Theses (Master in Health Professions Education)

Language, as a form of communication, is crucial for healthcare professionals as they communicate with various stakeholders including patients, patients' families, other healthcare professionals, administrators and students. Hence, it is important for them to have good communication skills, particularly proficiency in English, as English language is widely used in the field of medicine. While literature emphasises the importance of communication and language skills for medical students, there is a gap of knowledge on medical students’ perception on the importance of the English language skills during their medical education, and subsequently to the medical profession. Hence this study intends to explore medical students’ perception of the importance of English language. A qualitative study via focus group method was conducted where medical students were interviewed on their perspectives. A total of 6 sessions of focus groups were conducted, with 24 students. Data obtained were analysed by themes using the Braun and Clarke (2006) thematic analysis framework. Three main areas of the study include the use of English language in medical education, the influence of university culture in English language mastery and the impact of English language proficiency on medical students. Themes coded from the data indicate that medical students perceive English language to be important in 3 aspects, namely English language as a learning tool, a professional language and as a communication tool. Students discussed the availability of university and peer support in their mastery of English language. The study also found that English language proficiency impacts students’ academic progression, communication and personal and professional development. The study concludes that language awareness is important for medical students to deliver high quality patient care as language barriers during patient communication impedes patient care quality.

Introduction Effective communication is an essential skill in a patient-centred doctor-patient-relationship. Although medical graduates acquire communication skills during undergraduate training, these have been shown to be inadequate for their careers. The aim of this study was to close the gap in preparing medical students with patient-centred communication skills in readiness for the workplace for improved patient satisfaction and health outcomes. Methods A phenomenological study design using in-depth individual interviews was conducted on Semester 6 medical students and patients to study their experience in an outpatient department at a primary care clinic over two weeks. Data was transcribed verbatim, analysed, and triangulated with patients’ views on cross-cultural communication with students. Thematic analysis of Braun and Clark was used to analyse data. Results Three themes emerged namely, factors that play a role in communication skills of medical students, and perceived enablers and challenges of communication skills of medical students and patients in the primary care setting. Factors affecting communication skills were language, cultural beliefs, level of maturity and stage in students’ training, and patients’ socio-economic status. Enablers in communications skills includes adopting a biopsychosocial approach by establishing rapport, building trust, showing empathy, ensuring patient’s comfort and respecting their privacy, as well as, engaging in early and continuous experiential learning, using non-verbal communication, and engaging in self-reflection. Challenges faced by both students and patients were patient’s lack of trust in western medicine, students’ difficulty in eliciting sexual history, students’ emphasis on taskorientation, cultural insensitivity, student’s speech anxiety, and patients’ emotional state. Conclusion Results of the study identified the factors, and the enablers and challenges that influenced patient-centred communication skills of medical students in undergraduate training which could close the gap for patient satisfaction and improved health outcomes at the workplace. The study also reiterated the importance of early and continuous experiential in authentic work-based settings.

The achievement of learning goals in laboratory practicals depends on both extrinsic and intrinsic factors, and could be limited by laboratory time, incurred cost, safety, self-efficacy, inadequate prior preparation by learners and different learning styles. Besides, face to face laboratory sessions could be continuously interrupted as seen during the COVID-19 pandemic. Hence, virtual laboratory simulation (vLAB) may be an appropriate e-learning tool to overcome these restrictions. In this study, students' perception about the usefulness of vLAB was determined by using DNA gel electrophoresis and PCR as case examples. The perception of Year 2 and 3 health science undergraduate students’ (N=87) was studied using a questionnaire consisting of 12 items, rated on a 5-point Likert-scale. In addition, students experience and learning from the vLAB was further explored using qualitative analysis. Results showed that all participants perceived vLAB well, with a median score of 4(Agree for all items in the questionnaire. It provides a meaningful learning experience and an authentic environment where students feel safe to practice what they have learnt in lectures. Moreover, vLAB facilitates individualised learning and enhances selfefficacy among students. In conclusion, vLAB prepares students for physical laboratory sessions by activating the prehension dimension of the Kolb’s learning cycle, hence complementing and strengthening the attainments of health sciences laboratory learning goals and outcomes.

The study explored the practice of self-regulated learning (SRL) by university students in health professions programmes in an international medical university. Undergraduate students recruited from five different programmes took part in Focus Group Discussions. The data collected were analysed thematically following which three major themes were identified. It emerged that students had different goal orientations and had varied expectations from the university and therefore diverse academic orientations. These factors directed the practice of SRL by the students who applied different personalised study techniques for regulating their learning to reach their goals. Their view on success depended on their personal disposition, their goals and was contextual to their pattern of engagement. The 21st century learners were found not leaning heavily on academic pursuits alone but were equally focused on their self-development in terms of soft skills like communication and networking, leadership, problem-solving etc. and to gain a wholesome university experience. The findings of this study highlight the need for universities to meet the futuristic demands of the current students to acquire the qualities required for the future job market.

