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This study aimed to evaluate the effectiveness of using a virtual patient (VP) software program in increasing clinical reasoning skills confidence among medical students.

A quasi-experimental design was used to compare the outcomes of students’ confidence levels on clinical reasoning between problem-based learning (PBL) and VP program with 122 pre-clinical Year 2 medical students. History taking, physical examination, clinical investigations and diagnosis was investigated using four PBL cases in the oncology block. Pre- and post-differences in mean confidence scores between the arms were compared, as well as mean difference by type of case and skill category.

A total of 122/156 (78.2%) students participated; n = 55 were from 7 VP groups and n = 67 were from 13 control arm groups. For the primary outcome, the VP arm showed a statistically significant increase in confidence measures among 11/16 (4 cases × 4 skills) categories, compared to 4/16 for the control arm. The proportion of the students who indicated an improved confidence was statistically significant for the cervical cancer case for physical examination (60.0% improved in VP vs 12.5% in control), investigation (60.0% VP vs 18.8% control) and diagnosis (60.0% in VP vs 25.0% in control). Finally, analysis by case showed an increment in overall mean scores from the start to end of the case within the VP arm while the pattern was erratic in the control arm cases.

The study results showed that incorporating the VP into PBL was more effective in increasing students’ clinical reasoning confidence levels compared to the usual PBL. As the study utilized existing PBL cases, it demonstrates how medical schools can incorporate digital VP tools into pre-clinical years before students' transition to learning from actual patients in the clinical years.

The purpose of this paper is to bring out the possibility of selecting good leaders in Asian countries, i.e., China and Singapore.

Since comparative historical analysis enhances the objectivity for academic discussion, Deng Xiaoping’s and Lee Kuan Yew’s leadership successions have been chosen as the cases for studies by virtue of “method of agreement”. Incorporating “argument based on the contrary” into the context for macro-historical analysis, this paper characterises the duo’s successful (at least quite successful) leadership successions, thus offering an alternative paradigm beyond Western-style democracy.

Both cases of post-Mao China and the independent Singapore indicate that in quite a number of Asian countries, good leaders could still be selected beyond universal suffrage as practised among Western Electoral Democracies, mainly because of the elites-driven context. As to the duo’s succession results, Deng Xiaoping’s selection of leaders was somewhat successful, while Lee Kuan Yew’s was phenomenal.

This paper offers readers a glance over the possibility of selecting good leaders in Asian countries not fully based on Western-style democracy. Learning from the duo’s leadership successions, the West may treat elite politics as the supplement under Western Electoral Democracies in order to avoid their countries falling into the trap of populism. The West could meanwhile consider the exceptional criteria prized by the duo for leadership successions. Considering such interactions among elites in the real-life context, it could serve as an alternative model to Western-style democracy.

Outside the US and Europe, to establish a good government requires more than Western-style democracy. Adopting universal suffrage fully from the Western model is no longer a panacea to reach the ultimate goal of good governance in the East, i.e., to keep promoting socio-economic renovation can be noted as a prerequisite to have further meaningful political advancement in an Asian polity. The purpose of this paper is to explain how to establish a good but authoritarian government in the East.

Given the good of comparative historical analysis, Lee Kuan Yew in Singapore and Deng Xiaoping in China are selected as both cases for “method of agreement.” Further including “argument based on the contrary” to form a context for macro-historical analysis, this paper outlines two characteristics of the duo’s authoritarian leadership, namely, Ideologies and Policy-making; and Political Modernization, and hence provides a more balanced reevaluation of their governance.

Apart from noting how these two Asian giants more or less contributed to their good but authoritarian governments for long in the twentieth century, such a word of authoritarianism to the duo was quite positive to help legitimize their governance, which was far different from many negative views of the Western world.

As theories put forward by Western academics could not entirely justify modernization among Asian societies in the twentieth century, this paper attempts to answer one question: Does the meaning of authoritarianism remain unchanged in the discourse of the East and the West?

Lee Kuan Yew, Singapore’s first prime minister, who governed the country from 1959 to 1990, passed away on 23 March 2015 at the age of 91. The purpose of this paper is to assess his legacy of good governance in Singapore.

