MATERIALS AND METHODS: This review is on some of the issues in standard setting based on the published articles of educational assessment researchers.
RESULTS: Standard or cut-off score should be to determine whether the examinee attained the requirement to be certified competent. There is no perfect method to determine cut score on a test and none is agreed upon as the best method. Setting standard is not an exact science. Legitimacy of the standard is supported when performance standard is linked to the requirement of practice. Test-curriculum alignment and content validity are important for most educational test validity arguments.
CONCLUSION: Representative percentage of must-know learning objectives in the curriculum may be the basis of test items and pass/fail marks. Practice analysis may help in identifying the must-know areas of curriculum. Cut score set by this procedure may give the credibility, validity, defensibility and comparability of the standard. Constructing the test items by subject experts and vetted by multi-disciplinary faculty members may ensure the reliability of the test as well as the standard.
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.
MATERIALS AND METHODS: MCQ items in papers taken from Year II Parts A, B and C examinations for Sessions 2001/02, and Part B examinations for 2002/03 and 2003/04, were analysed to obtain their difficulty indices and discrimination indices. Each paper consisted of 250 true/false items (50 questions of 5 items each) on topics drawn from different disciplines. The questions were first constructed and vetted by the individual departments before being submitted to a central committee, where the final selection of the MCQs was made, based purely on the academic judgement of the committee.
RESULTS: There was a wide distribution of item difficulty indices in all the MCQ papers analysed. Furthermore, the relationship between the difficulty index (P) and discrimination index (D) of the MCQ items in a paper was not linear, but more dome-shaped. Maximal discrimination (D = 51% to 71%) occurred with moderately easy/difficult items (P = 40% to 74%). On average, about 38% of the MCQ items in each paper were "very easy" (P > or =75%), while about 9% were "very difficult" (P <25%). About two-thirds of these very easy/difficult items had "very poor" or even negative discrimination (D < or =20%).
CONCLUSIONS: MCQ items that demonstrate good discriminating potential tend to be moderately difficult items, and the moderately-to-very difficult items are more likely to show negative discrimination. There is a need to evaluate the effectiveness of our MCQ items.