Defining Malaysia's health research ethics system through a stakeholder driven approach.

The need to understand the systems that support ethical health research has long been recognized, but there are limited descriptions of actual health research ethics (HRE) systems. Using participatory network mapping methods, we empirically defined Malaysia's HRE system. 13 Malaysian stakeholders identified 4 overarching and 25 specific HRE system functions and 35 actors internal and 3 external to the Malaysian HRE system responsible for those functions. Functions requiring the most attention were: advising on legislation related to HRE; optimizing research value to society; and defining standards for HRE oversight. Internal actors with the greatest potential for more influence were: the national network of research ethics committees; non-institution-based research ethics committees; and research participants. The World Health Organization, an external actor, had the largest untapped potential for influence overall. In summary, this stakeholder-driven process identified HRE system functions and actors that could be targeted to increase HRE system capacity.

A Competency Framework for Health Research Ethics Educational Programs: Results from a Stakeholder-Driven Mixed-Method Process.

Educational programs are integral to building health research ethics (HRE) capacity, but no outcomes framework exists to guide them. We empirically developed a competency framework for health research ethics education-the Framework for Research Ethics Studies Competencies and Outcomes (FRESCO)-using mixed methods, including group concept mapping and a survey of international experts. FRESCO includes seven competency domains: (1) Foundational Knowledge; (2) Laws, Regulations, Guidelines, and Policies for Research Oversight; (3) Ethical-Issue Identification, Analysis, and Resolution; (4) Engagement, Communication, and Advocacy; (5) Lifelong Learning, Education, Research, and Scholarship; (6) Coordination, Stewardship, and Responsiveness in HRE Systems; and (7) Impartiality, Honesty, and Responsibility. These domains are detailed in 27 subdomains. Survey respondents rated FRESCO's relevance to HRE highly. FRESCO can be adapted and implemented in educational programs to refine recruitment and selection processes, educational and assessment methods, and performance measures to ensure that HRE educational programs have their intended effects.

Thinking about thinking: changes in first-year medical students' metacognition and its relation to performance.

BACKGROUND: Studies have shown the importance of metacognition in medical education. Metacognitive skills consist of two dimensions: knowledge of metacognition and regulation of metacognition. AIM: This study hypothesizes that the knowledge and regulation of metacognition is significantly different at the beginning and end of the academic year, and a correlation exists between the two dimensions of metacognitive skills with academic performance. METHODS: The Metacognitive Skills Inventory comprising 52 Likert-scale items was administered to 159 first-year medical students at the University of Malaya. Students' year-end results were used to measure their academic performance. RESULTS: A paired sample t-test indicated no significant difference for knowledge of metacognition at the beginning and end of the academic year. A paired sample t-test revealed significant difference for regulation of metacognition at the beginning and end of the academic year. A very strong correlation was found between the two dimensions of metacognition. The correlation between knowledge and regulation of metacognition with students' academic result was moderate. CONCLUSIONS: The improvement in students' metacognitive regulation and the moderate correlation between knowledge and regulation of metacognition with academic performance at the end of the academic year indicate the probable positive influence of the teaching and learning activities in the medical program.