Situated learning characterises the learning that takes place in the clinical environment. Learning in the workplace is characterised by transferring classroom knowledge into performing tasks and this may take various forms. In the medical education field, the cognitive apprenticeship instructional model developed by Collins (2016) supported this learning in the workplace setting due to its common characteristics of apprenticeship. This paper analysed two concrete learning situations in a Malaysian undergraduate and an Omani postgraduate learning environment. Both learning situations occurred in the primary healthcare outpatient setting. The cognitive apprenticeship model was used to identify characteristics of the individual learning environments and discusses factors that stimulate learning. Attention was paid to the role of reflection in stimulating learning in the described settings. The paper provided the context in both institutes, described the learning situation and provided an analysis based on the theoretical framework. Based on the analysis of the situations, solutions to problems in the two settings were suggested.

The Ministry of Higher Education introduced the integrated cumulative grade point average (iCGPA) system in 2016 as an aspiration to produce holistic and well-balanced graduates based on Malaysian Qualification Agency’s (MQA) learning domains. In this article, we provide a comparison of iCGPA with other established medical competency frameworks and share our experience in implementing iCGPA in the medical faculty. Throughout the process, it was noted that medical educators require several core competencies in order to successfully implement iCGPA in their courses. Two of the most important core competencies are understanding the pedagogies of the 21st century (heutagogies, paragogies, and cybergogies) and apprehending the concept of outcome-based education. On top of the requirement of core competencies, there were also challenges in tailoring teaching and learning to meet the requirement of the Industrial Revolution 4.0. We also describe in detail the benefits and other challenges of iCGPA implementation in our faculty. We conclude this article with our recommendation for successful iCGPA implementation in the future for the medical faculty. Keywords: iCGPA, Outcome-based education, Medical faculty, Industrial Revolution 4.0

The emergence of COVID-19 has affected people worldwide from all angles, from the aspects of health, wealth, emotional and also human interactions. This study aimed to look at the attributes such as positive behaviour, awareness, preparedness and relationships among Malaysians during the implementation of movement control order (MCO), and the predictors of preparedness in facing the COVID-19 pandemic. A cross-sectional study was conducted online involving 317 respondents above the age of 18 years old. A self-administered questionnaire was developed in both Malay and English languages to assess the level of positive behaviour, awareness, preparedness and relationships, as well as their main source of information retrieval regarding COVID-19. Overall, the measured attributes in this study showed the highest level in behaviour (84.2%), followed by awareness (73.5%), preparedness (62.5%) and relationships (60.6%). Multiple regression on preparedness revealed that all variables (behaviour, awareness, and relationships) are significant (p<0.05), while gender is not. The top two sources of information the respondents refer to during the MCO are social and broadcast media. This marks the influence of social and broadcast media in an Industrial Revolution 4.0 era. Despite having good awareness and positive behaviour, the MCO may also have caused relationship issues as well as lower preparation levels in facing a deadly pandemic. It is suggested that future research to look into whether this would have any association with the mental health of Malaysians facing the pandemic. By understanding the attributes related to the MCO during the COVID-19 pandemic, it would help the government in the implementation of policies and procedures in any future pandemic.

Introduction: The COVID-19 pandemic significantly impacted the global teaching and learning process (TnL). Unfortunately, to date, not many qualitative studies have been published specifically on the impact of COVID-19 on the Family Medicine course, particularly in Malaysia. Hence, this study aimed to explore the impact of COVID-19 pandemic on the teaching and learning experience of undergraduate students undergoing their Family Medicine course at a local university. Methods: A qualitative study using focused group discussion (FGD), was conducted among undergraduate students during the lockdown period. A semi-structured interview guide was used to interview 20 students, in their fifth undergraduate year, undertaking their fourth to fifth week of a total six-week course. They were selected using purposive snowball sampling method. There were four focus group discussions (FGD) with five students in a group. All interviews were audio-taped, transcribed verbatim, and the contents were analysed using the standard content analysis framework. Subsequently, thematic content analysis was conducted, and three major themes were produced. Results: The three major themes were (1) facilitators to learning, (2) barriers to learning, and (3) rooms for improvement. Conclusion: Although COVID-19 pandemic had significant impact on TnL of Family Medicine course among undergraduates, the students remained optimistic and proposed some improvement from their point of view. However, a creative, realistic, effective, and impactful way of TnL, particularly in clinical aspects should be developed and experimented. Technological progress and advancement should permit this idea to be achievable and implemented in near future.

Mental health conditions (MHC) have been found to have a negative effect on the outcome of respiratory diseases. MHC may increase readmissions and prolonged hospital stay for non-psychiatric hospitalisations. The study aimed to look at the depression, anxiety, and stress (DAS) levels of the Malaysian public in response to the pandemic and movement control order (MCO), using the Depression, Anxiety and Stress Scale 21 (DASS-21) questionnaire at different MCO stages. A cross-sectional survey was conducted using a non-probability and snowballing sampling method involving 317 respondents above 18 years of age in Malaysia. Descriptive statistics and t-tests were used to analyse the data to identify the DAS levels during the early phase MCO compared to the recovery phase MCO. Results demonstrate the stress level to be higher during the early phase in comparison to the recovery phase; however, for anxiety and depression, these levels are identical in both phases. Additionally, ttest results exhibit similar findings, where significant differences (at 5%) are found for stress levels between the early and recovery phases. Meanwhile, for anxiety levels, a significant difference is only found at the 10% level of significance. Interestingly, for depression, no significant difference is found between the two phases. The decrease in stress levels can be explained by the adaptation of the public response to the COVID-19 pandemic. Nevertheless, to a certain extent, anxiety was still present and postulated due to apprehension and uncertainties about the COVID-19 pandemic progression with time. Future research should further assess the public response toward the latest COVID-19 pandemic dynamics, and reasons for the anxiety component can be established.

Clinical reasoning is a vital medical education skill, yet its nuances in undergraduate primary care settings remain debated. This systematic review explores clinical reasoning teaching and learning intricacies within primary care. We redefine clinical reasoning as dynamically assimilating and prioritising synthesised patient, significant other, or healthcare professional information for diagnoses or non-diagnoses. This focused meta-synthesis applies transformative learning theory to primary care clinical reasoning education. A comprehensive analysis of 29 selected studies encompassing various designs made insights into clinical reasoning learning dimensions visible. Primary care placements in varying duration and settings foster diverse instructional methods like bedside teaching, clinical consultations, simulated clinics, virtual case libraries, and more. This review highlights the interplay between disease-oriented and patient-centred orientations in clinical reasoning learning. Transformative learning theory provides an innovative lens, revealing stages of initiation, persistence, time and space, and competence and confidence in students’ clinical reasoning evolution. Clinical teachers guide this transformation, adopting roles as fortifiers, connoisseurs, mediators, and monitors. Patient engagement spans passive to active involvement, co-constructing clinical reasoning. The review underscores theoretical underpinnings’ significance in shaping clinical reasoning pedagogy, advocating broader diversity. Intentional student guidance amid primary care complexities is vital. Utilising transformative learning, interventions bridging cognitive boundaries enhance meaningful clinical reasoning learning experiences. This study contributes insights for refining pedagogy, encouraging diverse research, and fostering holistic clinical reasoning development.