National Competency Research Articles

Recommendations for Specialty Palliative APRN Graduate Education

Background: Advanced practice registered nurses (APRNs) are essential to care for the growing number of individuals with advanced illness given the shortage of palliative care clinicians. Problem: Graduate education for specialty practice palliative APRNs lacks consistency in structure, content, and standardization of specialty palliative APRN education. Approach: A workgroup of expert palliative APRNs and graduate faculty conducted focused discussions and a literature review to develop consensus recommendations based on national palliative APRN competencies and aligned with the 8 core concepts of the AACN Essentials. Outcome: Recommendations include: (a) definition of core concepts; (b) associated skills; (c) andragogical approaches; (d) evaluation methods; and (e) references for curricular development. Conclusion: The Recommendations for Specialty Palliative APRN Education is a first step toward the standardization of quality advanced practice specialty palliative nursing education. These recommendations provide the foundation for a comprehensive curriculum for palliative APRNs.

Flexible Approach In English Language Learning Curriculum Design: Optimizing Teaching In Merdeka Curriculum

The Merdeka Curriculum implemented in Indonesia aims to create an education system that is more adaptive and responsive to local and global needs. In English language teaching, curriculum flexibility allows teachers to adjust learning materials to students' local contexts, thus encouraging student engagement in the learning process. This study aims to explore the application of flexibility in English curriculum design under the Merdeka Curriculum in five junior high schools in Solok City, West Sumatra. A qualitative approach with a case study method was used, with data collected through in-depth interviews, classroom observations, and student interviews. The results showed that flexibility in the preparation of teaching materials and teaching methods allowed teachers to adjust teaching to local needs. However, teachers faced challenges in balancing local materials with national competency standards and limited resources. This flexibility increased student engagement, although some students struggled without adequate guidance. In conclusion, support in the form of guidance, training, and additional resources are needed to optimize the implementation of curriculum flexibility

Preparing the future pharmacy workforce: competency-based undergraduate curricula for teaching, learning and assessment with a focus on antimicrobial stewardship

Abstract Introduction Competency-based teaching, learning and assessment underpins the requirements for initial training and education of pharmacists (IETPs) in the UK and is set by the General Pharmaceutical Council (GPhC). This competency-based pedagogic approach is conducive when teaching antimicrobial resistance (AMR) and antimicrobial stewardship (AMS) since it ensures that rather than only reciting and absorbing content, student pharmacists gain the necessary skills and behaviours to apply knowledge effectively in clinical practice. This is particularly relevant since newly graduate pharmacists will need to show competency in independent prescribing at the point of graduation from 2026 and education needs to evolve to incorporate prescribing skills including decision making. Aim The aim of this project was to develop a UK-wide national AMS competency framework specifically tailored for student pharmacists and foundation year trainees. Method A working group of academics and pharmacy practitioners from all four nations and with expertise in AMS was set up in September 2022. Student pharmacists from a national organisation (BPSA) and a professional pharmacy body (RPS) are also members. Development of the consensus indicative curriculum for student pharmacists was adapted from published frameworks including those for UK undergraduate medical students1, and a UK wide set of generic AMS competencies for undergraduate healthcare professional education2. The results of a survey3 conducted across Schools of Pharmacy (SoP) aiming to determine the nature and extent of implementation of the latter generic competencies, also informed this project. To ensure consistency, the group has worked with the British Society for Chemotherapy (BSAC) to align to the Keep Antibiotics Working (KAW) website, that provides resources for pharmacy students and educators, aligned to the curriculum domains. No ethics approval was required for this study since it did not involve any participants. Results The final curriculum consists of six domains: Infection prevention and control, antimicrobials and antimicrobial resistance, antimicrobial prescribing and stewardship, vaccine uptake, person-centred care and interprofessional collaborative practice. Each domain includes a competency statement together with accompanying descriptors (74) clearly outlining the knowledge and application required by the newly qualified pharmacist. To support implementation of the framework, the individual competencies were mapped to the revised GPhC standards for the IETPs together with Royal Pharmaceutical Society Prescribing Competency Framework that link to AMR and AMS. The group has also developed a set of suggested practice-based activities aligned with the framework domains to support pharmacists supervising or assessing students on placement. Discussion/Conclusion This project is timely to support development of future pharmacists as leaders in AMS and ensure a portable workforce, since pharmacists will be independent prescribers at the point of registration from 2026. A limitation of the development is the fact that not all SoP have been involved in the process; however, efforts are being made to communicate curriculum content as widely as possible. Though it is not mandatory to implement this curriculum, it provides a benchmark for embedding the competencies into undergraduate pharmacy curricula and allows identification of topics that may not be adequately covered. It also promotes consistency of approach across schools. (500 words)

