the prevalence and factors associated with

depression in order to help identify and prevent depression in the future. A cross-sectional study was

conducted to find the prevalence of depression using the Patient Health Questionnaire - 9 Thai

Version (PHQ-9-Thai) and associating factors including interpersonal relationship, mindfulness, and

self-esteem. The study was done on the preclinical student of the Faculty of Medicine Siriraj Hospital.

Analysis was done using risk estimation by contingency table and univariate logistic regression. Of

275 medical students participated in our study, 71 (25.8%, 95%CI[ 0.207,0.310]) has the PHQ-9 score

of 9 or more. Two factors are significantly correlated to the PHQ-9 score. The first one is presence of

personal counsellor or peer support which associated with lower PHQ-9 score (OR=0.395,

95%CI[0.207,0.751];P=0.004). The second is whether it was the participant’s own decision to study

in medical school. Students who made their own decision was correlated to a lower PHQ-9 score

(OR=0.362, 95%CI[0.159,0.826];P=0.013). This study revealed that prevalence of depression among

medical student are higher than those of general population (18.4%). The two factors related to lower

PHQ-9 score are presence of personal counsellor and participant’s decision to study medicine.

Keywords: Depression, Medical education


The Freshman Welcome Activities Improve Self-Recognition and Communication

Competency in Siriraj Medical Student

Pornlada Likasitwatanakul

1*, Kann Ruaytae

1, Sirajuk Khongviwatsathien

1, Napat Pongprasobchai

1,

Kongpob Tangnuntachai1, Woraphat Ratta-apha

2, Pittaya Dankulchai

3

1Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

2Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,

Thailand

3Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,

Thailand

*Corresponding Author’s E-mail : [email protected]

Abstract

Senior-initiated Freshman Welcome Activities is a major annual event in which selected topics are

delivered to help the attendance adapt to their new frontier of medical student life. There are various

activities in the past years, aiming to succeed in this goal, however up to this day, none of them

were systematically evaluated. This year, the topics are focused on self-recognition and social

adaptation. This study is performed to examine the effects of the activities on the self-recognition

and interpersonal skills of the second-year medical student of Faculty of Medicine Siriraj Hospital

(n=219) using pre-experimental design. The activities are divided into two three-hour sessions, each

consists of short introduction, small group discussion and role-play. Integrative Self-Knowledge

Scale (ISK) and Interpersonal Communication Competence Scale (ICC) are used as a tool to

quantitatively measure the outcome. The collected data was analyzed by one-tailed student paired t-

test. The result showed that participants achieve statistically significant higher post-test ISK score

(p=0.002, 95%CI 0.69-2.37) and ICC score (p<0.0001, 95%CI 1.08-2.06) than pre-test scores,

pointing out that the primary outcome of the activities was met, there was a proven improvement

after the intervention was done. However, more should be evaluated on the long-term effect of

these.

Keywords: Freshman, Medical student, Self-recognition, Interpersonal skill, Communication

competency



Implementation and Assessment of Pediatric Emergency Simulation Training for

Medical Students

Prakarn Tovichien1*

, Mongkol Chanvanichtrakool1, Teera Kijmassuwan

1,

Kraisoon Lomjansook1, Maynart Sukharomana

1 and Witchaya Srisuwatchari

1

1 Department of Pediatrics, Faculty of Medicine Siriraj Hospital Mahidol University,

Bangkok, Thailand


Abstract

Introduction: The increase of medical students and concern of patient safety limit

their opportunities to manage paediatric emergency cases. With increasing clinical

responsibilities and patient overload, debriefing is sometimes left aside. In 2018, we

implemented paediatric emergency simulation training for extern to improve their

competency in managing common paediatric emergency conditions. Objectives: To assess

the impact on their satisfaction and self-assessed clinical skills. Methods: The students were

asked to complete a form on a five-point rating scale to evaluate the courses following

Kirkpatrick model at the end of each training sessions. They also wrote their reflection what

they learned, what they would like to learn more and what could be improved in the training. Results: 123 (79%) of the 155 medical students who attended the training completed the

form. The mean agreement score that they haven’t met these emergency situations before was

4.29 ± 0.43. The mean satisfaction score that the objectives of these simulations were met

was 4.70 ± 0.19. The mean satisfaction score that these simulations will improve their

performance in actual clinical setting was 4.72 ± 0.17. From written reflections, most of them

learned how they can apply both technical and non-technical skills in real life situations and

forgotten dose of emergency medications was the most important factor which limited their

competency. Conclusions: Simulation training is an important part of clinical training which

responded to the perceived needs of medical students with consistently satisfactory

evaluations. Further studies are needed to assess the impact on their patient care.

