Final Grade Research Articles

Association of performance in medical residency selection with a psychiatric diagnosis, and depressive and anxiety symptoms

Objective Few studies have focused on medical students and residents’ mental health impact on medical residency selection (MRS) performance. The authors evaluated the association of performance in MRS with depressive and anxiety symptoms and with a reported psychiatric diagnosis (rPD). Methods The authors enrolled candidates after the second round of MRS examinations at a Brazilian Medical School. Performance was assessed by final grade. Depressive and anxiety symptoms were assessed by the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) and the State-Trait Anxiety Inventory (STAI). The authors performed mediation analysis and multiple linear regression analysis to investigate the impact of rPD, state and trait anxiety, and depressive symptom severity on performance. Results 515 of the 643 MRS candidates (80.1%) participated in the study. Higher age, attending a preparatory course for MRS, rPD, and the number of MRS applications that year were associated with poorer performance. In mediation analysis, trait anxiety was associated with a direct effect on performance and an indirect effect mediated by rPD. Conclusion The data suggest that psychiatric diagnosis is associated with poorer performance on MRS, regardless of current symptoms of anxiety and depression. Additionally, increased levels of trait anxiety may negatively impact performance, directly and indirectly.

R.I.M.E. and reason: multi-station OSCE enhancement to neutralize grade inflation

ABSTRACT To offset grade inflation, many clerkships combine faculty evaluations with objective assessments including the Medical Examiners Subject Examination (NBME-SE) or Objective Structured Clinical Examination (OSCE), however, standardized methods are not established. Following a curriculum transition removing faculty clinical evaluations from summative grading, final clerkship designations of fail (F), pass (P), and pass-with-distinction (PD) were determined by combined NBME-SE and OSCE performance, with overall PD for the clerkship requiring meeting this threshold in both. At the time, 90% of students achieved PD on the Internal Medicine (IM) OSCE resulting in overall clerkship grades primarily determined by the NBME-SE. The clerkship sought to enhance the OSCE to provide a more thorough objective clinical skills assessment, offset grade inflation, and reduce the NBME-SE primary determination of the final clerkship grade. The single-station 43-point OSCE was enhanced to a three-station 75-point OSCE using the Reporter-Interpreter-Manager-Educator (RIME) framework to align patient encounters with targeted assessments of progressive skills and competencies related to the clerkship rotation. Student performances were evaluated pre- and post-OSCE enhancement. Student surveys provided feedback about the clinical realism of the OSCE and the difficulty. Pre-intervention OSCE scores were more tightly clustered (SD = 5.65%) around a high average performance with scores being highly negatively skewed. Post-intervention OSCE scores were more dispersed (SD = 6.88%) around a lower average with scores being far less skewed resulting in an approximately normal distribution. This lowered the total number of students achieving PD on the OSCE and PD in the clerkship, thus reducing the relative weight of the NMBE-SE in the overall clerkship grade. Student response was positive, indicating the examination was fair and reflective of their clinical experiences. Through structured development, OSCE assessment can provide a realistic and objective measurement of clinical performance as part of the summative evaluation of students.

Teacher-assigned grades and external exams: sources of discrepancy

ABSTRACT Modest correlations between teacher-assigned grades and external assessments of academic achievement (r = .40–.60) have led many educational stakeholders to deem grades subjective and unreliable. However, theoretical and methodological challenges, such as construct misalignment, data unavailability and sample unrepresentativeness, limit the generalisability of previous findings. We overcome these challenges by exploiting rich, population-wide data from the National Registries in Norway (n = 511,858), where state regulations require close construct alignment between grades and external exams. Correlations between lower-secondary education final grades and external exam results (r = .64–.86) suggest that grades are better measures of academic achievement than previously acknowledged. Dominance analyses and multivariate regression analyses indicate that external exam results are the best predictor of grades in the same subject. However, our results also indicate that state regulations and quality assurance systems cannot completely eradicate potential sources of discrepancy.