From outdated to outstanding: an institution’s journey in reforming the dental materials science curriculum and lessons learned

BackgroundThe Dental Materials Science (DMS) course within Malaysian undergraduate dental education has traditionally been taught in isolation, with a relatively stagnant delivery mode. Recent shifts in national dental competency standards have necessitated substantial reform in the DMS curriculum. This study aims to outline the journey of a local dental institute in developing and implementing a competency-based DMS curriculum.MethodsA faculty curriculum task force was established to oversee the curriculum reform process. The reform was guided by a “bottom-up” approach using the five-step curriculum reform model: (1). Curriculum mapping, (2). Comprehensive needs assessment, (3). Clear learning objectives and outcomes, (4). Curriculum development and implementation, and (5). Continuous evaluation and improvement.ResultsStep 1 revealed the need to reduce content repetition and improve alignment with the new competency standards. Step 2 identified the need to include advanced materials, integrate theoretical and clinical aspects, and enhance teaching methods. The new curriculum included 25 relevant topics. Step 3 established three course learning outcomes, while Step 4 integrated DMS content horizontally and vertically across the curriculum, introduced innovative teaching methods, and diversified assessment methods. Step 5 ensured ongoing curriculum monitoring, with both short-term and long-term evaluations planned.ConclusionThe curriculum reform process represents a significant advancement in dental materials science while addressing challenges and aligning the curriculum with national standards. Ongoing evaluation, adaptability, interdisciplinary collaboration, and international engagement are essential for further improvements. This journey serves as a valuable reference for educators seeking to update their DMS curricula.

The Implementation of the National Standards for Higher Education Policy as Quality Assurance

Nahdhatul Ulama (NU) College in Aceh differs from other private universities because it has a complex organizational structure compared to other private universities. Nahdhatul Ulama (NU) College in Aceh, apart from being a higher education foundation leader, must also synergize with the Nahdhatul Ulama (NU) organization. This is what drives the author’s interest in studying the implementation of the National Higher Education Standards in quality assurance improvement at Nahdhatul Ulama College in Aceh. In this study, researchers focused on the implementation of the National Standards for Higher Education Policy at Aceh’s Nahdhatul Ulama Sharia Science College. The method used in this research is descriptive-qualitative. Furthermore, the data source used is the results of interviews with informants, who serve as primary data, and other documents as secondary data. In determining the informants, the researcher used the Purposive Sampling Technique; the data were then obtained through interviews, and documentation was analyzed using the Interactive Model, which follows the flow from data collection, data display, data condensation, and conclusions. Based on the results of research and findings, there are leadership, information technology, infrastructure, finance, university values, and culture, which include attitudes, habits, organizational behavior, work ethics, creating, serving, and interacting with colleagues and the community with good results, all of which contribute to organizational capacity in implementing internal quality assurance at the college. On the other hand, the limited opportunities available to academic staff to enhance their national and international competencies in line with their positions and areas of expertise and the inconsistent application of the PPEPP model at Aceh’s Nahdhatul Ulama College are some of the weaknesses. The implementation of the internal quality assurance system at Aceh’s Nahdhatul Ulama College demonstrated a good strategy; however, there are still areas that require constant improvement in addition to upholding current standards. Keywords: policy, education policy, quality assurance, national standards for higher education

Representing contemporary paramedic practice in Canada: Development of the national competency framework for paramedics

Representing contemporary paramedic practice in Canada: Development of the national competency framework for paramedics

Interprofessional Coproduction of Diagnosis with Medical and Pharmacy Students: An Interactive Case-Based Workshop.

