scholarly journals Knowledge and practices of bed sore prevention among staff nurses working in a selected hospital, Ludhiana, India

2017 ◽  
Vol 6 (2) ◽  
pp. 38-43
Author(s):  
R Shrestha
Keyword(s):  
Pressure Ulcers ◽  
Staff Nurses ◽  
Multiple Choice Questions ◽  
Medical College ◽  
Special Unit ◽  
Exploratory Approach ◽  
Instructional Module ◽  
To Come ◽  
General Wards

The majority of pressure ulcers are preventable. Nurses are able to constantly observe their client’s skin for breaks or impairment in skin integrity. Pressure ulcers not only cause suffering to the patients but also increases the workload on nurses. To identify the deficits in knowledge and practices of bed sore prevention among staff nurses’ working in general wards as well as special units and to prepare a Self Instructional Module (SIM) for improving the quality of nursing practices.An exploratory approach and participating observation approach was adopted. This study was conducted in Christian Medical College & Hospital, Ludhiana, Punjab, India among 60 staff nurses working in general wards and special units. Purposive sampling method was used for data collection with self prepared questionnaire. Multiple-choice questions were administered for study the knowledge level and an audit form with checklist for assessment of practice. The data was analyzed using in terms of descriptive and inferential statistics. SIM was developed based on the deficit found in the result. Staff nurses working in special units have significantly better knowledge (72.92%) than the nurses in general wards (62.50%). Similarly, the results showed special unit nurses practice significantly better (60.29%) than general ward nurses (46.68%). Overall knowledge of staff nurses was higher (67.71%) as compared to their practice (53.49%) regarding bed sore prevention. Although 40% of overall staff nurses achieved excellent level on knowledge, none of them crossed the excellent level on practice. It strongly suggested developing SIM for them. Self instructional Module was developed inferring the results that staff nurses’ working in special units have excellent (deficit only 2.08%) knowledge in different areas of knowledge compared to staff nurses working at general wards (deficit 12.50%) where as 100% of respondents did not achieve excellent level on practice regarding Bed Sore prevention. Hence all of them need improvement in practices of Bed Sore prevention to come up to excellence level.

scholarly journals Knowledge and practices of bed sore prevention among staff nurses working in a selected hospital, Ludhiana, Punjab, India

2017 ◽  
Vol 6 (4) ◽  
pp. 18-23
Author(s):  
R Shrestha
Keyword(s):  
Pressure Ulcers ◽  
Sampling Technique ◽  
Staff Nurses ◽  
Cross Sectional ◽  
Medical College ◽  
Special Unit ◽  
Costs Of Treatment ◽  
Level Of Knowledge ◽  
Theory Practice Gap ◽  
General Wards

The majority of pressure ulcers are preventable. Nurses should be able to constantly observe their client’s skin for breaks or impairment in skin integrity. Pressure ulcers not only cause suffering to the patients but also increases nurses’ work­load in clinical setting. Prevention of pressure ulcers is a significant nursing concern to reduce the costs of treatment and patients’ suffering. To assess the level of knowledge and observe the practices of bed sore prevention among staff nurses working in general wards as well as special units. A descriptive, cross sectional and participating observational method was adopted. This study was conducted in Christian Medical College & Hospital, Ludhiana, Punjab, India among 60 staff nurses working in general wards and special units. Non probability, purposive sampling technique was used. Semi structured self administered questionnaire was developed for assessing knowledge and observation checklist was developed for practice of bed sore prevention for data collection procedure. Data were entered in SPSS 17.0 version and analyzed using in terms of descriptive (Frequency, percentage, mean, standard deviation and mean percentage) and inferential statistics (Inde­pendent t test, ANOVA and correlation). Findings highlight a difference in knowledge between special (73%) and general (62%) based nurses regarding pressure ulcers. Similar results were also found for practice. Overall discrepancies between knowledge (68%) and practice (53%) were reported for staff nurses regarding bed sore prevention. The results showed special unit nurses’ practice significantly better (60.29%) than general ward nurses (46.68%). Although 40% of overall staff nurses achieved excellent level on knowledge, none of them crossed the excellent level on practice. It is concluded that knowledge and practice of bed sore prevention among nurses working within specialists and generalist ward differed and a theory practice gap exists which has implications for patients care suggesting the need for a specific educational interven­tion to respond to this need. 

scholarly journals Item Analysis of Multiple Choice Questions in Pharmacology

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Imtiaz Uddin ◽  
Iftikhar Uddin ◽  
Izaz Ur Rehman ◽  
Muhammad Siyar ◽  
Usman Mehboob
Keyword(s):  
Medical Education ◽  
Item Analysis ◽  
Multiple Choice ◽  
Multiple Choice Questions ◽  
Cross Sectional ◽  
Teaching Programme ◽  
Medical College ◽  
Item Writing ◽  
Difficulty Index

Background: MCQs type assessment in medical education is replacing old theory style. There are concerns regarding the quality of the Multiple Choice Questions.Objectives: To determine the quality of Multiple Choice Questions by item analysis. Material and Methods: Study was a cross sectional descriptive .Fifty Multiple Choice Questions in the final internal evaluation exams in 2015 of Pharmacology at Bacha khan Medical College were analyzed. The quality of each Multiple Choice Questions item was assessed by the Difficulty index (Dif.I), Discriminative Index (D.I) and Distracter Efficiency (D.E).Results: Multiple Choice Questions that were of moderate difficulty were 66%. Easy were 4% and high difficulty were 30%.Reasons for high difficult Multiple Choice Questions were analyzed as Item Writing Flaws 41%, Irreverent Difficulty 36% and C2 level 23%. Discrimination Index shows that majority of MCQs were of Excellent Level (DI greater than 0.25) i.e 52 , Good 32% . (DI=2.15-0.25), Poor 16%. MCQs Distracter Effectiveness (DE)= 4, 3,2,1 were 52%, 34%, 14%, and 0% respectively. Conclusion: Item analysis gives us different parameters with reasons to recheck MCQ pool and teaching programme. High proportions of difficult and sizable amount of poor discriminative indices MCQs were the finding in this study and need to be resolved

scholarly journals MULTIPLE CHOICE QUESTIONS;

2017 ◽  
Vol 24 (09) ◽  
pp. 1409-1414
Author(s):  
Muhammad Zafar Iqbal ◽  
Shumaila Irum ◽  
Muhammad Sohaib Yousaf
Keyword(s):  
Problem Solving ◽  
Descriptive Analysis ◽  
Multiple Choice ◽  
Development Program ◽  
Faculty Members ◽  
Multiple Choice Questions ◽  
Cross Sectional ◽  
Medical College ◽  
Item Writing

Objectives: The main objective of this study was to judge the quality of MCQs interms of their cognition level and item writing flaws, developed by the faculty of a public sectormedical college. Setting: This study was conducted in Sheikh Zayed Medical College, RahimYar Khan. Duration with Dates: Data was collected between June 2014 to March 2015 andthis study was completed in July 2016. Sample Size: A sample of 500 MCQs collected from25 faculty members were included in the study. Study Design: Quantitative method. StudyType: Cross sectional descriptive analysis. Material and Methods: This quantitative study wasconducted in Sheikh Zayed Medical College Rahim Yar Khan over six months period after theapproval of the study proposal. Every faculty member is supposed to write 25 MCQs in order tobecome supervisor. I collected 500 multiple choice questions from 25 faculty members readyfor submission to CPSP. The quality of all MCQs was checked in terms of item writing flawsand cognition level by panel of experts. Results: Absolute terms were observed in 10(2%),vague terms in 15(3%), implausible distracters in 75(15%), extra detail in correct option 15(3%),unfocused stem 63(12.6%), grammatical clues 39(7.8%), logical clues 18(3.6%), word repeats19(3.8%), >then one correct answer 21(4.2%), unnecessary information in stem 37(7.4%),lost sequence in data 15(3%), all of above16(3.2%), none of above 12(2.4%) and negativestem 23(4.6%). Cognition level l (recall) was observed in 363(72.6%), level ll (interpretation) in115(23%) and level lll (problem solving) in 22(4.4%) items. Total 378(75.6%) flaws were identifiedand four commonest flaws were implausible distracter 75(15%), unfocused stem 63(12.6%),grammatical clues 39(7.8%) and unnecessary information in stem 37(7.4%). Conclusion: It isconcluded that assessment of medical students is very demanding and need of the time. A wellconstructed,peer-reviewed single best type MCQ is best one to complete this task becauseof cost effectiveness, better reliability and computerized marking. It is very important to startfaculty development program in order to decrease the number of item writing flaws and improvecognition level towards problem solving and application of knowledge.

scholarly journals Nonfunctional distractor analysis: An indicator for quality of Multiple choice questions

