Completion Of Exam Research Articles

Access to a Patient Portal is Associated with a Higher Rate of Diabetic Eye Examination Completion

ABSTRACT Purpose To evaluate factors associated with a higher completion rate of annual diabetic eye examinations. Methods This retrospective, cross-sectional study included patients diagnosed with diabetes mellitus (DM) who were aged 18–75 years and receiving primary care in a suburban integrated delivery network (IDN). Patient demographic, sociomedical, biometric characteristics, and Healthcare Effectiveness Data and Information Set (HEDIS) measures within the Comprehensive Diabetes Care bundle were extracted from the electronic health record (EHR) and analyzed by using multivariate logistic regression to assess factors associated with completion of an eye exam (retinal) performed during the study year. Results Among 19,901 primary care patients with DM, 35.15% completed an eye examination in 2021. After adjusting for demographic and biometric characteristics, the two factors most closely associated with completing a diabetic eye examination were having had a primary care office visit (adjusted odds ratio [aOR], 3.525; 95% confidence interval [CI], 3.210–3.871, p < 0.001) or an eye examination in the prior year (aOR, 2.948; 95% CI, 2.752–3.158, p < 0.001). The next most important factor to emerge was having an activated, online patient portal (PP; aOR, 1.737; 95% CI, 1.592–1.896; p < 0.001) or PP recently activated within the prior year (aOR, 1.387; 95% CI, 1.220–1.576, p < 0.001). Conclusions Surveillance for diabetic retinopathy relies on annual diabetic eye examinations yet adherence to that standard remains unacceptably low. Our study suggests that engagement of patients through an online PP could help increase this rate.

35 - Balancing CT Scan Inpatient Orders: From Request to Exam Completion

35 - Balancing CT Scan Inpatient Orders: From Request to Exam Completion

Preparation Regimens to Improve Capsule Endoscopy visualization and diagnostic yield (PrepRICE); a multicentric randomized trial

Current guidelines recommend bowel preparation before small-bowel capsule endoscopy (SBCE). However, the optimal protocol is yet to be defined. To determine the best timing for preparation in SBCE, we compared small-bowel visualization quality (SBVQ), diagnostic yield (DY), and patient-reported outcomes across four purgative regimens. In this prospective, randomized (1:1:1:1), multicentric study, patients with suspected small bowel bleeding were randomized into four arms: G1 (1L of polyethylene-glycol + ascorbic acid [Moviprep®] the night before SBCE), G2 (1L in the morning, up to 2 hours before SBCE), G3 (0.5L up to 2 hours before + 0.5L after the capsule reached the duodenum), and G4 (1L after reaching the duodenum). To assess DY, lesions were categorized as having high (P2) or low (P0 or P1) bleeding potential. Small-bowel visualization quality (SBVQ) was assessed using the Brotz score. Transit times (TT) were measured, and patient tolerability was scored from 0 to 5 with higher scores indicating better tolerability. A total of 387 patients were included; 59% female with a median age of 73 years (IQR 23). The exam completion rate was lower in G1 (90%, p<0.001). Small bowel TT was shorter for patients receiving purgative during SBCE (G3 and G4, p=0.001). SBVQ was better in patients receiving purgative after reaching the SB (p<0.001): median of 7 for G1, 8 for G2, and 9 for G3 and G4. The overall DY of patients receiving intra-procedure purgatives (G3 + G4) was superior (42.7 vs 31.3%, p=0.02); significant differences were found in the second and third terciles. Likewise, G3 and G4 had higher angioectasia detection (p=0.04). Patients' satisfaction was significantly superior for G4 (median 4 points, IQR 1). The group that received the bowel preparation the night before SBCE had poorer outcomes. Intra-procedure purgative regimens reduced SBTT, enhanced visualization, improved DY, and increased angioectasia detection. G4 was the best-tolerated regimen.

Implementation Of The Talking Stick Learning Model Used By Koper Sebeni Media

The use of media can increase clarity and interest in the learning process, increase learning motivation, and make it easier to understand the material. The aim of this research is to determine the talking stick learning model that can improve student learning outcomes in comparative material in class VII Pagak Islamic Middle School with the help of the Koper Sebeni media. This classroom action research was carried out using qualitative methodology. The steps in the process are preparation, action, observation, and reflection. The flow model is used to analyze the data obtained, which includes data reduction, data presentation, and drawing conclusions. The research results showed that from cycle 1 to cycle 2 student learning outcomes increased. The percentage of completion of the final exams for cycles 1 and 2 was 83.33% and 91.67% respectively, which shows an increase in the proportion of students by 8.33%. Thus it can be said that the use of the Koper Sebeni media combined with the talk stick learning strategy can improve student learning outcomes. So that most students have the opportunity to answer questions, future researchers must spend sufficient time on the talking stick learning model.

Superior bowel preparation quality for colonoscopy with 1L-PEG compared to 2L-PEG and picosulphate: Data from a large real-world retrospective outpatient cohort

BackgroundSeveral randomized clinical trials comparing different bowel preparations (BP) have shown similar efficacy; however, there is a lack of real-world studies on this topic. AimsThis study aims to identify the most effective BP regimen in a real-world setting and any predictors of inadequate BP. MethodsA retrospective single-center study was conducted over 14 months at an academic hospital including outpatient colonoscopies in which adult patients did not teach on how to perform BP before colonoscopy. Colonoscopies with 1L-PEG, 2L-PEG and picosulphate mixtures were considered. A multivariable analysis for factors associated to poor BP was fitted. ResultsOverall, 1779 patients (51 %F, 60±14) years were included. The 1L-PEG regimen provided a higher rate of BP adequacy at multivariate analysis (adjusted OR 2.30, 95 %CI 1.67–3.16,p < 0.001) and was associated with higher median Boston Bowel Preparation Scale score (p < 0.001), higher rate of right-colon cleansing (p < 0.001) and exam completion (p = 0.04). Furthermore, we identified male sex, history of constipation, active smoking, previous pelvic surgery, concomitant psychiatric/neurological or chronic kidney diseases as predictors of inadequate BP. ConclusionsThis is the largest real-world study comparing 1L-PEG to other BP regimens. Our results suggest 1L-PEG provides better BP in a non-controlled setting, improving clinical practice quality and minimizing the need for repeated colonoscopies and saving healthcare resources.

Citizen science approach to assessing patient perception of MRI with flexible radiofrequency coils

Magnetic Resonance Imaging (MRI) is a major medical imaging modality, which is non-invasive and provides unique soft tissue contrast without ionizing radiation. The successful completion of MRI exams critically depends on patient compliance, and, thus patient comfort. The design, appearance and usability of local MRI radiofrequency (RF) coils potentially influences the patients’ perception of the exam. However, systematic investigations and empirical evidence for these aspects are missing. A questionnaire specifically evaluating the impact of RF coils on patient comfort in MRI would be a valuable addition to clinical studies comparing the performance of novel flexible RF coils with standard rigid coils. This paper describes the development of such a questionnaire in the scope of a citizen science (CS) initiative conducted with a group of students at the upper secondary school level. In this work, the CS initiative is presented in the format of a case report and its impact on scientific projects and the students’ education is outlined. The resulting questionnaire is made available in German and English so as to be directly applicable by researchers working on the clinical evaluation of novel RF coils or the comfort evaluation of specific hardware setups in general.

Autonomous artificial intelligence increases screening and follow-up for diabetic retinopathy in youth: the ACCESS randomized control trial

Diabetic retinopathy can be prevented with screening and early detection. We hypothesized that autonomous artificial intelligence (AI) diabetic eye exams at the point-of-care would increase diabetic eye exam completion rates in a racially and ethnically diverse youth population. AI for Children’s diabetiC Eye ExamS (NCT05131451) is a parallel randomized controlled trial that randomized youth (ages 8-21 years) with type 1 and type 2 diabetes to intervention (autonomous artificial intelligence diabetic eye exam at the point of care), or control (scripted eye care provider referral and education) in an academic pediatric diabetes center. The primary outcome was diabetic eye exam completion rate within 6 months. The secondary outcome was the proportion of participants who completed follow-through with an eye care provider if deemed appropriate. Diabetic eye exam completion rate was significantly higher (100%, 95%CI: 95.5%, 100%) in the intervention group (n = 81) than the control group (n = 83) (22%, 95%CI: 14.2%, 32.4%)(p < 0.001). In the intervention arm, 25/81 participants had an abnormal result, of whom 64% (16/25) completed follow-through with an eye care provider, compared to 22% in the control arm (p < 0.001). Autonomous AI increases diabetic eye exam completion rates in youth with diabetes.

641 Increasing annual eye exam completion for children with cystic fibrosis receiving CFTR modulators

641 Increasing annual eye exam completion for children with cystic fibrosis receiving CFTR modulators

Head and neck exam practices of dental professionals.

Periodic examination of the head and neck includes screening for oral cancer, which is largely performed in dental offices by vigilant oral healthcare providers. The aim of this study was to assess practice patterns among Virginia dentists in performing head and neck exams and the referral rates of biopsies after completion of head and neck exams. We hypothesized that not all dentists perform head and neck exams and there is a difference between dentists who refer patients for a biopsy and those that perform biopsies. General dentists and dental specialists who are members of the Virginia Dental Association were invited to participate in a cross-sectional survey study through REDCap to self-report their head and neck exam protocols. A total of 224 providers completed the survey. The majority of respondents were general dentists with more than 20 years in practice, who practice in a private setting, and see more than 10 patients in a day. All respondents stated they perform intraoral examinations, but 10 respondents stated they do not perform extraoral examinations. Nearly a third of respondents reported doing their own biopsies. Although only 8.5% of oral healthcare providers in Virginia responded to our survey, respondents are following the 2017 ADA good practice statement by providing their patients with head and neck exams to screen for oral cancer. Additional education pertaining to extraoral anatomy, malignant transformation of oral potentially malignant disorders, and pathology procedures may be helpful to clinicians.

Performance of Orthopaedic Shoulder and Elbow Surgeons on a Biostatistical Knowledge Examination.

The objective of this study is to evaluate the biostatistical interpretation abilities of fellowship trained orthopaedic surgeons. A cross-sectional survey was administered to orthopaedic surgeon members of the American Shoulder and Elbow Surgeons (ASES), assessing orthopaedic surgeon attitudes towards biostatistics, confidence in understanding biostatistics, and ability to interpret biostatistical measures on a multiple-choice test. A 4.5% response rate was achieved with 55 complete survey responses. The mean percent correct was 55.2%. Higher knowledge test scores were associated with younger age and fewer years since board exam completion (p ≤ 0.001). Greater average number of publications per year correlated with superior statistical interpretation (p=0.009). Respondents with higher self-reported confidence were more likely to accurately interpret results (p ≤ 0.017). Of the respondents, 93% reported frequently using statistics to form medical opinions, 98% answered that statistical competency is important in the practice of orthopaedic surgery, and 80% were eager to continue learning biostatistics. It is concerning that fellowship-trained shoulder and elbow surgeons, many of whom frequently publish or are reviewing scientific literature for publication, are scoring 55.2% correctly on average on this biostatistical knowledge examination. Surgeons that are further from formal statistical knowledge training are more likely to have lower biostatistical knowledge test scores. Respondents who published at the highest rate were associated with higher scores. Continuing medical education in biostatistics may be beneficial for maintaining statistical knowledge utilised in the current literature.

Dental caries incidence and associated factors in young adults.

