DESIGN: A qualitative study involving eight focus groups and twelve in-depth interviews. Focus groups and interviews were recorded and transcribed verbatim. An inductive thematic analysis approach was used to analyse the data.
SETTING: Four secondary schools in Perak and Selangor states (two urban and two rural schools) in Malaysia.
PARTICIPANTS: Focus groups were conducted with seventy-six adolescents aged 13-14 years, and in-depth interviews were conducted with four headmasters, four PA education teachers and four food canteen operators.
RESULTS: Stakeholders thought that adolescents' misperceptions, limited availability of healthy options, unhealthy food preferences and affordability were important challenges preventing healthy eating at school. Low-quality physical education (PE) classes, limited adolescent participation and teachers' commitment during lessons were perceived as barriers to adolescents being active at school. Affordability was the main challenge for adolescents from rural schools. Stakeholders perceived that a future school-based intervention should improve the availability and subsidies for healthy foods, provide health education/training for both adolescents and PE teachers, enhance active adolescent participation in PE and develop social support mechanisms to facilitate engagement with PA.
CONCLUSIONS: These findings provide important insights into developing school-based lifestyle interventions to improve healthy eating and strengthening PA of Malaysian adolescents.
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.