Performance Of Medical Students Research Articles

Comparative Performance of Medical Students, ChatGPT-3.5 and ChatGPT-4.0 in Answering Questions From a Brazilian National Medical Exam: Cross-Sectional Questionnaire Study

Abstract Background Artificial intelligence has advanced significantly in various fields, including medicine, where tools like ChatGPT (GPT) have demonstrated remarkable capabilities in interpreting and synthesizing complex medical data. Since its launch in 2019, GPT has evolved, with version 4.0 offering enhanced processing power, image interpretation, and more accurate responses. In medicine, GPT has been used for diagnosis, research, and education, achieving significant milestones like passing the United States Medical Licensing Examination. Recent studies show that GPT 4.0 outperforms earlier versions and even medical students on medical exams. Objective This study aimed to evaluate and compare the performance of GPT versions 3.5 and 4.0 on Brazilian Progress Tests (PT) from 2021 to 2023, analyzing their accuracy compared to medical students. Methods A cross-sectional observational study was conducted using 333 multiple-choice questions from the PT, excluding questions with images and those nullified or repeated. All questions were presented sequentially without modification to their structure. The performance of GPT versions was compared using statistical methods and medical students’ scores were included for context. Results There was a statistically significant difference in total performance scores across the 2021, 2022, and 2023 exams between GPT-3.5 and GPT-4.0 (P=.03). However, this significance did not remain after Bonferroni correction. On average, GPT v3.5 scored 68.4%, whereas v4.0 achieved 87.2%, reflecting an absolute improvement of 18.8% and a relative increase of 27.4% in accuracy. When broken down by subject, the average scores for GPT-3.5 and GPT-4.0, respectively, were as follows: surgery (73.5% vs 88.0%, P=.03), basic sciences (77.5% vs 96.2%, P=.004), internal medicine (61.5% vs 75.1%, P=.14), gynecology and obstetrics (64.5% vs 94.8%, P=.002), pediatrics (58.5% vs 80.0%, P=.02), and public health (77.8% vs 89.6%, P=.02). After Bonferroni correction, only basic sciences and gynecology and obstetrics retained statistically significant differences. Conclusions GPT-4.0 demonstrates superior accuracy compared to its predecessor in answering medical questions on the PT. These results are similar to other studies, indicating that we are approaching a new revolution in medicine.

The Use of Gamification as a Teaching Strategy for Embryology

Several strategies based on active methodologies have been used to teach content in courses in the health area, in this context, the use of games aimed at education become valuable resources. This study is characterized as a quasi-experimental modality of quantitative approach and aimed to evaluate the performance of medical students in relation to the contents of embryology, compared to the use of a board game. The study was carried out in a Brazilian higher education institution. 245 medical students enrolled from the 1st to the 8th of the medical course participated in the research. The research participants answered a pre-intervention questionnaire with content referring to the embryological period of development. After the activity, the same questionnaire was made available to the students (post-intervention). Statistical analysis was performed using the GraphPad Prism software, using the D'Agostino & Pearson and Shapiro-Wilk normality tests, subsequently opting for the Wilcoxon and Mann-Whitney and Kruskal-Wallis statistical test for non-existent data. parametric and Student's T and ANOVA with Dunn's post-test for parametric data. Better results were observed in the post-intervention questionnaire for the participating classes, favorably pointing to the use of this teaching strategy, focused on embryology.

Building the Building Blocks: Development of a Mission-Driven Residency Application Scoring Rubric for Holistic Review.

Traditional residency application review methods are fraught with bias. Literature on how to create and use rubrics to aid in holistic review is lacking. The authors describe their residency program's process of designing and implementing a mission-based rubric to aid in holistic review. After updating the University of Pittsburgh Medical Center internal medicine-pediatrics residency program's mission statement in April 2020, the authors used experiences, attributes, and metrics domains to create a rubric based on the Electronic Residency Application Service application. The rubric included sections on the personal statement, Medical Student Performance Evaluation notable points and curriculum vitae data, additional positives, academic metrics, and red flags, with each section weighted based on alignment with the program's mission and values. The authors, as program leadership, found the rubric to be clear, efficient, and easily replicable, requiring ~15-20 minutes to read, review, and score each application. The rubric aided in equitable scoring across reviewers, with underrepresented in medicine (URM) applicants scoring similarly to non-URM applicants for the 2020-2021, 2021-2022, and 2022-2023 seasons, and led to reproducible results with an intraclass correlation coefficient of 0.82. The rubric led to an increase in the number of applicants who identify as URM in the initial top 10 rank list each season, as compared to the prior 3 seasons, and the holistic review scores served as a starting point for a final rank list. Larger programs could scale similar holistic review processes by training additional reviewers to use the rubric or implementing it at various stages in the recruitment process. The authors were prompted to consider and improve ways their program could support potential residents. By implementing holistic review, programs can recruit diverse applicant classes that reflect their mission, values, and communities served, while mitigating biases inherent to graduate medical education systems.