Radiomics Machine Learning Analysis of Clear Cell Renal Cell Carcinoma for Tumour Grade Prediction Based on Intra-Tumoural Sub-Region Heterogeneity

Background: Renal cancers are among the top ten causes of cancer-specific mortality, of which the ccRCC subtype is responsible for most cases. The grading of ccRCC is important in determining tumour aggressiveness and clinical management. Objectives: The objectives of this research were to predict the WHO/ISUP grade of ccRCC pre-operatively and characterise the heterogeneity of tumour sub-regions using radiomics and ML models, including comparison with pre-operative biopsy-determined grading in a sub-group. Methods: Data were obtained from multiple institutions across two countries, including 391 patients with pathologically proven ccRCC. For analysis, the data were separated into four cohorts. Cohorts 1 and 2 included data from the respective institutions from the two countries, cohort 3 was the combined data from both cohort 1 and 2, and cohort 4 was a subset of cohort 1, for which both the biopsy and subsequent histology from resection (partial or total nephrectomy) were available. 3D image segmentation was carried out to derive a voxel of interest (VOI) mask. Radiomics features were then extracted from the contrast-enhanced images, and the data were normalised. The Pearson correlation coefficient and the XGBoost model were used to reduce the dimensionality of the features. Thereafter, 11 ML algorithms were implemented for the purpose of predicting the ccRCC grade and characterising the heterogeneity of sub-regions in the tumours. Results: For cohort 1, the 50% tumour core and 25% tumour periphery exhibited the best performance, with an average AUC of 77.9% and 78.6%, respectively. The 50% tumour core presented the highest performance in cohorts 2 and 3, with average AUC values of 87.6% and 76.9%, respectively. With the 25% periphery, cohort 4 showed AUC values of 95.0% and 80.0% for grade prediction when using internal and external validation, respectively, while biopsy histology had an AUC of 31.0% for the classification with the final grade of resection histology as a reference standard. The CatBoost classifier was the best for each of the four cohorts with an average AUC of 80.0%, 86.5%, 77.0% and 90.3% for cohorts 1, 2, 3 and 4 respectively. Conclusions: Radiomics signatures combined with ML have the potential to predict the WHO/ISUP grade of ccRCC with superior performance, when compared to pre-operative biopsy. Moreover, tumour sub-regions contain useful information that should be analysed independently when determining the tumour grade. Therefore, it is possible to distinguish the grade of ccRCC pre-operatively to improve patient care and management.

Can the Cartilaginous Thickness Determine the Risk of Malignancy in Pelvic Cartilaginous Tumors, and How Accurate is the Preoperative Biopsy of These Tumors?

