Browsing by Author "Yodying Dangprapai"

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    ItemOpen Access
    A study of the opinions of experts in learning design to develop a learning model using community-based learning
    (Mahidol University. Mahidol University Library and Knowledge Center, 2022) Autchara Ngamnoun; Vorawan Vanicharoenchai; Yodying Dangprapai
    This study aimed to study the opinions of experts on learning design using community-based learning in medical student education and develop a model of learning design using community-based learning for medical student education. The research design was a research and development study in medical education. We created an interview form to study the opinions of five experts on learning design using community-based learning for medical students, as well as teaching and learning models using community-based learning. The methodology was conducted in three steps: Step 1—study the model of course design and opinions of experts on learning models using community-based learning; Step 2—develop a learning model using community-based learning for medical students; and Step 3—propose the finalized learning model. The results showed that: 1) The components of community-based learning design for medical student education included four areas: academic, budget, personnel, and general management. 2) The steps for designing and developing a community-based learning process consisted of nine steps: stakeholder needs and social change, affiliation with the course, deliberation consistency, appraisal learning, use of field-of-study knowledge, corresponding partners, citizenship education, peer learning, and insemination. 3) The steps of the community-based learning teaching plan consisted of four steps: preparation, insertion, learning, and evaluation. The study concluded that the model for course design in a community-based learning model for Thai medical student education includes three main components: (1) course design components, (2) course design steps, and (3) teaching plans for course design. An important limitation of this study is that it represents only the views of educators and experts in community-based learning management. The implications of this study are that institutions should inform instructors and those involved in teaching and learning, provide adequate preparation, and permit more time within the implementation process for support.
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    Active learning classes in a preclinical year may help improving some soft skills of medical students
    (2020-09-01) Korakrit Imwattana; Yodying Dangprapai; Popchai Ngamskulrungroj; Faculty of Medicine, Siriraj Hospital, Mahidol University
    © 2020 Faculty of Medicine Siriraj Hospital, Mahidol University. Objective: Active learning methods are an effective way to improve essential soft skills, such as critical thinking and social skills, and so medical educators frequently implement active learning approaches as a means to improve the soft skills of medical students. This study reports an improvement in the soft skills of medical students after the implementation of an active learning curriculum. Methods: More active learning activities were implemented in 2016 in the 3rd year medical class, involving 330 students. Overall, the number of hours devoted to active learning classes was increased from 340 hours (38.2%) in 2015 to 481 hours (59.98%) in 2016. To evaluate whether this led to any improvements in the soft skills of medical students, students undertaking the 3rd year course in the 2015 and 2016 academic years were asked to complete questionnaires to evaluate themselves (self-evaluation) as well as four other students in their same study group (peer-evaluation) at the end of the academic year. The questionnaire responses from the 2015 and the 2016 groups were compared. Results: Most students believed there was no improvement in most of the evaluated soft skills during the year. However, students in the 2016 class showed improvements in eleven outcomes in the peer-evaluation: presentation, information, technology, creativity, communication, leadership, life planning, adaptability, self-sufficiency, courtesy, and punctuality (p < 0.05). The differences were not due to the students' different background skills as the initial scores of most outcomes were identical between the two student groups (p > 0.05). Conclusion: Even without a proper design for teaching soft skills, active learning classes in a preclinical year of the medical curriculum may help improve some of the essential soft skills that medical practitioners need and, therefore, should be implemented in the medical curriculum.
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    Associated factors of resilience among medical students
    (Mahidol University, 2023) Warisa Leethanakul; Cherdsak Iramaneerat; Yodying Dangprapai
    During training, medical students experienced multiple challenges. There was reported decline of medical students’ mental health after entering medical schools. Resilience is the characteristics that promote positive adaptation in the face of adversity. Fostering resilience would help protect medical students from emotional distress. Since there were limited studies of associated factors of resilience in medical students, a greater understanding of these factors would be advantageous for future interventions intended to enhance resilience in this context. This study aimed to explore factors associated with resilience among medical students. The study design was correlation research based on survey data. Participants were the 1st – 6th year medical students at Faculty of medicine Siriraj hospital in academic year 2022 (n=1735). There were 652 participants returned the survey (response rate 38%). Univariate analysis found that gender (r=0.09, p=0.02), physical activity (r=0.18, p<0.001), growth mindset (r=0.55, p<0.001), fixed mindset (r=−0.10, p=0.01), perceived social support (r=0.35, p<0.001), and perceived teacher’s support (r=0.28, p<0.001) were correlated with resilience. The multiple linear regression revealed that growth mindset (β=0.77, p<0.001), fixed mindset (β=−0.13, p=0.01), perceived social support (β=0.08, p<0.001), and perceived teacher’s support (β=0.02, p=0.04) were significant predictors of resilience. The multiple linear regression model provided significant predictive ability with coefficient of determination (R 2 ) of 0.35. In conclusion, growth mindset, fixed mindset, perceived social support and perceived teacher’s support were significant predictors of resilience among medical students. Implication of thesis: The findings from this study suggested that a medical school should focus on improving growth mindset, social support, and mentorship program in order to enhance resilience in medical students.
