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CASE #1: AWG KHAIRUL BIN HJ JUMAAT
RESEARCH SKILLS - Discrete data analysis:
1. Illustrate simple analysis of proportions using approximate methods (chi square).
2. Illustrate simple analysis of proportions using exact methods (Fischer’s method).
ETHICO-LEGAL SKILLS - Privacy and confidentiality):
1. Define privacy and confidentiality and their role in medical care.
2. Explain the regulations of disclosing of confidential information.
3. Review ethico-legal issues in the generation, use, storage, ownership, access to, and disclosure of medical records
PROBLEM SOLVING SKILLS - Awang Khairul Haji Jumaat
1. Discuss the impact of impotence on marital relations and possible legal and medical remedies
2. List and discuss the vulnerabilities of the handicapped and the assurance of their rights at work and in the community.
3. Use appropriate statistical tests to test the hypothesis that there is no difference in skin sensation between the left and right forearms.
CASE #2: MOHAMMAD DAUD
RESEARCH SKILLS - Continuous data analysis:
1. Contrast parametric and nonparametric analysis.
2. Illustrate the use of the t-test and F-test in continuous data analysis.
3. Review the interpretation of p-values.
ETHICO-LEGAL SKILLS -Issues in sensory disorders/conditions:
1. Describe legal guidelines for blind and deaf patients regarding salat, hajj, court testimony, marital contracts, civil transactions, financial transactions, and employment.
2. Describe legal guidelines for control of bad odors on the person and in the environment.
3. Describe legal guidelines for wudhu and salat in cases of excessive sensitivity to heat or cold;
4. Describe legal guidelines regarding salat and marital relations in situations with constant pain;
5. Describe legal guidelines on salat for patients with extreme hunger or thirst.
PROBLEM SOLVING SKILLS
1. Using the data provided use the paired t statistic to test the hypothesis that there is no difference in hearing between the silent and the noisy backgrounds.
2. Using the data provided use the F statistic to test the hypothesis that there is no difference in hearing among the three groups of workers tested.
3. Based on the information given discuss the liability of the employer for compensating the worker for work-related injury.
CASE #3: PG HAJAH KAMARIAH PG HJ IBRAHIM
PERSONAL SKILLS - Personal development: professional, entrepreneurial, and networking:
1. Describe and illustrate the following strategies for further professional development: postgraduate training, apprenticeship, mentoring, goal setting, quality results, and shunning cheap publicity.
2. Describe and illustrate strategies for accumulating assets with the eventual aim of investing to assure financial security.
3. Describe how to establish mutually beneficial professional relations and how to nurture them.
ETHICO-LEGAL SKILLS -Issues for CNS sensorimotor disorders:
1. Describe legal guidelines for addressing the impact of hemiplegia on wudhu and salat.
2. Describe legal guidelines for patients with cerebral lesions regarding civil transactions and financial transactions
3. Discuss ethico-legal issues relating to discrimination against the disabled.
PROBLEM SOLVING SKILLS
1.What is your opinion on granting the patient’s wishes with regard to capacity/competence?
2. List at least 6 criteria used in assessing capacity.
CASE #4: HJH SALMAH MOKSIN
PERSONAL SKILLS - Personal development: intellectual and psychosocial:
1. Describe general guidelines for selecting a prospective spouse with special emphasis on medical considerations.
2. Summarize the main elements of a marriage contract and how they relate to family health.
3. Describe general guidelines on conjugal issues (rights and obligations) with emphasis on health aspects.
ETHICO-LEGAL SKILLS -Issues in central neurological conditions:
1. Describe guidelines for salat and hajj (tawaaf) for patients with vestibular disorders.
2. Describe legal guidelines on civil contracts in patients with aphasia/dysphasia.
PROBLEM SOLVING SKILLS
1. Using the chi-square statistic, test the hypotheses that there are no differences in sensation between the left and the right side.
2. Using Fisher’s exact method, test the hypotheses that there are no differences in sensation between the left and the right side.
3. Using the Student t statistic, test the hypothesis that there is no difference in the speed of nerve impulse conduction between the left and right sides.
CASE #5: HJH SA’ADIAH AHMAD
RESEARCH SKILLS - Correlation analysis):
1. Define correlation analysis.
2. Relate correlation to the scatter-plot.
3. Define and illustrate the use of the Pearson correlation coefficient;
ETHICO-LEGAL SKILLS - Issues in neurological conditions:
1. Describe guidelines for salat and hajj for patients with impaired postural reflexes
2. Describe ethico-legal issues relating to heavy factory work for patients with hand tremors (resting and postural).
3. Describe ethico-legal issues that are associated with stem cell transplantation for treatment of degenerative diseases (review of previous work)
PROBLEM SOLVING SKILLS
1.Discuss ethico-legal considerations relating to driving licenses for patients with involuntary movements controllable by drug therapy.