Keywords: pediatrics, emergency simulation, medical students


Validation of Homemade Part-Task Trainer for Knee Arthrocentesis Training

Praveena Chiowchanwisawakit

1*, Somchai Chongpipatchaipron

2, Kotchaphan Wilaphan

3,

Bavornrat Vanadurongwan4

1Department of Medicine,

2Medical Education Technology Center,

3Education Department,

4Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol

University, Bangkok, Thailand


Knee pain is a common health problem worldwide. Knee arthrocentesis (KA) would be a vital skill

for practitioners to obtain synovial fluid for investigation. This study was aimed to validate the

homemade part-task trainer for training KA. Methods, it was a cross-sectional design validating the

knee model arranged at Siriraj Hospital, Mahidol University between June 1, 2017 and March 18,

2018. The target characteristics of model was simulating knee for which learners performed the

arthrocentesis process as in a real patient. The model was validated by 7 rheumatologists and

orthopedists with teaching experience at least 5 years, 30 residents in training and 155 the sixth year

medical students (MS). The questionnaires was 5 Likert scale [very poor, poor, fair, good, very good].

The target of evaluation was 80% of participants rated the model as good to very good. Results, the

model was achieved the goal characteristics. All lecturers evaluated the model as good to very good

for a simulated human knee, being able to perform the process as a real patient, and suitable for

practice. More than 80 % of MS and residents rated for simulated human knee, perceived increasing

experience and confidence, and global assessment as good to very good. Conclusions, the homemade

knee part-task trainer had good face and content validity for practicing arthrocentesis rated by

evaluators with various experiences in arthrocentesis. The model could be a useful tool for knee

arthrocentesis training.

Keyword: knee part-task trainer, knee model, validation of knee model



Holy Water Bathing Versus Antipsychotics in The Treatment of Schizophrenia: A

Scenario-Based Survey on Clinical Decision Making among Thai Medical Students

Pornjira Pariwatcharakul 1*

, Theenida Wannakowat2


Thailand 2 Hatyai Hospital, Songkhla, Thailand


Abstract

This study aims to understand clinical decision‒making of Thai medical students towards

cultural alternative treatment in patients with schizophrenia. Questionnaires were sent out to Thai

medical students asking them to show their opinion on a scenario of a patient with schizophrenia who

preferred ‘holy water’ bathing to antipsychotics. Questions were (1) whether she would be allowed to

take a bath with holy water and why, (2) If so, would antipsychotics be considered, (3) What if the

patient was the participant’s mother. Among all participants (n=515), most of them were female

(n=268; 52.04%). The mean age was 20.83 years (SD=2.16). For the patient’s scenario, most

participants allowed holy water bathing (67.96%), whereas 7.38% disallowed and 24.66% would not

comment. Older age (U= 4039, p = 0.010) and more years in medical schools (U= 4179.5, p=0.017)

were associated with different decision. Among those who allowed holy water bathing (n=350),

89.45% (n=313) would advise the patient to take antipsychotics and this was associated with studying

in clinical years (χ2=4.806, p=0.028). If the patient was their mother, most participants allow her to

use holy water (59.22%), whereas 20.97% disallowed, 15.15% would not comment and 4.66%

showed other ideas. Associated factors were regions of their medical schools. The influence of

studying in clinical years emphasizes the importance of medical education on clinical decision‒

making. Furthermore, the effect of medical schools’ regions on clinical decision‒making suggests that

different exposures to real‒life clinical situations or role models might shape the way they make

decision for their own families.

Keywords: medical students, clinical decision-making, schizophrenia, cultural belief, transcultural

psychopharmacology


Self-Evaluation After Using Educational Performance Excellence (EdPEx) Framework

as A Tool for Internal Quality Assurance (IQA) Program for 5 Years: Toward an

Effective and Sustainable Improvement

Vattanajun A, Staworn D, Hirunwiwatkul N, Srisawas C.


Abstract

Objectives: To describe lessons learned after 5 years of using EdPEx framework as a tool for IQA

program at Phramongkutklao College of Medicine (PCM).

Material & Method: In 2008, the executive committee of the Consortium of Thai Medical Schools

(COTMES) agreed to use the EdPEx framework as a tool to improve the quality of educational

performance of all medical schools. Ongoing implementation of EdPEx framework was implemented

at PCM over the last 5 years. Self-evaluation using after-action-review style of learning was used to

collect the lessons learned. Members of the EdPEx Task Force participated in this review.

Results: Best practices were identified including a 3-phase EdPEx implementation plan, in-house

EdPEx training course, decision to develop web-based application for an online SAR template,

simplify EdPEx criteria to fit with the department’s resource, integration of QA standard with EdPEx

criteria for the IQA visit, new KM activity known as Just-in-Time Learning, and PCMS system of

process improvement. Opportunities for improvement identified were the limited understanding of

EdPEx criteria among faculty members, limited linkages between departmental-level and college-

level of EdPEx implementation, limited availability of IT-based KPIs, cycle of learning and

improving the efficiency and effectiveness of the key processes.

Discussion & Conclusion: Key hurdles of EdPEx implementation at the departmental level is the

knowledge gaps. Although incremental improvement is evidenced, the college needs to establish the

management information system (MIS) to cultivate the fact-based improvement and performance

excellence culture to achieve an effective and sustainable improvement.