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    Can transformative learning improve empathy in fourth-year medical students?
    (Mahidol University, 2021) Chayut Wonglertwisawakorn; Cherdsak Iramaneerat; Yodying Dangprapai; Varuna Kolkijkovin
    Empathy is an essential skill in a physician; however, empathy levels often decline across the medical curriculum. This research explored the effectiveness of a unique transformative learning workshop to increase empathy levels in fourth-year medical students. The research questions were: 1) Does the empathy level of medical students improve after participating in the transformative learning workshop? 2) Is the empathy level of medical students in the group that participates in the transformative learning workshop significantly higher than those in the group that does not? and 3) Is the improvement in empathy level in the intervention group sustained for at least one month? Voluntary participants consisted of 74 fourth-year medical students from the Faculty of Medicine, Vajira Hospital, with 37 students in each group. The control group received standard workshops, while the intervention group received both standard and transformative learning workshops. The instrument for empathy measurement was the Jefferson Scale of Empathy (JSE) Student Version. Data were collected three times: before the intervention, immediately after the intervention, and one month later. Results showed no significant differences regarding gender or grade point average between the two groups, and pretest JSE scores did not significantly differ. After the transformative workshop, the immediate posttest JSE scores were significantly higher than the pretest scores in the intervention group (t(35) = 2.59, p = 0.014). The mean difference between immediate posttest and pretest JSE scores was significantly higher in the intervention group than in the control group (t(68) = 3.37, p = 0.001). Furthermore, there was no significant difference between the immediate posttest and delayed posttest JSE scores in the intervention group (t(35) = 0.49, p = 0.63). In conclusion, the transformative learning workshop significantly enhanced empathy and appeared to sustain that increase for at least one month in fourth-year medical students. Implication of Thesis: The pattern and sequence of this transformative learning workshop can be applied to increase empathy for medical and other healthcare professional students; additionally, this conceptual framework of transformative learning can be redesigned for improving other non-technical skills necessary for healthcare providers.
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    Comparison of the analgesic effect of nepafenac 0.1%, ketorolac 0.5%, and diclofenac 0.1% ophthalmic solution during intravitreal injection
    (2021-06-01) Nattawat Wongchaikanakorn; Yodying Dangprapai; Siriraj Hospital; Taksin Hospital
    Background: Pain during intravitreal injection (IVT) is inevitable and might reduce the patient's compliance. Topical anesthetic eye drop usually is administered to reduce pain during IVT. However, severe ocular pain has been reported in some patients. The most effective anesthesia for IVT is still controversy. Objective: To evaluate the analgesic effect of three topical non-steroidal anti-inflammatory drugs (NSAIDs) eye drop, nepafenac 0.1%, ketorolac 0.5%, and diclofenac 0.1%, during IVT. Materials and Methods: The present study was a prospective randomized, double-blinded, placebo-controlled study. Patients undergoing intravitreal bevacizumab injections were randomly divided into four groups. Group 1, group 2, group 3, and group 4 received topical nepafenac 0.1%, topical ketorolac 0.5%, diclofenac 0.1%, and artificial tear (placebo), respectively. One hour after receiving the eye drops, all patients underwent IVT with topical anesthetic eye drop. Pain assessment was performed immediately after IVT using the Thai version of Short-Form McGill Pain Questionnaire (SF-MPQ). The SF-MPQ consists of the main component of the SF-MPQ, the visual analogue scale (VAS), and the present pain intensity (PPI). Results: Eighty patients voluntarily enrolled in the present study. Median of VAS scores were 1.5 (0.8 to 4.6), 2.3 (1.5 to 4.6), 1.5 (1 to 3.2), and 2.4 (1.4 to 3.6) in nepafenac group, ketorolac group, diclofenac group, and placebo group, respectively (p=0.159). Median of the main component of the SF-MPQ scores were 4 (1.25 to 5.75), 5 (2.25 to 11.5), 5 (1.25 to 9.5), and 5 (3 to 13), in nepafenac group, ketorolac group, diclofenac group and placebo group, respectively (p=0.409). Median of the PPI scores were 1 (1 to 1.75), 1 (1 to 2), 1 (1 to 1), and 1 (1 to 2), in nepafenac group, ketorolac group, diclofenac group, and placebo group, respectively (p=0.529). Conclusion: There were no significant differences in analgesic effect during IVT between topical NSAIDs, nepafenac 0.1%, ketorolac 0.5%, diclofenac 0.1%, and placebo.
