Accreditation of medical schools: the question of purpose and outcomes.

Accreditation is a process by which official accrediting bodies evaluate institutions using a set of criteria and standards, following established procedures, to ensure a high quality of education needed to produce highly competent graduates. Additional objectives include (1) ensuring quality institutional functioning, (2) strengthening capabilities of educational institutions for service to the nation and (3) improving public confidence in medical schools. The accreditation process provides an opportunity for the institution to critically reflect upon all the aspects of its programme and the level of compliance or attainment of the requirements. The self-evaluation exercise, which identifies strengths and weaknesses, is perceived as formative. It is envisaged that eventually institutions will adopt a learning culture for curriculum development, implementation, monitoring and matching the outcomes. In conclusion, periodic accreditation activities can act as a "monitoring" system to ensure that the quality of medical education is maintained according to established standards.

Preparing for and managing change: some thoughts for curriculum planners and implementers.

This paper outlines issues related to curricular reforms, and strategies to be considered for planning and implementation so as to ensure that the change is institutionalised. In Malaysia, in general, some imminent curricular changes have been carried out to prepare graduates for future changes in the practice environment. Change of reform requires planning, with consideration of the directions in which the change is needed, and the possible educational approaches to be utilized. To ensure change can occur and be maintained there should be effort to induce a paradigm shift amongst teachers and administrators at all levels, there must be transparency and dissemination of information of the required change and why, there must be involvement of teachers in decision making to ensure better compliance.

Encouraging learning how to fish: an uphill but worthwhile battle.

INTRODUCTION: Encouraging teaching practices such as problem-based learning (PBL) amongst undergraduate students within a lecture-based, system-based integrated curriculum is a challenge. Students are apprehensive about developing an organised framework for acquiring knowledge while lecturers are required to reframe their views on the educational process and their role as educators. 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.