Effectiveness of Curriculum-Level Verification Activity at Phramongkutklao College of

Medicine During Academic Year 2017-18 and 2018-19

Ruangvith Tantibhaedhyangkul, Raweewan Ekgasit, Nawaporn Hirunwiwatkul, Dusit

Staworn, Chantrapa Sriswasdi.

Phramongkutklao College of Medicine, Bangkok, Thailand.


Abstract

Objectives: To determine the effectiveness of a curriculum-level verification activity (VA) at

Phramongkutklao College of Medicine (PCM) during academic year (AY) 2017-18 and

2018-19.

Material and Method: At least 25% of courses offered in each AY were selected by the

verification committee for curriculum-level VA. Course directors completed a self-evaluation

form for course-level VA and submitted samples of examination questions, results of student

evaluation and student grades. The committee would review documents, meet and discuss

with course directors and teaching instructors to verify that student learning outcomes (LOs)

were achieved.

Results: Numbers of courses verified in AY 2017-18 and 2018-19 were 34.8% (34/69) and

49.2% (24/69) of courses offered respectively. There was an incremental improvement in

areas of appropriateness of teaching/learning and evaluation methods used, and number of

courses that used formative evaluation and encouraged student reflection. Recommendations

for improvement included test analyses with B-index, test depository system, appealing

system for summative results, and remediation process for students.

Discussion: Curriculum-level VA is a part of the internal quality assurance to verify that the

expected LO standards are understood across the institution and are being consistently

achieved. Findings from our curriculum-level VA reflected its effectiveness in promoting

alignment of student LOs and the teaching/learning methods as well as the evaluation

methods used. Requests from the course directors could be forwarded for knowledge

management activity.

Conclusion: PCM’s curriculum-level VA was effective in improving the alignment of

student LOs and the teaching/learning methods as well as the evaluation methods used.



Knowledge and Attitude of Medical Students Towards Complementary and Alternative

Medicine in Thailand

Theenida Wannakowat1, Pornjira Pariwatcharakul

2,*

1 Hatyai Hospital, Songkhla, Thailand


Thailand *Corresponding Author’s E-mail: [email protected]

Abstract

Complementary and alternative medicine (CAM) has become more popular among patients

though the evidence of its effectiveness and safety are still limited. This study aims to explore self-

perceived knowledge and attitude of Thai medical students towards CAM. Questionnaires were sent

out to Thai medical students. They were asked to show their experiences and knowledge in some

kinds of CAM and their opinion on the effectiveness or safety of CAM. Among all participants

(n=515), most of them were female (n=190; 52.04%) and were medical students in preclinical years

(n=352, 68.35%). The mean age was 20.83 years (SD=2.16). About one third of the participants were

born in Bangkok (30.9%) or studied at medical schools in Bangkok (36.9%). About two third (60%)

of the participants thought that their knowledge in CAM is low to very low. However, almost half of

them (49.3%) thought that CAM had high effectiveness and only 6.6% thought CAM had minimal or

no effectiveness. Meanwhile, 90.3% thought the safety of CAM was low to moderate. When they

were asked if they would recommend CAM to their patients in the future, 51.7% were uncertain;

whereas 41.4% and 7.0% would recommend and would not recommend CAM, respectively.

Interestingly, 87.4% agreed that CAM should be included in the medical curriculum. Overall, most

Thai medical students seemed to have positive attitude towards CAM, but aware of their limited

knowledge and would like to learn more about it. The results of this study should be applied with

caution due to the small sample size.

Keywords: complementary medicine, alternative medicine, medical students, attitude, knowledge


21Th

Century Skills and Voluntary Community Services among Medical Cadets,

Phramongkutklao College of Medicine 21Th

Century Skills, Social & Emotional Skills

Theethach Eamchotchawalit¹*, Phunlerd Piyaraj²

¹ Phramongkutklao College of Medicine

² Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand

*Corresponding author email: [email protected]

Abstract

Introduction: Medicine is a service-oriented profession which requires professional attitudes

and a sense of empathy and caring. Participation in voluntary community service (VCS) among

medical students is associated with numerous positive outcomes that essential for 21th century skills,

such as promoting empathy, enhancing leadership qualities, good collaboration, social responsibility

and ease in communication. Objective of study: This study aim to examine the motivations and

obstacles among medical cadets in Phramongkutklao College of Medicine (PCM) from participating

in VCS. Methods: This cross-sectional study was conducted among medical cadets at PCM in

October 2019. An anonymous online survey was designed to assess demographic data, perceptions,

motivations and obstacles towards com VCS activity. Result: Of 600 students enrolled in the 2019

academic year, 197 (32.8%) responded the online survey, where males constituted (60.9%). Of these,

63.4% had participated in VCS while 80.2% expressed their interest in participating in these activities

in the medical school. Motivations to participate in VCS include past-positive VCS experience and

compassion. Students reported higher empathy levels, improved communication, organization,

decision-making, interpersonal, and leadership skills. In the other hands, the obstacles include

difficulties in recruiting and managing volunteers and attaining recognition for the project to acquire

funding and resources. Conclusion: Beyond the command of knowledge and facts the core

competencies for medical students in 21th century must include social and emotional skills such as

empathy, leadership, communication, collaboration. Participating in VCS in medical school enriches

medical students by bringing about improved self-reported outcomes, leadership skills, and

interpersonal skills.

