INTRODUCTIONVarious curricular innovations were adopted by medical schools worldwide in an attempt to produce medical graduates that could meet future healthcare needs of society locally and globally. This paper presents findings on curricular approaches implemented in Malaysian medical schools, in trying to meet those needs.

METHODSInformation was obtained from published records, responses from various questionnaires, personal communication and involvement with curricular development.

RESULTSCurricular 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.

CONCLUSIONIn 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.

Curriculum ; trends ; Education, Medical ; methods ; Humans ; Malaysia ; Schools, Medical

INTRODUCTIONA process-oriented instrument was developed for the summative assessment of student performance during problem-based learning (PBL) tutorials. This study evaluated (1) the acceptability of the instrument by tutors and (2) the consistency of assessment scores by different raters.

MATERIALS AND METHODSA 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.

RESULTSThe 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.

CONCLUSIONThe 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.

Education, Medical ; methods ; standards ; Educational Measurement ; methods ; Humans ; Problem-Based Learning ; standards ; Retrospective Studies ; Students, Medical ; Surveys and Questionnaires ; standards