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    Development of a new scoring system to accurately estimate learning outcome achievements via single, best-answer, multiple-choice questions for preclinical students in a medical microbiology course
    (2020-02-01) Yodying Dangprapai; Popchai Ngamskulrungroj; Sansnee Senawong; Patompong Ungprasert; Azian Harun; Faculty of Medicine, Siriraj Hospital, Mahidol University; School of Medical Sciences - Universiti Sains Malaysia
    © 2020 Author(s). Published by the American Society for Microbiology. This is an Open Access ar ticle distributed under the terms of the Creative Commons Attribution-Noncommercial-NoDerivatives 4.0 International license (https://creativecommons.org/licenses/by-nc-nd/4.0/ and https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode), which grants the public the nonexclusive right to copy, distribute, or display the published work. During the preclinical years, single-best-answer multiple-choice questions (SBA-MCQs) are often used to test the higher-order cognitive processes of medical students (such as application and analysis) while simultaneously assessing lower-order processes (like knowledge and comprehension). Consequently, it can be difficult to pinpoint which learning outcome has been achieved or needs improvement. We developed a new scoring system for SBA-MCQs using a step-by-step methodology to evaluate each learning outcome independently. Enrolled in this study were third-year medical students (n = 316) who had registered in the basic microbiology course at the Faculty of Medicine, Siriraj Hospital, Mahidol University during the academic year 2017. A step-by-step SBA-MCQ with a new scoring system was created and used as a tool to evaluate the validity of the traditional SBA-MCQs that assess two separate outcomes simultaneously. The scores for the two methods, in percentages, were compared using two different questions (SBA-MCQ1 and SBA-MCQ2). SBAMCQ1 tested the students' knowledge of the causative agent of a specific infectious disease and the basic characteristics of the microorganism, while SBA-MCQ2 tested their knowledge of the causative agent of a specific infectious disease and the pathogenic mechanism of the microorganism. The mean score obtained with the traditional SBA-MCQs was significantly lower than that obtained with the step-by-step SBA-MCQs (85.9% for the traditional approach versus 90.9% for step-by-step SBA-MCQ1; p < 0.001; and 81.5% for the traditional system versus 87.4% for step-by-step SBA-MCQ2; p < 0.001). Moreover, 65.8% and 87.8% of the students scored lower with the traditional SBA-MCQ1 and the traditional SBA-MCQ2, respectively, than with the corresponding sets of step-by-step SBA-MCQ questions. These results suggest that traditional SBA-MCQ scores need to be interpreted with caution because they have the potential to underestimate the learning achievement of students. Therefore, the step-by-step SBA-MCQ is preferable to the traditional SBA-MCQs and is recommended for use in examinations during the preclinical years.
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    Effects of Live Lecture Attendance on the Academic Achievement of Preclinical Medical Students
    (2020-01-01) Wasit Wongtrakul; Yodying Dangprapai; Faculty of Medicine, Siriraj Hospital, Mahidol University
    © 2020, International Association of Medical Science Educators. Background: Live lecture remains a ubiquitous form of knowledge delivery in preclinical medical education. However, voluntary live lecture attendance has markedly decreased at several medical schools. This case-control study examined the effect of live lecture attendance on academic achievement in selected basic science courses. Methods: Cases (n = 174) were defined as students with below average examination scores, and controls (n = 198) were defined as students with above average examination scores. The exposure was absenteeism, which was defined as attending live lecture less than 75% of total live lecture sessions. Second-year and third-year students reported self-estimated frequency regarding live lecture attendance, and they estimated the time spent engaged in various behaviors during live lectures. Results: Absenteeism was identified as a significant risk factor for having below average score in preclinical medical science courses with a 2.34-fold risk (95% confidence interval [CI]: 1.27–4.33). Distracting behavior more than 25% of live lecture time was a factor with non-significantly increased risk for having below average score (1.36-fold risk, 95% CI: 0.86–2.13). Conclusions: Absenteeism was compellingly associated with poorer examination performance among medical students in basic science medical courses. Preclinical medical students should be encouraged to attend live lectures as often as possible.
