Objective: To identify essential psychomotor skills for all the medical graduates of an undergraduate programme in Pakistan. Materials and Methods: Twenty-five physicians practising in a tertiary care centre and ninety primary care physicians used a Likert's scale, ranging from ''very essential'' to ''not required at all'', to mark 99 psychomotor skills in the undergraduate medical curriculum in Pakistan. Results: Overall the opinions of both the groups about the essential skills matched except for a few areas. Conclusion: This study provides baseline data about psychomotor skills that a medical graduate in developing countries should be able to perform. Further studies will be undertaken by involving other stakeholders to identify and incorporate these skills in the undergraduate medical curriculum, thereby enabling graduates to practice in all the settings in Pakistan.

Context: During a family health clerkship at the University of The West Indies, students are expected to acquire individual and community diagnosis skills and the ability to relate the two, as well as acquire knowledge of other community agencies involved in health care. Objective: To determine the main assumptions related to disease treatment, which students have had to re-think after engaging in this clerkship. Methods: End of clerkship assessments were carried out from two successive groups of third year medical students (n = 64) at the University of West Indies, Jamaica. Students were asked to ''list two assumptions regarding treating disease that have been challenged by your experience''. A subsequent content analysis was done. Results: Fifty-five students (86%) completed the assessment. All assumptions were listed (n = 99) and similar issues were linked into emerging themes. Twenty-five groups of assumptions produced seven main themes: ''Issues related to compliance'' (27.3%), ''Patient's treatment is mainly physical'' (17.2%), '' Superiority of western medicine over alternative'' (15.2%), ''Patients' health seeking behavior and attitudes'' (12.1%), '' The extent of the contribution of social factors on health'' (12.1%) and ''Patients' knowledge and understanding of health'' (7.0%). Conclusion: The majority of students examined felt challenged on three themes: relating to issues of compliance, treating the ''whole'' patient not just the physical, and the superiority of western medicine over alternative. The three most popular individual assumptions were; patients have a mindset that favours compliance, medication affordability does not affect compliance and treatment is independent of social and environmental conditions.

Aim: This paper presents the results of an exploratory project undertaken to evaluate the change to teaching and learning of surgical specialties in the Postgraduate Diploma in Advanced Nursing (Perioperative) conducted at La Trobe University, Victoria, Australia. Background: The teaching of perioperative nursing practices has traditionally been based on the medical model of surgical specializations, using information transmission as the main teaching approach. It has become clear to perioperative educators that it is possible to look at the basic theoretical principles involved in the teaching of surgical interventions from a different perspective. Method: This project is an exploratory descriptive study that employed a qualitative approach, using a reflective approach to teaching, results of a focus group discussion and subject assessment as data. Research Ethics Committee protocols were followed. A version of nominal group technique was used for the focus group interview. Outcomes: The restructure of this subject shows potential in bringing about a conceptual shift in nurse education in three areas: (1) Organizational principle or curriculum structure: from content focus to theoretical principles; (2) Learning mode: student involvement from passive student to professional decision maker; (3) Teaching strategy: from teacher-focused strategy with intentions to transmit information to a student-focused strategy aimed at students changing their conceptions. Conclusion: This study suggests that perioperative students are able to demonstrate critical thinking and apply principles of surgical technique across a range of specialty areas without having participated in the particular surgery beforehand.

Purpose: An evaluation study of an undergraduate HIV/AIDS interprofessional education program for medical, nursing and pharmacy students was undertaken to assess changes in role perception, attitudes towards collaboration, selfreported teamwork skills and satisfaction with a shared learning experience. Methods: A combined one group pretest-posttest and time-series study design was used. Several survey instruments and observation checklists were completed by students and tutors before, during and after the educational program. Results: Students reported greater awareness of roles and the continuous exposure to interprofessional learning led to improved attitudes towards teamwork. Standardized patients were effective in fostering an experience of realism and motivating collaboration between students. Conclusion: A problem-based learning approach combined with standardized patients was effective in enhancing HIV/AIDS interprofessional role perception, enhancing attitudes towards collaboration and interprofessional approaches to HIV/AIDS care and fostering confidence in teamwork skills among pre-licensure health sciences students.

Objective: The purpose of this article is to report on a study conducted to investigate the additional value of lectures in problem-based learning. We hypothesized that lecture quality, as indicated by students, would have a positive influence on time students would spend on self-study, that they would increase intrinsic interest in subject matter and would have a positive influence on achievement. Lecture quality would, in this view, add to other factors that play a role in problem-based learning, such as prior knowledge of students, the quality of problems presented, the functioning of the tutor and small-group collaboration. Method: The hypothesis on the influence of lecture quality on learning was assessed by means of testing a structural equating model, using data from 1500 students. Discussion and Conclusions: We concluded that lecture quality does not affect time spent on study, does not add to achievement and does not influence intrinsic interest in subject matter. Post-hoc analysis, however, demonstrated the quality of lectures was related to other components of problem-based learning, not part of the presented model, such as students' perceptions of lectures as organizer of their study efforts or lectures as a means of putting the problems into a broader perspective.

Context: In problem-based learning (PBL), students are actively engaged with psychological learning principles as activation of prior knowledge, elaboration and organization of knowledge. In their tutorial groups, however, students do not always apply these principles when working with a procedure like the ''Seven-Jump'' method. To stimulate students to use these principles more often, they were offered another format within a PBL context: PBL with study teams. During the period of self-study, students work on a regular basis in so-called study teams, small groups of 3-4 persons. In these groups they explain to each other their learning outcomes, clarify for each other their problems while studying texts and organize their knowledge to present this to the members of other study teams in their tutorial group. Previous research showed that students spent more time on self-study in a PBL with study team condition than in a traditional PBL context. In this study the achievement as well as appreciation of students participating in a PBL with study teams' environment, is compared with students working in a traditional PBL environment. Objectives: To determine whether PBL with study teams differs from the traditional PBL environment in students' appreciation and study time. Methods: We conducted an experiment in two blocks over two years. Questionnaires were administered to collect data on appreciation and time for self-study. Results: Students' appreciation of the two formats did not differ much. The large standard deviations indicate considerable differences in appreciation between individual students. Appreciation was slightly higher in the second experiment when instructions about how to collaborate were less strict. Students devoted twice as many hours studying in the study group format compared with the traditional PBL format. Conclusions: The students indicated that they enjoyed the format but that the increased workload disturbed their customary study rhythm. Assessment scores and tutors'impressions suggest that study teams foster deeper learning for understanding. Whether this can be attributed to more intensive individual and collaborative elaboration activities should be the subject of further studies.