The Covid-19 pandemic imposes global disruption. Closing of medical schools including all teaching activities and clinical placement is mandatory to reduce the risk of spreading the disease. These sudden changes may have a significant effect on medical students’ well-being. This study aims to explore the challenges faced and coping strategies used by preclinical year medical students during a pandemic. This is a qualitative study involving 11 preclinical year medical students; four international and seven local students. The study, conducted between August 2020 and September 2020 at an international medical university in Malaysia, explored the mental health and well-being challenges the students faced during the pandemic, and their coping strategies. The data were analyzed through thematic analysis to assist in answering the research questions. Multiple challenges contributing to the medical students’ mental health were identified. These included the psychosocial impact of quarantine, significant lifestyle changes, and impact of skills competency and professional progression during a pandemic. The students used behavioral strategies, re-appraised the uncertainties of situation, applied active coping mechanism, and regulated their emotion with coping reserve to manage the challenges during a pandemic. There are indications of personality traits underlying the way medical students choose to cope with challenges faced during pandemic which may either lead to resilience building or experiencing burnout. The findings of the study highlighted the urgent need to develop preventive measures and intervention strategies to address the mental health of medical students to mitigate stress and promote positive well-being.

Background: Learning analytics (LA) is a tool for gathering, analysing, and interpreting the data related to student’s learning behaviour, engagement and performance. As the student data are main sources to construct LA, this study was aimed to explore medical and health professions students’ perceptions on the use and values of LA. Method: A sequential mixed method research design was used in this study. Validated questionnaire was distributed to undergraduate students of Medical, Dentistry and Pharmacy programmes to collect their general perception on LA. Focus group interviews were then arranged to explore their perception in-depth and thematic analysis was performed. Results: The students were aware of their demographic data, utilisation of learning management system and academic performance data being collected by the university. They were agreeable for collection of those data which had direct association with their learning to be used for LA in order to contribute towards improvement of learning experience and environment. However, they had expressed their concerns on their privacy, confidentiality, and security about their data. Five themes emerged from the interview, i.e., outcome-based education, personalised learning and student support, evidence-based decision-making, data management and analysis, and data confidentiality and privacy. Conclusion: LA is a useful tool to promote personalised learning as long as precautions are taken by the education institutions to ensure data privacy and security.

BACKGROUND: Resilience is robustly connected with mental well-being. It has been suggested that possessing resilience can expedite recovery from stressful incidents and act as a preventive measure against mental health issues. Notably, students in health professions programmes experience elevated levels of stress and anxiety due to academic workload and other reasons. This study aimed to investigate the contributing factors influencing the resilience and explore effective support systems that universities can implement to assist undergraduate health professions students in fortifying their resilience and managing their mental health. METHODS: The study was conducted using qualitative method. A total of 28 students from the fields of medicine, dentistry, pharmacy, and nutrition with dietetics participated in semistructured interviews. All interviews were audio-recorded and transcribed verbatim. The interviews were stopped when no new theme emerged. The data were analysed using a thematic analysis approach to explore the contributing factors influencing resilience and identify effective support systems. RESULTS: Thematic analysis following the interviews revealed five key themes: life experience, socioeconomic factors, personal attributes, support resources, and role modelling as the contributing factors to resilience. Universities play a key role in fostering health professions students' resilience through soft skills training workshop, workplace-oriented training, mentoring and extracurricular activities. These opportunities allow students to cultivate and enhance their resilience both within formal curriculum settings and through participation in extracurricular endeavors. CONCLUSION: This study provided a comprehensive understanding of contributing factors of students' resilience. The availability of support resources together with a nurturing environment provided by university are essential for the training of healthcare professionals to be adaptive to the demanding and fast changing landscape of healthcare.

Background: Learner agency is recognised as a critical attribute in health professions education, influencing students’ motivation, engagement, and capacity for self-regulated learning. However, the relationship between assessment practices and learner agency in medical education remains underexplored. Objective: This study explored the perceptions and experiences of undergraduate medical students regarding assessment practices and their influence on the development of learner agency within the MBBS programme at IMU University. Methods: A qualitative phenomenological design using focus group discussions (FGDs) was employed to examine the experiences of 27 medical students across Years 1 to 4. A purposive sample of 21 females and 6 males from diverse backgrounds participated in seven online FGDs conducted via Microsoft Teams©. Each session included 3–5 students. Data was analysed using iterative transcript review, inductive coding, and thematic analysis. Results: Three main dimensions of learner agency—environmental, behavioural, and intrapersonal—emerged as central to students’ experiences. Continuous assessments and timely, constructive feedback supported engagement and self-regulation. However, variability in feedback quality, limited student voice in assessment design, and lack of clarity in expectations hindered students’ sense of control and ownership of learning. Conclusion: Assessment practices significantly influence the development of learner agency among medical students. Enhancing the quality of feedback, promoting opportunities for co-agency, and designing student-inclusive assessment systems may strengthen learner empowerment and self-directed learning within medical education.

