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  1. Arunachalam S, Pau A, Nadarajah VD, Babar MG, Samarasekera DD
    Eur J Dent Educ, 2023 May;27(2):332-342.
    PMID: 35484781 DOI: 10.1111/eje.12809
    OBJECTIVE: Entrustable professional activities (EPAs) are tasks that a person who is qualified or is in the process to be credentialed are allowed to engage. There are several levels of entrustment based on degrees of supervision assigned to each EPA. This paper aims to describe the process and outcome of creating EPAs; validate EPAs relevant to undergraduate dental training.

    METHODS: A draft set of EPA statements was developed based on the consensus of an expert panel. These were then mapped to the nationally determined minimum experience thresholds (clinical and procedural experiences/competencies) and aligned to task-based instructional strategy. The EPAs were validated to improve the relevance by using a criterion-based rubric.

    RESULTS: An end-to-end process workflow led to the development of an EPA-based educational framework to bridge the gaps in the curriculum. The process identified a total of 41 EPAs and out of which, 10 EPAs were notated as core EPAs and will be subjected to structured workplace-based assessment complying to the national standards. The validation exercise rated core EPAs with an overall score matching close to the cut-off of 4.07 (Equal rubric).

    CONCLUSION: The end-to-end process workflow provided the opportunity to elaborate a structured process for the development of EPAs for undergraduate dental education. As validation is a continuous process, feedback from implementation will inform the next steps.

    Matched MeSH terms: Competency-Based Education*
  2. Salam A, Zainuddin Z, Latiff AA, Ng SP, Soelaiman IN, Mohamad N, et al.
    Ann Acad Med Singap, 2008 Sep;37(9):814-6.
    PMID: 18989506
    Matched MeSH terms: Competency-Based Education*
  3. Tudehope DI, Osuch M
    J Paediatr Child Health, 2001 Apr;37(2):103-4.
    PMID: 11328460
    Matched MeSH terms: Competency-Based Education*
  4. Lai NM, Ramesh JC
    Singapore Med J, 2006 Dec;47(12):1053-62.
    PMID: 17139402
    INTRODUCTION: Outcome-based curriculum is adopted at the International Medical University (IMU), Malaysia, where specific learning objectives are laid out progressively under eight major outcomes. We present an outcome-guided, self-reported competency profile of our undergraduate students near the end of their training, focusing on elements that are considered most immediately relevant for their internship.
    METHODS: Anonymous surveys were conducted on two cohorts of medical students in their final semester at IMU. The surveys covered a range of competencies, including practical skills, ward routines, generic attributes and evidence-based medicine, grouped under the exit outcomes as defined by the university.
    RESULTS: A total of 92 students were assessed. In general, the students were confident of their ability on common practical skills and ward routines. They were comfortable with the level of professionalism and personal attributes required for internship, with the prospect of handling unexpected additional tasks and working away from home perceived as the main difficulties. Most students referred to at least three sources of clinical information to answer their clinical queries. However, they referred more to single journals than databases or collections. The majority could critically appraise journal articles to a variable extent, but nearly half took 30 minutes or longer to trace an abstract of interest.
    CONCLUSION: This report demonstrates the strength of outcome-based curriculum in its ability to produce competent students that are well prepared for their internship. Assessing students using this educational approach provides a clear picture of their strengths and weaknesses, and identifies stages in their training where additional inputs are required.
    Matched MeSH terms: Competency-Based Education/methods*
  5. Vanderschmidt L, Massey JA, Arias J, Duong T, Haddad J, Noche LK, et al.
    Am J Public Health, 1979 Jun;69(6):585-90.
    PMID: 443499
    Matched MeSH terms: Competency-Based Education*
  6. Maloney S, Nicklen P, Rivers G, Foo J, Ooi YY, Reeves S, et al.
    J Med Internet Res, 2015;17(7):e182.
    PMID: 26197801 DOI: 10.2196/jmir.4346
    Blended learning describes a combination of teaching methods, often utilizing digital technologies. Research suggests that learner outcomes can be improved through some blended learning formats. However, the cost-effectiveness of delivering blended learning is unclear.
    Matched MeSH terms: Competency-Based Education/economics; Competency-Based Education/methods; Competency-Based Education/standards
  7. Shankar PR, Azhar T, Nadarajah VD, Er HM, Arooj M, Wilson IG
    Korean J Med Educ, 2023 Sep;35(3):235-247.
    PMID: 37670520 DOI: 10.3946/kjme.2023.262
    PURPOSE: The perception of faculty members about an individually tailored, flexible-length, outcomes-based curriculum for undergraduate medical students was studied. Their opinion about the advantages, disadvantages, and challenges was also noted. This study was done to help educational institutions identify academic and social support and resources required to ensure that graduate competencies are not compromised by a flexible education pathway.

