It has been suggested that the 'ideal' measure of reliability of an examination is obtained by test and retest using the one examination on the same group of students. However, because of practical and theoretical arguments, most reported reliabilities for multiple choice examinations in medicine are actually measures of internal consistency. While attempting to minimize the effects of potential interfering factors, we have undertaken a study of true test-retest reliability of multiple true-false type multiple choice questions in preclinical medical subjects. From three end-of-term examinations, 363 items (106 of 449 from term 1, 150 of 499 from term 2, and 107 of 492 from term 3) were repeated in the final examination (out of 999 total items). Between test and retest, there was little overall decrease in the percentage of items answered correctly and a decrease of only 3.4 in the percentage score after correction for guessing. However, there was an inverse relation between test-retest interval and decrease in performance. Between test and retest, performance decreased significantly on 33 items and increased significantly on 11 items. Test-retest correlation coefficients were 0.70 to 0.78 for items from the separate terms and 0.885 for all items that were retested. Thus, overall, these items had a very high degree of reliability, approximately the 0.9 which has been specified as the requirement for being able to distinguish between individuals.
The multidiscipline laboratories (MDLs) of University of Malaya are a significant feature in the Faculty of Medicine. They provide facilities for a number of activities within the teaching curriculum. This is in contrast to the departmental type of laboratories. Being the first in the eastern hemisphere, they are gaining popularity among new medical schools in this part of the world. Since a number of visitors testify to a continued interest in the multidiscipline laboratories, an attempt is made to discuss our experience with these facilities in relation to tthe design, uses, organisation, staff requirement, student usage and space problems.
The tracer concept was applied to evaluate the delivery of family health care and the training of family health workers. A retrospective evaluation permitted linking the products of care to process, input and context, by isolating and analysing potential factors contributing to a limited number of representative concerns. Contributory learning deficiencies identified in health workers, one input to health care as well as a product of training, enabled the evaluation of training programmes to be focused on related segments of the courses. The latter were evaluated through a pathway analysis which followed the same deficiency model as the evaluation of health care. Links were thus established between the traditionally compartmentalized training and service sectors in health.