Background Peripheral osteochondral tumors are common, and the management of tumors presenting in the pelvis is challenging and a controversial topic. Some have suggested that cartilage cap thickness may indicate malignant potential, but this supposition is not well validated. Questions/purposes (1) How accurate is preoperative biopsy in determining whether a peripheral cartilage tumor of the pelvis is benign or malignant? (2) Is the thickness of the cartilage cap as determined by MRI associated with the likelihood that a given peripheral cartilage tumor is malignant? (3) What is local recurrence-free survival (LRFS), metastasis-free survival (MFS), and disease-specific survival (DSS) in peripheral chondrosarcoma of the pelvis and is it associated with surgical margin? Methods Between 2005 and 2022, 289 patients had diagnoses of peripheral cartilage tumors of the pelvis (either pedunculated or sessile) and were treated at one tertiary sarcoma center (the Royal Orthopaedic Hospital, Birmingham, UK). These patients were identified retrospectively from a longitudinally maintained institutional database. Those whose tumors were asymptomatic and discovered incidentally and had cartilage caps ≤ 1.5 cm were discharged (95 patients), leaving 194 patients with tumors that were either symptomatic or had cartilage caps > 1.5 cm. Tumors that were asymptomatic and had a cartilage cap > 1.5 cm were followed with MRIs for 2 years and discharged without biopsy if the tumors did not grow or change in appearance (15 patients). Patients with symptomatic tumors that had cartilage caps ≤ 1.5 cm underwent removal without biopsy (63 patients). A total of 82 patients (63 with caps ≤ 1.5 cm and 19 with caps > 1.5 cm, whose treatment deviated from the routine at the time) had their tumors removed without biopsy. This left 97 patients who underwent biopsy before removal of peripheral cartilage tumors of the pelvis, and this was the group we used to answer research question 1. The thickness of the cartilage cap was recorded from MRI and measuring to the nearest millimeter, with measurements taken perpendicular in the plane that best allowed the greatest measurement. Patient survival rates were assessed using the Kaplan-Meier method with 95% confidence intervals as median observation times to estimate MFS, LRFS, and DSS. Results Of malignant tumors biopsied, in 49% (40 of 82), the biopsy result was recorded as benign (or was considered uncertain regarding malignancy). A malignant diagnosis was correctly reported in biopsy reports in 51% (42 of 82) of patients, and if biopsy samples with uncertainty regarding malignancy were excluded, the biopsy identified a lesion as being malignant in 84% (42 of 50) of patients. The biopsy results correlated with the final histologic grade as recorded from the resected specimen in only 33% (27 of 82) of patients. Among these 82 patients, 15 biopsies underestimated the final histologic grade. The median cartilage cap thickness for all benign osteochondromas was 0.5 cm (range 0.1 to 4.0 cm), and the median cartilage cap thickness for malignant peripheral chondrosarcomas was 8.0 cm (range 3.0 to 19 cm, difference of medians 7.5 cm; p < 0.01). LRFS was 49% (95% CI 35% to 63%) at 3 years for patients with malignant peripheral tumors with < 1-mm margins, and LRFS was 97% (95% CI 92% to 100%) for patients with malignant peripheral tumors with ≥ 1-mm margins (p < 0.01). DSS was 100% at 3 years for Grade 1 chondrosarcomas, 94% (95% CI 86% to 100%) at 3 years for Grade 2 chondrosarcomas, 73% (95% CI 47% to 99%) at 3 and 5 years for Grade 3 chondrosarcomas, and 20% (95% CI 0% to 55%) at 3 and 5 years for dedifferentiated chondrosarcomas (p < 0.01). DSS was 87% (95% CI 78% to 96%) at 3 years for patients with malignant peripheral tumors with < 1-mm margin, and DSS was 100% at 3 years for patients with malignant peripheral tumors with ≥ 1-mm margins (p = 0.01). Conclusion A thin cartilage cap (< 3 cm) is characteristic of benign osteochondroma. The likelihood of a cartilage tumor being malignant increases after the cartilage cap thickness exceeds 3 cm. In our experience, preoperative biopsy results were not reliably associated with the final histologic grade or malignancy, being accurate in only 33% of patients. We therefore recommend observation for 2 years for patients with pelvic osteochondromas in which the cap thickness is < 1.5 cm and there is no associated pain. For patients with tumors in which the cap thickness is 1.5 to 3 cm, we recommend either close observation for 2 years or resection, depending on the treating physician’s decision. We recommend excision in patients whose pelvic osteochondromas show an increase in thickness or pain, preferably before the cartilage cap thickness is 3 cm. We propose that surgical resection of peripheral cartilage tumors in which the cartilage cap exceeds 3 cm (aiming for clear margins) is reasonable without preoperative biopsy; the role of preoperative biopsy is less helpful because radiologic measurement of the cartilage cap thickness appears to be accurately associated with malignancy. Biopsy might be helpful in patients in whom there is diagnostic uncertainty or when confirming the necessity of extensive surgical procedures. Future studies should evaluate other preoperative tumor qualities in differentiating malignant peripheral cartilage tumors from benign tumors. Level of Evidence Level III, diagnostic study.

Validation of rubric-based evaluation for bachelor's theses in a food science and technology degree.

An effective evaluation of a bachelor's thesis (BT) needs the use of valid tools such as rubrics. There are few studies providing a validation of rubrics for these theses and even fewer in the academic field of food science and technology; hence the aim of this study was to validate a rubric for the assessment of relevant competencies in the BT. Ninety-seven students presented their thesis and 56 teachers participated as members of the committees. The degree of relevance, suitability, and clarity of the rubrics were assessed as well as the relationship between student perception and academic performance and the congruence between the teacher's and students' evaluations. The content validity index and intraclass correlation coefficient (ICC) were calculated. Students had a moderate level of knowledge about rubrics, but they mostly agreed with the premise that the rubrics are an accurate tool to assess the quality of BTs. Teacher's and student's marks mostly aligned. No significant relationship was found between the positive perception of rubric's validity and the final grades. Regarding clarity, suitability, and relevance as perceived by teachers, the used rubrics were highly valued. The ICC of criteria indicated that the rubrics were valid in the studied terms. Hence, the validation of a food science and technology degree BT assessment system based on a rubric has been achieved. Supporting Information PRACTICAL APPLICATION: The conclusions drawn from this research could enable teachers at other universities to use this methodology for validating their rubrics for bachelor's theses. Furthermore, they could use this validated rubric to evaluate projects presented at their respective institutions.

EFFECT OF POST-THAW CHANGE IN EMBRYO SCORE ON SINGLE EUPLOID EMBRYO TRANSFER SUCCESS RATES

ObjectiveTo assess whether the change in embryo morphology from pre-cryopreservation to post-thaw is associated with embryo transfer success rates in single euploid embryo transfer cycles. DesignRetrospective cohort study SubjectsPatients who underwent a single euploid embryo transfer cycle from September 2016 – April 2022 were included. A decision support tool was used to assign each embryo a reproductive potential score based on the day of biopsy, expansion, and grade of trophectoderm and inner cell mass (ICM) at the time of cryopreservation and post-thaw.(1) Embryos were divided into 4 groups: Group 1 included embryos with the same score post-thaw (reference), Group 2 higher score, Group 3 lower score, and Group 4 embryos that did not re-expand post-thaw. Intervention(s)No interventions administered. Main Outcome MeasuresPrimary outcome was live birth rates per embryo transfer (LBR). Secondary outcomes included chemical pregnancy, clinical pregnancy, and clinical pregnancy loss rate. Comparative statistics and univariate analyses were performed using Kruskal-Wallis and chi-square tests. Multivariate logistic regression fitted with generalized estimating equation was performed to compare the odds of live birth between groups. ResultsA total of 7750 embryo transfers performed for 4613 patients met inclusion criteria: 5331 in Group 1, 486 in Group 2, 1726 in Group 3, and 207 in group 4. On univariate analysis, there was a statistically significant difference in LBR between groups 1, 2, 3, and 4 (55.8% vs 51.4%, 47.5%, 26.6%, p<0.0001). Logistic regression controlling for oocyte age, AMH, BMI, endometrial thickness, year of embryo transfer, time from thaw to final grading, and embryo score prior to cryopreservation showed significantly lower odds of LBR when the embryo was downgraded (OR 0.70, CI 0.62-0.79, p=<.0001) or did not re-expand (OR 0.36, CI 0.26-0.51 p=<.0001) compared with no change in score. When controlling for all variables, there was a significant increase in odds of live birth between embryos that had higher score post-thaw versus those without a change (OR 1.42, CI 1.14-1.76, p=0.002). There was no significant difference in clinical pregnancy loss rate among the 4 groups. ConclusionsThe change in quality of the embryo post-thaw is an important factor in embryo transfer success. In an adjusted analysis, the chemical pregnancy, clinical pregnancy, and LBR per embryo transfer are all significantly decreased in embryos that were downgraded or did not expand on the day of single euploid embryo transfer. Embryos that re-expand and improve their quality post-thaw have the highest odds of live birth.

Decoding Student Success in Higher Education: A Comparative Study on Learning Strategies of Undergraduate and Graduate Students

&#x0D; &#x0D; Learning management systems (LMS) provide a rich source of data about the engagement of students with courses and their materials that tends to be underutilized in practice. In this paper, we use data collected from the LMS to uncover learning strategies adopted by students and compare their effectiveness. Starting from a sample of over 11,000 enrollments at a Portuguese information management school, we extracted features indicative of self-regulated learning (SRL) behavior from the associated interactions. Then, we employed an unsupervised machine learning algorithm (k-means) to group students according to the similarity of their patterns of interaction. This process was conducted separately for undergraduate and graduate students. Our analysis uncovered five distinct learning strategy profiles at both the undergraduate and graduate levels: 1) active, prolonged and frequent engagement; 2) mildly frequent and task-focused engagement; 3) mildly frequent, mild activity in short sessions engagement; 4) likely procrastinators; and 5) inactive. Mapping strategies with the students' final grades, we found that students at both levels who accessed the LMS early and frequently had better outcomes. Conversely, students who exhibited procrastinating behavior had worse end-of-course grades. Interestingly, the relative effectiveness of the various learning strategies was consistent across instruction levels. Despite the LMS offering an incomplete and partial view of the learning processes students employ, these findings suggest potentially generalizable relationships between online student behaviors and learning outcomes. While further validation with new data is necessary, these connections between online behaviors and performance could guide the development of personalized, adaptive learning experiences.&#x0D; &#x0D;

