Sudden Transition in Anatomy Education: Assessing the Perception of Anatomy Course Delivery among Medical Students during COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19) pandemic has undoubtedly impacted anatomy education. This has led to a vast shift from a face to face (F2F) session to a complete online session and practical demonstration. Nonetheless, this pandemic provides an opportunity for anatomy educationists to embark on an alternative delivery of anatomy education via an online platform. The aim of this study was to evaluate the students’ perception of the online teaching and learning in anatomy course delivery among the first-year medical students in Universiti Sains Islam Malaysia (USIM). A total of 90 first-year medical students partook in an online questionnaire-based survey after semester completion of online anatomy course delivery. Synchronous online lectures conferred positive responses from the students with 73.0% of the students perceived effective communication with lecturers through the online platform. Out of these, 71.6% inclined towards online lectures as it allows them the flexibility to record the lecture and revisit it. Gross anatomy practical sessions were executed asynchronously via pre-recorded video with an additional supplementary quiz on USIM’s Global Open Access Learning system (GOALS) while histology practical was executed synchronously via virtual slide demonstration. A total of 80.1% students felt convenient with histology practical, however, only 48.3% students responded positively to the gross practical. Overall, 76.4% students favoured the conventional practical compared to the online sessions. Meanwhile, an online examination had disputable responses between the different exam formats whereby 71.9% students perceived that Multiple Choice Questions (MCQ) were conducted conveniently contradictory to the Modified Essay Questions (MEQ) in which only 34.9% students responded positively. In addition, 57.3% students disclosed multiple setbacks during the Objective Structures Practical Exam (OSPE). The extensive and impromptu changes in the study technique have received multiple responses from the students. Overall, the students preferred an online platform for didactic sessions but a real live classroom for practical sessions.

The Effect of Online Problem-Based Learning Methods on Students’ Performance

The COVID-19 pandemic has a significant impact on the education process in higher education institutions. The medical faculty is forced to adapt by implementing distance learning. The entire face-to-face learning is replaced with virtual meetings to prevent transmission of the COVID-19 virus. Problem-based learning (PBL) is carried out online. This study aimed to analyse students' performance during an online PBL in terms of their content knowledge about the modules. The study was conducted in the 2019/2020 academic year with 92 respondents enrolled in the Neuropsychiatry course. The students’ performance was measured by direct observation using a rubric filled out by the tutor during the session. Content knowledge about the module was measured by test, before and after the PBL. A cross-sectional study design was used in this study. The results showed a statistically significant increased score between pre and post-test (with p-value < 0.000, Wilcoxon signed-rank test) with an overall better performance of the students during the online PBL. Students showed good participation and communication skills, even though the discussions were done synchronously via teleconferencing. They had the ability to apply and link concepts to problems and draw valid conclusions. As a conclusion, there was a weak association between students’ performance and their knowledge of the module contents shown by the increasing score in the test. The limitations or obstacles during online PBL can be overcome with better preparation from the students with sufficient digital literacy, self-regulation, and adequate internet network support.

Reliability and Validity of an Instrument to Evaluate Knowledge, Attitude and Practice towards Measures for Preventing the Spread of COVID-19 in Malaysia: A Pilot Study

Preventing the spread of COVID-19 is crucial in flattening the COVID-19 infection curve. General population control measures should emphasise on understanding the knowledge about the disease and importance of following regulations related to restriction on movement. The aim of this pilot study was to develop a valid, reliable and practical instrument on Knowledge, Attitude and Practice towards Measures for Preventing the Spread of COVID-19 in Malaysia. The instrument was developed based on a Knowledge, Attitude and Practice (KAP) conceptual framework. The instrument in the form of a questionnaire was distributed online to a sample of 40 adults. The initial questionnaires contained 16, 17 and 14 questions on knowledge, attitude and practices domains, respectively. The content validity was assessed by the experts. The reliability of the instrument was measured using internal consistency reliability, which was measured using alpha coefficient reliability of Cronbach Alpha. The analysis showed that the total Cronbach Alpha value for knowledge, attitude and practice were 0.93, 0.89 and 0.87 respectively. After one item dropped from the attitude domain, the findings of this pilot study show that the instrument is valid and reliable to be used in a further larger study. This study demonstrated that the three scales of knowledge, attitude and practice were reliable and valid for assessing the prevention of spread of COVID-19 in Malaysia, although further analysis are needed to improve especially on the knowledge scale due to the low level of difficulty.