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    Efficacy of Communication Skills Training of Preclinical Medical Students via Health Literacy Teaching to High School Students: A Pilot Study
    (2021-01-01) Tissana Prasartseree; Pittaya Dankulchai; Yodying Dangprapai; Thanjira Jiranantakan; Siriraj Hospital; Royal Prince Alfred Hospital; Faculty of Medicine and Health; Division of Radiation Oncology
    Objective: Communication Skills via Health Literacy (CSvHL) was a pilot elective communication skills training (CST) course, which allowed preclinical medical students to gain communication competence through the experience of being a health educator for high school students (HSSs). The efficacy of CSvHL was explored. Materials and Methods: All 10 medical students were prepared for their HSS-health-educator roles by participating in several observation sessions at an outpatient department and via communication workshops. In-field health education courses were subsequently delivered to HSSs by the medical students. Developments of the medical students’ communication skills were fostered through loops of learning activities and regular feedbacks. Assessments of the pre- and post-CSvHL communication skill levels by means of an OSCE, with adapted ComON Check were evaluated by each medical student, a standardized patient, and three medical instructors. Results: In general, the overall and category-specific average ComON Check scores of the whole class were significantly improved after the CSvHL course. The 3 communication defects with the lowest scores in the pre-CSvHL assessments were subsection division, summarization, and comprehension-check while counseling. Conclusion: CSvHL was successfully established as a preclinical-year CST course. The improvements in the ComON Check scores reflected the transformative learning gained from the hands-on experience, individualized CST, and 360° feedback OSCE for communication skill assessment.
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    Patient interviews improve empathy levels of preclinical medical students
    (2019-01-01) Sapol Thepwiwatjit; Sasiriyar Athisereerusth; Wanicha Lertpipopmetha; Thanit Nanthanasub; Yodying Dangprapai; Faculty of Medicine, Siriraj Hospital, Mahidol University
    © 2019 Siriraj Medical Journal. Objective: In order to cultivate and maintain empathy during medical school, an experiential learning program, "A Patient as a Human Being", was designed to promote empathy in second-year medical students through interviews with patients focusing on their suffering and the difficulties arising from their illnesses and hospital stays. Methods: The second-year medical students were divided into groups of three and four. Each group was assigned a patient to interview under close supervision. The selected patients were informed beforehand about the interview and voluntarily agreed to participate. The Thai version of the Jefferson Scale of Physician Empathy-Student Version (JSPE-SV) was used to assess the students' empathy levels. Results: The baseline JSPE-SV score (n = 310) was 114.10±10.20. After the interview, the scores significantly increased (1.19 [0.21-2.18], P = 0.009). Students in the lower-half group of baseline scores showed a higher improvement (2.64 [1.14-4.15], P < 0.001) than those in the upper-half group. The difference coefficient by multivariate analysis of the improved JSPE-SV scores between the two groups was 3.03 [1.08-4.98] (p = 0.002), accompanied by a correlation between the pre-activity empathy score and the improved score ( p = - 0.21, P-value < 0.01). Conclusion: The patient interviews improved the empathy levels of the preclinical medical students, especially those with lower baseline empathy levels.