Keyword: 21th century skill, Voluntary community service, Motivation, Obstacles


The Initial Study of Efficiency and Satisfaction of Multimedia Flashcard Application in

1St

Year Medical Students, Khon Kaen University

Buri Sritrakool1, Chanapa Chaisakgreenon

1, Godchamon Laohaviroj

1, Krit Na Nongkai

1,

Saritkeat Rerktanakajorn1, Thitipong Nonnoi

1, Wasin Soisook

1* and Waranon Munkong

2

1 1

st year medical student,

2 Department of Student Affair, Faculty of Medicine, Khon Kaen University,

Khon Kaen, Thailand


Abstract

A large number of literatures indicate that retrieval practice and spaced repetition learning can

help students improve memory and better long-term retention of knowledge. Anki is a free, open-

source, multimedia flashcard application based on test-enhanced learning and spaced repetition

theory, which is prevailing in the western medical student. Our initial objectives are to make our

medical students try to use this application for enhancing their learning, and practicing the long term

memory, including to support self-efficacy belief before their exam. In a short term period, 15% of

our 1st year medical students have participated in our initial study. Efficiency of Anki seems to be

high, because most of participants (98%) have satisfied with this application and our management

process. Moreover, in term of memorized efficiency and self-efficacy belief before exam, 93% of

them have satisfied. Finally, for a long term of application engagement, the population is divided into

2 groups, continuous (41%) and discontinuous (59%) users, which can be an interesting topic for the

next study.

Keywords: spaced repetition learning, multimedia flashcard application, self-efficacy belief before

exam


Implementation of Simulation Based Medical Education (SBME): The Use of

Normalisation Process Theory (NPT) to Elucidate Process and Outcome Drivers

Tanongson Tienthavorn

1, Stella Howden

1, Lysa Owen

1, Stuart Cable

2

1 Centre for Medical Education, University of Dundee, 2 School of Nursing, Edinburgh Napier

University

Corresponding author’s Email: [email protected]

Abstract

Introduction: Simulation Based Medical Education (SBME) is an approach used to support medical

student development through experiential learning in a safe, mock representation of realistic situations

(Purva, Fent, & Prakash, 2016). Objectives: This paper reports on the exploration of SBME in the

Dundee undergraduate medical programme to illuminate enablers and inhibitors of the

implementation using Normalisation Process Theory (NPT) as a framework. Methods and materials:

The study adopted a qualitative, interpretative methodology using in-depth, semi-structured ‘elite’

interviews with staff involved in leading and supporting the implementation. Data were analysed

using an explanation building and a logical model approach described by Yin (2014) within the

constructs of NPT. Results: SBME in Dundee is embedded and integrated across five years of its

undergraduate programme. It was acknowledged as an important learning activity to prepare students

to meet the professional/clinical learning outcomes (Coherence). A range of activities including

positive feedback loops and leadership support were seen to be a crucial component to the

implementation and legitimisation of SBME (Cognitive participation). Contextual factors, particularly

health needs and the General Medical Council (GMC), were perceived as main drivers to securing the

involvement of clinicians/unit leads who helped systematise and disseminate SBME as a learning

vehicle (Collective action). Improved students’ learning experiences appraised through internal and

external mechanisms supported the co-development of SBME (Reflexive monitoring). Conclusions:

NPT offers a useful framework in illuminating the implementation of the Dundee SBME approach.

This framework offers a structure to support the translation of this approach to different contexts.

Keywords: Simulation Based Medical Education, Coherence, Cognitive participation, Collective

action, Reflexive monitoring


Leveraging Internal Quality Assurance (IQA) Program Using Web-Based Application:

Initial Experience at Phramongkutklao College of Medicine

Anusara Vattanajun, Sommai Yochana, Nutchon Charoenphol and Dusit Staworn.

Office of Quality Assurance in Education, Phramongkutklao College of Medicine, Bangkok, Thailand.


Abstract

Objectives: To report the initial experience of using web-based application to leverage the internal

quality assurance (IQA) program by the Office of Quality Assurance in Education (OQE) at

Phramongkutklao College of Medicine (PCM).

Methods: The IQA program at PCM is composed of two mechanisms: 1) self-assessment report based

on the HEI’s IQA criteria and EdPEx criteria, 2) IQA visit. The web-based application was introduced

in 2018. Each department prepares the self-assessment report (SAR) via an online SAR template

(relevant documents and photos included). The dates for the IQA visit were organized using the IQA

reservation program. IQA assessors could access the SAR via any mobile devices and prepare the

report via the IQA report program. The IQA assessors are trained to evaluate the performance of the

department based on EdPEx criteria. Online survey as well as focus group discussion (FGD) at the

end of IQA visits were used to collect the feedback of all relevant parties.