    METHODS: The study was done at the International Medical University, Malaysia, and the University of Lahore, Pakistan. Semi-structured interviews were conducted from 1st August 2021 to 17th March 2022. Demographic information was noted. Themes were identified, and a summary of the information under each theme was created.

    RESULTS: A total of 24 (14 from Malaysia and 10 from Pakistan) faculty participated. Most agreed that undergraduate medical students can progress (at a differential rate) if they attain the required competencies. Among the major advantages mentioned were that students may graduate faster, learn at a pace comfortable to them, and develop an individualized learning pathway. Several logistical challenges must be overcome. Providing assessments on demand will be difficult. Significant regulatory hurdles were anticipated. Artificial intelligence (AI) can play an important role in creating an individualized learning pathway and supporting time-independent progression. The course may be (slightly) cheaper than a traditional one.

    CONCLUSION: This study provides a foundation to further develop and strengthen flexible-length competency-based medical education modules. Further studies are required among educators at other medical schools and in other countries. Online learning and AI will play an important role.

    Matched MeSH terms: Competency-Based Education
  8. Boo NY, Pong KM
    J Paediatr Child Health, 2001 Apr;37(2):118-24.
    PMID: 11328464
    OBJECTIVES: To determine the number of providers and instructors trained by the initial 37 core instructors during the first 2 years following the launch of the Malaysian Neonatal Resuscitation Program (NRP). To identify remediable problems which interfered with the propagation of the NRP in Malaysia.

    METHODOLOGY: A prospective observational study carried out over a 2-year period between 2 September 1996 to 2 September 1998. For every training course conducted, the instructors completed a NRP course report form (Form A) that documented the instructors involved in the course. For every participant who attended the course and successfully completed it, the instructors submitted a record form (Form B) that contained the name, hospital address, department, profession, place of work, language used for training and the marks obtained by the individual participant. After each course, completed forms A and B were returned to the NRP secretariat for compilation.

    RESULTS: Of the 37 core instructors, 35 (94.6%) carried out training courses in their respective home states. A further 513 new instructors and 2256 providers were trained subsequently. A total of 2806 health personnel from all 13 states of Malaysia were NRP-certified during the first 2 years. However, 61.2% (n = 335) of the 550 instructors were inactive trainers, having trained less than four personnel per instructor a year. Most of the NRP-certified personnel were either doctors (32.0%) or nursing staff (64.4%). More than 60% of these worked either in the labour rooms, neonatal intensive care units or special care nurseries. At least one person from all three university hospitals and all general hospitals, 89.3% (92/103) of the district hospitals, 3.5% (73/2090) of the maternal and child health services, and 21% (46/219) of the private hospitals and maternity homes, were trained in the NRP.

    CONCLUSION: Dissemination of the NRP in Malaysia during the first 2 years was very encouraging. Further efforts should be made to spread the program to private hospitals and the maternal and child health services. In view of the large number of inactive instructors, the criteria for future selection of instructors should be more stringent.