2020 ◽  
Vol 36 (5) ◽  
Author(s):  
Madiha Sajjad ◽  
Samina Iltaf ◽  
Rehan Ahmed Khan
Keyword(s):  
Item Analysis ◽  
Multiple Choice ◽  
Multiple Choice Questions ◽  
Medical College ◽  
Creative Commons ◽  
Irrelevant Distractors ◽  
Item Writing ◽  
Writing Errors ◽  
Distractor Analysis

Objectives: To analyze the low to medium distractor efficiency items in a multiple-choice question (MCQ) paper for item writing flaws. Methods: This qualitative study was conducted at Islamic International Medical College Rawalpindi, in October 2019. Archived item- analysis report from a midyear medium stakes MCQ paper of 2nd year MBBS class, was analyzed to determine the non-functional distractors (NFDs) and distractor efficiency (DE) of items, in a total of 181 MCQs. DE was categorized as low (3-4 NFDs), medium (1-2 NFDs) and high (0 NFD). Subsequently, qualitative document analysis of the MCQ paper whose item analysis report was assessed was conducted to investigate the item flaws in the low to medium DE items. The flaws identified were coded and grouped as, within option flaws, alignment flaws between options and stem/ lead-in and other flaws. Results: Distractor efficiency was high in 69 items (38%), moderate in 75 items (42%) and low in 37 items (20%). The item-writing flaws identified in low to moderate DE items within distractors included, non-homogenous length (1.8%), non-homogenous content (8%) and repeat in distractor (1.7%). Alignment flaws between distractors and stem/ lead-in identified were linguistic cues (10%), logic cues (12.5%) and irrelevant distractors (16%). Flaws unrelated to distractors were low cognitive level items (40%) and unnecessarily complicated stems (11.6%). Conclusions: Analyzing the low to medium DE items for item writing flaws, provides valuable information about item writing errors which negatively impact the distractor efficiency. doi: https://doi.org/10.12669/pjms.36.5.2439 How to cite this:Sajjad M, Iltaf S, Khan RA. Nonfunctional distractor analysis: An indicator for quality of Multiple choice questions. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.2439 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Contributing Factors for Perceived Satisfaction with Nursing Care among Inpatients in General Wards

2016 ◽  
Vol 3 (2) ◽  
pp. 34
Author(s):  
Mamta Koirala ◽  
Mohan Laxmi Koirala
Keyword(s):  
Hospital Stay ◽  
Nursing Care ◽  
Satisfaction Score ◽  
Contributing Factors ◽  
Significant Relation ◽  
Medical College ◽  
Perceived Satisfaction ◽  
General Wards ◽  
Quality Of Nursing

Introduction: Patients' perceived satisfaction with  quality of care may affects health outcomes. Patients who are satisfied with their nursing care are more likely to follow treatment and consequently to have better health outcomes. It encourages them to behave in a healthy way after discharge, and positive rating of service quality seems to be correlated with no hesitation about revisiting the same hospital ward in time of need. This study was done to identify the contributing factors for perceived satisfaction with nursing care among inpatients in general wards in Lumbini Medical College.   Methods: A descriptive cross sectional study was conducted in Lumbini Medical College Teaching Hospital throughout the month of August, 2015. A total of 60 heterogeneous study population from three different wards (Medical, Surgical, and Orthopedics), who gave consent for participation, were included using non-probability convenient sampling technique. Nepalese version of  Newcastle Satisfaction with Nursing Scale (NSNS) was used to measure the satisfaction score.   Results: There were a total of 60 respondents with mean age of 30.08 years (SD= 9.72). Male, duration of hospital stay, and number of hospital stay had a significant relation with the satisfaction score when calculated individually. However, the relationship was not significant when adjusted for other variables by linear regression.   Conclusion: Majority of respondents were satisfied with the quality of nursing care. Male, duration of hospital stay, and number of hospital stay had a significant relation with the satisfaction score when calculated individually. The nurses should know the factors influencing patients' satisfaction and work on those to improve the quality of nursing care.

scholarly journals Analysis of multiple choice questions from a formative assessment of medical students of a medical college in Delhi, India

2018 ◽  
Vol 7 (1) ◽  
pp. 174
Author(s):  
Richa Garg ◽  
Vikas Kumar ◽  
Jyoti Maria
Keyword(s):  
Formative Assessment ◽  
Item Analysis ◽  
Multiple Choice ◽  
Medical Knowledge ◽  
Discrimination Index ◽  
Multiple Choice Questions ◽  
Medical College ◽  
Best Response ◽  
Difficulty Index