The Institute of Medicine and national competencies emphasize the importance of interprofessional education to reduce diagnostic error. Clinical pharmacists are increasingly integrated into clinical teams and participate in the diagnostic process. However, few educational resources explicitly teach medical and pharmacy students to collaborate on the production of diagnoses. We implemented a 2-hour, online, case-based workshop with 154 second-year medical students and third-year pharmacy students. After brief didactics on the diagnostic process and scope of practice of pharmacists, small groups of eight to 12 medical and pharmacy students with faculty facilitators worked through a case unfolding in two aliquots. Students were provided different but complementary information authentic to their profession. They had to communicate with each other to develop an appropriate differential diagnosis. Students then reflected on how communicating with the other profession impacted their diagnostic reasoning. Comments were coded and counted. The majority (99%) of students identified their data gathering and differential diagnoses were impacted by working through the case together. More pharmacy students commented on how medical students broadened their differential diagnosis (71%) and added information (72%), contextualizing information, such as past history, medication indications, and physical exam data. More medical students commented on how pharmacy students helped justify (54%) and clarify (22%) the differential diagnosis, often connecting the underlying mechanism of medications with clinical findings. This interactive case-based workshop was effective in teaching medical and pharmacy students to collaborate in the coproduction of diagnosis. It is feasible with minimal resources.

Positive or Negative and General or Differentiated Effect? Correlation between Parental Involvement and Student Achievement

Parents can have a significant impact on student progress, but it is unclear whether generally influential forms of parental involvement can be identified or if they have a differential impact. Our research focuses on the impact of different forms of parental involvement (at-home and in-school involvement) on primary and high school students’ academic performance, and we also examine the differences between low- and high-status families. Our quantitative research analyzed data from all students that were in Grade 6 and Grade 10 in Hungary in 2019, and we conducted analysis using the Hungarian National Competency Assessment database (n = 183.366). We examined how parental involvement affects children’s mathematics and reading achievements. The results of our research were as follows: (1) Parental involvement type impacts student achievement. Home-based PI has a negative effect, while teacher–parent conferences and discussing school events have a positive effect. (2) The link between parental involvement and student achievement is weaker for higher-status families compared to lower-status families. Based on our results, the generalizability of the positive impact of parental involvement can be questioned because not all forms of it have a favorable effect on student achievement.

Development of the Link and Match Learning Program through the Application of the Dual-System Method to Support the Industrial Revolution 4.0 in Sinergy with Freedom to Learn

This study aims to describe a Link and Match program used on dual-system models that is valid, practical, and effective to support industrial revolution 4.0 in profile freedom to learn. This type of research is development research with the ADDIE development design which includes analyze, design, development, implementation, and evaluation. The data analysis technique uses a mixed method which combines qualitative and quantitative methods. The results showed that: The Link and Match program using a dual-system model is declared valid, including syllabus, RPP, e-LKPD and e-Handout whose learning process is designed to include activities that adapt to Indonesian national work competency standards (SKKNI Level II) by maximizing the use of various representation that can support the industrial revolution 4.0 with the profile of independent learning. The presentation of e-LKPD and e-Handouts has been adapted to the local wisdom competencies available in Lampung Province and the needs of students to study independently or in groups so that they can support the industrial revolution 4.0 with the profile of independent learning; The practicality of the Link and Match program using a dual-system model is reviewed based on student responses which include responses to the learning process, responses to e-LKPD and e-Handouts so that they can be used as a productive learning topic on Rubber Processing in SMK class XI semester odd; The effectiveness of the Link and Match program using a dual-system model is categorized as high which show that there is an average difference between the experimental class and the control class. The output of this development is the establishment of MoU (Memorandum of Understanding) with various DUDI in Lampung Province.