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    ItemOpen Access
    Prevalence and associated factors of burnout among medical students at faculty of medicine Siriraj hospital
    (Mahidol University, 2022) Kanokphol Supasirimontri; Tripop Lertbunnaphong; Yodying Dangprapai
    Medical students around the world were increasingly struggling with burnout. However, important information of medical students’ burnout at Faculty of Medicine Siriraj Hospital was insufficient. The objectives of this cross-sectional survey study were (1) to investigate prevalence of burnout and (2) to explore associated factors of burnout among medical students in the medical school. Self-assessment questionnaires including demographic data, experiences of mistreatment perception, and Maslach Burnout Inventory-Student Survey (MBI-SS) were distributed to second-year to sixth-year medical students in academic year 2021 via electronic transmissions. The criteria to diagnose burnout consisted of high level of emotional exhaustion, high level of depersonalization, and low level of professional efficacy. Response rate was 50.1 % (716/1428) and the findings demonstrated that prevalence of burnout among medical students was 31.1 % (223/716). Frequencies of medical students with high level of emotional exhaustion, high level of depersonalization, and low level of professional efficacy were 69.4 %, 70.9 %, and 43.9 %, respectively. According to multivariate logistic regression analysis, the results found that academic year, lower grade point average, feeling unfulfillment as medical students, inadequately educational support from medical teachers, and idea of resignation were independently associated factors of burnout among medical students (p < 0.05). However, medical students with mistreatment perception were not associated with burnout, but prevalence of mistreatment perception among medical students was 29.9% (214/716). In conclusion, nearly one-third of medical students met the criteria of burnout and the associated factors of burnout were academic year, lower grade point average, feeling unfulfillment as medical students, inadequately educational support from medical teachers, and idea of resignation. Implication of the Thesis: The medical school could use these findings to explore these issues in depth. To reduce medical students’ burnout, the faculty should implement surveillance systems for medical students’ well-being, mental health literacy program, academic assistance, and supportive system. To minimize the occurrences of mistreatment, the medical school should promote faculty development program and organizational trust to enhance positive educational environment in the medical school.
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    Reliability and validity study of the Thai adaptation of the Copenhagen Burnout Inventory-Student Survey (CBI-SS) among preclinical medical students at the Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand
    (2021-12-01) Wasit Wongtrakul; Yodying Dangprapai; Nattha Saisavoey; Naratip Sa-Nguanpanich; Siriraj Hospital
    Burnout syndrome is a syndrome of emotional exhaustion, professional efficacy and cynicism. A significant proportion of medical students reported having burnout syndrome during their training in medical education. Several tools including the Copenhagen Burnout Inventory-Student Survey (CBI-SS) are considered to be a valid measurement of burnout syndrome in medical students. This study aimed to translate, culturally adapt, and validate the CBI-SS for assessing burnout syndrome among preclinical medical students in Thailand. This study was conducted during February to March 2019 at the Faculty of Medicine Siriraj Hospital, Mahidol University (Bangkok, Thailand), which is Thailand’s largest and oldest medical school, and Thailand’s largest national tertiary referral center. After receiving formal permission to do so from the copyright owner, the original English language version of the CBI-SS was translated to Thai language using an internationally recommended and accepted forward-backward translation protocol. The Thai version of the CBI-SS (Thai CBI-SS) comprises 25 items, including 6 items for personal burnout, 7 items for study-related burnout, 6 items for colleague-related burnout, and 6 items for teacher-related burnout. Standardized Cronbach’s alpha coefficient was calculated to evaluate internal consistency reliability, and correlation coefficient was computed to determine test-retest reliability. A total of 414 preclinical medical students participated in this study. Due to sub-optimal factor weights (<0.50), items 6, 10 and 17 were excluded. The Cronbach’s alpha coefficients of the 22-item Thai CBI-SS for personal, study-related, colleague-related, and teacher-related burnout were 0.898, 0.896, 0.910 and 0.900 respectively. The correlation coefficients for test-retest reliability after three weeks were 0.820, 0.870, 0.821, and 0.787 for personal, study-related, colleague-related, and teacher-related burnout, respectively. Maximum likelihood analysis with oblimin rotation indicated four main components, and confirmatory factor analysis revealed good fit indices of the Thai CBI-SS. Confirmatory factor analysis showed good fit indices of CBI-SS domains (χ2/df = 2.39; CFI = 0.957; GFI = 0.909; RMSEA = 0.058; TLI = 0.949; and NFI = 0.928). The convergent validity analysis using the Average Variance Extracted (AVE) and the Composite Reliability (CR) was adequate for all dimensions (personal: AVE = 0.626, CR = 0.893; study-related: AVE = 0.601, CR = 0.899; colleague-related: AVE = 0.677, CR = 0.913; teacher-related: AVE = 0.606, CR = 0.900). The HTMT values for all variables are in the range from 0.315 to 0.833, confirming the discriminant validity. The Thai CBI-SS was found to be a valid and reliable tool for evaluating burnout syndrome in preclinical medical students in Thailand.