Multiple-choice Questions Scores Research Articles

A Comparative Study between the Conventional MCQ Scores and MCQ with the CBA Scores at the Standardized Clinical Knowledge Exam for Clinical Medical Students

Background and purpose: Partial knowledge is one of the main factors to be considered when dealing with the improvement of the administration of Multiple Choice Questions (MCQ) in testing. Various strategies have been proposed for this factor in the traditional testing environment. Therefore, this study proposed a Confidence Based Assessment (CBA) as a pertinent solution and aims at comparing the effect of the CBA Scoring system with that of the conventional scoring systems (with and without negative score estimation as penalty) on the students’ scores and estimating their partial knowledge on clinical studies. Methods: This comparative study was conducted using a standardized clinical knowledge exam for 117 clinical students. After two-step training, both the conventional MCQ and CBA examination was given in a single session simultaneously. The exam included 100 questions and the volunteers were requested to complete a questionnaire regarding their attitude and satisfaction on their first experience of the CBA after exam. A new confidence based marking system was selected for the scoring, which was a hybrid of the UCL and MUK2010 systems. The MCQ-Assistant, SPSS and Microsoft office Excel software were used for scoring and data analysis. Results: The mean age of the volunteers was 27.3±5.47, of whom 43.6% were men and 69.2% were senior medical students. Exam reliability was 0.977. The fit line of the MCQ scores without penalty estimation was R 2 =0.9816 and Intercept=18.125 or approximately.2 deviation in the low scores. The MCQ scoring with penalty had a fit line approximately parallel to the 45-degree line but on or above it and the CBA scoring fit line was nearer to the 45-degree line, parallel to it and a little below it. These two sets of scores had a significant p value0.037. The response percentage to the CBA is higher (p value=0.0001). The discrimination power of the MCQ and the CBA for the upper and lower 1/3 of the students was not significantly different (p value=0.34). The students’ satisfaction score was high and acceptable to the CBA system and expressed a positive perspective on this system for their examinations. Conclusions: The CBA method can increase the competencies of the MCQ exams. It was found to have a greater fairness assessment, was an effective examination, an authentic testing method, with precise estimation and higher constructs validity than the conventional MCQ exam. The CBA simulate the reflection for deeper learning among the students.

Are Spot Test Multiple Choice Questions Easier to Answer than Short Answer Questions?

Machine marked multiple choice assessments are often preferred over those requiring manual marking, with most medical schools and boards using multiple choice questions (MCQs), usually single best answer, as the main format for written tests. While these often give excellent reliability and validity, disadvantages are that students can guess the answers with no penalty, or can rely on recognition rather than having to produce information. In order to investigate whether this makes tests easier for students, 277 first year medical students were randomly allocated into two groups (A and B). Both groups wrote a formative spot test, delivered by PowerPoint. The questions were largely anatomical, but with a few other basic science questions included. The test was composed of both MCQ and short answer question (SAQ) format questions. Each group answered 40 questions in total, with 20 of each type, but the 20 questions that Group A answered in MCQ format were given to Group B as SAQs and vice versa. A Student t test was carried out to determine if there was a difference between the mean scores achieved for the two types of questions in each format. The mean SAQ score (with no half marks awarded) was 34.3% (±14.8), while that for the MCQs was 54.7% (±15.6). If half marks were included in the scores attained for the SAQs, the mean score was 37.0% (±14.9). There was a statistically significant difference (p<0.01) between the SAQ and MCQ scores, regardless of whether half marks were included. It is therefore suggested that MCQs alone should not be relied upon, at least for spot tests, as scores achieved with MCQs are significantly higher than for SAQs. Free written response type questions should also be included.

Correlation of MCQ and SEQ scores in written undergraduate ophthalmology assessment.