2. Discuss ethico-legal issues relating to disclosure of incipient illnesses on insurance and employment application forms.
3. Discuss breach of confidentiality in this case
4. Using data provided on Hjh Sa’adiah, draw a scatter plot, compute and interpret a Pearson correlation coefficient.
CASE #6: ZALEHA ABDUL HAMID
PERSONAL SKILLS - Character and behavior: integrity and responsibility:
1. Explain the relation between character and behavior.
2. List and illustrate the various components of a positive character.
3. List and illustrate some of the manifestations of positive behavior.
4. Characterize the social environment that leads to positive behavior.
ETHICO-LEGAL SKILLS - Depression):
1. Describe ethico-legal issues in compulsory detention and treatment of patients with psychiatric conditions associated with self-harm or harm to others.
2. Describe legal liabilities of a physician who fails to recognize and treat a mental condition that later leads to self-harm or harm to others.
3. Discuss the conflict between religious rulings on suicide with autonomy rights.
PROBLEM SOLVING SKILLS - Depression):
1. Draw a scattergram of the results
2. Compute and interpret the Pearson coefficient of linear correlation.
CASE #7: CATHERINE NG
RESEARCH SKILLS - Regression analysis
I: Contrast the concepts of dependent and independent variables in a scatter-gram.
2. Explain the difference between correlation and regression.
3. Define and illustrate the simple linear regression line.
4. Interpret the intercept and the coefficient of regression.
5. Illustrate the use of the regression line for testing association.
6. Illustrate the use of the regression line for prediction (interpolation and extrapolation)
ETHICO-LEGAL SKILLS – MS Peripheral neuropathies:
1. Describe advance directives: definition, scope, and format.
2. Discuss ethico-legal issues in using advance directives for patients with progressive neurological conditions
PROBLEM SOLVING SKILLS – Preventing relapses
1. Build a step-up multiple linear regression model with the number of relapses as the dependent variable and the following as independent variable: age at diagnosis, current age, gender, race, and various drugs (azathioprine, interferon, and glatiramer acetate.
2. Use the regression model above to determine which drug(s) is/are beneficial.
3. Explain why the model contains ‘confounding’ variables of age, gender, and race.
CASE #8: JOANA HALIM (Spina bifida)
RESEARCH SKILLS - Regression analysis II:
1. Define and illustrate multiple linear regression.
2. Illustrate methods of fitting a multiple linear regression line (step-up, step-down, and stepwise).
3. Illustrate at least 1 method of checking the goodness of fit of a regression line.
ETHICO-LEGAL SKILLS -Delivery of infants with neural tube defects (anencephaly, spina bifida, or hydrocephalus):
1. Describe the ethico-legal issues in deciding to deliver congenitally malformed children before term and the selection of delivery methods.
2. Discuss ethico-legal issues on withholding CPR for congenitally abnormal children immediately after delivery
3. Discuss ethico-legal issues in long-term life support for congenitally abnormal children.
PROBLEM SOLVING SKILLS
1. Construct a step up multiple linear regression model to predict survival after delivery of a spina bifida child including method of delivery and other determinants in the data provided and check the goodness of fit
2. Construct a step down multiple linear regression model to predict survival after delivery of a spina bifida child including method of delivery and other determinants in the data provided and check the goodness of fit.
3. Construct a step-wise multiple linear regression model to predict survival after delivery of a spina bifida child including method of delivery and other determinants in the data provided and check the goodness of fit.
CASE #9: NURUL AL JANNAH IBRAHIM (Cerebral palsy)
RESEARCH SKILLS - Time series analysis):
1. Describe and illustrate the plot of y against time to show time trends, seasonal patterns, random / irregular patterns, or mixtures of the above.
2. Illustrate use of time plots for forecasting.
3. List other methods for time series analysis: longitudinal regression, autoregression, and auto-correlation.
ETHICO-LEGAL SKILLS -Parental rights in cases of child abuse and neglect especially of congenitally abnormal children):
1. Define and describe the concept of Child protection re: Gillick, Fraser.
2. Explain the role of the state as a protector of children and the conditions in which it can intervene to provide care if parents neglect their duty.
PROBLEM SOLVING:
1. Construct growth charts for weight, height, and head circumference for children aged 0-48 months using the data provided.