Student Performance and Perceived Effectiveness and Management of CUSTAR 425 (Customs &amp; Tariff) Course

With the objective to produce efficient workforce, the primordial goal of the Bachelor of Science in Customs Administration (BSCA) educational program is to produce ethical and socially responsible customs broker professionals whose skills and competence conform to, and are compliant with, international standards and best customs practices (CHED, 2017). Prior to putting all the basic and fundamental knowledge of customs into practice, students ought to attend a technical course to review the essential aspects of the customs profession. As such, this course serves as a preparation for students in taking the Customs Broker Licensure Examination (CBLE). At the Asian Institute of Maritime Studies (AIMS), this is covered under the Customs and Tariff (CUSTAR 425) course. There are essential aspects that may affect the performance of students in engaging with this course: learning materials, and effective professors. Right (2018) reiterated that learning materials are crucial to the success of student achievement while the biggest opportunity for faculty members to impact, inspire, and engage students (Koproske, 2016) is by mapping concrete skills and outcomes to the syllabi in order to help their departments systematically measure and improve the learning experiences of their students over time. This led the researchers to examine the performance, effectiveness and management of the Customs and Tariff course (CUSTAR 425) of AIMS. Applying the tenets of descriptive-survey design, the study gathered data from 198 BSCA students of AIMS who were enrolled in CUSTAR 425 during SY 2015-2016 to 2017-2018. Employing total enumeration as sampling technique, all members of the population were measured in terms of their performance (using final grade as data) in CUSTAR 425, as well as their assessment on the effectiveness and management (utilizing a self-made questionnaire) of the above course. With the aid of SPSS (version 23), data were derived using mean (for grades) and average weighted mean (for effectiveness and management). In terms of performance, majority of the students earned “Good” grades (83 to 85) in CUSTAR 425 while the effectiveness of the course was also favorably rated by the respondents specifically on the following indicators: Course Content (M=4.12) and Course Materials (M=3.94). However, though generally perceived that the Course Timeline aspect have helped them in preparing for the exam, a fraction of students however thought otherwise (neutral and/or disagree) as indicated by the slightly low mean of 3.78. Perhaps, two issues can be raised on this part: insufficient time allotted to complete the course; or, time management skill of students. Lastly, yielding a composite mean of 4.20 (Agree), the students generally agreed that the Customs Administration Department has efficiently managed the CUSTAR 425 course. In consideration of the results, it is recommended that the Customs Administration Department shall strategically set reasonable course timeline to facilitate learning and enhance students’ knowledge. Perhaps, course topics shall also be revisited and calibrated in order to streamline course contents and make fit with the allotted timeline. Students who are planning to take a licensure examination are also advised to enhance their time management skills and learn to properly schedule their school activities especially extending priority to requirements that need more time and attention. Lastly, AIMS, through the Customs Administration Department, shall maintain the good management of the course as majority of its elements was favorably assessed.

The Impact of Performance-Based Assessment on Academic Writing Instruction

This study seeks to determine the positive impact of PBA, which synchronizes student achievement in the learning process with final grades. Performance-Based Assessment (PBA) is a pedagogical strategy used to achieve student targets in the following learning objectives, especially in Academic Writing courses that aim to make students competent novice writers. The Performance-Based Assessment teaching style allows students to write seminar-ready draft proposals at the end of the Academic Writing course. It was decided to adopt a single case study research design to get more thorough data about the respondents. This study used Performance-Based Assessment (PBA) in academic writing classes. This study shows that Performance-Based Assessment improves student learning, notably in Academic Writing, proving that PBA is a good teaching method.

ONLINE QUIZZES IN IMPROVING STUDENT LEARNING

Distance learning educators include self-assessment formative quizzes into the curriculum to enhance students’ learning experiences. Online quizzes are a useful learning tool, particularly when courses are delivered online, thanks to technical advancements in web-based delivery. The greatest aspect of offering online quizzes is that the correct answer and any suitable comments are offered to students instantly after they complete a question. The present study evaluates students’ overall performance in one of the core courses, in which self-assessment quizzes were administered through the e-learning system in order to reflect their learning behaviour towards the coursework. As part of formative assessment, it was noted that students’ frequent efforts aggregated during the final exam session; yet, as soon as the quizzes were made available, a few students took them. The data demonstrated a substantial link between students who took the quizzes and their overall achievement as measured by final grades. This paper delves through the essential factors to consider when developing well-crafted quizzes for technical courses and so maximising their potential as an effective learning tool.

