UKM Learning and Research Repository

Development and validation of an instrument to assess the readiness of entrustable professional activity implementation in undergraduate medical education in Indonesia

Sun, 01 Mar 2026 00:00:00 GMT

Title: Development and validation of an instrument to assess the readiness of entrustable professional activity implementation in undergraduate medical education in Indonesia Authors: Oktarina (P116929) Abstract: Entrustable Professional Activities (EPAs) bridge competency-based education and workplace activities. Limited evidence exists for EPA implementation in Indonesian undergraduate medical education. This study aimed to develop and validate an instrument assessing EPA implementation readiness in Indonesian undergraduate medical programs. A sequential exploratory mixed-method design was employed across three stages. The qualitative research stage involved interviews with Asian and Indonesian medical education experts, heads of medical education units, and medical teachers. In the second stage, the instrument was developed and validated through content, face, and construct validation. Stage three comprised a quantitative study at Universitas Muhammadiyah Jakarta (UMJ). Results found the needs for each dimension of EPA implementation (EPA development, EPA application, entrustment decision, and management initiatives for change). EPA development necessitates conceptualization and standardization, the development team, and stakeholder involvement. The EPA application requires the readiness of teachers, medical students, curriculum, and supportive systems. Entrustment decisions need a systematic entrustment assessment and the assessors for entrustment decisions. Management initiatives for change require leaders’ commitment, strategic planning for change, resource management, faculty development, stakeholder engagement and support, and quality assurance. Thus, the questionnaire was developed based on the teachers’ roles in each dimension. The content validation with seven experts resulted in an s-CVI of 0.94-0.96. After the construct validation, the questionnaire contained 72 items covering Knowledge, Attitude, and Practice (KAP) domains of teacher readiness, plus management preparedness perception domains. Teachers’ readiness is represented by ten factors of KAP domains. Management initiatives' preparedness for change consisted of three factors associated with perceptions of students-curriculum-support systems, and two factors related to change management preparedness. The UMJ readiness preliminary study revealed teacher readiness varied across roles: curriculum planner (35.7% high readiness), learning facilitator (27.1%), assessor (28.6%), and change agent (14.3% high readiness). Management initiative preparedness showed balanced distribution (27.1% high, 22.9% moderate, 24.3% developing, 25.7% limited), indicating heterogeneous institutional capacity. This pioneering study provides a validated questionnaire for assessing EPA implementation readiness in Indonesian undergraduate medical education programs.

Virtual antenatal consultation service in Malaysian primary care: acceptance and barriers to consumer digital health

Thu, 25 Dec 2025 00:00:00 GMT

Title: Virtual antenatal consultation service in Malaysian primary care: acceptance and barriers to consumer digital health Authors: Halila Mohamed (P113690) Abstract: The integration of digital health technologies, such as virtual consultation (VC) services, into antenatal care, holds significant potential to enhance accessibility and efficiency in maternal healthcare delivery. VC services were introduced in Malaysian public primary care clinics in 2019, initially focusing on chronic disease management, health education, smoking cessation programs, and follow-ups on investigation results and appointments. In response to the COVID-19 pandemic, these services were expanded in 2022 to include maternal and child healthcare, offering antenatal care through virtual consultations. This study investigates the determinants influencing the acceptance of VC services and identifies barriers to their adoption among healthcare providers (HCPs) and antenatal mothers with prior experience using the VC service in primary health clinics in Malaysia. Guided by the Unified Theory of Acceptance and Use of Technology (UTAUT) framework, the research explores the impact of individual factors such as performance expectancy (PE), effort expectancy (EE), social influence (SI), health literacy (HL), and user satisfaction (SAT) alongside organisational factors like facilitating conditions (FC) and technological factors such as system and service quality, on behavioural intention (BI) to use VC services. Moderating variables, including income, education level, and training, were analysed to understand their role in shaping these relationships. A mixed-methods approach was employed, combining quantitative data from structured surveys with qualitative insights from in-depth interviews to provide a comprehensive understanding of the determinants and barriers to VC adoption. The findings revealed that, for HCPs, the overall model explained 64% of the variance in BI (R² = 0.64), with facilitating conditions (β = 0.59, p < 0.001) emerging as the strongest determinant. Among antenatal mothers, the model explained 62% of the variance in BI (R² = 0.62), with health literacy (β = 0.202, p < 0.001) being the most influential determinant. Technological factors significantly influenced user satisfaction, which in turn strengthened the intention to use VC services. User satisfaction contributed 42% to BI among HCPs and 17% among antenatal mothers and mediated the relationship between system and service quality and BI in both groups. Training was identified as a significant moderator in the relationships between PE, EE, FC, SI, and BI among HCPs, with more substantial effects observed in those who received training. For antenatal mothers, education and income levels moderated the relationships between PE, SI, HL, and BI. The barriers to VC adoption were predominantly linked to technological constraints, limitations in remote monitoring that undermined confidence, fear of misjudgement, and insufficient knowledge or empowerment, particularly among antenatal mothers. These findings provide valuable insights for policymakers and healthcare providers in designing and implementing effective, user-centred VC solutions to strengthen maternal healthcare delivery.

