Christina Phoay Lay Tan

The use of two-dimension electrophoresis to identify serum biomarkers from patients with dengue haemorrhagic fever

Dengue infection is a major public health problem affecting millions of people living in tropical countries. With no suitable vaccines and specific antiviral drugs, treatment for dengue is usually symptomatic and supportive. Early diagnosis and recognition of severe disease is therefore crucial for better management of the patient. Two-dimension electrophoresis was used to identify disease-associated proteins that can be used for diagnosis and as drug targets for treatment. Two markers, identified by mass spectrometry analysis as alpha1-antitrypsin and NS1 proteins were found to be upregulated in dengue fever (DF; n=10) and dengue haemorrhagic fever (DHF; n=10) patients compared with healthy individuals (n=8). Both alpha1-antitrypsin and NS1 proteins were overexpressed two-fold in DHF patients compared with DF patients. Our study suggests that alpha1-antitrypsin and NS1 protein could be used as biomarkers as early indicators of DHF risk among patients with suspected dengue infection.

The impact of a faculty development programme for health professions educators in sub-Saharan Africa: an archival study

BackgroundIn 2008 the sub-Saharan FAIMER Regional Institute launched a faculty development programme aimed at enhancing the academic and research capacity of health professions educators working in sub-Saharan Africa. This two-year programme, a combination of residential and distance learning activities, focuses on developing the leadership, project management and programme evaluation skills of participants as well as teaching the key principles of health professions education-curriculum design, teaching and learning and assessment. Participants also gain first-hand research experience by designing and conducting an education innovation project in their home institutions. This study was conducted to determine the perceptions of participants regarding the personal and professional impact of the SAFRI programme.MethodsA retrospective document review, which included data about fellows who completed the programme between 2008 and 2011, was performed. Data included fellows’ descriptions of their expectations, reflections on achievements and information shared on an online discussion forum. Data were analysed using Kirkpatrick’s evaluation framework.ResultsParticipants (n=61) came from 10 African countries and included a wide range of health professions educators. Five key themes about the impact of the SAFRI programme were identified: (1) belonging to a community of practice, (2) personal development, (3) professional development, (4) capacity development, and (5) tools/strategies for project management and/or advancement.ConclusionThe SAFRI programme has a positive developmental impact on both participants and their respective institutions.

Improving OSCE examiner skills in a Malaysian setting

Context and setting Objective structured clinical examinations (OSCEs) are used for summative assessment at final year level in the undergraduate medical programme of a medical school in Malaysia. Training of examiners was instituted 3 years after the OSCE was introduced. Why the idea was necessary Previous observations of examiners in OSCEs raised 2 concerns: faculty were inconsistent in marking checklists and some demonstrated inappropriate behaviour, such as prompting and teaching. What was done Examiner training was instituted in February 2006 to improve skills in OSCE examination. To date, 36 OSCE examiners have been trained through 4 training workshops. In the workshops, volunteer students and 4 standardised stations were used to train examiners using a 2-way mirror system. Examiner behaviour was scored using a checklist and examiners, both inside and outside the consultation room, scored student performance. Station checklist scores were compared before and after discussion. Evaluation of results and impact During the training workshops, examiners showed wide variation in scoring. Examiners were observed during subsequent OSCEs to determine whether their scoring skills and behaviour had improved. Observers in the OSCEs reported wide variations in scoring practices between trained and untrained examiners who examined the same OSCE station in parallel tracks. In addition, examiners who underwent training prior to the OSCE were generally consistent in their behaviour and provided none or minimal prompting. By contrast, untrained examiners were inconsistent and prompted students. These preliminary results confirm that examiner training workshops improved examiner scoring skills, which resulted in better consistency during administration of OSCEs.

Inducing curricular change: initial evaluation of outcomes

Context and setting Data on interns obtained during their 1-year pre-registration service were used to induce curriculum change. The initiative resulted in a 5-year, semi-integrated, organ system-based curriculum implemented in 1998. It is the third curriculum to be initiated since our medical school was established in 1965. Why the idea was necessary In 1994, Ministry of Health consultants who supervised our graduates indicated that, although the graduates excelled in knowledge and skills, they lacked leadership qualities, interpersonal and communication skills, teamwork skills, and knowledge of medical economics and recent advances in medicine. What was done A curriculum review carried out in 1996 resulted in the New Integrated Curriculum (NIC). This consisted of 3 vertical strands: