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Educational change, particularly change involving the adoption of educational innovations, is a complex process. In Malaysia, the significant role of information and communication technologies (ICTs) in promoting digital education is reflected in the national ICT in education policy. Nevertheless, studies in the Malaysian educational context have shown that the policy implementation resulted in varying degrees of success. Through a discourse analysis approach, this paper aims to examine the evaluation studies on large scale initiatives introduced to digitize the Malaysian education system, from the Smart Schools programme to the incorporation of the Frog Virtual Learning Environment in classroom. The rationale behind these top-down initiatives and how they affected the stakeholders at the micro level, namely, teachers and students, are reviewed and analysed. The analysis informs our understanding of the factors that contribute to the successful and unsuccessful implementation of these initiatives and guide the planning of future policies.

ObjectiveTo investigate whether the use of apatient decision aid (PDA) for insulin initiation fulfils its purpose of facilitating patient-centred decision-making through identifying how doctors and patients interact when using the PDA during primary care consultations.DesignConversation analysis of seven single cases of audio-recorded/video-recorded consultations between doctors and patients with type 2 diabetes, using a PDA on starting insulin.SettingPrimary care in three healthcare settings: (1) one private clinic; (2) two public community clinics and (3) one primary care clinic in a public university hospital, in Negeri Sembilan and the Klang Valley in Malaysia.ParticipantsClinicians and seven patients with type 2 diabetes to whom insulin had been recommended. Purposive sampling was used to select a sample high in variance across healthcare settings, participant demographics and perspectives on insulin.Primary outcome measuresInteraction between doctors and patients in a clinical consultation involving the use of a PDA about starting insulin.ResultsDoctors brought the PDA into the conversation mainly by asking information-focused ‘yes/no’ questions, and used the PDA for information exchange only if patients said they had not read it. While their contributions were limited by doctors’ questions, some patients disclosed issues or concerns. Although doctors’ PDA-related questions acted as a presequence to deliberation on starting insulin, their interactional practices raised questions on whether patients were informed and their preferences prioritised.ConclusionsInteractional practices can hinder effective PDA implementation, with habits from ordinary conversation potentially influencing doctors’ practices and complicating their implementation of patient-centred decision-making. Effective interaction should therefore be emphasised in the design and delivery of PDAs and in training clinicians to use them.

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With the closure of schools due to imposed lockdowns in many parts of the world, teachers had to make a rapid transition from teaching in physical classrooms to online teaching, even though they had little to no experience teaching online prior to the pandemic. Adopting a narrative inquiry approach, this study aimsto explore the factors that influence Malaysian English language teachers’ professional agency in adapting to online teaching. Data were collected via interviews with ten secondary school teachers from rural and urban schools. The findings show how factors such as teachers’ perceptions of the affordances of digital tools and existing support structures influence teachers’ enactment of agency in online teaching and learning. They also demonstrate teachers' agentic potential to adapt their lessons to suit their learners’ needs. These findings suggest the need for teacher professional development programs to recognize teacher agency in the design of future training modules. This involves providing a differentiated training curriculum that can support and sustain language teachers’ development organically by taking into consideration their existing technology skills, teaching experiences and work contexts.