To assess the caries incidence from late adolescence to early adulthood and to identify the factors associated with caries incidence. This is a secondary analysis of longitudinal caries data of young adults aged 17-23 from the Iowa Fluoride Study cohort. The inclusion criteria required completion of dental exams at both ages 17 and 23 and having cumulative exposure (AUC) variables data for at least 8 out of the 11 time periods between ages 17 and 23. Mean imputation was used to handle the missing explanatory variable data. Multiple linear regressions were conducted using a generalized linear model to assess the effects of sociodemographic and behavioral/dietary variables on the age 17-23 adjusted cavitated caries (D2+ MFS) increment (AdjCI17-23 ). Multicollinearity was assessed using the variance inflation factor (VIF) and the final model was selected based on the Akaike Information Criterion (AIC) using backward selection and the net effects calculated. The mean AdjCI17-23 was 2.08 (SD = 4.02). The net effects (main effect plus interactions) of higher composite socioeconomic status, higher combined daily fluoride intake, higher frequency of milk intake, lower amount of sugar-sweetened beverages intake, and lower age 17 dental caries counts were associated with lower mean AdjCI17-23 . The incidence of caries from age 17 to 23 in this study was low. This study suggests and reinforces the need to continue to advocate for caries preventive strategies such as fluoride use, encouraging milk intake, and reducing sugar-sweetened beverage intakes.

Bovine physical examination

The physical examination is the foundation of the diagnostic workup in cattle. The physical exam begins with a distance exam where the animal is observed prior to restraint where pa­rameters such as mental status, abdominal contour and lame­ness are best evaluated. With completion of the distance exam, the hands-on examination begins. It has been said that you miss more by not looking than by not knowing. For this reason, a systematic physical examination in which the examining veterinarian follows a standard pattern for every animal exam­ined is to be followed.

Frequency of endoscopic photodocumentation of large colorectal polyps

Colonoscopy quality affects colorectal cancer (CRC) incidence and mortality. The U.S. Multi-Society Task Force on Colorectal Cancer strongly recommends photodocumentation (PD) of lesions ≥10mm in size (ie, large polyps [LPs]) pre-resection and suggests PD postresection to enhance the quality of colonoscopy. No studies have assessed the frequency of LP PD. We evaluated the frequency of and factors associated with PD of LPs. Reports from endoscopists performing≥50 colonoscopies with LP resection between 2016 and 2021 were reviewed. The frequency of LP PD pre-resection and post-resection and factors associated with PD were collected. A composite score of 2 quality metrics (PD of completeness of examination and bowel preparation quality) was created. Endoscopists were divided into 2 tiers based on the frequency of the score on all included examinations: Tier 1,≥95% of examinations; and Tier 2,<95% of examinations. Univariate and multivariate analyses were used to assess factors associated with PD. A total of 1322 colonoscopies, 1693 LPs, and 25 endoscopists were included in this study. PD of LPs occurred in 1392 (82%) pre-resection and in 878 (52%) post-resection. Factors associated with pre-resection PD include endoscopist subspecialty (colorectal surgery vs gastroenterology: odds ratio [OR], .12; 95% confidence interval [CI], .04-.42); >1 LP on examination (2 vs 1 LP: OR, .41 [95% CI, .27-.61]; and≥3 vs 1 LP: OR, .41 [95% CI, .24-.70]), and longer withdrawal time (OR, 1.02; 95% CI, 1.01-1.04). We provide the first data on PD of LP pre-resection and post-resection, which can inform future benchmarking in this area. The implications of PD on metachronous advanced neoplasia need to be studied.

110-OR: Autonomous Artificial Intelligence Diabetic Eye Exams to Mitigate Disparities in Screening Completion

Diabetic retinopathy (DR) is a complication of diabetes that can result in vision loss, but early detection and treatment through screening can prevent this. Few individuals with diabetes meet recommended DR screening guidelines, and racial/ethnic minority youth are less likely to undergo recommended screening. We sought to determine if implementing point of care (POC) autonomous artificial intelligence (AI) screening could mitigate disparities in diabetic eye exam completion. In a preregistered prospective study, ACCESS2, youth with type 1 and type 2 diabetes meeting American Diabetes Association criteria for needing DR screening underwent point of care autonomous AI diabetic eye exams at diabetes clinic visits. Completion rates of diabetic eye screening exams were compared prior to and after implementation of autonomous AI using chi-square tests. A total of 152 youth with T1D (69.7%) and T2D (30.3%) were enrolled, mean age 15.5y, 45.4% non-Hispanic (NH) White, with duration of diabetes of 5.7y, and median HbA1c of 8%. A greater percentage of NH White participants reported any prior diabetic eye exam compared to non-white and Hispanic participants (92.8% v 65.1%, p&amp;lt;0.001). Multivariable analysis demonstrated that even when controlling for age, sex, HbA1c, Medicaid insurance, diabetes type and duration of diabetes, non-white youth are less likely to have had a prior diabetic eye exam (OR 0.26, CI: 0.07-0.93, p=0.04). After undergoing POC autonomous AI diabetic eye exams, completion rates were 99% for participants in all subgroups. Implementation of autonomous AI at the point of care increases access to and completion of diabetic eye exams, and promotes health equity for minority youth with diabetes. Disclosure A.Zehra: None. M.D.Abràmoff: Board Member; Digital Diagnostics, Consultant; AbbVie Inc., NovaGo Therapeutics AG, Other Relationship; Digital Diagnostics, Stock/Shareholder; Digital Diagnostics. R.M.Wolf: Research Support; Dexcom, Inc., Boehringer Ingelheim Inc. L.A.Bromberger: None. B.Pan: None. A.Shehadeh: None. D.Patel: None. E.A.Brown: None. R.Channa: None. T.Liu: None. H.Lehmann: None. Funding National Eye Institute (R01EY033233, 5K23EY030911-03)

Pediatric Eye Care Treatment Rates and Community Compliance to a Spectacle Provision Program in an Underserved School District in San Diego, CA.

The need for early identification and treatment of young children's refractive error needs has become a public health concern. The UCSD Eyemobile for Children (EyeMobile) provides vision screenings and comprehensive eye exams on the Eyemobile among a population of underserved, predominantly Hispanic preschool and elementary school children. The program also provides spectacles for children who fail eye exams due to refractive error. We performed a retrospective cross-sectional analysis of all children screened from 2011 to 2017 by the Eyemobile across 10 San Diego elementary schools. We examined demographics, distance and near visual acuity, autorefraction, stereopsis, and color vision. To measure compliance to our spectacle program, we checked if children who were prescribed spectacles were wearing them, as instructed, at the following year's screening. Differences between compliance measures with respect to school, age, ethnicity, and gender were determined using chi-square analysis, while all other measures were fit to a binary logistic regression to determine statistically significant factors. A total of 12,176 elementary school children were screened between 2011 and 2017. Of these children, 5269 (43.3%) were referred for a comprehensive eye examination. Across six years, 3163 (60.0%) of the children referred completed their eye examinations. There was a significant increase (p < 0.001) in exam completion in the successive years. Exam completion was significantly higher in ten-year-olds (p = 0.0278) and in 3 of the 10 schools (p < 0.0001, p = 0.0027, and p = 0.0309). A total of 1089 (8.9% of screened) children were prescribed spectacles. Of the 409 children that were recorded with the compliance method, 342 (83.6%) were found to be fully compliant and wearing their spectacles as prescribed. The Eyemobile program demonstrated high levels of compliance for both eye examination completion and prescribed spectacle wear in underserved populations in the San Diego region, compared to similar national programs.

Impact of Blended Learning on NCLEX Scores and Subscores

The nursing workforce shortage is the biggest crisis that demands increased qualified licensed graduate nursing students. The shortage of licensed professional nurses has tremendously affected the quality of health care delivery. Subsequently, nursing schools are challenged to educate nursing students faster. Undergraduate nursing colleges have been challenged to educate more nurses faster to meet the increasing demands of qualified nurses in the workforce. Successful completion of the NCLEX exam is an entry requirement to practice as a registered nurse in the United States . The purpose of this quantitative, correlational research study is to compare the NCLEX score rates and sub-scores of psychosocial integrity and safety using data from multiple cohorts of the pre-licensure nursing program to evaluate the impact of the sudden transition from face-to-face (F2F) learning to a blended learning format. The study participants included students from the 2019 Spring and 2019 Fall cohorts who completed nursing in a F2F setup and 2020 Fall and 2021 Spring cohorts who completed nursing in a blended format. The pre-existing data of NCLEX scores and subcategory scores were obtained from two hundred and eighteen students enrolled in the F2F track, and two hundred and twenty-one students enrolled in the blended track of the nursing program. The pre-existing data obtained were coded separately in three sets using '0' for fail grade and '1' for pass grade to assess the correlation. The chi-square test of independence and Phi were employed to test the null hypothesis. The statistical analysis reported a significant difference in the NCLEX scores of the students, p &lt; .001. Findings of the NCLEX safety and psychosocial subsection scores showed no ranked significant difference, p &lt; .133 and p &lt; .355. This study's results will help modify appropriate teaching-learning platforms to foster successful student learning outcomes and NCLEX success rates. Suggestions for future research include qualitative research to erase certain limitations, correlational studies including demographic factors, and a comparative study using a diverse, larger sample size. Additionally, as the global pandemic impacts this study, a follow-up study is recommended in the future to analyze NCLEX scores with sub-scores after the COVID pandemic. Keywords: Nurse education, NCLEX, COVID-19, Blended Learning, Exam scores. DOI: 10.7176/RHSS/13-6-02 Publication date: March 31 st 2023

The ability of high school mathematics teachers in designing daily exam questions

Daily exam completion is one of the pedagogical skills that a teacher must possess. In actuality, not all teachers prepare exam questions based on the IPK and KD; hence, the questions frequently do not support the attainment of learning objectives. This study aimed to describe the ability of high school mathematics teachers to create daily exam questions. This research employed a qualitative descriptive study. The subjects of the research were five high schools and mathematics teachers. Data was collected using documentation techniques by analyzing the lesson plans, question grids, and daily exam questions created by five teachers. The data was analyzed by comparing the suitability of the daily exam question indicators to the IPK contained in the lesson plans. Lesson plans and questions for KD 3.1 and 4.1 for spatial geometry and lesson plan for KD 3.2 and 4.2 for statistics were analyzed. The teacher has formed a grid and daily exam questions that refer to the IPK to administer the daily exam; however, not all indicators of the daily exam questions adhere to the predetermined IPK. The average percentage of questions suitable for the IPK of the five subjects at KD 3.1 and KD 4.1 was 86.8%, with a highly appropriate category. The average percentage of the suitability of the questions to the IPK of the five subjects at KD 3.2 and KD 4.2 was 88.6%, with a highly appropriate category.

Revision and Implementation of a New National Training Curriculum for Radiation Oncology

<h3>Purpose/Objective(s)</h3> The purpose of this project was to develop and implement a new national training curriculum for radiation oncology. Rapid advances in radiation techniques, and increased expansion of services in our country required a new curriculum to reflect radiation oncology practice in the modern era. Once established and ratified by the training faculty, the aim was to introduce the new curriculum into clinical practice across all training sites. <h3>Materials/Methods</h3> An educational subcommittee of the Faculty of Radiologists Radiation Oncology Committee was established. This included representation from faculty members, the National Training Coordinator, the local training coordinators, and two trainee representatives. The National Medical Council's 8 domains of good clinical practice were taken as a basis on which to build the new curriculum. This is to ensure trainees develop a professional approach to work, rather than focusing on clinical aspects alone. International guidelines from the US, Canada, UK, Australia, and ESTRO were all reviewed to guide the clinical content of the program. Grant's 6 steps of curriculum design were utilized. <h3>Results</h3> The new training curriculum has been implemented as of July 2021. There is a clear roadmap for trainees to guide them through its clinical and non-clinical aspects. Requirements to pass through each of the 5 years (full-time equivalent) of training are outlined. Trainees develop progressive expertise in the use of radiotherapy to treat patients with all cancer types. This starts with management of oncological emergencies in first year and progresses to include advanced techniques including SABR and brachytherapy. A newly-developed standardized logbook was established for recording radiotherapy planning experience. Workplace based assessments were introduced (including Direct Observation of Radiotherapy Planning skills), initially a minimum number of non-site specified assessments per year was stipulated, with a view to expanding this over the coming years. A list of non-clinical training commitments is now in place, including Problem-Based Learning and Human Factors courses. These aim to develop communication, management and leadership skills. The examination process remains unchanged and is directly associated with another national training program. Satisfactory completion of exams leads to conferring with the Fellowship of the Faculty of Radiologists Royal College of Surgeons (FFR RCSI) Satisfactory completion of training will lead to Certificate of Completion of Specialist Training which permits the doctor to register on the Specialist Division of the Medical Council and to practice independently as a radiation oncologist. <h3>Conclusion</h3> A modern attainable training curriculum was implemented which reflects the 8 domains of good clinical practice. The clinical content is in keeping with the highest international standards allowing international recognition of qualifications

Time Between Completion of Third Year Clerkship and Shelf Exam Does Not Impact Scores

INTRODUCTION: As Step 1 has become pass-fail, residency programs are investigating other objective measures to evaluate applicants, such as shelf exams. Therefore, optimizing shelf scores is increasingly important to medical schools and applicants. METHODS: During the COVID pandemic, third-year medical students were given the opportunity to schedule shelf exams independent of clerkships. Completion dates of the clerkship and shelf exam dates were used to determine if students took the exam prior to, at the immediate end, or sometime after the clinical experience. Shelf exam scores between the groups were compared. RESULTS: Included in the analysis were 1132 shelf exam scores. Of these, 41 were taken prior to the clinical experience, 735 were taken at the conclusion of the clinical experience, and 356 were taken afterwards. For those who delayed the exam, the mean number of weeks between the completion of the clerkship and the shelf exam was 11.8. The mean ± SD shelf score for those taking it prior to the clerkship was 78.61 ± 6.79, at the conclusion was 79.91 ± 8.74 and for those taking it sometime after was 76.56 ± 7.70. The difference between those taking it at the end and sometime after was not statistically significant (p = 0.16). CONCLUSION: There is no correlation between shelf exam scores and the interval between completion of the clinical experience and shelf exam. Medical schools may choose to introduce flexibility in scheduling shelf exams without negatively impacting scores. This flexibility may reduce stress while increasing control and accountability.

AWARENESS AND USE OF ELECTRONIC RESOURCE BY VISUALLY IMPAIRED STUDENTS AT DELHI UNIVERSITY

For the purpose of determining if visually impaired students at Delhi University are aware of and making use of online resources, researchers utilized a survey approach that relied on structured interviews to examine 300 students who were blind or partially sighted. Using 'SPSS version 23', the data was evaluated and compiled. More than 90% of visually impaired pupils (90%) are aware of and utilize e-books and e-newspapers, according to the study's findings (83.33 percent). Furthermore, the results of this study are expected to help professionals in libraries and institutions serving the visually impaired to develop effective electronic services to facilitate access to knowledge in a digital environment. trends among others. Institutions. This study's goal is to learn more about the educational institutions' efforts to accommodate blind students and the challenges they face. Students from the University of Delhi who were blind for the duration of the research participated in this investigation. Researchers used a questionnaire they developed after conducting extensive literature reviews on the subject of the present study to interview several pupils with visual disabilities. The purpose of this study was to determine the different services given by their individual universities, assistive technology available in their libraries, and the difficulties experienced by visually impaired students in accessing information via the available resources. Students with visual impairments have access to Braille books, large-screen computers with assistive technology, recorded audiobooks on CDs or cassettes, and other necessary infrastructure, according to the findings of this research. Additionally, libraries provide their patrons a variety of services, including access to tutors and writers to aid in the completion of assignments and exams. A lack of suitable assistance equipment and assistants, a lack of internet connection, and a lack of adequate assistive technology are among the challenges students confront while using the library for their research.