Table 3 Institutional Issues in Implementation identified on the basis of questionnaire (completed by the faculty) and key informant interviews (with the administrators)

Infrastructure

· Need adequate infrastructure like library, skills lab, rooms for small group discussion with teaching aids (92% felt it is a must).

· The concerned Ministry was willing to provide financial support for infrastructure however they needed proper documentation (5/16).

· WHO has not provided adequate support for the equipment (38%).

· WHO has not provided adequate support for the equipment (4/16).

Faculty Development

· Adequate number of teachers not trained in conducting PBL sessions (65%).

· Teachers adequately trained, institutional changes take time (10/16).

· WHO has not provided adequate support for training (40%).

· WHO only provides for technical assistance, however training support was adequate (3/16).

· Adequate number of teachers not aware of PBL principles and concepts (65%).

· Due to slow progression of COME the faculty enthusiasm is dying off (6/16).

· Transfer of trained faculty to other institutions. (65%)

· Transfer of trained faculty to other institutions (4/16).

· Lack of fellowships by WHO (54%).

Faculty Apprehensions

· Increase work load for the faculty (70%).

· Time consuming hence incentives need to be added (4/4 principals of COME colleges mentioned it).

· Fear of failure (reverting back to the traditional curriculum) (55%).

· No fear of failure (3/4 principals).

· The program has been imported from the west and hence not suitable for our educational system (30%).

· The program has been initiated after the government signed the Edinburgh Declaration and acquired WHO support (1/16).

· The program has not been initiated in consultation with concerned faculty; it has been forced on us because of WHO pressures (20%).