Academic performance and musculoskeletal pain in adolescents with uncorrected vision problems

BackgroundUndetected vision problems are common in school children, and a prevalence of up to 40% has previously been reported. Uncorrected vision and lack of optimal eye wear can have a significant impact on almost all aspects of everyday life, such as development and learning, academic performance, pain and discomfort, and quality of life. This study aimed to analyze the relationship between uncorrected vision problems, educational outcomes, and musculoskeletal pain symptoms.MethodsA total of 152 school children (15.1 ± 0.8 years, mean ± SD; 40% males) were included in the study. All participants were recruited from a free-of-charge school vision testing program in Kathmandu, Nepal. Academic grades were collected from the school records of the participants’ nationwide final grade examinations. A questionnaire was used to record the use of digital devices, screen time, and associated symptoms, including musculoskeletal pain (Wong-Baker FACES Pain Rating Scales).ResultsA total of 61 children (40%) had uncorrected vision, with a cycloplegic refraction of SER − 0.53 ± 0.52 (mean ± SD). Children with uncorrected vision had significantly more third division grades (26 vs. 9%, p = 0.004) and shoulder pain in general/during screen use (66 vs. 43/40%, p = 0.008/0.003; 2.1/1.9 vs. 1.1/1.0 mean pain score, p = 0.002/0.001) compared with children with normal vision. Sex based subanalyses showed that only girls with uncorrected vision had more third division grades (25 vs. 4%, p = 0.006), and only boys with uncorrected vision had more shoulder pain in general/during screen use (76 vs. 28/31%, p < 0.001; 2.2/2.4 vs. 0.7 mean pain score, p < 0.001), compared with children with normal vision.ConclusionsThe results of this study showed that even small refractive errors may impact educational outcomes and musculoskeletal pain in adolescents. Most of the participating children had low myopia, easily corrected with glasses. This suggests that regular eye examinations are important in school children, and there is a need for raised awareness among parents, and school- and healthcare personnel.

The effect of pre-body donor quizzes on student performance in a hybrid anatomy course.

Learning human anatomy is essential for Doctor of Physical Therapy (DPT) education. Body donors are traditionally utilized to understand content, but in a hybrid learning environment, students have limited time to use body donors. To improve body donor access and learning, we created online synchronous pre-body donor activities. The impact of these online strategies on students' subsequent exams and final grade were investigated in a non-randomized, observational study. These activities were hypothesized to positively influence students' anatomy performance. In a 16-week semester, DPT students (case [n = 91], control [n = 22]) participated in a hybrid program of asynchronous/synchronous online learning and two in-person immersions. Measures included student course grades and teaching surveys. Spearman's rho correlations analyzed the relationship between four pre-body donor quizzes to body donor exams, written exams, and final course grade. Mann-Whitney U tests assessed differences in grades between cohorts. A linear regression model examined the influence of pre-body donor quizzing on exams/final grades. Correlation tests revealed a strong relationship between the average pre-body donor quiz score and both the first written exam and final course grade (p = 0.0001). The case group achieved significantly higher scores than the control group on the first in-person body donor exam (p = 0.011), the second written exam (p = 0.0001), and the final grade (p = 0.004). The pre-body donor quizzes predicted performance on the subsequent in-person body donor exams, written exams, and the final grade. Implementation of online pre-body donor learning activities was associated with increased academic performance among hybrid DPT students and may aid in learning anatomy concepts for clinical practice.

What topics of peer interactions correlate with student performance in physics courses?