Development and validation of a national clinical pharmacy competency framework for hospital pharmacists in Austria: a multi-method study.

Despite the publication of a European wide competency framework for hospital pharmacy by the European Association of Hospital Pharmacist (EAHP) in 2017, not all countries have adopted and implemented such a framework. This study aimed to develop and validate a bespoke national hospital pharmacy competency framework for Austria that supports the hospital pharmacy workforce development. A multi-method study was carried out in three phases. (I) A systematic literature review across 48 websites of healthcare-related associations and six scientific databases was conducted, identifying competency frameworks, guidelines and related documents. (II) Extracted behaviour competencies were reviewed for contextual national appropriateness by three researchers prior to mapping against the "Patient Care and Clinical Pharmacy Skills" domain of European Common Training Framework (CTF). (III) Validation of the resultant draft clinical skills competency framework took place by an expert panel (n = 4; Austrian Association of Hospital Pharmacists (AAHP) board members) discussion. Reporting of findings is aligned with the recommendations for reporting Competency Framework Development in health professions (CONFERD-HP guidelines) and the PRISMA 2020 checklist. The systematic review (SR) resulted in 28 frameworks, guidelines and related documents and the identification of 379 behaviour competencies, with nineteen mapped to the "Patient Care and Clinical Pharmacy Skills" domain of the CTF (after removal of duplicates). Expert panel discussion resulted in suggested changes to ensure contextual national appropriateness. This study resulted in the development and validation of the first clinical national pharmacy competency framework for Austria. Future studies should focus on political and practical structures necessary for its successful implementation.

Use of telehealth simulation to teach the enhanced primary care RN role through community/public health-focused simulations.

America is facing a primary care provider shortage. Enhanced primary care RNs (EPC-RNs), registered nurses working at the top of their practice scope, can be an important part of community-based primary care provision. Typically, community health nursing education has not included primary care-based clinical experiences, and there is a clinical site shortage. Teaching students about EPC-RN roles can be an important domain of community/public health nursing education. Simulation is a creative pedagogical approach to learning about the EPC-RN role. The purpose of this manuscript is to 1) describe EPC-RN Telehealth Simulation development; and 2) describe student simulation feedback. Nursing faculty and simulation experts designed five simulations for community health students to teach about the EPC-RN role, incorporating recommendations from the Quad Council Coalition of Public Health Nursing Organizations community/public health nursing competencies and the National Competencies for Registered Nurses in Primary Care. Retrospective, descriptive quantitative, and qualitative student feedback data (n=519) was collected through QuestionPro over multiple semesters. Student feedback data demonstrated support of the use of the simulations in community/public health nursing education. The EPC-RN Telehealth Simulations prepared pre-licensure nursing students to practice in community-based primary care settings. Innovative, sustainable experiences such as this can improve community/public health nursing education.

반도체 제조공정 전문인력 양성을 위한 NCS 기반 교육 프로그램 개발

Objectives This study was conducted to develop an education program based on the NCS(National Competency Standards) that can be applied to students in semiconductor-related departments to train semiconductor manufacturing process experts. Methods To this end, a development team was formed including content experts in the semiconductor field and instructional design experts in the pedagogy field. In addition, NCS in the next-generation semiconductor manufacturing process field was selected through analysis of previous research on job competencies in the semiconductor field. Afterwards, an educational program was developed according to the procedures and methods of the RPISD(Rapid Prototype to Instructional System Design) model, an alternative instructional design model. Results The training program developed in this study consisted of two main components: group training for theoretical training and subgroup training for practical training. Theoretical education was designed as a mixture of online and offline methods to accommodate differences in learners' prerequisite knowledge, allowing students to repeat the course according to their individual level. In addition, content related to equipment operation and advanced learning was conducted offline to increase convergence with practical training. In addition, the entire program was operated as a team-based project learning to promote constructivist learning activities. In addition, programs such as career suitability assessment, counseling, and semiconductor company interview mentoring were also conducted to support employment activities. Conclusions This study is significant in that it developed an educational program that can develop job competencies for job seekers in semiconductor-related departments in a situation where there are very few opportunities to experience the semiconductor manufacturing process. In particular, it is more meaningful in that it was developed systematically by actively reflecting the opinions of education consumers, and that classes were structured using constructivist teaching and learning methods using online/offline blending and team-based project learning.