Results: The feedbacks from all relevant parties are very positive. Less time was used by the

departments to prepare the SAR and by the OQE to prepare the relevant documents for the IQA

assessors. The IQA visit schedule took only 9 minutes to organize via an online reservation program.

The areas for improvement were identified as more responsive and user-friendly program.

Conclusion: Using web-based application helps the OQE to manage the IQA processes more

effectively. Responsive and user-friendly program is an enabler for the project to be successful.


Quality of Life and Association Factors of Medical Cadet at the Phramongkutklao

College of Medicine, 2019

Putt Narongdej1*

, Phunlerd Piyaraj2

1Phramongkutklao College of Medicine, Bangkok, Thailand

2Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand

* Corresponding author’s Email: [email protected]

Abstract

Introduction: Quality of life (QoL) is an essential component of learning and has strong

links with the practice and study of medicine. During the process of their education, medical students

learn to attend to the QoL of their patients. However, their own QoL can begin to decrease early in

medical school. Objectives: This study was to evaluate QoL of medical cadets in Phramongkutklao

College of Medicine. Methods: A cross-sectional survey was conducted in October 2019. We using

the Thai version of the World Health Organization Quality of Life Instrument (WHOQOL – BREF –

THAI) to assess psychological well-being, physical health, social relationships and environmental

conditions of Medical cadets. Results: The total of 216 medical cadets in every educational year were

enrolled into the study, where males constituted (57.4%). In general, 35.7% of the students described

their QoL as “good”, 58.2% as “average”, and only 6.1% felt it was “poor”. With regard to QoL

domains were reported by study students at good level were as the following; 46.48% in social

relationships domain, 34.74% in psychological domain, 31.46% in physical health domain and

28.17% in environment domain. Less sleeping time was significantly associated with poor QoL

among medical cadets (odds ratio = 3.73, 95% confidence interval, 1.85 – 7.51). Conclusion: Future

doctors with a low QoL may translate into their poorer performance, impairing patient care. Sleeping

time is associated with overall poor QoL. Finding other factors that correlated with poor QoL is

important. Further study for evaluating QoL in medical cadets is recommended.

Keywords: Quality of life, Medical cadet


Fourth Year Medical Students’ Experiences in Transitioning to the Clinical Practice

Sukanya Srisawat1*

, Chitkhwan Kaewjungwad1, Supaporn Dissaneevate

2, Busayamas Suttisang

1

1Educator, Registrar’s Division, Faculty of Medicine, Prince of Songkla University, Hat Yai,

Songkhla, Thailand

2Assistant Professor, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University,

Hat Yai, Songkhla, Thailand

*Corresponding author’s Email: [email protected]

Abstract

Experiences in transitioning from preclinical to clinical practice of 4th year medical students’

initiate insight to develop effective clinical teaching strategies in medical education at Prince of

Songkla University. The objective of this study was to explore 4th year medical students’ perceptions

of their first clinical year. Four group of students were assigned to clinical practice rotations. Twelve

students were randomly selected from each group, totaling to 48 students. First focus group interviews

were conducted during the first week of rotation of each group. The second focus group interviews

were conducted at the end of second rotation of each group. All focus group sessions were recorded

and transcribed literally. Qualitative content analysis of the transcription was performed. From the

students’ points of view, 5 themes of common concern could be derived. They were 1) initial clinical

anxiety, 2) knowledge and skills, 3) clinical supervision, 4) clinical reasoning and 5) patient

encounters. These findings indicated medical students’ anxiety in their initial clinical placement.

Apparently the students were not confident in their own knowledge and skills to take care of various

patients.

Keywords: anxiety, perceptions, transitioning, focus group


Relationship of Resilience, Stress and Job Burnout in First-Year Residents

Gobhathai Sittironnarit 1, Sasipat Senawong

1, Thanayot Sumalrot

1, Wachiraya Lertgrai

1

1 Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Corresponding Author’s E-mail : [email protected]

Abstract

Resilience is the ability to face adversities and overcome obstacles. Resilience encouraged

efficiency in workplace’s environment. Therefore, we aimed to study the relationship between

resilience, stress, and job burnout in first-year residents. Participants included 140 first-year residents

who completed a self-administered structured questionnaire which analyzed through qualitative

methods by SPSS verion 18. The results demonstrated that most of the sample had average level of

stress and resilience. Everyone perceived and valued personal achievement. About half of them

experienced higher emotional exhaustion but lower depersonalization than average.Resilience had an

inverted relationship with stress (r = -0.643, p < 0.001) and job burnout in all aspects (r = -0.342 to -

0.487, p < 0.001). As a correlation, resilience correlated with being dependable on their families,

experienced of potential resignation, and risks in having mental health problems. Furthermore,

resilience also correlated with overall job satisfaction (r = 0.370, p < 0.05), with self-satisfaction in

regards to work (r = 0.420, p < 0.001) had higher correlation than satisfaction of receiving funding

from various places (r = 0.166, p < 0.05). In conclusion, level of stress should be decreased as well as

job burnout to foster resilience.