Abstract Research suggests that interacting with more peers about physics course material is correlated with higher student performance. Some studies, however, have demonstrated that different topics of peer interactions may correlate with their performance in different ways, or possibly not at all. In this study, we probe both the peers with whom students interact about their physics course and the particular aspects of the course material about which they interacted in six different introductory physics courses: four lecture courses and two lab courses. Drawing on methods in social network analysis, we replicate prior work demonstrating that, on average, students who interact with more peers in their physics courses have higher final course grades. Expanding on this result, we find that students discuss a wide range of aspects of course material with their peers: concepts, small-group work, assessments, lecture, and homework. We observe that in the lecture courses, interacting with peers about concepts is most strongly correlated with final course grade, with smaller correlations also arising for small-group work and homework. In the lab courses, on the other hand, small-group work is the only interaction topic that significantly correlates with final course grade. We use these findings to discuss how course structures (e.g., grading schemes and weekly course schedules) may shape student interactions and add nuance to prior work by identifying how specific types of student interactions are associated (or not) with performance.

Determinants of serious in-hospital complications in patients with Killip class 1/2 ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention.

Killip classification has been used to stratify the risk of patients with acute myocardial infarction (AMI). There were many reports that Killip class 3 or 4 is closely associated with poor clinical outcomes. In other words, Killip class 1 or 2 is associated with favorable clinical outcomes in patients with AMI, especially when patients received primary percutaneous coronary intervention (PCI). However, some patients with Killip class 1/2 suffer from serious in-hospital complications. This study aimed to identify factors associated with serious in-hospital complications of ST-segment elevation myocardial infarction (STEMI) in patients with Killip class 1/2. The primary endpoint was serious in-hospital complications defined as the composite of in-hospital death and mechanical complications. We included 809 patients with STEMI, and divided them into the non-complication group (n = 791) and the complication group (n = 18). In-hospital death was observed in 14 patients (1.7%), and mechanical complications were observed in 4 patients (0.5%). Final TIMI flow ≤ 2 was more frequently observed in the complication group (33.3%) than in the non-complication group (5.4%) (p < 0.001). Multivariate logistic regression analysis revealed that serious in-hospital complication was associated with final TIMI flow grade ≤ 2 (Odds ratio 6.040, 95% confidence interval 2.042-17.870, p = 0.001). In conclusion, serious in-hospital complication of STEMI was associated with insufficient final TIMI flow grade in patients with Killip class 1/2. If final TIMI flow grade is suboptimal after primary PCI, we may recognize the potential risk of serious complications even when patients presented as Killip class 1/2.

Student engagement with a novel online assessment strategy

The study investigated the impact on student engagement and achievement of a "formative thresholded" continuous assessment strategy in which students had to meet a modest threshold, but their continuous assessment marks did not contribute to their final grade. Students were free to choose their own blend of tutor-marked and computer-marked assignments provided they met the threshold in a minimum number of assignments. For students reaching this threshold, the final grade was determined solely by an end-of-year examination. This assessment strategy was compared with one in which summative assignments contributed to the final grade alongside the final examination. The methodology took the form of data analysis of assessment records from more than 3500 anonymized students over a period of 7 years. Evidence was found for improved student engagement under the formative thresholded assessment strategy, with students choosing to complete many more computer-marked assignments, balanced by slightly fewer tutor-marked assignments. There was no change in overall retention. Many students made use of the capability to repeat different versions of the computer-marked questions. There was some evidence of students gaming the system (repeating questions until they obtained a version they had seen before), though most students did not do this at all and only a small number did so regularly. Students appeared to make better use of model answers, provided in response to three incorrect tries at a question, than of hints provided after each try. It was noted that the formative thresholded assessment strategy has potential for wider use.

Student-Perceived Supervisor Motivation and Grade Pressure as Predictors of German Psychology Students’ Thesis Motivation

Writing a final thesis is an important step for many students. Many thesis programs in research-oriented fields are structured as projects in which there is a one-to-one working relationship with a supervisor. In addition, the thesis’ final grade is often perceived as particularly important. This research uses a cross-sectional survey design ( N = 217) to assess student-perceived supervisor motivation and experienced grade pressure as predictors of student motivation when writing their thesis. Derived from expectancy-value models, valence, expectancy, and instrumentality towards achieving a good thesis grade as well as stress from the thesis work are assessed as mediating variables. The results indicate that, as hypothesized, high student-perceived supervisor motivation is associated with higher motivation components and less stress. Grade pressure is associated with higher valence, but also more stress. In turn, motivational components are positively and stress negatively associated with student motivation. The mediation analysis suggests a partially mediated positive effect of student-perceived supervisor motivation and a suppressed net zero effect of grade pressure on student motivation. Although this research cannot establish causality, the results suggest that motivating supervisors may improve student motivation in thesis writing significantly. Furthermore, the negative effects of high grade pressure may not extend to student motivation.