Development and characterization of small extracellular vesicles-loaded genipin cross- linked gelatine hydrogel for vocal fold fibroblasts regeneration in glottic insufficiency patients

Thu, 05 Mar 2026 00:00:00 GMT

Title: Development and characterization of small extracellular vesicles-loaded genipin cross- linked gelatine hydrogel for vocal fold fibroblasts regeneration in glottic insufficiency patients Authors: Zarqa Iffah Zamlus (P118298) Abstract: Glottic insufficiency occur due to the injury on laryngeal nerve, which affects the quality of voice and difficulty in breathing. Currently, injection augmentation using hyaluronic acid is done as treatment, but it requires re-injection every 3-6 months. The aim of this study is to incorporate small extracellular vesicles (sEV) derived from Wharton’s Jelly mesenchymal stem cells (WJMSCs) into genipin-crosslinked gelatin hydrogels (GCGH) and observe its therapeutic potential on vocal fold fibroblasts (VFF) regeneration in vitro. WJMSCs were isolated from umbilical cord, characterized, and expand for isolation of sEV by using tangential flow filtration (TFF) system. A total of number of sEV particles were detected using bicinchoninic assay (BCA). Then sEV were further characterized with nanoparticle tracking analysis (NTA), transmission electron microscopy (TEM), and western blot. Afterwards, 6 different concentrations of sEV were assayed to observe its cytotoxicity and proliferative efficacy on VFF. From the results, 75 μg/mL of sEV was chosen because it promotes the highest VFF proliferation and cell viability up until day 7 when tested with MTT assay and LIVE/DEAD assay. Subsequent test incorporates GCGH with WJMSCs, WJMSCs with basic fibroblast growth factor (WJMSC-bFGF), or sEV, respectively. Physicochemical results showed that all the groups were able to be extruded from syringe in under 20 minutes and took average 42 days to fully degrade. In terms of biocompatibility with VFF, GCGH-MSC provide better cell viability than GCGH-sEV, GCGH-MSC-bFGF, and GCGH. The same result can be seen in collagen gel contraction assay, where foldchange collagen contraction of GCGH-MSC is higher than others. In addition, this study also found that all GCGH groups do not induce immune response when co-cultured with peripheral mononuclear blood cells (PBMC) for 7 days. In conclusion, GCGH was found suitable for delivery of WJMSC, bFGF, and sEV to VFF and has the potential in promoting regeneration of vocal fold tissues, based on the enhanced VFF proliferation and biocompatibility without any immune response. Further in vivo studies of the above combinations are necessary to uncover their full potential in true environment.

Tibi boleh berjangkit secara ‘senyap’

Fri, 27 Feb 2026 00:00:00 GMT

Title: Tibi boleh berjangkit secara ‘senyap’ Authors: Noorsuzana Mohd Shariff