Keywords: Resilience, Residents, Stress, Job burnout


Implementation and Evaluation of an Educational Intervention on Drug-Drug

Interactions for Medical Students

Veerapong Vattanavanit1*

, Rattana Leelawattana1, Jaroenporn Kawla-ied

1, and Sirima Sitaruno

2

1 Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand

2 Department of clinical pharmacy, Faculty of Pharmaceutical science, Prince of Songkla University,

Hat Yai, Thailand


Abstract

Introduction: Drug-drug interactions (DDIs) are common adverse events, leading to morbidity and

mortality. A case-based approach for teaching DDIs was designed for sixth year medical students at

Songklanagarind hospital.

Objectives of the study: To evaluate the effect of DDIs training.

Methods: This study is a cross-sectional study. DDIs training is described and evaluated for

effectiveness, using Kirkpatrick’s model for learner-centred outcomes. The sixth-year medical

students participated in a two-week course; during an internal medicine rotation in 2018, consisting of

orientation, cased-based approach, feedback and reflection. The evaluation process consisted of: 1) an

immediate post-course survey to measure learner satisfaction, 2) knowledge assessment with a Likert-

type scoring by attending physicians, 3) a three-month follow-up self-report to measure behavioural

change, and 4) number of DDIs that occurred in medical patients before and after educational

intervention. Data were collected through a researcher-made questionnaire, and electronic medical

records.

Results: All 58 medical students participated in the evaluation process. Learner satisfaction was high,

with an average score of 4.22 ± 0.80 (on a 1-5 scale). Attending physicians reported students’

knowledge Likert scores of 3.02 ± 0.57 (on a scale of 1-4). Participants reported behavioural change

after 3 months of training 94.82%. Lastly, miss events of DDIs after the course were significantly

lower than at the beginning (7% vs. 19%, P=0.012).

Conclusions: The DDIs training was a successful medication safety intervention in this setting, as

measured by the Kirkpatrick model. Future research along with evaluation should focus on translation

into practice in a general practitioner setting.

Keywords: drug-drug interactions, medication safety, medical students


Enhancing the Student-Preceptor Relationship by Promoting Preceptor’s Role in

Developing Preceptee’s Clinical Skills and Professionalism at the Bedside During

Pediatric Clerkship

Soraya Chatchawalanon, Boonchai Boonyawat, Sanitra Sirithangkul, Ruangvith

Tantibhaedhyangkul


Abstract

Objectives: To enhance the student-preceptor relationship by promoting preceptor’s role in

developing preceptee’s clinical skills and professionalism at the bedside.

Method: Longitudinal preceptorship has been developed for all 4th-year medical students during

pediatric clerkship at Phramongkutklao College of Medicine since 2012. Preceptor’s role has been

expanded to include direct observation of medical students’ performance during clinical encounter to

improve clinical skills and professionalism. Each student was required to meet his/her preceptor to

discuss the first patient’s history and physical findings as well as patient assessment before submitting

the medical write-up. The preceptor would then observe the student’s history taking and physical

examination skills at the bedside. Feedback and coaching were provided at the end of the case

discussion. Students were encouraged to immediately reflect on their learning experience.

Results: Medical students were highly satisfied with the preceptorship program. They reported

gaining more confidence after receiving feedback and coaching from the preceptor. Focus group

discussion revealed that students were more likely to ask for feedback from the preceptor and their

clinical reasoning skill improved from this activity. Preceptors indicated that quality of students’

written report improved after this activity.

Discussion and Conclusion: By promoting preceptor’s role in developing preceptee’s clinical skills

& professionalism at the bedside, we were able to enhance the student-preceptor relationship.

Students highly valued the just-in-time feedback and coaching after clinical encounter.


Factor Analysis of Spirrituality as Medical Teachers, Faculty of Medicine Siriraj

Hospital, Mahidol University

Miss Pattaraporn Naknagraed1, Miss phachadapan Odompet

1

1Educator Division of Medical Education, Faculty of Medicine Siriraj Hospital, Mahidol University,

Bangkok, Thailand.


Abstract

The research aimed to exploratory factor analysis of spirituality as medical teachers. The

sample consisted of 300 professors from the Faculty of Medicine Siriraj Hospital, Mahidol

University. The instrument of this research is questionnaire concerning the characteristics of

spirituality as medical teachers, Content validity by Index of Item-Objective Congruence was

between 0.60 to 1.00 and the alpha coefficient reliability was 0.98. The data were analyzed using

an Exploratory Factor Analysis (EFA) with the factor extraction consisted common factor

analysis (CFA) by principal axis factor (PAF) and orthogonal by varimax method. The results of

this the research were 7 factors with 1) Roles and duties as a medical teacher 2) Operating in an

Integrity profession 3) Responsibility 4) Innovation and academic works 5) Soulful of faith in the

profession, medical teachers 6) Consider the benefits of work and altruism 7) Focus on self-

development and journey to excellence. In particular, the obtained factors accounted for 63.81

percent of spirituality as medical teachers. In conclusion, the doctor who teaches or called

"medical teacher" should have the spirit of being a teacher because the doctor is not only treating

patients but also has to teach medical students to have knowledge, skills, and attitudes so that

Able to treat patients effectively.