Surgical simulation in emergency management and communication improves performance, confidence, and patient safety in medical students

ABSTRACT Introduction This study aims to enhance the confidence and operational safety of 5th-year medical students in the operating room (OR), addressing their corona pandemic gap in surgical training. Methods We augmented the surgical curriculum focusing on pre-, intra-, and post-operative skills, centered around a phantom operation as a pre-test-retest simulation. We measured confidence to assist in surgery on a 5-level Likert-scale and monitored surgical performance metrics (skin-to-skin time, blood loss, blood and volume transfusion, complications, fatal outcome). Half the cohort was explicitly video trained in hemostasis, while the other half in emergency communication. Factual knowledge gains were assessed with online questionnaires. The groups served as reciprocal controls, as confidence (communication group) and surgical performance (bleeding group) were compared. Results Initially, the pre-test performance of the 126 participants on the phantom operation was suboptimal, ranging from poor to mediocre. Notably, the retest outcomes demonstrated significant surgical performance improvements following the targeted lessons (e.g. blood loss pre-test 906 ± 468 mL, retest 292 ± 173 mL, p < 0.01, n = 35 teams), with the most pronounced enhancements observed in confidence and emergency communication skills (confidence pre-test 2.42 ± 0.52, retest 3.55 ± 0.64, p < 0.01, n = 35 teams). There is a strong tendency (p = 0.08) that the communication group (1.28 ± 0.53) had higher gains in confidence than the bleeding group (0.997 ± 0.4) with a moderate effect size (Cohen’s D = 0.6). Students reported increased confidence in assisting in surgery compared to their initial self-assessments. These results show that the structured exposure to a pre-test-retest phantom operation substantially elevates students’ capability to act safely and assertively in the OR. Discussion This approach appears to foster a justified increase in confidence and surgical performance, potentially elevating patient safety among students and residents in training.

NeuroOwls: A Branch of the Osler Apprenticeship and Its Impact on Medical Student Preparedness and Performance in the 3rd Year Neurology Clerkship (P7-5.001)

NeuroOwls: A Branch of the Osler Apprenticeship and Its Impact on Medical Student Preparedness and Performance in the 3rd Year Neurology Clerkship (P7-5.001)

Infographics with Clinical Summaries Improve Medical Student Performance: A Within-Subject Intervention Study with Gender-Based Analysis

Abstract Introduction This study aimed to evaluate the impact of infographics and social media threads (SMT) on academic performance in the Musculoskeletal Medical and Surgical Pathology (MMSP) course. Additionally, gender differences in the effectiveness of these tools were examined. Methods A within-subject educational intervention study was conducted over three academic years, involving 459 fifth-year medical students. Infographics and SMT were exclusively provided for the rheumatology section of the MMSP course, while no additional tools were offered for the traumatology section, serving as a control. Students completed a final exam comprising multiple-choice questions (MCQs) for both sections. Survey data were collected to assess tool usage and perceptions (completed by 84.1%). Statistical analysis included Mann–Whitney U, Kruskal–Wallis, and Jonckheere-Terpstra tests with Z-score standardization. Results The use of infographics significantly improved standardized scores in rheumatology MCQs (p = 0.035), particularly among male students (p = 0.046), while no impact was observed for traumatology section. SMT showed limited association with improved performance. Surveys indicated that 86% of students found infographics helpful for studying, and 85% would recommend them. In contrast, SMT received lower ratings, with 44% of students finding them useful for studying. Conclusions Infographics effectively enhanced academic performance, with gender-specific variations in impact. In contrast, SMT had limited influence. These findings suggest that infographics are effective supplementary tools in medical education, especially when designed to align with diverse learning preferences. Further exploration of SMT’s potential and development of gender-inclusive teaching strategies is warranted. Graphical Abstract