Anxiety Levels of Undergraduate and Clerkship Medical Students during the COVID-19 Pandemic

The COVID-19 pandemic has brought a devastating impact on the world. Medical students who belong to psychologically vulnerable groups also share more burdens due to the medical education academic demands, curriculum transition to virtually-delivered format, and the risk of being infected by the disease during clinical settings. This study aims to identify the anxiety level of undergraduate and clerkship medical students to create proper and effective strategies to build good mental status among medical students during the COVID-19 pandemic. It is a cross-sectional study. The survey was conducted using an online questionnaire to assess respondents’ identity, demographic data, family history, perceptions about online/offline learning, and the researchers used the Taylor Manifest Anxiety Scale (TMAS) test to measure the anxiety level of the subjects. The subjects of this study were 164 medical students, divided into two groups, 94 final year undergraduate students and 70 final year clerkship students who were still doing their clinical rotations at the hospital. The findings of this study informed that the average anxiety level was 18.3 for undergraduate students and 19.6 for clerkship students. The TMAS score was higher among clerkship students than undergraduate students. However, the statistical analysis showed no difference (p=0.306) in TMAS scores between clerkship and undergraduate students. A close approach and continuous observation are needed because the higher the TMAS score indicates the higher the anxiety level.

Understanding the Impacts of Lockdown during COVID-19 Pandemic on Financial Threat and Psychological Response among Sarawak Adults

The Malaysian government announced the lockdown measures following the Coronavirus Disease 2019 (COVID-19) outbreak in mid-March 2020. This action unavoidably led to economic instability and negative psychological effects. The present study examines perceived financial threats and psychological impacts on Sarawak adults during lockdown for the COVID-19 pandemic. Data from 336 respondents were collected from all divisions in Sarawak using an online self-reported questionnaire that included sociodemographic, the Financial Threat Scale (FTS), and the Depression, Anxiety, Stress Scales 21 (DASS-21). Results showed that perceived financial threat was associated with the employment sector, the number of children, and the change in income during the lockdown period. Almost half (47.9%) of the respondents perceived moderate-to-severe financial threat, particularly self-employed persons and those who had reduced income during the lockdown. Negative psychological effects were found to be associated with the employment sector, marital status, number of children, and number of liabilities. In general, people who perceived severe financial threats were significantly associated with severe levels of depression, anxiety, and stress. The study provided some insights into the urgent need to build on strategic plans to mitigate the economic and psychological crisis for the affected communities.

Factors Associated with Stress Level among School Teachers at Bantaeng Regency in the COVID-19 Pandemic Era

The COVID-19 pandemic has a serious impact on people’s lives, including teachers. The need to continue the learning process during a pandemic has caused teachers and students to encounter many problems, including limited internet access in remote areas. Landang Elementary School (SDN 19 Landang) in Bantaeng Regency is one of the elementary schools in South Sulawesi located in the remote area facing the aforementioned problem. The teachers are forced to teach the students by home visit to provide learning activities. The condition in which people must keep their distance from each other to avoid the spread of COVID-19 virus yields stress. The study aims to analyze the factors that cause stress among elementary school teachers. This cross-sectional survey method involved 47 respondents using Perceived Stress Scale (PSS) on Google Form platform as the instruments. Age and teaching duration had significant association with the stress level among teachers after analysis using chi square test.

Intubation Ergonomics and Effectiveness using Aerosol Box

The pandemic COVID-19 has caused a rupture and disturbance in many ecosystems, especially in healthcare. Although previously patients were treated and given first-hand treatment especially during life threatening event, currently, the safety of healthcare workers have also become the utmost priority. Due to the nature of COVID-19 virus that is able to spread easily via respiratory droplets and aerosols, using mouth and eyes as the route of entry, healthcare workers need to protect themselves while saving the patients at the same time. Therefore, the most common lifesaving procedure at accident and emergency department was chosen, i.e. the intubation procedure. The aerosol box is introduced and used widely during the intubation procedure, especially in accident and emergency department. The study has three objectives. First, to determine whether the aerosol box can provide protection to its users, secondly to suggest an improvement based on the current design of the aerosol box and thirdly to determine the risk of musculoskeletal injuries among healthcare workers using Rapid Entire Body Assessment (REBA). In this study, direct observation was made during the assessment before suggesting the required recommendation on how to improve the existing aerosol box. The first objective was achieved by conducting a direct observation when participants were conducting the intubation procedure. Any possibility of participants getting exposed to the risk of COVID-19 due to the failure of the box in guarding, was noted by the observer. Recommendation for improvement was made based on these findings, and served the second objective of the study. To achieve the third objective, ergonomics assessment using Rapid Entire Body Assessment (REBA) was conducted. REBA scores represent the severity of musculoskeletal risk imposed to healthcare workers during intubation procedure. Two participants took part in the study voluntarily. Results showed that the aerosol box used in this study does not protect healthcare workers from COVID-19. The current design of aerosol box used must be improvised in order to increase its effectiveness. As for body postures, REBA scores were between medium and high, thus it required immediate corrective actions. With modification, the aerosol box may better protect healthcare workers from being exposed to the COVID-19 virus.