Evaluation of bias and gender/racial concordance based on sentiment analysis of narrative evaluations of clinical clerkships using natural language processing

There is increasing interest in understanding potential bias in medical education. We used natural language processing (NLP) to evaluate potential bias in clinical clerkship evaluations. Data from medical evaluations and administrative databases for medical students enrolled in third-year clinical clerkship rotations across two academic years. We collected demographic information of students and faculty evaluators to determine gender/racial concordance (i.e., whether the student and faculty identified with the same demographic). We used a multinomial log-linear model for final clerkship grades, using predictors such as numerical evaluation scores, gender/racial concordance, and sentiment scores of narrative evaluations using the SentimentIntensityAnalyzer tool in Python. 2037 evaluations from 198 students were analyzed. Statistical significance was defined as P < 0.05. Sentiment scores for evaluations did not vary significantly by student gender, race, or ethnicity (P = 0.88, 0.64, and 0.06, respectively). Word choices were similar across faculty and student demographic groups. Modeling showed narrative evaluation sentiment scores were not predictive of an honors grade (odds ratio [OR] 1.23, P = 0.58). Numerical evaluation average (OR 1.45, P < 0.001) and gender concordance between faculty and student (OR 1.32, P = 0.049) were significant predictors of receiving honors. The lack of disparities in narrative text in our study contrasts with prior findings from other institutions. Ongoing efforts include comparative analyses with other institutions to understand what institutional factors may contribute to bias. NLP enables a systematic approach for investigating bias. The insights gained from the lack of association between word choices, sentiment scores, and final grades show potential opportunities to improve feedback processes for students.

The bidirectional longitudinal association between academic performance and cardiovascular disease risk factors in adolescents.

The limited prior research examining the association between academic performance and cardiovascular disease (CVD) risk factors in youth did not explore the reciprocal association between these constructs, and analyzed CVD risk factors individually. Thus, the aim of the present study was to explore the bidirectional longitudinal association between clustered CVD risk score and academic performance in adolescents over a 24-month interval. A total of 237 adolescents (45.6% girls), aged 13.9 ± 0.3 years old at baseline, from DADOS (Deporte, ADOlescencia y Salud) study were included in this study. A clustered CVD risk score was created by calculating the mean age- and gender-standardized z-scores of waist circumference, systolic blood pressure, total cholesterol to high-density lipoprotein cholesterol ratio, triglycerides, homeostatic model assessment of insulin resistance, and cardiorespiratory fitness (inversed). Academic performance was assessed through the final academic grades and the test of educational abilities. Our results showed that the clustered CVD risk score at baseline was not associated with academic performance 24 months later (all p > .05). Nevertheless, except for physical education, academic grades at baseline were inversely associated with clustered CVD risk score at follow-up in adolescents (β ranged from -0.140 to -0.102; all p < .05). No associations were found between academic abilities at baseline and clustered CVD risk score at follow-up (all p > .05). Academic grades could help predict CVD risk 24 months later during adolescence. Education professionals should foster adolescents' academic performance not only to improve academic results but also to maximize future cardiovascular health benefits.

The Mediating Role of Learning Analytics

Researchers in learning analytics have created indicators with learners’ trace data as a proxy for studying learner behaviour in a college course. Student Approaches to Learning (SAL) is one of the theories used to explain these behaviours, distinguishing between deep, surface, and organized study. In Latin America, researchers have demonstrated that organized approaches to learning could be more effective in higher education, leading to better performance and course approval. However, further analysis of student behavioural data is needed to understand this relationship and inform interventions targeting study habits and academic performance. In this study, we analyzed the relationship between student approaches to learning and their final grade in six college courses, using behavioural trace data as a mediator variable. Specifically, we conducted a quantitative study in two Latin American institutions where data of different granularity was collected from their Learning Management Systems. We observed that most learning analytics indicators do not mediate the effect between approaches to learning and course performance. However, there was evidence for fine-grained indicators acting as total mediators. Implications are discussed at methodological and pedagogical levels, aiming to inform the advancement of learning analytics in the region and its use for supporting student learning.