0803-Knowledge, opinions, attitudes, and practice of medical ethics among medical students

Omar Hasan Kasule, Sr¹

¹Institute of Medicine, Universiti Brunei Darussalam.

Abstract (379 words)

This papers reports results of a cross sectional self-administered questionnaire study on ethical knowledge among medical students at the Institute of Medicine of Universiti Brunei Darussalam. The primary objective of the research was to establish the general level of knowledge and understanding medical students to provide a baseline that can be used to assess student progress as they move through the medical course. The results of data analysis would be used in refining the design of the ethico-legal section of the undergraduate medical curriculum. The questionnaire had previously been used in a similar study [1]. The questionnaire had a total of 40 scenarios distributed as follows: knowledge of ethics 8 (4 general and 4 Islamic), attitude & practice 21 (15 general and 6 Islamic), and opinions 11 (Islamic). After explaining the aims and procedures of the study as well as obtaining written consent, students were asked to complete and return the questionnaire. Students had to choose the best of 3-4 alternative solutions for the ethical dilemma in each scenario. Each alternative had, unknown to the student, an embedded interpretation based on general and Islamic ethical principles. The interpretation was the one coded for statistical analysis. Knowledge scenarios were coded as ‘do know’, ‘do not know’, ‘not sure’, or ‘avoid. Attitude and practice alternatives were coded as ‘avoid’, ‘take action’, ‘refer’, or ‘report’. Opinion alternatives were coded as ‘acceptable’, ‘not acceptable’ or ‘not sure’. SPSS and STATA statistical packages were used for data management and data analysis. Proportions were computed with 95% confidence intervals. Cross tabulations were made and associations were tested using Fisher’s exact test because of the small numbers. Twenty nine out of a study population of 30 students returned questionnaires. The gender distribution was 14 males and 15 females. There was no significant variation of gender by year of study. Year of study, gender, and ethnicity had no significant statistical effect on ethics KAP. The conclusion from the analysis was that the proportion of students with expected knowledge of ethics was about 55%. Students were more likely to confront ethical dilemmas to find a solution than they were likely to avoid them, report them, or refer them to someone else. The proportions preferring taking action were 64.8% for general scenarios and 85.9% for Islamic scenarios. Ethical opinions were in high agreement with Islamic ethical principles.

Reference

1. Naznin Muhammad et al. The impact of the teaching of medical ethics in the medical and allied health sciences curriculum in International Islamic University Malaysia. Paper being submitted to the International Medical Journal (personal communication)

Key words: ethics knowledge medical students

0803-Knowledge, attitudes, and practices (KAP) regarding cancer prevention among students of the institute of medicine, Universiti Brunei Darussalam.

Omar Hasan Kasule Sr.¹

¹Institute of Medicine, Universiti Brunei Darussalam

Abstract (383 words)

The paper reports results of a cross-sectional questionnaire study of cancer knowledge, attitudes, and practices (KAP) among students of the Institute of Medicine, Universiti Brunei Darussalam. An extensive questionnaire of cancer KAP profiles designed and used previously by the author was employed in the study [1]. The self administered self coding questionnaire was distributed after explaining the aims of the study and obtaining student consent. Data was coded and was analyzed using the SPSS and STATA packages. The data was summarized as proportions. Contingency 2 x 2 tables were generated and bivariate relations were tested using Fisher’s exact test. The response rates by year of study were: 1^st year 17/17 (100%), 2^nd year 12/13 (92.3%), and third year 9/15 (60%). There were 18 males and 20 females. There was no statistically significant variation of gender distribution by year of study. The age range was very narrow 2-3 years in the early twenties. Results of data analysis revealed high KAP scores on most indicators. The following are the proportions of students with appropriate knowledge: cancer sites 39.5-100%, cancer detection methods 42.1-92.1%, cancer treatment methods 42.1-97.4%, and cancer risk factors was: 42.1-97.4%. Opinions about cancer were: cancer can be cured if detected early 86.8%, most cancers are life-threatening 57.9%, some cancers can be detected early 63.2%, all cancers can be detected early 23.7%, and some cancers are hereditary 92.1%. Attitudes towards cancer were: I would like to detect cancer early in order to save my life 92.1%, all individuals are at risk of getting cancer 92.1%, I prefer traditional treatment if I have breast cancer 2.6%, I will not see a doctor even if I have early signs of cancer 2.6%, I do not like to sit next to someone smoking 81.6%, and I am not concerned about what I eat 26.3%. Practices regarding cancer prevention were: Hepatitis B vaccination 73.3%, breast examination by a doctor or a nurse 47.4%, mammography 31.5%, breast self-examination 60.5%, pap smear 36.8%, and annual physical examination 52.5%. The scores also corresponded with what would be expected from epidemiological data for example all respondents knew lung cancer which is common but only 39.5% knew eye cancer that is rare. Some of the opinions were unexpected like 26.3% of the respondents saying that they were not concerned about what they ate.