Peran Hukum Internasional Guna Menjaga Keamanan Dunia (Dalam Perspektif Kedamaian Negara)

The purpose of this writing is to understand the role of international law and to analyze and describe the role of international law in state peace. The approach method used in this writing is the normative juridical method, which is legal bibliography writing, namely writing on secondary data such as benchmarks in order to look for symptoms of events which are the object of writing. The type of writing used is descriptive analytical, namely writing which explains the applicable laws and regulations in connection with legal theories and implementation practices, in the end of which conclusions will be made according to the problem which is the object of writing. Based on the results, it is concluded that International Law is the part of law which regulates the activities of international organizations. The aim of international relations is to increase bilateral, regional and multilateral cooperation through many forums which are based on national interests and competencies. Even though a country's international relations are not always positive and often trigger disputes between countries, the international community is very interested in efforts to resolve them. This effort aims to improve relations between countries so that they are more harmonious based on the principles of international peace and security. This raises important questions about the role of international law in upholding justice in order to achieve world peace and security and build relations between countries based on the principles of international peace and security.

패션디자인 및 머천다이징 전공의 역량 추출에 대한 기초 연구

The aim of this study is to identify the competencies required for fashion-related majors that meet contemporary demands, align with the objectives of university education, and reflect the qualities desired in graduates. To achieve this goal, we conducted content analysis of relevant data and in-depth interviews with experts. First, the content analysis involved coding key information from the introductions, educational goals, desired qualities of graduates, and curricula published on the websites of both South Korea and international fashion-related universities. Additionally, we analyzed the National Competency Standards (NCS) and the Meta-goals of higher education programs set by the International Textile Apparel Association (ITAA), extracting six core competencies. Second, in-depth interviews were conducted with six experts, each with 23 to 31 years of experience in Korean and international apparel industry and academia. The interviews were recorded, transcribed, and keywords were extracted. To ensure the validity of the coding results, cross-checks were performed among the researchers. The analysis identified the following competencies: empathic communication, social responsibility, professional thinking, creative and integrative thinking, global perspective, and challenging leadership. Based on these findings, establishing competencies that meet contemporary demands and developing corresponding curricula are essential steps towards creating a feedback system. Future research should focus on developing and implementing curricula that foster a virtuous cycle, ultimately enhancing students' competency levels.

Keterlibatan Orang Tua Dalam Pembentukan Karakter Religius Peserta Didik di SD Islam Almadina, MI Al Khoiriyyah 2 dan SDN Purwoyoso 02 Semarang

This research aims to describe and explain parental involvement in the formation of children's religious character at SDI Al Madina, MI Al Khoiriyyah 2, and SDN Purwoyoso 02 Semarang. This research uses a descriptive qualitative approach to describe parental involvement in the formation of children's religious character at SDI Al Madina, MI Al Khoiriyyah 2, and SDN Purwoyoso 02 Semarang. Data was obtained through observation, in-depth interviews and documentation, and analyzed using reduction, display and conclusion techniques. The results show the effectiveness and differences in the approaches used by each school in forming children's religious character. This research succeeded in describing parental involvement in the formation of religious character at SDI Al Madina, MI Al Khoiriyyah, and SDN Purwoyoso 02, including parenting, volunteering, and other school activities. The religious characters that are instilled include diligent prayer, recitation of the Koran, devotion to parents, independence, responsibility, care for the environment, honesty, tabligh, tolerance and discipline. The methods for forming religious character used are habituation, example, as well as advice and motivation. Each school shows similarities and differences in the application of these religious values, but in general the character formed is in accordance with national character and core learning competencies. In conclusion, comprehensive parental involvement is very important in strengthening the habituation of religious values ​​in children.