Smart Phone Use and its Effect on Cognition: A Cross-sectional Study in Undergraduate Medical Students

Introduction: Mobile smartphones have become an integral part of everyone’s life. However, concerns have been raised about the various health hazards associated with their use. The presence of smartphones among students reduces their attention span and acts as a distraction in their classes, which could lead to poor academic performance. Medical students, being an important element of society, need to be made aware of the health hazards of excessive smartphone use so that they can spread awareness among others, especially adolescents. Aim: This study aims to investigate the effect of smartphone use on academic performance and to associate the behavioural aspects of smartphone use with cognitive impairment in medical students. Materials and Methods: This observational cross-sectional study was conducted in the Physiology Department at Dr. DY Patil Medical College, Hospital and Research Centre, Pune, India, among first MBBS students from March to April 2024. Institute ethics committee clearance was obtained, and written informed consent was acquired from each participant. Participants were selected based on inclusion criteria that included a willingness to participate and a willingness to complete the questionnaire. They were provided with a validated questionnaire that included their personal details, followed by questions related to various aspects of mobile phone use. Their performance was assessed based on the marks (out of 100) in the Physiology theory paper of the first internal assessment examination. Out of a total of 250 first MBBS students, 72 were present on the day of the study. Out of these, eight were unwilling to participate, resulting in a total of 64 participants. The data was tabulated in an Excel sheet, and analysis was performed using SPSS 23. For analysis, participants were divided into three groups based on their theory marks (less than 50, 50-60, and 61 to 80). A chisquare test was used to find the association between theory marks and mobile phone use, with a p-value of less than 0.05 considered significant. Results: Eighteen students (28.12%) scored less than 50%, 26 students (40.62%) scored between 50% and 60%, while 20 students (31.25%) scored above 60%. Forty students (62.5%) use either glasses or contact lenses. Twenty-nine students (45.31%) started using mobile phones before 10th standard, 30 students (46.87%) began in 10th to 12th standard, and 5 students (7.81%) started after 12th. Thirty-five students (54.68%) use only 1-2 social media platforms, 27 students (42.18%) use 3-4, and only 2 students (3.12%) use more than 4. Eleven students (17.1%) use mobile phones for less than two hours daily, 37 students (57.81%) use them for 2-4 hours daily, and 16 students (25%) spend more than four hours on them. A total of 32 students, or 50%, use mobile phones just before going to sleep. Twenty-one students (32.81%) admitted that they use their mobiles as soon as they wake up in the morning. More than 50% of students use mobile phones or other electronic gadgets for studying and use them frequently between classes. Overall, mobile phone usage was reported to be higher among students who scored up to 60% compared to those who scored above 60%, although this difference was not statistically significant (p-value &gt;0.05). Statistically, mobile phone use has not affected the academic performance of the students who scored less than 60%. Conclusion: Since the results of this study are not statistically significant, it can be concluded that mobile phone use has not affected the academic performance of undergraduate medical students. Future studies with a larger sample size and conducted across other professional year MBBS students can provide further insights.

Evaluation of Navigating a Foodborne Outbreak: Medical Learners Before and During COVID-19.

Evaluation of Navigating a Foodborne Outbreak: Medical Learners Before and During COVID-19.

An Analysis of Obstetrics and Gynecology Medical Student Performance Evaluation Clerkship Narratives: Insights From the PRIME+ Framework

An Analysis of Obstetrics and Gynecology Medical Student Performance Evaluation Clerkship Narratives: Insights From the PRIME+ Framework

The Effectiveness of Teacher Feedback in Augmenting the Academic Performance of Medical Students

The Effectiveness of Teacher Feedback in Augmenting the Academic Performance of Medical Students

The Impact of Sleep Deprivation on Academic Performance Among Medical Students at Central Asian International Medical University, Jalal-Abad, Kyrgyzstan

Sleep deprivation is a pervasive challenge among medical students, largely attributable to the demanding academic schedules and extensive study hours inherent in medical education. This study investigates the effects of sleep deprivation on the academic performance of medical students at Central Asian International Medical University (CAIMU) in Jalal-Abad, Kyrgyzstan. Data were collected from 50 students (25 males and 25 females) across various academic years using a structured questionnaire that evaluated sleep patterns and self-reported academic performance. Findings indicate a significant negative correlation between sleep duration and academic achievement, with students averaging fewer than six hours of sleep per night demonstrating poorer performance. Additionally, variations in sleep patterns were observed across gender and academic years. These results underscore the necessity for institutional interventions to mitigate sleep deprivation, given its profound implications for academic success, mental health, and physical well-being.