    Matched MeSH terms: Competency-Based Education/organization & administration*; Competency-Based Education/standards
  9. Rukhsana Hussain Malik, Alam Sher Malik
    MyJurnal
    Introduction: With the increasing number of institutions implementing competency-based education which demands to provide feedback to students at regular intervals, there is an increase in the frequency of assessments. For this purpose, the written examinations using multiple choice questions (MCQs) are the most feasible form of assessment. However, constructing MCQs is an arduous task and significantly adds to the work-load of the academ- ic staff members. To ease this burden, the institutions may consider to develop banks of valid and reliable MCQs. Methods: Based and built on our experience and literature review, the steps – relating to the process of constructing valid and reliable questions and development of question banks (QBs) – are the actions needed to develop new QBs or improve on the existing ones. Results: We have described ten practical steps for developing and banking of MCQs. The first five steps relate to the development of quality items and the remaining steps relate to the development of QBs, their maintenance, growth and safety and security. We have also established the criteria for selection and the frequency of reuse of questions. Conclusion: Using QBs will alleviate some of the burden of constructing novel quality questions needed for frequent assessments of students using 21st century teaching/learning approaches. The use of banked questions with known psychometric properties would allow the authorities to take charge and control of items’ quality and overall examination standards.
    Matched MeSH terms: Competency-Based Education
  10. Siew Kheong Lum, Wei Rong Lee, Syn Dee Ch’ng, Navin Raj a/l Balachandran, Chee Kit Tee
    MyJurnal
    Introduction: Undergraduate medical education should be broad-based, holistic, integrated and should promote a framework for the development of higher order cognitive skills like communication, professionalism and teamwork to prepare the student for a life-long challenging medical career. Recent calls for a competency-based medical education require, in addition, competency in clinical and procedural skills prior to graduation. This study investigates how often opportunities exist for medical students to perform four common ward procedures prior to graduation.
    Method: A prospective cross-sectional study to assess the opportunities a medical student have in performing four common ward procedures, comprising intravenous cannulation, nasogastric tube insertion, urinary catheterisation and chest tube insertion, in a State General hospital in Malaysia was done.
    Results: A medical student has sufficient opportunity to perform only intravenous cannulation prior to graduation. He has a remote chance to insert a urinary catheter and is unlikely to have the opportunity to insert a nasogastric tube or insert a chest tube prior to graduation.
    Conclusion: Although competency in clinical skills and procedural skills prior to graduation are desirable, this is increasingly difficult to achieve due to shortage of clinical material, teachers to supervise, the large numbers of medical students and house officers, the short time spent on the main disciplines and the failure of many universities to invest heavily in skills laboratories staffed by full time clinicians. The calls to introduce competency-based medical education in undergraduate medical education, particularly in procedural competence, should take into account the challenges in delivery and the realities in the hospitals today. This is necessary to avoid demoralising students who are unable to achieve their quota of procedures through no fault of theirs.
    Keywords: procedural competency, medical education, Malaysia
    Matched MeSH terms: Competency-Based Education
  11. Yeap R, Beevi Z, Lukman H
    Med J Malaysia, 2008 Aug;63(3):244-6.
    PMID: 19248699
    This article describes the development of four assessment tools designed to evaluate the communication skills training (CST) programme at the International Medical University (IMU). The tools measure pre-clinical students' 1) perceived competency in basic interpersonal skills, 2) attitude towards patient-centred communication, 3) conceptual knowledge on doctor-patient communication, and 4) acceptance of the CST programme.
    Matched MeSH terms: Competency-Based Education/organization & administration*
  12. Waran V, Narayanan V, Karuppiah R, Pancharatnam D, Chandran H, Raman R, et al.
    J Surg Educ, 2014 Mar-Apr;71(2):193-7.
    PMID: 24602709 DOI: 10.1016/j.jsurg.2013.08.010
    The traditionally accepted form of training is direct supervision by an expert; however, modern trends in medicine have made this progressively more difficult to achieve. A 3-dimensional printer makes it possible to convert patients imaging data into accurate models, thus allowing the possibility to reproduce models with pathology. This enables a large number of trainees to be trained simultaneously using realistic models simulating actual neurosurgical procedures. The aim of this study was to assess the usefulness of these models in training surgeons to perform standard procedures that require complex techniques and equipment.
    Matched MeSH terms: Competency-Based Education
  13. Razak IA, Latifah RR, Jaafar N, Abu Hassan MI, Ab Murat N
    J Dent Educ, 2008 Mar;72(3):364-9.
    PMID: 18316541