2. Interpret the growth parameters of a normal child using the charts constructed above.
3. Interpret the growth parameters of a cerebral palsy child using the charts constructed above.
CASE #10: MOHAMMED FIKRI (autism)
PERSONAL SKILLS - Character and behavior: futuristic outlook and creativity:
1. Describe a futuristic outlook.
2. Define creativity and innovativeness.
3. List and describe components of creativity
ETHICO-LEGAL SKILLS – (Child abuse and neglect)
1. Classify child abuse as physical, psychological, and sexual.
2. Describe one illustration of each of the three forms of child abuse mentioned above.
PROBLEM SOLVING SKILLS
1. Identify the implications of the physician’s reporting of child abuse to authorities on family integrity/break-up.
2. Describe the physician’s liability for failure to report child abuse.
CASE #11: The Stephenson’s family (cystic fibrosis)
RESEARCH SKILLS: Basics of Survival Analysis:
1. List 2 main purposes of survival analysis
2. Explain the measurement of time and the concept of zero time
3. Define censoring and mention 2 of its causes
4. Illustrate the use of the Lifetable and the Kaplan-Meir methods in survival analysis
5. Illustrate the use of the proportional hazards method in survival analysis.
6. How are 2 survival curves compared?
ETHICO-LEGAL SKILLS -Pre-natal diagnosis, screening, and counseling for congenital anomalies:
1. List and describe benefits and potential risks of pre-natal diagnosis.
2. Discuss the ethico-legal implications of the potential relation between pre-natal diagnosis and non-therapeutic abortion.
3. Define human rights of the embryo and the fetus
4. Describe ethico-legal issues in neonatal genetic screening and genetic counseling.
PROBLEM SOLVING SKILLS:
1. Construct a multiple logistic model to predict diagnosis of a congenital anomaly from the symptoms and signs provided.
2. Construct a logistic regression model to identify drugs most effective in improving lung function in a patient with a congenital anomaly.
3. Construct a logistic regression model to identify determinants of survival to age 40 in patients born with congenital anomalies
4. Review laws of probability with reference to genetic inheritance
5. Explain and illustrate the use of the Hardy-Weinberg equation using the data given.
CASE #12: Nur Suhada Ameer
PERSONAL SKILLS - Character and behavior: interdependence and positive attitudes:
1. Define and illustrate interdependence.
2. Distinguish interdependence from child-like dependency
3. Define and illustrate the following positive attitudes: commitment, effort and action to achieve goals, taking responsibility, learning from previous experiences (positive and negative), pursing real needs and not mere wants, and contentment.
ETHICO-LEGAL SKILLS –
human sexuality & sexual behavior:
1. List and discuss appropriate and inappropriate forms of sexual expression and behavior.
2. List and describe various ways used by society to regulate human sexuality.
3. List and describe general guidelines for sexual behavior in marriage.
4. List and describe legal guidelines on coitus.
5. Discuss in general issues of moral / cultural relativism with regard to sexual behavior.
Menstruation:
1. Describe exemptions from acts of worship for menstruating women
2. What is the legal ruling about using hormones to delay menstruation during hajj
3. Discuss the benefits and risks of hormonal replacement therapy
4. What are the legal rulings relating to acts of worship in cases of prolonged menstruation or dysfunctional uterine bleeding
Intra-uterine development: 1.
At what stage of pregnancy does life begin?
Pregnancy:
1. Describe one legal issue that necessitate determining the minimum gestation period
2. Describe legal rulings about divorce in pregnancy
CASE #13: Nora Sulaiman (abortion)
PERSONAL SKILLS - Character and behavior: assertiveness, self-confidence, and self-esteem:
1. Define and illustrate assertiveness and self-confidence.
2. Illustrate the difference between self-confidence and arrogance.
3. List and illustrate factors underlying self-esteem.
4. Define and illustrate the following traits: self control, self-discipline, and self-development.
ETHICO-LEGAL SKILLS
1. List and discuss causes, adverse consequences, and prevention of unwanted pregnancy
2. Discuss ethico-legal issues in voluntary termination of pregnancy;
3. Identify socially-acceptable alternatives to abortion in cases of unwanted pregnancy;
CASE #14: Hjh Salamah Awang
PERSONAL SKILLS - Character and behavior: self-reliance, positive image, and entrepreneurship):
1. Describe self-reliance.
2. Describe 5 ways of projecting a positive image
3. Describe an entrepreneurship attitude
ETHICO-LEGAL SKILLS - Ethico-legal issues relating to childbirth and breast feeding):
1. Discuss ethico-legal issues relating to refusal of medically indicated Cesarean section
2. Discuss ethico-legal issues relating to request for Cesarean delivery for which there are no medical indications.
3. Discuss issues of obligations of worship during labor and delivery
4. Discuss legal issues arising out of foster breastfeeding.