Teaching abdominal aorta anatomy applied to clinical practice through active methodology and 3D printing.

3D printing of anatomical structures from computed tomography (CT) or magnetic resonance imaging (MRI) scans enables new didactic strategies in the teaching anatomy applied clinical medicine, allowing the reproduction of organs affected by diseases or traumas. This approach brings students closer to real clinical cases, promoting the development of critical thinking through a practical and immersive experience. The present study aimed to analyse the performance of medical students in identifying vascular structures of the abdominal aorta associated with an aneurysm and horseshoe kidney using a 3D printed model. We also analysed the costs related to the 3D printing of the models. This is a randomized study with a quantitative approach. The performance of medical students regarding anatomical and clinical knowledge of aorta artery associated with an aneurysm and a horseshoe kidney was analysed. Active methodology and 3D printed models of the abdominal aorta were used in the project. The results show that the methodologies used were effective in improving students' performance regarding anatomical and clinical knowledge of aorta artery, specially in the group that used 3D models associated with 2D images. The use of an integrated and interactive approach, which places the student as the protagonist of the learning process, improves performance and knowledge in anatomy. 3D printing, capable of producing high-quality and low-cost anatomical models, can become an additional tool in the teaching- learning process.

Social Media Usage Pattern and Its Impact on Academic Performance of Public-Sector Medical Students

Introduction: Social media plays a vital role in students' lives, providing connectivity and access to information while posing distraction risks. Aims and Objectives: This study aimed to evaluate social media usage patterns and their impact on academic performance among medical students in Lahore. Place and Duration of study: This study took place in public sector medical colleges of Lahore in 6 months from April to September 2024. Material &amp; Methods: This was an analytical cross-sectional questionnaire-based study conducted among 150 medical students of different medical colleges including KEMU, AMC, FJMU, AIMC, SIMS &amp; SKZMDC selected through convenience sampling in Lahore. Data collected through the questionnaire included demographics, social media usage patterns, and academic performance indicators. The impact of social media usage on academic performance was determined by applying Chi-square with statistical significance determined at a p-value of less than 0.05. Data analysis was performed using SPSS version 27. Results: Regarding social media use specifically for academic purposes, YouTube was the most popular platform, used by 119 participants (79.3%) followed by WhatsApp by 54 participants (36%). Average screen time of over 4 hours per day was reported by 78.7%, with maximum before going to bed (96%) and over the weekend (77.3%), main uses were entertainment in 86.7% and academics in 54.7%. Only one variable spending more than 04 academically directed hours on social media led to better examination performance in the male gender (p value&lt;0.05). Conclusion: The male gender spending more than 04 hours on social media for educational purposes had a positive impact on academic performance

Impact of Socioeconomic Determinants on Academic Performance of Medical Students in Lahore, Pakistan: A Cross-Sectional Study

Background: Academic performance among students is recognized to be significantly influenced by socioeconomic status (SES) with factors such as family income, parental education and home environment profoundly shaping students' academic outcomes. Limited studies have evaluated the role of socioeconomic factors on medical student performance in Pakistan. Objective: This study aims to investigate how family income, parental education, and home environment influence the academic performance of medical students in Lahore, Pakistan Methods: This cross-sectional study was conducted over six months across public medical institutions in Lahore, Pakistan. Using non-probability convenience sampling, 272 medical students participated in an online survey. The sample size was calculated using Cochran's formula to ensure adequate representation and data were analyzed using SPSS version 27.0, applying descriptive statistics, chi-square tests and binary logistic regression to assess significant relationships. Results: Among the 272 participants, 54.4% demonstrated high academic performance (above 70%), 33.5% had average performance (60-70%), and 12.1% exhibited low performance (below 60%). Statistical significance was found between family income and academic performance (p &lt; 0.05), with high-income students performing better academically. Conclusion: Findings from this cross-sectional study indicate that socioeconomic factors particularly family income and parental education, significantly impact the academic performance of medical students. Addressing SES disparities through targeted educational policies could support academic equity

