MATERIALS AND METHODS: A survey of the tutors who had used the instrument was conducted to determine whether the assessment instrument or form was user-friendly. The 4 competencies assessed, using a 5-point rating scale, were (1) participation and communication skills, (2) cooperation or team-building skills, (3) comprehension or reasoning skills and (4) knowledge or information-gathering skills. Tutors were given a set of criteria guidelines for scoring the students' performance in these 4 competencies. Tutors were not attached to a particular PBL group, but took turns to facilitate different groups on different case or problem discussions. Assessment scores for one cohort of undergraduate medical students in their respective PBL groups in Year I (2003/2004) and Year II (2004/2005) were analysed. The consistency of scores was analysed using intraclass correlation.
RESULTS: The majority of the tutors surveyed expressed no difficulty in using the instrument and agreed that it helped them assess the students fairly. Analysis of the scores obtained for the above cohort indicated that the different raters were relatively consistent in their assessment of student performance, despite a small number consistently showing either "strict" or "indiscriminate" rating practice.
CONCLUSION: The instrument designed for the assessment of student performance in the PBL tutorial classroom setting is user-friendly and is reliable when used judiciously with the criteria guidelines provided.
METHODS: Information was obtained from published records, responses from various questionnaires, personal communication and involvement with curricular development.
RESULTS: Curricular innovations tended to be implemented in new medical schools upon their establishment. Established medical schools seemed to implement these innovations much later. Curricular trends appear to move towards integration, student-centred and problem-based learning as well as community-oriented medical education, with the Student-centred learning, Problem-based learning, Integrated teaching, Community-based education, Electives and Systematic programme (SPICES) model used as a reference. The focus is based on the premise that although the short-term aim of undergraduate medical education in Malaysia is to prepare graduates for the pre-registration house officer year, they must be able to practise and make decisions independently and be sensitive to the needs of the country's multiracial, multi-religious, and often remote communities.
CONCLUSION: In most cases, curricular planning starts with a prescriptive model where planners focus on several intended outcomes. However, as the plan is implemented and evaluated it becomes descriptive as the planners reassess the internal and external factors that affect outcomes. A common trend in community-oriented educational activities is evident, with the introduction of interesting variations, to ensure that the curriculum can be implemented, sustained and the intended outcomes achieved.
MATERIALS AND METHODS: MCQ items in papers taken from Year II Parts A, B and C examinations for Sessions 2001/02, and Part B examinations for 2002/03 and 2003/04, were analysed to obtain their difficulty indices and discrimination indices. Each paper consisted of 250 true/false items (50 questions of 5 items each) on topics drawn from different disciplines. The questions were first constructed and vetted by the individual departments before being submitted to a central committee, where the final selection of the MCQs was made, based purely on the academic judgement of the committee.
RESULTS: There was a wide distribution of item difficulty indices in all the MCQ papers analysed. Furthermore, the relationship between the difficulty index (P) and discrimination index (D) of the MCQ items in a paper was not linear, but more dome-shaped. Maximal discrimination (D = 51% to 71%) occurred with moderately easy/difficult items (P = 40% to 74%). On average, about 38% of the MCQ items in each paper were "very easy" (P > or =75%), while about 9% were "very difficult" (P <25%). About two-thirds of these very easy/difficult items had "very poor" or even negative discrimination (D < or =20%).
CONCLUSIONS: MCQ items that demonstrate good discriminating potential tend to be moderately difficult items, and the moderately-to-very difficult items are more likely to show negative discrimination. There is a need to evaluate the effectiveness of our MCQ items.
MATERIALS AND METHODS: A total of 122 year 4 medical students responded to this study. The Attitudes Towards Mental Illness (AMI) and Attitudes Towards Psychiatry (ATP) questionnaires were administered before and after an 8-week attachment in psychiatry.
RESULTS: We found that students had somewhat favourable attitudes towards psychiatry and mental illness at the start of their attachment, with a mean score of 108.34 on ATP (neutral score, 90) and 68.24 on AMI (neutral score, 60). There was a significant increase in the mean scores of both scales following the psychiatric attachment for female students (ATP: P = 0.003; AMI: P <0.0005), but not male students (ATP: P = 0.435; AMI: P = 0.283).
CONCLUSIONS: An 8-week clinical posting of fourth-year medical students in psychiatry was associated with an increase in positive attitudes to mental illness and to psychiatry among female students but not among male students.
METHODS: This critique on the OSCE is based on the published findings of researchers from its inception in 1975 to 2004.
RESULTS: The reliability, validity, objectivity and practicability or feasibility of this examination are based on the number of stations, construction of stations, method of scoring (checklists and/ or global scoring) and number of students assessed. For a comprehensive assessment of clinical competence, other methods should be used in conjunction with the OSCE.
CONCLUSION: The OSCE can be a reasonably reliable, valid and objective method of assessment, but its main drawback is that it is resource-intensive.
MATERIALS AND METHODS: Lecturers and students in the Phase (Year) II programme were asked to fill questionnaires following the second and fourth PBL cases. The two sets of survey responses were compared to see whether the students' and teachers' perceptions had changed over the 5-month period.
RESULTS: Students' responses from both surveys (1 and 2) were similar in that a majority agreed that the PBL tutorials had encouraged the seeking of information (66% and 67%, respectively), had improved understanding (57% and 56%), integration (65% and 70%) and application (50% and 64%) of knowledge. However, the views given in the form of written comments, following their positive responses, were somewhat contradictory. A large number of students (38% and 40%) faced difficulties in getting involved in discussions during the PBL tutorial and a majority (73% and 82%) preferred the normal subject-based tutorials. The reasons given by approximately 20% of the students were that the subject-based tutorials were more efficient for obtaining information and/or that the information had been pre-selected by the lecturers. More than 80% of the lecturers (in both surveys) perceived that the students had identified the appropriate learning objectives and covered the subject matter. The percentage of lecturers who agreed that PBL tutorials encouraged rapport and teamwork amongst students had increased in the second survey, from 70% to 92% and 55% to 83% respectively.
CONCLUSION: Implementing PBL is not simply a matter of developing new teaching materials and new effective ways of presenting them. It requires a paradigm shift, a change in the roles of students and teachers, and time.