To determine the psychometric worth of Multiple-Choice Questions (MCQs) and Short-Essay Questions (SEQs) used in internal summative assessment of undergraduate ophthalmology annual send-up examination and to ascertain the quality of items using subjective measures. Correlational analytical study. Fatima Jinnah Medical College, Lahore, from January to March 2012. Fourth year MBBS students appearing in their written send-up annual examination in ophthalmology. The MCQ and SEQ scores were correlated for validity and reliability. Construct validity was estimated (Pearson correlation coefficient). MCQ's split-half reliability (Spearman correlation coefficient) and SEQ's inter-rater reliability (Pearson correlation coefficient) were also estimated. Moderate correlation was seen between MCQ and SEQ scores (r=0.5, p < 0.01). Split-half reliability of MCQs had moderate correlation (r=0.4, p < 0.01) while inter-rater reliability of SEQs scores showed high correlation (r=0.9, p < 0.01). Most of the MCQs (55%) and SEQ's (90%) were at recall level of Bloom's taxonomy. MCQs (30%) attained a higher level (interpretation) as compared to SEQ's (10%). None of the MCQ and SEQ attained problem solving level. Using variety of tools for assessment improves both the validity and reliability enabling examiners to draw fair conclusions about a student's ability. Validity and reliability can be further improved by arranging training opportunities for item writers to achieve accurate transfer of hypothetical construct in the form of an item. This is crucial since essential and important learning outcomes can only be assessed with valid and reliable tools.

Do medical students' scores using different assessment instruments predict their scores in clinical reasoning using a computer-based simulation?

PurposeThe development of clinical problem-solving skills evolves over time and requires structured training and background knowledge. Computer-based case simulations (CCS) have been used for teaching and assessment of clinical reasoning skills. However, previous studies examining the psychometric properties of CCS as an assessment tool have been controversial. Furthermore, studies reporting the integration of CCS into problem-based medical curricula have been limited.MethodsThis study examined the psychometric properties of using CCS software (DxR Clinician) for assessment of medical students (n=130) studying in a problem-based, integrated multisystem module (Unit IX) during the academic year 2011–2012. Internal consistency reliability of CCS scores was calculated using Cronbach’s alpha statistics. The relationships between students’ scores in CCS components (clinical reasoning, diagnostic performance, and patient management) and their scores in other examination tools at the end of the unit including multiple-choice questions, short-answer questions, objective structured clinical examination (OSCE), and real patient encounters were analyzed using stepwise hierarchical linear regression.ResultsInternal consistency reliability of CCS scores was high (α=0.862). Inter-item correlations between students’ scores in different CCS components and their scores in CCS and other test items were statistically significant. Regression analysis indicated that OSCE scores predicted 32.7% and 35.1% of the variance in clinical reasoning and patient management scores, respectively (P<0.01). Multiple-choice question scores, however, predicted only 15.4% of the variance in diagnostic performance scores (P<0.01), while students’ scores in real patient encounters did not predict any of the CCS scores.ConclusionStudents’ scores in OSCE are the most important predictors of their scores in clinical reasoning and patient management using CCS. However, real patient encounter assessment does not appear to test a construct similar to what is tested in CCS.

Effectiveness of early cardiology undergraduate learning using simulation on retention, application of learning and level of confidence during clinical clerkships.

This study aimed to assess the effectiveness of the use of a cardiopulmonary patient simulator in the teaching of second-year medical students. Effectiveness was measured in terms of the extent of knowledge retention and students' ability to apply the skills learned in subsequent real-life patient contact. In this study, ten third-year medical students who had previously undergone simulator training as part of their second-year curriculum underwent an objective structured clinical examination (OSCE) and a multiple-choice question (MCQ) test to assess their ability to apply the knowledge gained during the simulator training when dealing with real patients. The performance of this group of students was compared with that of a group of ten fourth-year medical students who did not undergo simulation training. Although the third-year medical students performed well in the OSCE, they were outperformed by the group of fourth-year medical students, who had an extra year of clinical exposure. The MCQ scores of the two groups of students were similar. Post-simulation training survey revealed that students were generally in favour of incorporating cardiopulmonary simulator training in the preclinical curriculum. Cardiopulmonary simulator training is a useful tool for the education of preclinical medical students. It aids the translation of preclinical knowledge into real-life clinical skills.

SMS photograph-based external quality assessment of reading and interpretation of malaria rapid diagnostic tests in the Democratic Republic of the Congo.