Teacher empathy and academic performance in medical students: systematic review

Introduction: Empathy, defined as the ability to understand and share the emotions of others, is key in medical education, influencing both academic performance and the holistic development of students. There are two types: cognitive empathy, which allows understanding the perspective of others, and emotional empathy, which involves experiencing the emotions of another. The aim of this research is to analyze the available scientific evidence on the influence of faculty empathy on the academic performance of medical students. Methods: This work consists of an exploratory systematic review based on the identification of 25 relevant studies published between 2000 and 2024 in the scientific databases Google Scholar and PubMed. Results and Discussion: The results suggest that faculty empathy positively influences the learning environment and, consequently, academic performance; however, many educators lack training in interpersonal skills. The use of the Jefferson Scale is suggested as an instrument that could be useful for measuring faculty empathy in medical education contexts. Conclusions: Faculty empathy is fundamental in the training of medical students. Factors such as stress and lack of training in the field may limit faculty empathy, highlighting the need to apply effective instruments and interventions to assess and improve this skill in medical education.

The impact of COVID-19 pre-university education on first-grade medical students. A performance study of students of a Department of Histology.

The recent coronavirus disease (COVID-19) forced pre-university professionals to modify the educational system. This work aimed to determine the effects of pandemic situation on students' access to medical studies by comparing the performance of medical students. We evaluated the performance of students enrolled in a subject taught in the first semester of the medical curriculum in two pre-pandemic academic years (PRE), two post-pandemic years (POST), and an intermediate year (INT) using the results of a final multiple-choice exam. Consistency analysis among periods was performed using the Cronbach alpha coefficient (α), the difficulty index with random effects correction (DI), and the point-biserial correlation index (PB). The five exams were homogeneous and had similar α, DI, and PB difficultness. Performance significantly decreased in POST students compared with PRE students, with a correlation between performance and the academic years (PRE-POST). A significant decrease in the percentage of correct answers was detected in the academic years, with POST students showing lower results than PRE students, but not in the percentage of questions answered incorrectly. Significantly higher percentages of unanswered questions were found among POST students. These results confirm the negative impact of the POST pre-university educational system on the performance of students accessing medical school and suggest that POST students could have a higher degree of uncertainty. Specific education programs should be implemented during the first years of the medical curriculum to tailor this effect and increase students' self-confidence and knowledge, which may be associated with confidence.

Narrative comments in internal medicine clerkship evaluations: room to grow

ABSTRACT The use of narrative comments in medical education poses a unique challenge: comments are intended to provide formative feedback to learners while also being used for summative grades. Given student and internal medicine (IM) grading committee concerns about narrative comment quality, we offered an interactive IM Grand Rounds (GR) session aimed at improving comment quality. We undertook this study to determine the quality of comments submitted by faculty and post-graduate trainees on students’ IM Clerkship clinical assessments, and to explore the potential impact of our IM-GR. Archived comments from clerkship cohorts prior to and immediately following IM-GR were reviewed. Clinical clerkship assessment comments include three sections: Medical Student Performance Assessment (MSPE), Areas of Strength, and Areas for Improvement. We adapted a previously published comment assessment tool and identified the performance domain(s) discussed, inclusion of specific examples of student performance, evidence that the comment was based on direct observations, and, when applicable, the inclusion of actionable recommendations. Scoring was based on the number of domains represented and whether an example within that domain was provided (maximum score = 10). Analysis included descriptive statistics, t-test, and Pearson correlation coefficients. We scored 697 comments. Overall, section ratings were MSPE 2.51 (SD 1.52, range 0–9), Areas of Strength 1.53 (SD 1.09, range 0–6), and Areas for Improvement 1.27 (SD 1.06, range 0–8). Significant differences were noted after Grand Rounds only in the MSPE mean scores. Within domains, trends toward increased use of specific examples in the post-GR narratives were noted. Assessment of both the breadth and depth of the included comments revealed low-quality narratives offered by our faculty and resident instructors. A focused session on best practices in writing narratives offered minimal change in the overall narrative quality, although we did notice a trend toward the inclusion of explanative examples.

The National Basic Science Examination of Medicine in Peru: A future Predictor of Medical Student Performance?

The National Basic Science Examination of Medicine in Peru: A future Predictor of Medical Student Performance?

Effect of the Use of Electronic Media on the Cognitive Intelligence, Attention, and Academic Trajectory of Medical Students.