    A survey was conducted to assess competencies of dental graduates of the Faculty of Dentistry, University of Malaya, as perceived by the graduates and their employers, based on the five-year undergraduate curriculum introduced in 1995. All senior dental officers in the Ministry of Health (MOH), representing employers, and all 164 dental graduates of the years 2000, 2001, and 2002 were sent a self-administered questionnaire covering eight areas of competency. The respondents had to rate these areas on a scale of 1 (very poor) to 4 (very good). The responses for each area were then dichotomized into poor (1 and 2) and good (3 and 4). If less than 60 percent of the respondents rated an area as good, then it was categorized as needing attention; 60-69 percent as satisfactory; and 70 percent and above as excellent. One hundred and six graduates (64.6 percent) and twenty-nine employers (96.7 percent) responded; of the graduates, 73.6 percent were working in the MOH and 22.6 percent in private practice. About 57.1 percent of employers reported that at least five graduates have worked under them. Graduates (85.7 percent) and employers (83.3 percent) agreed that graduates have excellent skills in communication. Although all graduates perceived their competency to be excellent in the four areas (treatment planning; community-based skills; management, administrative skills, and personal management; and professional development skills), employers felt that these are the areas that are of concern and needed attention. In conclusion, whilst generally the graduates' level of competency in almost all areas is acceptable or good, there are areas of concern that need to be addressed to further improve the five-year curriculum at the University of Malaya.
    Matched MeSH terms: Competency-Based Education
  14. Ramasamy P, Osman A
    Med J Malaysia, 2005 Aug;60 Suppl D:58-65.
    PMID: 16315626
    The integrated curriculum at the newly established medical school at University Malaysia Sabah is examined from aspects of the objectives of the medical training in achieving development of the required skills and knowledge as well as personal and professional development. The teaching is spread over five years with an emphasis on basic medical sciences in the first two years although the students are exposed to clinical skills right from the onset. A gradual transition to emphasis on the acquisition of clinical skills occurs from the third year onwards. However, community medicine and professional development are incorporated into the programme from the first year and are carried over to the final year. Although there are examinations to be passed in all the courses taught every semester, with a Cumulative Grade Point Average (CGPA) of 3.0 (65 percentile score) and the candidate has to pass all the examinations in that year to clear a particular year, two professional examinations are administered, one at the end of the Third Year (end of the Phase I of the Medical Programme) and another at the end of the Fifth or Final year (end of the Phase II of the Medical Programme). Programmes for Postings, Shadow House Officers (SHOP) and Population Health are also incorporated into the curriculum. Delivery of the courses involve Lectures, Self-Learning Packages (SLP), Small Group Discussions (SGD), Seminars, Debates, Dramas, Video clips, Special Study Modules (SSM), Computer-Aided Instruction (CAI), Problem-based Learning (PBL), Problem-solving Sessions (PSS) and Clinical Skills Learning (CSL). The examination involves elements of continuous assessment and final end of semester or end of phases I and II Professional Examinations. Practical may involve Objective Structured Practical Examinations (OSPE) and/or Objective Structured Clinical Examinations (OSCE). They may also involve viva voce and/or short and long case presentations and assessment of log book entries.
    Matched MeSH terms: Competency-Based Education
  15. Harwant S, Pravin D, Teng EM
    Med J Malaysia, 2005 Aug;60 Suppl D:69-70.
    PMID: 16315628
    Matched MeSH terms: Competency-Based Education
  16. Noor Ghani S, Saimy I
    Med J Malaysia, 2005 Aug;60 Suppl D:66-8.
    PMID: 16315627
    In 1977, the World Health Assembly (WHA) set the social target--the "Health For All" goal and in 1995, urged member states to "re-orientate medical education and medical practice for "Health For All" (resolution WHA 48.8). This led to World Health Organisation to enunciate the "5-star doctor" needing skills in healthcare management, quality assurance and health economics. The Faculty of Medicine, University of Malaya introduced the New Integrated Curriculum (NIC) in 1995. The objective was aimed at producing a competent doctor with a holistic approach to the practice of medicine. This was to be achieved by having 3 strands of studies i.e. The Scientific Basis of Medicine (SBM), the Doctor, Patient, Health and Society (DPHS), and Personal and Professional Development (PPD) over the 5-year programme, split into 3 phases. Elements of the "5-star doctor" were introduced in strand 2--DPHS and strand 3--PPD. Management studies were introduced in the Personal and Professional Development (PPD) strand. This led to an instructional module--"Principles of Management in Health Care Services (PMGT)" comprising of the Management of Self, Resources and People and incorporating a three week field programme. Evaluation is undertaken at the end of the phase IIIA of the studies. This NIC approach will be able to produce a "5-star doctor", a team player, leader, communicator and an effective manager.
    Matched MeSH terms: Competency-Based Education
  17. Sim SM, Achike FI, Geh SL
    Med J Malaysia, 2005 Aug;60 Suppl D:41-7.
    PMID: 16315623
    In Malaysia many new medical schools (both public and private) have been set up in the last 12 years. As a result of global changes and local adjustments made in medical training, cross-breeds of different medical curricula have produced a wide spectrum of teaching-learning methods in these medical schools. In this paper, we have selected three medical schools--two public (Universiti Malaya and Universiti Putra Malaysia) and one private (International Medical University) to illustrate different approaches in the teaching-learning of pharmacology that exist in Malaysia. How do these different teaching-learning approaches affect the students' interest and ability to "master" pharmacology and in turn to develop a good prescribing practice?
    Matched MeSH terms: Competency-Based Education
  18. Boo NY
    Singapore Med J, 2009 Feb;50(2):152-9.
    PMID: 19296030
    The neonatal resuscitation programme (NRP) published by the American Academy of Paediatrics and American Heart Association was launched in Malaysia in 1996. This study aimed to review the outcome of NRP in Malaysia during the first eight years.
    Matched MeSH terms: Competency-Based Education
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