BackgroundThe present External Quality Assessment (EQA) assessed reading and interpretation of malaria rapid diagnostic tests (RDTs) in the Democratic Republic of the Congo (DRC).MethodsThe EQA consisted of (i) 10 high-resolution printed photographs displaying cassettes with real-life results and multiple choice questions (MCQ) addressing individual health workers (HW), and (ii) a questionnaire on RDT use addressing the laboratory of health facilities (HF). Answers were transmitted through short message services (SMS).ResultsThe EQA comprised 2344 HW and 1028 HF covering 10/11 provinces in DRC. Overall, median HW score (sum of correct answers on 10 MCQ photographs for each HW) was 9.0 (interquartile range 7.5 – 10); MCQ scores (the % of correct answers for a particular photograph) ranged from 54.8% to 91.6%. Most common errors were (i) reading or interpreting faint or weak line intensities as negative (3.3%, 7.2%, 24.3% and 29.1% for 4 MCQ photographs), (ii) failure to distinguish the correct Plasmodium species (3.4% to 7.0%), (iii) missing invalid test results (8.4% and 23.6%) and (iv) missing negative test results (10.0% and 12.4%). HW who were trained less than 12 months ago had best MCQ scores for 7/10 photographs as well as a significantly higher proportion of 10/10 scores, but absolute differences in MCQ scores were small. HW who had participated in a previous EQA performed significantly better for 4/10 photographs compared to those who had not. Except for two photographs, MCQ scores were comparable for all levels of the HF hierarchy and non-laboratory staff (HW from health posts) had similar performance as to laboratory staff. Main findings of the questionnaire were (i) use of other RDT products than recommended by the national malaria control programme (nearly 20% of participating HF), (ii) lack of training for a third (33.6%) of HF, (iii) high proportions (two-thirds, 66.5%) of HF reporting stock-outs.ConclusionsThe present EQA revealed common errors in RDT reading and interpretation by HW in DRC. Performances of non-laboratory and laboratory staff were similar and dedicated training was shown to improve HW competence although to a moderate extent. Problems in supply, distribution and training of RDTs were detected.

Development, Evaluation, and Delivery of an Innovative National Undergraduate Surgical Workshop: Recognition and Management of the Acutely Unwell Surgical Patient

Problem: Recognition and management of acutely unwell surgical patients is an important skill to which medical students have little exposure. Intervention: We present the evaluation of a novel national surgical workshop that consisted of high-fidelity simulations, lectures, case demonstrations, case discussions, and a basic surgical skills tutorial. The high-fidelity simulations re-created genuine patient encounters and were used to facilitate the acquisition of knowledge and skill in the early recognition and management of acutely unwell surgical patients. Context: The optional workshop was designed for senior medical students and delivered by surgical trainees. Students were asked to complete a 12-item evaluation questionnaire and a 26-item multiple-choice question (MCQ) quiz, which assessed their confidence; self-perceived competence; and knowledge prior to, immediately following, and 8 weeks after the workshop. Pre- and postdata were compared using student's two-tailed t test. Outcome: A total of 66 medical students from 6 UK universities attended, the majority of whom enjoyed the workshop (98.3%, n = 59). Participants' confidence rating (scale = 1–5) in assessing an unwell surgical patient improved from a mean of 2.5 (n = 47) to 4.4 (n = 60). Confidence in commencing initial management improved from a mean of 2.7 (n = 47) to 4.1 (n = 59). Confidence and self-perceived competence across 12 domains improved significantly following the workshop, two-tailed unpaired t test, t(22) = 8.64, p <.0001, d = 3.68. MCQ scores immediately following the workshop were a statistically significant improvement on the preworkshop MCQ scores (n = 44), paired two-tailed t test, t(43) = 7.76, p <.0001, d = 2.37, and the improvement was sustained 8 weeks following the workshop (n = 18), paired two-tailed t test, t(17) = 3.34, p =.0039, d = 1.62. Lessons Learned: Feedback from students was very positive and clearly demonstrated that a workshop taught by surgical trainees improved medical students’ confidence, self-perceived competence, and knowledge in the assessment and management of acutely unwell surgical patients.

One size does not fit all in the assessment of pharmacology learning in a diverse multidisciplinary undergraduate student class