Introduction Electronic media are an integral part of university students' academic and personal lives; however, their excessive use may interfere with the cognitive functions critical for learning. Intelligence can be assessed through crystallized intelligence (Gc), which reflects accumulated knowledge, and fluid intelligence (Gf), which is associated with problem solving and adaptability. Also, neurophysiological measurements like the event-related potentials (ERPs), particularly P300, provide high temporal resolution measures of cognitive processing, allowing an assessment of attention (neurophysiological measures) and memory functions. This study hypothesizes that excessive screen time negatively impacts attention, fluid and crystallized intelligence, and academic performance in medical students. Materials and methods A total of 305 second-year medical students from a public university participated in the study (mean age: 20 years). Variables assessed included intelligence, attention, academic trajectory, and screen time. Intelligence was measured using the Shipley-2 test, and screen time was measured using a validated Screen Time Survey. For the neurophysiological measures, a subsample (n=30) underwent ERPrecording with the P300 oddball paradigm for neurophysiological analysis. Academic performance was determined from standardized physiology test scores. Data were analyzed using IBM SPSS Statistics for Windows, Version 25.0 (2017; IBM Corp., Armonk, New York, United States), GraphPad Prism (Dotmatics, Boston, Massachusetts, United States), and Excel (Microsoft Corporation, Redmond, New York, United States) through descriptive and inferential statistics. Results A significant relationship emerged between screen time, cognitive performance, and academic achievement. Participants reported an average daily screen exposure of 7.1 ± 4.3 hours. A negative correlation was identified between screen time and standardized test scores (r = -0.24, p < 0.001), indicating that increased screen use was associated with lower academic performance. Cognitive intelligence assessments revealed that Gf (R² = 0.848) and general cognition (R² = 0.400) were significantly affected, while Gc remained stable (R² = 0.001). Neurophysiological measures showed average P300 latencies of 358.33 ± 45.6 ms and amplitudes of 259.63 ± 61.6 μV. Shorter N100 latencies (86.7 ± 24.6 ms) correlated with better academic performance (r = -0.45, R² = 0.199). Discussion Students with greater screen time exhibited lower standardized exam scores, suggesting that excessive digital exposure may deplete the cognitive resources essential for academic tasks. The decline in fluid and general cognitive intelligence suggests a diminished capacity for problem-solving and adaptability. Neurophysiological markers indicated prolonged latencies and reduced amplitudes of key ERPs (N100, N200, and P300), reflecting impaired attentional control and working memory in students with higher screen exposure. These findings suggest that prolonged screen use contributes to slower and less efficient cognitive processing. Conclusions Excessive screen time, particularly due to recreational electronic media use, negatively affects cognitive performance and academic outcomes in medical students. The observed decline appears to be mediated by deficits in attention and working memory along with a reduction in Gf, which may impair problem-solving skills and adaptability in complex academic settings.

The Impact of Same-Level or Near Peer Assisted Learning Program (NPAP) on Academic Performance of Students in CMH Lahore, Pakistan.

To determine the improvement in academic performance of undergraduate medical students by comparing pre- and post- Near Peer Assisted Learning programs (NPAP) academic scores in the subject of Otorhinolaryngology. Our study was a quasi-experimental pretest-posttest study and it was carried out at CMH Lahore Medical College, Lahore during the 2022-2023 academic year. We worked with 72 fourth-year MBBS students, 24 students took on the role of NPAL tutors, while 48 were tutees. The NPAP included regular sessions that emphasized crucial Otorhinolaryngology topics. We gauged academic performance by comparing pretest scores from the 2nd Module Examination with posttest scores from the Send Up and Annual Examinations. Our data analysis, done through IBM SPSS Statistics, focused on both overall and gender-based performance improvements. Our study demonstrated that NPAP significantly improved academic scores in Otorhinolaryngology, with NPAL tutors showing higher overall improvements in scores. Gender based comparison showed that in both groups of NPAL Tutors and NPAL Tutees, female students scored slightly better than males. The P-value less than 0.001 validated the improvement in academic scores of both NPAP groups of Tutors and Tutees displaying the effectiveness of NPAP as an educational intervention at undergraduate level in the subject of Otorhinolaryngology. NPAP has shown significant impact on improvement of Academic Performance in undergraduate medical students in the subject of Otorhinolatngology at CMH Lahore Medical College.