Keywords: Factor Analysis, Spirituality, Medical teacher


Development and Evaluation of a Student Feedback Questionnaire of Academic

Experiences

Ittipol Pongphanruam1, Nuengruethai Wisalee

1*, Pornchanok Pobundit

1, Juthamas Siriwatsopon

1,

Sirin Supatheerawong1

1 Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol



Abstract

The Sirindhorn School of Prosthetics and Orthotics has developed a ‘student feedback’ based

on the formative and summative assessment theory introduced by Michael Scriven. This study aimed

at evaluating the validity and reliability of the questionnaire and also compared the students’ feedback

given at the midterm and the end of the module. 80 participants were recruited for this study. The

sample size was calculated using the Preacher and Coffman method and data were analyzed for

reliability and Paired T-Test was utilized using SPSS 23.0, and Confirmatory Factor Analysis using

LISREL 9.1. The research findings were as follows: the instrument’s reliability via Cronbach’s Alpha

for reliability was 0.832 – 0.921. Validity examined by a CFA was satisfactory because a good fit to

the data was found for a model of student feedback (Chi-square 35, p = .092). It was discovered that

the students’ feedback given at the midterm and the end of the module had statistically significant

differences, at the alpha level of 0.05. The results indicated that the student feedback questionnaire

had good reliability and construct validity. Moreover, the students evidenced higher questionnaire

scores at the end of the module when compared to the intermediate data collection points.

Keywords: student feedback, reliability, validity


Improvement of Self-Efficacy after Simulation-Based Practical Management in

Obstetric Emergencies (PMOE) Training among Sixth-Year Medical Student

Anantaporn Nomrak1*

, Tachjaree Panchalee2, Vuthinun Achariypota

2, Vitaya Titapant

2, and

Perapong Inthasorn*2

1 Division of Medical Education, Department of Obstetrics and Gynecology, Faculty of Medicine

Siriraj Hospital, Mahidol University, Bangkok, Thailand. 2 Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol

University, Bangkok, Thailand.


Abstract

The obstetric emergency is the life-threatening situation that required a particular precisely decision to

manage these circumcisions. Medical students, mainly the sixth-year medical student, are required to

cope with these situations. However, because of a large number of medical students and the gradual

decline of pregnancy rate in Thailand, not every sixth-year medical students are not familiar with

obstetric emergencies. To solve this problem and improve self-efficacy, the Department of Obstetrics

and Gynecology (OB-GYN), Faculty of Medicine Siriraj Hospital are consistently setting simulation-

based learning, Practical Management in Obstetric Emergencies (PMOE), for the sixth-year medical

students. The obstetric emergency simulations comprise shoulder dystocia delivery, assisted vaginal

breech extraction, vacuum extraction, postpartum hemorrhage management, eclampsia treatment,

prolapsed umbilical cord management, and electronic fetal monitoring interpretation. We conducted a

cross-sectional survey of 308 sixth-year medical students who passed four weeks of OB-GYN

rotation. The study revealed that PMOE training significantly improved self-efficacy scores (p-value

< 0.001). In conclusion, sixth-year medical students could gain experience and knowledge in obstetric

emergency management after PMOE training.

Keywords: Obstetric emergency, simulation-based learning, sixth-year medical student, self-efficacy,

medical education


Student Feedback can be a Tool to Improve the Jigsaw Technique Implemented on

Case-Based Learning (CBL) for Better Learning Activity in the Second Year Medical

Students

Souvannakitti D, Vattanajun A, Hatthachote P

Department of Physiology, Phramongkutklao College of Medicine, Bangkok,

Thailand


Abstract

Objective: To improve the process of Jigsaw technique implemented on Case-based learning (CBL)

in the second year medical students and compare student satisfaction and responses between the first

and the second implementation.

Material & Method: The jigsaw technique was implemented for the first time to enhance CBL in the

Cardiovascular and Respiratory system. A focus group discussion for this technique combined with

self-evaluated information including ratings from 1-10 were the method of gathering feedback from

medical students. Information on problems, limitations and benefits during usage of the jigsaw

technique were brought into the block system committee for better planning and improving learning

process. The improved-jigsaw technique was implemented for the second time in The Medical

Neuroscience-1 system. Comparison of student feedback between the first and the second usage were

carried out. Rating score was presented as mean ± SD and the student responses were analyzed.

Results: As compared to the first student feedback, the second implementation after adjusted

limitations and processes satisfied the medical students with rating scores increased from 6.67 ± 1.57

to 7.18 ± 1.70. The analysis of self-evaluated responses showed that the improved-jigsaw technique

promoted better learning and developed various skills such as team work, communication skill,

searching information skill, and provided experience to share responsibility to the group.

Discussion & Conclusion: Listening to useful student feedback can invite block committee to

improve method used on CBL in this setting and using feedback effectively can be a valuable tool to

enhance student learning activity.