Background: Assessment not only drives student learning but is also an indicator of the success of teaching methodologies employed. There is considerable pressure on pharmacology instructors to effectively teach the discipline to diverse multidisciplinary (biochemistry, chemistry, physiology, and medicine) undergraduate students. To date, there are no studies documenting and assessing pharmacology learning in the aforementioned group. This is an 8 years retrospective study aimed at compiling, analyzing, and evaluating different types of assessment to gauge multidisciplinary student learning in pharmacology. Methods: Quantitative and qualitative (rather than single) methods of data collection were used to provide a richer and mutually corroborative array of evidence. Assessment of student learning included computer-based assessment (CBA) of laboratory practicals, end of the module (EOM) multiple choice questions (MCQ) examination and an EOM essay paper. Results: Our findings indicate significant variation in students’ scores depending on the type of assessment employed. Strikingly over the 8-year period annual mean scores in the physiology student cohort were consistently and significantly lower compared to other groups. This contrasts with the medical student cohort who demonstrated a consistent and significant increase in mean scores compared to overall class means. Interestingly, no deviations were observed in the overall CBA, MCQ scores among all student groups. However, on closer analysis laboratory practical type influenced student performances with lower scores in the computer-assisted learning (CAL) CBA versus the wet laboratory practical CBA. Conclusion: Our research-based evidence suggests that certain modes of assessment may preferentially suit some but not all students from multidisciplinary backgrounds within the one pharmacology class.

Developing an International Combined Applied Surgical Science and Wet Lab Simulation Course as an Undergraduate Teaching Model.

Background. Essential Skills in the Management of Surgical Cases (ESMSC) is an international, animal model-based course. It combines interactive lectures with basic ex vivo stations and more advanced wet lab modules, that is, in vivo dissections and Heart Transplant Surgery on a swine model. Materials and Methods. Forty-nine medical students (male, N = 27, female N = 22, and mean age = 23.7 years) from King's College London (KCL) and Greek Medical Schools attended the course. Participants were assessed with Direct Observation of Procedural Skills (DOPS), as well as Multiple Choice Questions (MCQs). Paired t-test associations were used to evaluate whether there was statistically significant improvement in their performance. Aim. To evaluate the effectiveness of a combined applied surgical science and wet lab simulation course as a teaching model for surgical skills at the undergraduate level. Results. The mean MCQ score was improved by 2.33/32 (P < 0.005). Surgical skills competences, as defined by DOPS scores, were improved in a statically significant manner (P < 0.005 for all paired t-test correlations). Conclusions. ESMSC seems to be an effective teaching model, which improves the understanding of the surgical approach and the basic surgical skills. In vivo models could be used potentially as a step further in the Undergraduate Surgical Education.

Team-based learning as a teaching strategy for first-year medical students.

Teaching programmes in medical education are now routinely employing active learning strategies to enhance the learning process and engage students in higher levels of learning. Team-based learning (TBL) is one active learning strategy that builds on individuals' strengths by allowing them to collaborate and work as a team to achieve a common learning objective. The present study aims to evaluate the impact of TBL on student performance. It also aims to assess students' attitudes towards TBL and the feasibility of its incorporation into the course curriculum. From a class of 241 students, 128 who agreed to participate in the study underwent two sessions of TBL each consisting of Individual and Group Readiness Assurance Tests (IRATs and GRATs). The readiness assurance tests each had 13 multiple choice questions (MCQ). To analyse the impact of TBL supplementation, the median sessional MCQ scores of students who underwent TBL supplementation (group 1) were compared with those who did not undergo the session (group 2). Students' experiences with TBL and their attitudes towards incorporation of TBL into the course curriculum were analysed using a feedback questionnaire that was given to students who underwent TBL. Students belonging to the TBL group performed significantly better than the students who did not undergo TBL (p<0.001). The median sessional MCQ score of the TBL group was seven and non-TBL group was six. The overall mean attitude score obtained from feedback questionnaires was 3.57, which indicates a positive attitude towards TBL. The team-based learning session improved student engagement with course content. The majority of the students felt that TBL supplementation enhanced their understanding of course content and believe that it will help them perform better in their exams.

SAT0584 Impact of an Online Training on Skin Cancer Diagnosing in Rheumatologists, A Nationwide Randomized Web-Based Survey

BackgroundRecent data suggest an increased risk of melanoma and of cutaneous carcinoma in patients receiving TNF blockers. Thus, there is a need that rheumatologists improve their abilities to recognize skin...