How Successful was Large-scale Social Restrictions Policy in Suppressing COVID-19

Large-scale Social Restrictions (LSR) was the Indonesian government's primary instrument to break the chain of coronavirus or COVID-19 transmission at the early phase of the pandemic. LSR implementation such as school and workplace closure, restrictions on religious activities, and or restrictions on activities on public premises or facilities. This study aims to investigate the effect of LSR policy on COVID-19 developments in Indonesia. This study was a cross-sectional study with a total population of 99,077,313 people from three provinces in Indonesia. This research analyzed the LSR policy implemented in the entire province or partially as an exposure and the development of Covid-19 as an outcome. The outcome was measured by doubling the times needed for new cases. Data were taken from secondary source namely from the COVID-19 task force report that has been announced publicly. The unpaired two-tailed Student’s t-test was used as statistical analysis of the secondary data. The results showed a significant impact (p<0.05) when comparing the province with full LSR policy with those implementing the LSR policy in some of their selected cities. The LSR policy of total province seems effective to suppress COVID-19 development as indicated by a more rapid and considerable increase in the doubling time of new cases following the implementation of LSR as early as possible in the provinces implementing LSR for their entire region than in the compared provinces. It can be concluded that LSR policy has a significant effect on COVID-19 development in Indonesia as indicated by a significant difference in the doubling time of COVID-19 new cases. Each province may have different times of the beginning and end of the COVID-19 epidemic; therefore, each province needs to design their coping strategy based on their particular condition.

The Consistency of Islamic and Medical Perspectives in the Control of the COVID-19 Pandemic

Controlling the current COVID-19 pandemic requires infection control at both the individual and global levels. There is insufficient information on the consistency between Islamic principles and medical guidelines regarding infection control measures. Therefore, this study aimed to explore the consistency between Islamic principles and evidence-based medical recommendations during the pandemic time. A comparison was made between the latest medical infection control recommendations and Islamic references (the Quran and its interpretation, and Sunnah and its explanation). Relevant materials such as books and research articles in Arabic or English were reviewed. The information was then classified into different levels of infection control strategies, which were individual, household, community and healthcare unit levels. This study demonstrated that both Islamic principles and medical guidelines are consistent in terms of infection control, which involves crisis supervision by the infection control authority and specialised agencies, hand and general hygiene, personal protection, seeking specialist consultation and treatment, comprehensive care, guidelines in the event of limited resources, home isolation, travel bans and quarantine. Moreover, it was observed that Islamic principles combine and optimise both the individual frame and societal cohesion.

Attitudes and Experience of Malaysian Parents towards School Closure during the COVID-19 Pandemic

In 2020, the Coronavirus disease 2019 (COVID-19) pandemic had triggered the lockdown in many countries around the world. School closure was no exception as a measure to limit the spread of the disease. This step was expected to bring some impact on parents, especially if both of them were working. In this study, we aimed to investigate Malaysian parental attitudes and experiences during the COVID-19 pandemic. We conducted an online cross-sectional survey by using a structured questionnaire, between May and June 2020. A total of 273 parents with children aged below 18 years old were involved. Descriptive analysis was done to determine the sociodemographic data of the respondents, their attitudes, and their experiences associated with the school closure during the outbreak. 97.4 % of parents agreed with the school closure. The majority of them believed the outbreak was serious and the school dismissal was appropriate to protect their children and the community. However, only 54.9 % were well prepared for the measure. 11.4 % of parents had difficulty arranging childcare. During the outbreak, 85.7 % experienced missing work and 71.4 % felt at risk of losing their jobs. The school closure also indirectly incurred additional costs for 88.6% of the parents and partially contributed to 75.5% of the parents losing income. Unexpected long-term school closure might cause some adverse outcomes to the employed parents during a pandemic, therefore, the health authority and education department should take this into consideration when mitigating this issue.