Implementing Entrustable Professional Activity (EPA) Framework for Assessment of

4th

-Year Medical Cadets: Initial Experience

Pongthorn Narongroeknawin1*

, Ouppatham Supasyndh1, and Dusit Staworn

1

1 Phramongkutklao College of Medicine, Bangkok, Thailand


Abstract

Introduction and objective. Entrustable professional activity (EPA) is a new paradigm in

undergraduate competency-based medical education (CBME) bringing great promise to enact

competence-based education in the workplace. Implementing EPA requires changes to systems of

assessment including increased frequency of formative and increased specificity and quality of

feedback. We have initiated an EPA framework since 2018.

Methods. Five EPAs and milestones have been formulated for the clerkship years. Two EPAs has

been selected and implemented during the internal medicine rotation of the 4th-year medical cadet. We

modified our mini-clinical evaluation exercise (mini-CEX) evaluation form to comply with each EPA.

Electronic logbook was also developed to facilitate teacher’s feedback, student’s reflection, and data

collection.

Results. One hundred and four medical cadets and 36 teachers were participated in this pilot phase.

Seventy-two percent of medical cadets assessed by EPA reported that EPA helped them gain more

clinical skill and medical knowledge compared with 62% of medical cadets assessed by mini-CEX.

Eighty-two percent of teachers indicated that EPA is feasible and useful assessment method.

Furthermore, there was a significant correlation between the number of trusted activities of the

students and their summative objective structured clinical examination (OSCE) score.

Discussion & Conclusions. Our initial experience revealed that implementing EPA framework for

workplace-based assessment is not only feasible but also helpful to shape clinical skill and medical

knowledge in our undergraduate medical education program. Currently, we are working to implement

all 5 EPAs in all clerkship years.

Keywords: entrustable professional activities, EPA, mini-CEX, competency-based education



Translational Parasitology: Bridging Medical Science and Practice from Bench to

Community

Picha Suwannahitatorn1*

, Phunlerd Piyaraj1, Toon Ruang-areerate

1, Paanjit Taamasri

1, Mathirut

Mungthin2

1Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand

2Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, Thailand

*Corresponding Author’s E-mail: [email protected], [email protected]

Abstract

From bench to bedside perspective, translational medicine offers the integrative approach

from basic medical science to clinical practice. This fundamental concept is applied to teaching and

learning process in Medical Parasitology where medical students could utilize knowledge, exercise

practice and provide intervention to the community. From bench to community, translational

parasitology comprises of core contents and laboratory skills in 3rd

year curriculum. Later, medical

students will conduct a health survey in rural community where they provide stool examination for

parasitic infection and survey for head louse infestation then the intervention will be developed as

community participation to engage the parasitic infection problem. In their 4th year, medical students

will learn about epidemiology and research methodology. Research in parasitology will also be

developed to investigate the risk factor and burden of parasitic diseases in the community. Ongoing

health intervention model will be developed and exercised with community stakeholders. In 5th year,

their works will be distributed to academic community through presentation and publication. As

externship in 6th year, integrated knowledge and skills would potentially support their work as medical

practitioners in Thailand healthcare system, where parasitic infections are still a major health burden.

Keywords: translational parasitology, translational medicine, medical parasitology


The Study of iPad Usage Behavior among the Second and Third Year Medical Students

in Mae Fah Luang University

Nanthaporn Leedeesri 1, Yotsaphon Akkarathunyarat 1, Suwipha Suwannatt 1

1 School of medicine, Mae Fah Luang University, Chiangrai, Thailand

Corresponding Author’s E-mail: [email protected]

Abstract

Over the last several years, the trend of using iPad among medical students increase rapidly

because the tablet has a role in promoting learning on medical education. The purpose of this research

report was to study of iPad usage behavior among the second and third year medical students in Mae

Fah Luang University. A cross sectional descriptive study was used. The sample were 49 second and

third year medical students in Mae Fah Luang University. A study found that an average iPad usage

hour among second and third year medical students was 56 hours 18 minutes/week. Productivity is the

application group that is used the most. An average hour of Productivity usage is 36 hours 32

minutes/week (64.82%).The results of this study can be seen that the most usage of iPad of medical

students of second and third years are the applications used in education.

Keywords: iPad, medical student, Education


Effective Intervention for The Undergraduate Prosthetic and Orthotic Student-at-Risk-

Program

Sirintip Kaewtip1*

, Sirirat Seng-iad1, and Prawina Sutdet

1

1 Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol



Abstract

Students-at-risk, who encounter academic achievement problem, receive learning support and

intervention. Unfortunately, the extent to the successful intervention has been less explored especially

in the prosthetic and orthotic (P&O) students. Therefore, a mixed-method study was conducted in the

featured P&O School to evaluate the extent to which facilitate the program called ‘student in

attention’ success. The study of student-at-risk from academic year 2017-2019 including the

intervention details, perspective of involved teachers and students and also the students’ performance

at pre- and post- interventions has been described. The potential applications and recommendations

have been proposed for other study programmes.

Keywords: student at risk, education intervention

abstract - mahidol university

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