A pilot study exploring the relationship between internists’ self-reported sleepiness, performance on multiple-choice exam items and prefrontal cortex activity

Background: Studies of resident fatigue and performance have shown mixed results. However, research has not examined daytime sleepiness and performance among attending physicians. The purpose of this study was to explore the relationship between sleep, performance and prefrontal cortex (PFC) activity. We hypothesized that sleepiness scores would negatively correlate with multiple-choice question (MCQ) performance and would also correlate with PFC activity.Methods: Board-certified physicians completed an Epworth Sleepiness Scale (ESS) and then answered MCQs from licensing examinations while in a functional Magnetic Resonance Imaging (fMRI) scanner.Results: Seventeen board-certified internists completed the study. The mean number of correct responses was 18.5/32. The correlation between the ESS and MCQ score was −0.30, and higher ESS scores were negatively associated with statistically significant changes in medial PFC (mPFC) activity.Conclusions: Attending physicians who reported higher sleepiness scores performed worse on licensing exam questions. Notably, our cohort had normal to mild sleepiness scores. Moreover, higher sleepiness scores were negatively associated with changes in mPFC activity on fMRI, which is consistent with emerging work implicating the PFC in fatigue-related cognitive impairment. Our findings have implications regarding the impact of sleep on physician performance during examinations and potentially on their care of patients.

Using a 360-degree assessment of pediatric residency training: experience at Prince of Songkla University, Thailand

Abstract Background: The Department of Pediatrics, Prince of Songkla University (PSU) with 7-10 pediatric residents per year has implied a 360-degree evaluating instrument for residency training since 2007. Objective: We determined the competency ratings of pediatric residents during their training. Methods: During 2007-2011, 23 pediatric residents finished the pediatric residency program. At each ward rotation, each pediatric resident was rated for competency skills by four different categories of raters: attending staff, nurses, medical students, and the patients’ parents. The average score of each competency given by each category of raters was calculated, and was compared to scores of multiple-choice questions (MCQ) and constructed response questions (CRQ) of Thai Board of Pediatric Examination. Results: The mean overall scores of each resident rated by the attending staff, nurses, medical students, and patients’ parents increased with year of residency training. The mean overall scores of each resident rated by attending physicians were positively correlated with the MCQ (r = 0.42, p = 0.04) and CRQ (r = 0.71, p &lt; 0.001) scores of the Thai Board of Pediatrics Examination. Conclusion: The 360-degree assessments with ratings by attending physicians during the pediatric training are reliable for assessment the medical knowledge of the residents.

Validation of open inguinal hernia repair simulation model: a randomized controlled educational trial

BackgroundA hernia repair open surgical simulation computer software was developed at Imperial College London. A randomized controlled educational trial was conducted to investigate the benefit of the simulation on the development of procedural knowledge. MethodsMedical students in their clinical years were invited to participate in the trial. Students were block randomized to 4 groups: G1 - Interactive Simulation; G2 - Non-interactive Simulation; G3 - Video Tutorial; G4 – Control. On completion, they were objectively assessed on their ability to recall the tasks involved in an open inguinal hernia repair in the form of a multiple choice question (MCQ) and a simulated discussion with a consultant surgeon. ResultsFifty-six students completed the study. Each arm carries similar baseline scores (pre-intervention MCQ) with means 43.33, 38.92, 38.33, and 39.57 in G1 to G4, respectively. MCQ score improvements and final assessment scores proved better in the intervention groups (1, 2, and 3) compared to controls. ConclusionThe interactive simulation has shown an objective benefit in teaching medical students the anatomical and procedural knowledge in performing an open inguinal hernia repair.

The effectiveness of a 'train the trainer' model of resuscitation education for rural peripheral hospital doctors in Sri Lanka.

BackgroundSri Lankan rural doctors based in isolated peripheral hospitals routinely resuscitate critically ill patients but have difficulty accessing training. We tested a train-the-trainer model that could be utilised in isolated rural hospitals.MethodsEight selected rural hospital non-specialist doctors attended a 2-day instructor course. These “trained trainers” educated their colleagues in advanced cardiac life support at peripheral hospital workshops and we tested their students in resuscitation knowledge and skills pre and post training, and at 6- and 12-weeks. Knowledge was assessed through 30 multiple choice questions (MCQ), and resuscitation skills were assessed by performance in a video recorded simulated scenario of a cardiac arrest using a Resuci Anne Skill Trainer mannequin.Results/Discussion/ConclusionFifty seven doctors were trained. Pre and post training assessment was possible in 51 participants, and 6-week and 12-week follow up was possible for 43, and 38 participants respectively. Mean MCQ scores significantly improved over time (p<0.001), and a significant improvement was noted in “average ventilation volume”, “compression count”, and “compressions with no error”, “adequate depth”, “average depth”, and “compression rate” (p<0.01). The proportion of participants with compression depth ≥40mm increased post intervention (p<0.05) and at 12-week follow up (p<0.05), and proportion of ventilation volumes between 400-1000mls increased post intervention (p<0.001). A significant increase in the proportion of participants who “checked for responsiveness”, “opened the airway”, “performed a breathing check”, who used the “correct compression ratio”, and who used an “appropriate facemask technique” was also noted (p<0.001). A train-the-trainer model of resuscitation education was effective in improving resuscitation knowledge and skills in Sri Lankan rural peripheral hospital doctors. Improvement was sustained to 12 weeks for most components of resuscitation knowledge and skills. Further research is needed to identify which components of training are most effective in leading to sustained improvement in resuscitation.

