Multiple Choice Questions (MCQs) are generally recognized as the most widely applicable and useful type of objective test items. They could be used to measure the most important educational outcomes - knowledge, understanding, judgment and problem solving. The objective of this paper is to give guidelines for the construction of MCQs tests. This includes the construction of both "single best option" type, and "extended matching item" type. Some templates for use in the "single best option" type of questions are recommended.

Background: Breaking bad news is one of the most stressful and difficult things a physician has to do. Good communication skills are required in order to ensure that bad news is delivered in a humane but effective way. Objectives: This study was designed to explore the preferences and attitude of the Saudi population toward receiving bad news. Second, it was to identify the associations between preferences, attitudes, and sociodemographic characteristics. Materials and Methods: This was a cross-sectional study conducted during the month of April 2009 in Riyadh. Data were collected from 1013 adult Saudis. Stratified random sampling technique was used through a self-administered questionnaire. Results: In this study, 474 (46.8%) were males and 539 (53.2%) were females. Almost two-third of the participants preferred to be the first to receive the bad news. A majority of the participants 695 (68.6%) preferred to be told the bad news at a private place, whereas, 441 (43.5%) preferred to be told by the head of the medical team. Moreover, almost half of the participants would like the one who breaks the bad news to remain with them to give them some more information about the disease. Significant associations were observed between participants' perception and attitude with age, marital status, gender, and education (P < 0.001), respectively. Conclusion: Factors such as marital status, age, and gender, and education play significant roles in how bad news is received. Understanding what is important in the process of breaking bad news may help in determining how best to perform this challenging task.

The prevalence of hypertension in Saudi Arabia has been assessed only in preliminary reports. The aim of this study was to determine the degree of control of blood pressure and the prevalence of common hypertension co-morbidities among hypertensive patients attending primary healthcare (PHC) centers in Riyadh. A cross-sectional study was conducted by reviewing medical records of hypertensive patients during May and June 2001. Two hundred fifty-five medical records were selected by a stratified randomization process according to the distribution of the 73 PHC centers in the city and the total number of hypertensive patients registered in the mini-clinic of each PHC center. Trained mini-clinic nurses collected data using a data collection form developed for this purpose. Of 255 patients, 121 (47.5%) were males and 134 (52.5%) were females; the mean age was 57.2±11.1 years and 8.3% were smokers. The majority, 204 (85.7%), had greater than normal body weight. Only 101 (40.4%) had controlled systolic BP and 129 (51.6%) had controlled diastolic BP. The most common co-morbidity was diabetes mellitus, found in 98 (38.4%), followed by dyslipidemia in 50 (19.6%), bronchial asthma in 28 (11.0%) and renal diseases in 12 (4.7%). Except for osteoporosis, which was reported by females only (P=0.003), the occurrence of hypertensive co-morbidities did not vary from other demographic characteristics. This study demonstrated poor blood pressure control in the mini-clinics in PHC centers. To improve the quality of care for hypertensive patients, we recommend an improvement in PHC physician knowledge of and attitudes toward the importance of achieving targeted blood pressure levels.

Background: Competence-Based Medical Education CBME becomes an essential requirement amongst medical education and practice societies. In response to the increasing call for national standard of Saudi medical education, the Denary of Saudi Medical Colleges developed “Saudi MEDs project ” in 2009, which aimed to have a national competence-based framework for medical schools. Purpose: This paper summarizes Phase II of the Saudi MEDs project, which aims to develop a comprehensive competence-based medical education framework for medical schools. This includes detailed statement of the essential learning outcomes and enabling competences for each domain identified in Phase I of the project. Method: Triangulation approach is utilized to increase the credibility and validity of research findings. The study consists of two-round Modified Delphi Technique; Focused Group interviews with stakeholders; and structural review by international experts. Results: The Saudi MEDs framework is expressed as a three-level model; six major themes related to a description of a physician's duties and obligations (Level1), seventeen essential learning outcomes of a physician (Level 2), eighty enabling competences to be fulfilled by all undergraduate medical programs in Saudi Arabia (Level 3). Discussion: The Saudi MEDs framework is expressed as a three-level model, which provides flexibility to ensures a school autonomy and diversity of contextual curricula. Also the study develop national consensus among stakeholders about the framework and its importance to develop and maintain a quality medical education and practice in the Kingdom. However, successful deployment of the Saudi MEDs required a strategic plan and roadmap.

Medical ethics and professionalism are two essential parts of building up the identity of a competent physician. This study was conducted to determine the nature, content, and methods of medical ethics and professionalism education in Saudi public and private medical schools. It also sought to identify the challenges and obstacles in teaching and assessing medical ethics and professionalism and suggest appropriate changes. A cross-sectional study was carried out in Saudi private and public medical schools. To achieve the study’s aim, an assessment tool in the form of a novel self-administered questionnaire was developed, piloted, and then used. A representative from each of the 28 Saudi medical schools participated in the study. Twenty-four (82.1%) responding medical schools have no medical ethics department. Most of the medical schools (64.2%) have 25% or less of their faculty staff who teach ethics holding a qualification in medical ethics. Most schools have a specific course for medical ethics and professionalism (85.7% and 57.1%, respectively). Multiple-choice questioning is the most popular assessment method in medical ethics and professionalism courses (89.3% and 60.7%, respectively). The need for more qualified staff and clear guidelines/resources is a significant drawback to the teaching of medical ethics. Therefore, the study recommends developing national guidelines dedicated to the undergraduate teaching curriculum from which courses would be designed to enhance medical ethics and medical professionalism.

OBJECTIVE: To audit the medical care provided to hypertensive patients in a health care center in Riyadh, Kingdom of Saudi Arabia (KSA) and determine the efficient control of hypertension. METHODS: We carried out this cross-sectional study on all patients who visited the Health Care Specialty Center of King Abdul-Aziz Medical City, Riyadh, KSA for hypertension follow-up during the study period from October to December 2004. A representative sample of patients was allocated randomly using simple randomization method. All patient9s records were reviewed for proper recording in a designed form. RESULTS: Out of the 242 records we reviewed, 201 were included in the study. The patients9 mean age was 58.3 ± 12.5 years. All were Saudis and 78.6% were females. Most of them (84.3%) received their management at primary care level only. Age, gender, presence of diabetes, level of medical care, blood glucose, lipid levels and drugs used for management of hypertension were sufficiently recorded. Smoking history, body mass index and family history of ischemic heart disease were poorly recorded. Quarter of the hypertensive patients was sufficiently controlled. The factors associated with poor blood pressure (BP) control were advanced age (p=0.008) and presence of diabetes, [odds ratio (95% CI)=2.98 (1.47-6.08)]. CONCLUSION: The study reflects the deficiencies in BP control and physicians practice. Introducing a checklist or electronic medical records may help the improvement of care. Frequent auditing is recommended to ensure the required development.