The changes in Singapore’s policy context during 1959-2014 are described first before analyzing Lee’s legacy of good governance in Singapore by examining his books and major speeches.

Lee Kuan Yew’s commitment to meritocracy, empowerment of the Corrupt Practices Investigation Bureau to curb corruption effectively, reliance on competitive salaries to attract the “best and brightest” citizens to join the civil service, and maintenance of the rule of law, constitute his legacy of good governance in Singapore.

This paper will be useful to policy-makers, scholars and readers who are interested in learning about Lee Kuan Yew’s contribution to good governance in Singapore.

This paper aims to present the host experience of student hosts in Hong Kong, a popular educational destination for international students from mainland China and other countries. This study examines the interconnection between the experience-based and sociocultural dimensions of visiting friends and relatives (VFR) travel, considering the overall host experience, the host–guest relationship and post-hosting changes in perception of both the VFR experience and destination.

This research adopts a qualitative approach to compare the experience-based and sociocultural dimensions of VFR travel considering international university students as VFR hosts in Hong Kong, taking a student sample from both mainland Chinese and overseas students. Based on a voluntary sampling approach, the research team had face-to-face interviews with the students that agreed to participate. The interviews were conducted voluntarily and anonymously and included those students who had hosted any friends or relatives in the past 12 months. A total of 26 interviews were successfully completed, including 10 mainland Chinese and 16 non-mainland Chinese students.

The results confirm that the VFR host experience is generally shaped by an integration of internal characteristics (sociocultural characteristics of both hosts and visitors) and external environment (urban infrastructure and tourism resources). The two groups distinctively express their host experience that shows some areas of cultural barriers and geographical proximity.

The limitations of this research mainly lie on its relatively small sample size because of constraints in accessing the contact information of international students across universities. These shortcomings should be improved by adopting a research design that uses other sampling approaches, such as snowball sampling, to include a wider scope of students from different local universities, or convenience sampling, to interview and compare responses of international students from various educational destinations. Alternative data sources may be considered, for example, through user-generated contents from online and social media platforms that contain sharing of students as hosts.

The geographical and cultural proximities influence VFR tourism development and social construction of values and the consequent hosting behaviour. The unique role of international students should be further explored, especially in the Asian context. The outcome of VFR travel must be evaluated and studied more from cultural and personal dimensions than economic gain, which should be relevant to host perspective such as improved quality of life, social ties and place attachment and psychological benefits. The changing risk perception caused by the COVID-19 pandemic may be examined through some forms of travel intention.

Firstly, the destination marketing organisations of the educational destination should address the difficulty faced by student hosts in terms of external attributes such as local culture, urban infrastructure, tourism resources and information accessibility. Secondly, to target the hosts, some specific VFR-related products and services may be developed for international students through local tertiary institutions such that the role of hosts as ambassadors can be facilitated and enhanced. Thirdly, the functional role of international students can be distinctive based on their unique network, activities and knowledge constructed upon learning during the period of education.

The studentification of many educational destination cities, the dynamism of the role of international students as VFR hosts and their cultural differences between places of origin have provided an opportunity for deepening the understanding of VFR tourism.

This paper aims to explore and explain following a generational change, the latter generation in Chinese family firm is seen to apply different innovation strategies to thrive in a competitive environment. The Chandlerian perspective on management, marketing and manufacturing techniques (3Ms), derived from American business historian, Alfred Chandler has shown conclusively that one of a small yet established enterprises in Malaysia, London Biscuits Berhad (LBB) was able to capture a larger market by focusing on strategy and structure. This case study analytically and empirically describes the insights surrounding enterprise development among family small and medium enterprises (SMEs) in Malaysia.

By using the longitudinal way to compare the development of family business through time, the historical profiles that were obtained from Malaysia’s companies commission house (Suruhanjaya Syarikat Malaysia) shows how organizational characteristic is often formulated by capitalizing tacit knowledge as a controlled input in the production process while promoting organization capabilities, as generations change. Secondly, findings from the interviews will show how the latter generation of this family firm innovates and adds value in product manufacturing by upgrading its quality, using resources and revitalizing the stages of business cycle.