Examining Pediatric Resuscitation Education Using Simulation and Scripted Debriefing

Resuscitation training programs use simulation and debriefing as an educational modality with limited standardization of debriefing format and content. Our study attempted to address this issue by using a debriefing script to standardize debriefings. To determine whether use of a scripted debriefing by novice instructors and/or simulator physical realism affects knowledge and performance in simulated cardiopulmonary arrests. DESIGN Prospective, randomized, factorial study design. The study was conducted from 2008 to 2011 at 14 Examining Pediatric Resuscitation Education Using Simulation and Scripted Debriefing (EXPRESS) network simulation programs. Interprofessional health care teams participated in 2 simulated cardiopulmonary arrests, before and after debriefing. We randomized 97 participants (23 teams) to nonscripted low-realism; 93 participants (22 teams) to scripted low-realism; 103 participants (23 teams) to nonscripted high-realism; and 94 participants (22 teams) to scripted high-realism groups. INTERVENTION Participants were randomized to 1 of 4 arms: permutations of scripted vs nonscripted debriefing and high-realism vs low-realism simulators. Percentage difference (0%-100%) in multiple choice question (MCQ) test (individual scores), Behavioral Assessment Tool (BAT) (team leader performance), and the Clinical Performance Tool (CPT) (team performance) scores postintervention vs preintervention comparison (PPC). There was no significant difference at baseline in nonscripted vs scripted groups for MCQ (P = .87), BAT (P = .99), and CPT (P = .95) scores. Scripted debriefing showed greater improvement in knowledge (mean [95% CI] MCQ-PPC, 5.3% [4.1%-6.5%] vs 3.6% [2.3%-4.7%]; P = .04) and team leader behavioral performance (median [interquartile range (IQR)] BAT-PPC, 16% [7.4%-28.5%] vs 8% [0.2%-31.6%]; P = .03). Their improvement in clinical performance during simulated cardiopulmonary arrests was not significantly different (median [IQR] CPT-PPC, 7.9% [4.8%-15.1%] vs 6.7% [2.8%-12.7%], P = .18). Level of physical realism of the simulator had no independent effect on these outcomes. The use of a standardized script by novice instructors to facilitate team debriefings improves acquisition of knowledge and team leader behavioral performance during subsequent simulated cardiopulmonary arrests. Implementation of debriefing scripts in resuscitation courses may help to improve learning outcomes and standardize delivery of debriefing, particularly for novice instructors.

Effectiveness of a national approach to prescribing education for multiple disciplines

To evaluate the effectiveness of a national approach to prescribing education on health professional students' prescribing and therapeutics knowledge, across multiple disciplines. In a university examination setting, 83 medical, 40 pharmacy and 13 nurse practitioner students from three different universities completed a set of multiple choice questions (MCQs) before and after completing an online module from the National Prescribing Curriculum (NPC). To minimize overestimation of knowledge, students had to indicate the level of certainty for each answer on a three-point scale. MCQs were scored using a validated certainty-based marking scheme resulting in a composite score (maximum 30 and minimum -60). Students were asked to rate their perception of usefulness of the module. At the pre-module phase, there were no significant differences in the composite MCQ scores between the medical (9.0 ± 10.3), pharmacy (10.2 ± 10.6) and nurse practitioner (8.0 ± 10.7) students. The scores improved significantly for all groups at the post-module phase (P < 0.01 for all groups) by similar extents (post-module results: medical, 14.5 ± 9.6; pharmacy, 14.4 ± 9.9; nurse practitioner, 12.1 ± 9.6). 39.4% of the MCQs answered incorrectly with high level of certainty at the pre-module phase were still answered incorrectly with high level of certainty at the post-module phase. Almost all students (with no significant difference between the groups) found the NPC modules, post-module MCQs and feedback useful as a learning tool. A national online approach to prescribing education can improve therapeutics knowledge of students from multiple disciplines of health care and contribute towards streamlining interdisciplinary learning in medication management.