Key words: cancer prevention, knowledge, attitudes, practices

1.      Omar Hasan Kasule Sr, MD Tahir MD Azhar, Syed Hassan al-Mashor, Hooi Lai Ngoh, Zarihad Md. Zain, Gerald Lim, Aziz Baba, Fuad Ismail, impact of school-based health intervention on cancer KAP. International Medical Journal Vol 1 No. 1 (www.e-imj.com)

0803-Evaluating the impact of training on knowledge and practice of medical ethics among nurses

Omar Hasan Kasule Sr¹ and Lin Naing¹

¹Institute of Medicine, Universiti Brunei Darussalam

Abstract (385 words)

The paper reports results of an assessment of knowledge and practice of medical ethics among nurses in a public hospital before and after an intervention which consisted of a training workshop on medical ethics and provision of reading material on ethics. The results of the study were to be used to formulate policies on ethical training for healthcare workers. The questionnaire used had been employed previously in research on ethics [1]. Respondents were presented with case scenarios. They were asked to choose the best among 3-4 approaches to resolving the ethical problem(s) in each scenario. The questionnaire was administered a few hours before the workshop on ethics. The participants were asked to complete the same questionnaire within 1 month of the ethics workshop. To make sure that responders gave honest answers, no personal identifiers were included on the questionnaires. Data was key-punched and analyzed using the SPSS program. Data analysis focused on estimating the proportion of participants who changed responses to the scenarios after the ethics training workshop. There was no interest in studying whether the responses were correct or not. Pre- and post intervention responses were compared and coded as ‘change’ or ‘no change’. The frequencies, proportions (percentages), and binomial 95% confidence intervals were calculated using Stata/IC 10.0. The degree of change for each question was graded as ‘little’ for changes in <10% of respondents, ‘some’ for 10 to <30%, ‘moderate’ for 30 to <50% and ‘great’ for 50% and above. Eighty two out of the 83 nurses who attended the workshop returned both the pre- and post-intervention questionnaires. The percentage of respondents who changed their responses to questions after the intervention ranged from 15.5% to 56.5%. On average of 37.4% and 29.2% of respondents changed in Islamic questions and general questions respectively. The most changed five questions are Islamic questions in the aspects of ‘animal research’ (56.5%), ‘life support’ (43.2%), ‘euthanasia’ (42.2%), ‘halal medicine’ (40%), and ‘needles to addicts’ (39.1%). The conclusion from the study is that there were considerable changes in response to questions after the intervention and greater changes were observed in the Islamic questions than in the general questions. It is recommended, after further studies to corroborate this finding, that teaching of medical ethics should consider the religious medium because it seems to have a bigger impact on the trainees.

Key words: nurses ethics training

1. Naznin Muhammad et al. The impact of the teaching of medical ethics in the medical and allied health sciences curriculum in International Islamic University Malaysia. Paper being submitted to the International Medical Journal (personal communication)