Virtual reality (VR) is an emerging tool to enhance teaching and learning across multiple fields, including health professions education. Usage of VR in training undergraduates and postgraduates have shown benefits, however there are few studies in literature with regards to faculty motivation to adopt VR, creating a significant barrier to successful implementation of VR in higher education setting. Identifying key factors which motivate faculty to use VR is the main purpose of this quantitative study, performed from the lens of a South-East Asian perspective within a tertiary education centre. Data was collated in the form of an adapted survey and analysed using social learning theories. Face and content validation was performed by a panel of experts. Reliability testing was performed using Cronbach’s alpha for most constructs. The analysis revealed that enhanced student engagement, improved learning outcomes, interest in contemporary learning methods, institutional support for VR, professional development opportunities, and educational research were significant factors that motivate faculty to use VR in the undergraduate teaching and learning environment. Faculty with personal motivation placed higher weightage on these factors compared to those who did not possess intrinsic motivation, suggesting they are interested in using VR. The implications were that faculty with personal motivation are likely to be the early adopters of VR. Coupled with strong university guidelines geared towards technology enhanced learning, advancement of health education using VR is possible with strong leadership, adequate material resources and competent support staff. More research using qualitative methods and exploration into the psychology of adopting new technology is recommended. As technology advances, so too should the leaders of health professions adapt to the needs of the 21st century healthcare professionals. (277 words)

Students frequently react negatively to academic remediation. Moreover, research shows that remediations tends to offer “more of the same” without addressing the underlying factors contributing to poor performance of the students. Recognizing this gap, the present study seeks to explore the experiences, challenges, and coping strategies of underperforming pre-clinical medical students during their period of academic remediation. This study was guided by two theories: the self-regulated learning theory and the Lazarus coping theory. Eight participants were purposely sampled based on the inclusion criteria of failing more than two consecutive assessments in a semester and/or failing a summative examination, and they underwent academic remediation as a result. A descriptive qualitative research design with semi-structured individual interviews was employed for data gathering. The interviews were transcribed, and the data were analysed using Braun and Clarke’s Six Phases of Thematic Analysis. A total of five themes were established. The themes include “Remedial Sessions Helpful and Great”, “Academic Pressure & Emotional Turmoil”, “Academic Exposure of Failure”, “Acceptance of Failure & Self-Directed Growth After Academic Setbacks” and “Peer Influence & Alumni Support in Academic Recovery”. Students provided insights into their perspectives while on academic remediation and its effects on their personal, social and academic life. Several significant trends were found related to academic gains, students’ participation, as well as faculty and peer interactions during academic remediation. However, students frequently expressed concerns about privacy in online grouped remediation sessions and the strong emotional toll that arose from academic setback and failure. The results of this study support the need for proactive academic remediation efforts which focus on fostering skills like goal setting, effective course revisions within a limited time, resourcefulness and self-reflection, while also creating a supportive environment that encourages active participation and builds confidence rather than content remediation. The study's findings add to the body of research on academic remediation efforts aimed at resolving students' difficulties and promoting their general well-being in a vulnerable state to improve their overall experiences during the remediation phase. The insights of this study from the viewpoint of underperforming pre-clinical medical students would be helpful for the educators while designing academic remediation.

Medical students frequently experience inconsistent and inadequately structured mentorship. Moreover, research shows that mentorship programmes tend to focus narrowly on academic monitoring without addressing the underlying factors contributing to students' holistic developmental needs. Recognising this gap, the present study seeks to explore the experiences and needs of undergraduate medical students regarding mentorship during their medical training. This study was guided by three theories: Kram's Mentoring Functions Theory, Social Support Theory, and Developmental Network Theory. Nine participants were purposely sampled based on their enrolment in Semesters 4-8. A descriptive qualitative research design with semi-structured individual interviews conducted via Microsoft Teams was employed for data gathering. The interviews were transcribed, and the data were analysed using Braun and Clarke's six steps of thematic analysis. The themes for the mentorship experiences and needs were constructed. The experience themes include "Mentorship as Multifaceted Support System," "Quality of Mentor-Mentee Relationship and Communication," "Mentorship as Catalyst for Growth," "Mentor Attributes and Credibility," and "Structure of Systems." Meanwhile the themes for need of mentorship include "Academic Support," "Trusting Relationship," "Driver of Growth," "Systems that Enable Support," and "Credible, Well-Prepared Mentors." Students provided insights on their mentorship experiences and needs as well as its effects on their personal, academic, and professional development. Several significant trends were found related to academic guidance, emotional support, career preparation, networking, and research engagement. However, students frequently expressed concerns about poor mentor responsiveness, inadequate career guidance, dysfunctional communication infrastructure, and strong emotional impact from a lack of proactive support and unclear expectations. The results supported the need for comprehensive mentorship programmes focusing on career planning, time management, stress management, networking, and research competencies, whilst creating supportive environments characterised by psychological safety, genuine engagement, and structured meeting frequencies rather than perfunctory monitoring. The study's findings add to the literature on mentorship programmes aimed at addressing students' multidimensional needs and promoting holistic wellbeing during medical training. The insights from the undergraduate medical students' viewpoint are helpful for institutions in designing evidence-based mentorship programmes.