Findings show that enterprise development is influenced by objective setting during generational change. As time goes by, the next generations have a tendency of minimizing risk and maintaining harmony in the family enterprise. The next generation starts to recruit and retain professional staff while contributing innovative ideas toward the enterprise development, in comparison to the founding generation. The findings also show that diversification activities (manufacturing), improvement in domestic and international networking (marketing) and professional management adoption (management) can clearly be seen in the development of LBB.

This case study traces how organizational and administrative characteristics of a firm are crucial if the enterprise is to capitalize on tacit knowledge and commercialize it through product development. It also clearly indicates that family enterprises may last several generations if the Chandlerian perspective on 3Ms is successfully transferred and practiced among family members.

The selected case study focuses on the Chandlerian concept, which is the contribution of organization capabilities that foster strategic competition. This is done by investigating a successful enterprise run by a prominent Chinese family in Malaysia, which has gone through generational change. This paper proves that strategizing a family enterprise through the Chandlerian concept of 3Ms can transform a small business into a large and successful multinational enterprise.

The contributions in this special issue focus specifically on pertinent issues concerning governance in Asian developmental states – Singapore, Hong Kong, and Macao. The purpose of this paper is to provide, first of all, an overview of conceptual issues on governance and its potential application for addressing the rise and development of Asia’s successful developmental states – Singapore, Hong Kong, and Macao.

This introduction will show the relevance of these contributions theoretically, methodologically, and empirically in relation to the current literature on governance studies.

The overview section links the theoretical and conceptual considerations with the empirical studies on either single country or a comparison between states.

The concluding remarks point to the lessons drawn from these contributions and the implication(s) for further research in good governance.

Cost of living is an important consideration for the decision-making of expatriates and investment decisions of businesses. As competition between cities for talent and capital becomes global instead of national, the need for timely and internationally comparable information on global cities’ cost of living increases. While commercial research houses frequently publish cost of living surveys, these reports can be lacking in terms of scientific rigour. In this context, this paper aims to contribute to the literature by formulating a comprehensive and rigorous methodology to compare the cost of living for expatriates in 103 world’s major cities.

A cost of living index for expatriates composed of the ten consumption categories is constructed. The results from the study covers a study period from 2005 to 2014 in 103 cities. More than 280 individual prices of 165 goods and services have been compiled for each city in the calculation of the cost of living index for expatriates. New York has been chosen as the base city for the study, with other cities being benchmarked against it. A larger cost of living index for expatriates implies that the city is more expensive for expatriates to live in and vice versa.

While the authors generate the cost of living rankings for expatriates for 103 cities worldwide, in this paper, the authors focus on five key cities, namely, London, Hong Kong, Singapore, Tokyo and Zurich, as they are global financial centres. In 2013, the latest year for which data are available, Zurich was the most expensive for expatriates among the five cities, followed by Singapore, Tokyo, London and Hong Kong. These results pertain to the cost of living for expatriates, and cities compare very differently in terms of cost of living for ordinary residents, as ordinary residents follow different consumption patterns from expatriates.

Cost of living in the destination city is a major consideration for professionals who look to relocate, and organisations factor such calculations in their decisions to post employees overseas and design commensurate compensation packages. This paper develops a comprehensive and rigorous methodology for measuring and comparing cost of living for expatriates around the world. The value-addition lies in the fact that the authors are able to differentiate between expatriates and ordinary residents, which has not been done in the existing literature. They use higher quality data and generate an index that is not sensitive to the choice of base city.

The purpose of this paper is to explain why Singapore is a success story today despite the fact that its prospects for survival were dim when it became independent in August 1965.

This paper describes the changes in Singapore’s policy context from 1959 to 2016, analyses the five factors responsible for its success and concludes with advice for policy makers interested in implementing Singapore-style reforms to solve similar problems in their countries.

Singapore’s success can be attributed to these five factors: the pragmatic leadership of the late Lee Kuan Yew and his successors; an effective public bureaucracy; effective control of corruption; reliance on the “best and brightest” citizens through investment in education and competitive compensation; and learning from other countries.

This paper will be useful to those scholars and policy makers interested in learning from Singapore’s success in solving its problems.