Accreditation of medical schools in Saudi Arabia: A qualitative study.

CONTEXT: The accreditation of undergraduate medical education is a universal undertaking. Despite the widespread adoption of accreditation processes and an increasing focus on accreditation as a mechanism to ensure minimum standards are met in various fields, there is little evidence to support the effectiveness of accreditation. Traditionally, accreditation has worked toward achieving two ends: assuring and improving quality. Many recent articles emphasize the need for continuous quality improvement mechanisms to work, as well as the quality assurance role of accreditation. METHODS: The aim of the study was to examine the purposes and outcomes of accreditation, and stakeholders' experience of accreditation in Saudi Arabia. Triangulation of data was achieved through literature review, analysis of accreditation documents, examined the outcome of accreditation process (pre and post) through stakeholders' experience of accreditation (learner, teacher, and academic leader perspectives). Data were interrogated using thematic analysis approach involving identifying, analyzing, and reporting repeated patterns (themes) of meaning within data. RESULTS: Three themes emerged from the three phase study: "Passing the exam" versus long-term benefit, generic versus specialized accreditation standards, and internal quality assurance and self-evaluation. The data revealed a number of strategies that stakeholders can employ to achieve a balance between an "accreditation threat" and a quality improvement approach that is likely to have a lasting effect on educational outcomes. DISCUSSION: This empirical study revealed strong parallels between assessment and accreditation purpose, engagement, and outcomes. Like an increasing number of commentaries in the literature, this study suggests that accreditation bodies would do well to shift toward a holistic approach to quality management in medical education; implementation of quality improvement by an external "other"-described by some participants as the "policeman approach"-is not ideal for promoting sustainable quality education. Sustainable accreditation for long-term education improvement is not presented as a method, but as a way of thinking about important, and often overlooked, aspects of accreditation practice. Sustainable accreditation means that there is a need to meet both the immediate accreditation standards ("the exam") as well as establishing a basis for continuing quality improvement.

The development of a locus of control measure predictive of injured athletes' adherence to treatment.

The Sports Rehabilitation Locus of Control (SRLC) scale was developed to facilitate study of the behaviour of athletes recovering from injury. The SRLC was built specifically to assess locus of control in injured athletes by adapting selected items from the Multidimensional Health Locus of Control (MHLC) questionnaire developed by Wallston, Wallston, & DeVellis (1978), and in accordance with their rationale for the construction of domain-specific LOC scales. The resultant locus of control measures (internal, powerful others, and chance) were administered (along with the MHLC) to a sample of 145 sports-injured athletes. Good internal consistency (alphas ranged from .72 to .79) and test-retest reliability (correlations ranged from .75 to .85) was shown by the SRLC scales, and the pattern of inter-scale correlations supported the three-factor conceptualisation of locus of control on which the SRLC was based. In the subsequent initial validation study, the relationship between SRLC scale scores and adherence to treatment was tested with a sample of injured athletes. Encouragingly, internality was positively associated p<.05 with treatment adherence.

Locus of control of smokers, nonsmokers, and nonpracticing smokers.

In this survey, score analyses of 123 male and female respondents, ages 21 to 33 years, yielded no significant differences between either sex and smokers versus nonsmokers on Rotter's locus of control scale. Of particular interest was that nonpracticing smokers (quitters) scored more internal than either smokers or nonsmokers.