Competency Standardization for Indonesian Tourism Human Resources: Implementation in Education, Training and Competency Certification

The increasing trend of Indonesia's tourism competitiveness has placed it as one of the priority industrial sectors in Indonesia. However, this achievement is not in line with increasing the competitiveness of human resources (HR). The national work competency standardization system (SKKN), which the Indonesian Government has implemented since 2012, has not been effective, and human resources' competitiveness has even shown a negative trend. It is feared that this situation will hamper the growth rate of Indonesia's tourism competitiveness in the future. The purpose of this study is to critically analyze the application of the SKKNI system, which is focused on education, training, and competency certification of Indonesian tourism human resources, to uncover the inhibiting factors for its implementation. This education, training, and competency certification are the main components in the performance of the SKKNI system in Indonesia. The research was carried out by reviewing the relevant literature, analyzing the processes and elements in applying the SKKNI system. Research data is secondary data collected from data sources of Government and non-government institutions and scientific and non-scientific literature available on official government websites and the internet. The research results are then triangulated to get a comprehensive picture and understanding of the application of the SKKNI system. The results showed that the implementation of the SKKN system was effective in increasing the capacity of Indonesian tourism human resources but has a tiny growth Quantitatively. The main obstacle is limited trainer, assessor, facilities, and educational, training, and certification institutions to produce trained and certified human resources of tourism.

4년제 대졸 취업자의 NCS 직업기초능력 요구 분석

The primary objective of this study is to identify the discrepancies between the required and current levels of NCS(National Competency Standards) among graduates from four-year universities. Subsequently, this study aims to elucidate the implications of developing and implementing NCS-based curricula in universities to enhance the fundamental vocational abilities of college students. To achieve this, a survey was conducted among 195 individuals who graduated from four-year universities and are currently employed to determine the required and current levels of vocational fundamental proficiencies as defined by the National Competency Standards(NCS). The paired sample t-test, Borich analysis, and Hershkowitz Critical function were then employed to analyze the discrepancies between the two levels. The findings of this study indicate that firstly, among the 34 areas of NCS (National Competency Standards), graduates demonstrated statistically significant discrepancies between the necessary state and the current state in document writing ability, expression ability, basic foreign language ability, basic arithmetic ability, thinking ability, problem-solving ability, self-management ability, career development ability, time resource management ability, budget resource management ability, leadership ability, conflict management ability, negotiation ability, information processing ability, technical understanding ability, technical application ability, and job comprehension ability. Secondly, it was determined that basic foreign language ability and expression ability within the sub-abilities of communication, career development ability, and self-management ability within the sub-abilities of self-development, and conflict management ability and negotiation ability within the sub-abilities of interpersonal communication should be given the highest priority in the consideration process. Based on the findings, it is recommended that a comprehensive consideration of the educational needs perceived by graduates be taken into account when developing and applying NCS-based education programs. It is expected that this will serve as important foundational data for effectively developing the NCS basic vocational skills of future university students.

A TRACER STUDY OF THE GRADUATES OF BACHELOR OF SCIENCE IN OFFICE ADMINISTRATION MAJOR IN OFFICE MANAGEMENT COVERING THE ACADEMIC YEARS 2018, 2019, 2022, & 2023 OF THE KAPALONG COLLEGE OF AGRICULTURE, SCIENCES AND TECHNOLOGY