The impact of various assessment parameters on medical students′ performance in first professional examination in physiolog

Background:This study was carried out to assess the relationship between thevarious assessment parameters, viz. continuous assessment (CA), multiple choice questions (MCQ), essay, practical, oral with the overall performance in the first professional examination in Physiology.Materials and Methods:The results of all 244 students that sat for the examination over 4 years were used. The CA, MCQ, essay, practical, oral and overall performance scores were obtained. All the scores were rounded up to 100% to give each parameter equal weighting.Results:Analysis showed that the average overall performance was 50.8 ± 5.3. The best average performance was in practical (55.5 ± 9.1), while the least was in MCQ (44.1 ± 7.8). In the study, 81.1% of students passed orals, 80.3% passed practical, 72.5% passed CA, 58.6% passed essay, 22.5% passed MCQ and 71.7% of students passed on the overall performance. All assessment parameters significantly correlated with overall performance. Continuous assessment had the best correlation (r = 0.801, P = 0.000), while oral had the least correlation (r = 0.277, P = 0.000) with overall performance. Essay was the best predictor of overall performance (β = 0.421, P = 000), followed by MCQ (β = 0.356, P = 000), while practical was the least predictor of performance (β = 0.162, P = 000).Conclusion:We suggest that the department should uphold the principle of continuous assessment and more effort be made in the design of MCQ so that performance can improve.

Improving Trauma Care in India: the Potential Role of the Rural Trauma Team Development Course (RTTDC).

The Rural Trauma Team Development Course (RTTDC) was devised to optimize trauma resuscitation training in under-resourced rural institutions. This program appears ideal for India because of its dense traffic, large population, and high frequency of rural trauma. We report on the feasibility and desirability of introducing RTTDC in India. An instructor course for 20 faculties and a provider course for 23 were conducted in New Delhi, India. The courses were evaluated by multiple choice question (MCQ) performance, by rating the modules on a three-point scale (1 = very relevant, 2 = relevant, and 3 = not relevant) for communication skills, principles of performance improvement and patient safety (PIPS), and clinical scenarios. Evaluation questionnaires including desirability of promulgation in India were completed using a five-point Likert Scale (1 = strongly agree, 2 = agree, 3 = neutral, 4 = disagree, and 5 = strongly disagree). Overall written comments were also provided. Both faculty and providers improved post-course MCQ scores (p < 0.05) with lower scores in the provider group. Seventy-eight percent faculty and 74% providers rated the communication module very relevant. PIPS was rated very relevant by 72% faculty and 65% providers. There were over 150 comments, generally positive with over 90% of both faculty and providers rating strongly agree to agree that the course be promulgated widely in India. The RTTDC including plans for promulgation was enthusiastically received in India, and its potential for improving trauma care including communication skills and PIPS appears excellent.

Correlation of CPX Scores with the Scores on Written Multiple-Choice Examinations on the Certifying Examination for Family Medicine in 2009 to 2011.

Recently, the clinical practice examination (CPX) using standardized patients has been introduced into several specialty certifying examinations in Korea. The purpose of this paper was to determine the correlation of a resident's performance on the CPX with the comprehensive written multiple-choice question (MCQ) examination on the certifying examination for family medicine. The subjects of this study were 1,023 residents who completed the 1st and 2nd certifying examination for family medicine between 2009 and 2011. We determined the correlation between the total scores and 4 domain scores (history taking, physical examination, patient education, and patient-physician interaction) on the CPX with the MCQ scores of the 1st written test and 2nd slide examination and the correlation between the total CPX score and scores on the CPX domains. The correlation between CPX score with each MCQ examination (0.21~0.45 with 1st written MCQ, 0.15~0.33 with 2nd slide MCQ) was lower than that between each MCQ examination (0.46~0.59). The CPX score on patient education did not correlate with the 1st written and 2nd MCQ scores. The CPX scores on history taking and physical examination correlated slightly with the 1st written MCQ scores. The global ratings of preceptor examiners had the highest correlation (r=0.68~0.82) with the total CPX scores. Considering the mild correlation of CPX scores with each MCQ examination, the CPX is more likely to measure other qualities, such as critical thinking and communication skills.