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Front. Med.    2016, Vol. 10 Issue (1) : 91-100    https://doi.org/10.1007/s11684-016-0428-0
RESEARCH ARTICLE
Effectiveness of preventive medicine education and its determinants among medical students in Malaysia
Shirin Anil1,*(),Mohamed Shukry Zawahir2,Redhwan Ahmed Al-Naggar3
1. Public Health Solutions Pakistan, Islamabad 44000, Pakistan
2. Department of Pharmacy, University of Ruhuna, Galle 70, Sri Lanka
3. Faculty of Medicine, Universiti Teknologi MARA (UiTM), Shah Alam 40450, Malaysia
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Abstract

Preventive medicine has been incorporated in the medical school curriculum, but its effectiveness and the factors that affect it are yet to be widely looked into in the context of Malaysia. We aimed to measure the familiarity with, perception about the importance to learn, and the ability to practice preventive medicine as well as its determinants among the medical students in Malaysia. Thus, a cross sectional study was conducted through an anonymous online survey among 387 randomly selected final year medical students of four large public medical schools in Malaysia from March to September 2014. Of the total sample, only 340 (response rate 87.8%) gave a written informed consent and took part in the survey. The familiarity of the sample with preventive medicine was measured in 19 preventive medicine areas, and their perception about the importance of preventive medicine and their ability to practice it were gauged on a Likert scale (low score indicates disagreement and high indicates agreement). Descriptive statistical analysis was performed, followed by logistic regression. The mean age of the respondents was 23.7 (SD 0.77) years, and 61.2% (n = 208) of them were females. Results showed that 22.9% of the sample (n = 78) had a low familiarity with preventive medicine, whereas 76.8% (n = 261) had a high familiarity. The study sample specified that among all the preventive medicine subjects, screening and control as well as smoking cessation and immunization are “extremely important to learn.” In univariable analysis, being a female, medical school, family size, and perception about the importance to learn preventive medicine were associated with the ability to practice it. In multivariable analysis, the perception towards the importance to learn preventive medicine was the only significant determinant: aOR (adjusted odds ratio) for those who “agreed” 17.28 (95% CI aOR 4.44 – 67.26, P<0.001) and for “strongly agreed” 35.87 (95% CI aOR 8.04 – 159.87, P<0.001). Considering these findings, the familiarity of medical students with preventive medicine should be increased. The perception about the importance to learn preventive medicine is a strong determinant for the ability to practice it.
Keywords preventive medicine      medical school      medical students     
Corresponding Author(s): Shirin Anil   
Just Accepted Date: 01 December 2015   Online First Date: 29 December 2015    Issue Date: 31 March 2016
 Cite this article:   
Shirin Anil,Mohamed Shukry Zawahir,Redhwan Ahmed Al-Naggar. Effectiveness of preventive medicine education and its determinants among medical students in Malaysia[J]. Front. Med., 2016, 10(1): 91-100.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-016-0428-0
https://academic.hep.com.cn/fmd/EN/Y2016/V10/I1/91
Baseline characteristics Response
Age in years (mean (SD)) 23.7 (0.77)
Male gender (n (%)) 132 (38.8)
Academic college (n (%))UKMUMUiTMUPM 68 (20)88 (25.9)104 (30.6)80 (23.5)
Malaysian nationality (n (%)) 339 (99.7)
Urban residence 264 (77.6)
Father’s education (n (%))PrimarySecondaryTertiaryMissing 38 (11.2)145 (42.6)156 (45.9)1 (0.3)
Mother’s education (n (%))PrimarySecondaryTertiary 37 (10.9)166 (48.8)137 (40.3)
Father doctor by profession (n (%)) 11 (3.2)
Mother doctor by profession (n (%)) 4 (1.2)
Family size (n (%))2–45–7>7Missing 89 (26.2)195 (57.3)52 (15.3)4 (1.2)
Monthly household income (n (%))MR<1000MR 1000–3000MR 3000–6000MR>6000 33 (9.7)101 (29.7)110 (32.4)96 (28.2)
Tab.1  Baseline characteristics of the final year medical students — preventive medicine study, Malaysia, 2014
Fig.1  The familiarity of final year medical students with preventive medicine courses in Malaysia is extremely low mostly for “poison control education,” followed by “genetic counseling.”
Fig.2  Blood pressure screening and control followed by smoking cessation and immunization are considered by the final year medical students in Malaysia as “extremely important to learn” among all the preventive medicine courses.
Factors cOR(95% CI cOR) P value aOR(95% CI aOR) P value
Age 1.47 (0.91–2.39) 0.117
GenderMaleFemale 12.25 (1.11 – 4.57) 0.025a 11.29 (0.54–3.09) 0.557
Medical schoolUKMUMUiTMUPM 10.18 (0.05–0.64)0.64 (0.16–2.55)0.48 (0.121–1.97) 0.006a0.008a0.5230.314 10.47 (0.12–1.90)0.65 (0.15–2.79)0.92 (0.21–4.12) 0.5730.2920.6570.922
ResidenceRuralUrban 11.01 (0.44–2.33) 0.972
Father’s educationPrimarySecondaryTertiary 10.30 (0.04–2.41)0.17 (0.02–1.28) 0.0940.2590.086
Mother’s educationPrimarySecondaryTertiary 10.31 (0.04–2.42)0.16 (0.02–1.27) 0.0770.2630.083
Father being a doctorNoYes 11.17 (0.14–9.41) 0.884
Mother being a doctor Regression cannot be performed due to data scarcity for this variable
Family size2–45–7>7 12.8 (1.33–5.91)5.7 (1.28–26.17) 0.006 a0.007 a0.023 a 11.54 (0.62–3.83)1.93 (0.36–10.17) 0.5820.3510.437
Monthly household incomeMR<1000MR 1000–3000MR 3000–6000MR>6000 11.10 (0.32–3.73)1.36 (0.39–4.67)1.17 (0.34–4.03) 0.9530.8740.6200.801
Familiarity with preventive medicineLowHigh 11.73 (0.80–3.74) 0.160
Perception about the importance to learn preventive medicineNeither agree nor disagreeAgreeStrongly agree 127.42 (7.78 – 96.59)56.33 (15.12 – 209.89) <0.001a<0.001a<0.001a 117.28 (4.44–67.26)35.87 (8.04–159.87) <0.001a<0.001a<0.001a
Tab.2  Determinants of the ability to practice preventive medicine by final year medical students — preventive medicine study, Malaysia, 2014
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[1] Luz Helena Alba,Nora Badoui,Fabián Gil. Attitude toward preventive counseling and healthy practices among medical students at a Colombian university[J]. Front. Med., 2015, 9(2): 251-259.
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