Tracer studies are crucial for gauging the effectiveness and applicability of programs provided by higher education institutions and their alignment with the job market. Hence, the aim of this quantitative research is to track the career paths of graduates from Kapalong College of Agriculture, Sciences, and Technology (KCAST). Particularly, the study successfully contacted 97% of the graduates from the BSOA Department, with 299 out of 308 graduates participating covering the A.Y. 2018, 2019, 2022, and 2023. Among the total respondents, 34 (44.82%) graduated in 2023, while 85 (28.643%) graduated in 2022, 56 (18.73%) graduated in 2019, and 24 (8.03%) graduated in 2018. The majority of respondents were female, comprising 268 (89.63%) who were single. The most common age group among participants was 24 years old. Notably, 30 (10.03%) respondents acquired vocational education and/or TESDA National Competency certification, and 5 (2%) pursued higher education after completing their bachelors degree. Regarding employment status, 211 individuals (70.57%) are presently employed, with the majority, 189 (89.70%), holding full-time positions. Notably, nearly 93 (43%) of the employed graduates earn monthly salaries ranging between 11,000.00 and 15,000.00, having secured their current positions within 1 to 3 months after graduation. Interestingly, the majority of respondents, totaling 259 (86%), expressed a neutral opinion when asked about the relevance of their degree to their current job. Furthermore, among the respondents, 51 work as office clerks and/or encoders, 48 hold administrative positions across various offices, 30 serves as accounting staff, and 24 are engaged in roles related to customer relations. The BSOA graduates consistently demonstrate a high level of attitude towards work, appreciation for the quality education provided by the institution, and the development of skills and abilities. This descriptive rating indicates that these attributes are consistently observed in BSOA graduates. Therefore, it is advised that the BSOA Department of KCAST continues to uphold and enhance the current programs and activities aimed at improving the employability skills of its students. KEYWORDS: BSOA Graduates, Philippines, quantitative descriptive method, tracer study

Multiple-Choice Questions in Basic Biomedical Science Module

The evaluation process in medical education involves evaluating knowledge, skills, and attitudes based on the achievements and competencies to be achieved. The multiple-choice question (MCQ) instrument is an assessment instrument often used in the medical field. So far, the MCQs have been implemented in Indonesia's national medical competency examination. Furthermore, maintaining the quality of MCQs at the faculty level is very important to maintain the quality of medical graduates. In this study, an evaluation was carried out on 250 items of MCQs in three basic biomedical modules, followed by analyses of the MCQs characteristics, item difficulty index (DIF-I), and item discrimination index (DI). The analysis found that the Kr-20 value was >0.8 in the three modules. Analysis of the item difficulty index (DIF-I) in the ideal category obtained 33 (36.7%), 29 (38.7%), and 34 (39.5%), respectively. The ideal category's item discrimination index (DI) was 63.3%, 77.3%, and 69.4%, respectively. The results of this study illustrate that there are still MCQs that are not ideal and need attention for future improvements. These results prove that more work must be done to improve the standard of MCQs used in medical examinations. Periodic evaluation and training on making standardized multiple-choice question components need to be planned within the faculty.

Az európai regionális integráció jövője. Kormányzási és elosztási dilemmák

The cornerstone of the global system, as well as the EU, is the principle of the sovereign equality of states. However, states are far from being equal. This paradox is one of the main obstacles to the smooth functioning of international organisations, including the EU. Sovereigntist critics of the EU pretend that national competencies are sacrificed in exchange for co-operation and joint governance at a larger scale. In reality, EU membership has widened the scope of member states’ sovereignty: they are better informed and can take part in decision-making at the European level. However, the EU’s decision-making power has weakened for two main reasons. First, EU competencies have been watered down: exclusive union competencies exist only in five sectors, in parallel with a large and growing number of mixed and shared competencies. As a result, EU decision-making tends towards intergovernmental methods, and consensus seeking opens the way for veto players. Second, after the end of the Cold War, in the 1990s, many new states were formed because of the dissolution of former federal structures. In place of the Soviet Union, Yugoslavia, and Czechoslovakia 24 new states have taken form so far, 19 out of them Europeans, and the majority is attracted by the EU. The EU member states from the former eastern bloc which have Soviet-type political, economic, and social heritage, have ‘imported’ their unsolved – internal and external – conflicts into the EU. After the European elections in 2024 and the renewal of the European Parliament and the European Commission, those institution should undergo a ‘slimming diet’ and speed up decision-making by extending qualified majority voting. This is an absolute precondition of further enlargements.