Background: Assessment is a dominant motivator to direct and drive students learning. Different methods of assessment are used to assess medical knowledge in undergraduate medical education. Multiple choice questions (MCQs) are being used increasingly due to their higher reliability, validity, and ease of scoring. Item analysis enables identifying good MCQs based on difficulty index (DIF I), discrimination index (DI), and distracter efficiency (DE).Methods: Students of second year MBBS appeared in a formative assessment test, that was comprised of 50 “One best response type” MCQs of 50 marks without negative marking. All MCQs were having single stem with four options including, one being correct answer and other three incorrect alternatives (distracter). Three question paper sets were prepared by disorganizing sequence of questions. One of the three paper sets was given to each student to avoid copying from neighboring students. Total 50 MCQs and 150 distracters were analyzed and indices like DIF I, DI, and DE were calculated.Results: Total Score of 87 students ranged from 17 to 48 (out of total 50). Mean for difficulty index (DIF I) (%) was 71.6+19.4. 28% MCQs were average and “recommended” (DIF I 30-70%). Mean for discrimination index (DI) was 0.3+0.17. 16% MCQs were “good” and 50% MCQs were in “excellent” criteria, while rests of the MCQs were “discard/poor” according to DI criteria. Mean for distracter efficiency (DE) (%) was 63.4+33.3. 90% of the items were having DE from 100 to 33%. It was found that MCQs with lower difficulty index (<70) were having higher distracter efficiency (93.8% vs. 6.2%, p=0.004).Conclusions: Item analysis provided necessary data for improvement in question formulation and helped in revising and improving the quality of items and test also. Questions having lower difficulty index (<70) were significantly associated with higher discrimination index (>0.15) and higher distractor efficiency.

scholarly journals Item Analysis of Multiple-Choice Questions at the Department of Community Medicine, Wah Medical College, Pakistan

2020 ◽  
Vol 1 (2) ◽  
pp. 4
Author(s):  
Musarat Ramzan ◽  
Shezadi Sabah Imran ◽  
Sana Bibi ◽  
Khola Waheed Khan ◽  
Imrana Maqsood
Keyword(s):  
Pearson Correlation ◽  
Item Analysis ◽  
Multiple Choice ◽  
Community Medicine ◽  
P Value ◽  
Multiple Choice Questions ◽  
Medical College ◽  
Significant Difference ◽  
Difficulty Index

Objective: The objective of the study was to assess the quality of multiple-choice questions (MCQs) of three different assessments in the subject of Community Medicine by computing the difficulty index, discrimination index and reliability and to estimate the relationship between difficulty and discrimination indices. Study Design: Retrospective observational study. Place and Duration of Study: Department of Community Medicine at Wah Medical College from August to December 2018. Materials and Methods: Three sets of MCQs were included in the study. Mean and standard deviation of difficulty and discrimination indices were calculated and one-way analysis of variance and Kruskal Wallis test were applied on difficulty and discrimination indices. The association was determined by Pearson correlation and considered significant at p value of < 0.05. Results: The mean difficulty index of first term, second term and send-up examination were 41.5, 48.8 and 51.9 respectively. Mean discrimination indices were 0.28, 0.27 and 0.26 and reliability were 0.83, 0.81 and 0.79. In the study, 72% MCQs of the first term, 61.5 % of the second term and 63% of the send-up examinations were in the range 30-70% of difficulty. There was a significant difference in the difficulty indices of the three question papers. The correlation between discrimination and difficulty indices was curvilinear and positively correlated. Conclusion: It is concluded that all three question papers have acceptable reliability, more than 65% MCQs have acceptable difficulty index and about 69% have good discriminatory power.

scholarly journals Item analysis to identify quality multiple choice questions/items in an assessment in Pharmacology of II MBBS students in Guntur Medical College of Andhra Pradesh, India

2018 ◽  
Vol 7 (8) ◽  
pp. 1517
Author(s):  
Vijaya K. Suryadevara ◽  
Zaheda Bano
Keyword(s):  
Item Analysis ◽  
Multiple Choice ◽  
Correct Choice ◽  
Assessment Tools ◽  
P Value ◽  
Choice Response ◽  
Multiple Choice Questions ◽  
Medical College ◽  
Difficulty Index

Background: In medical education, multiple choice questions/Items are the more frequently used assessment tools to assess the knowledge abilities and skills of medical students, for being their objectivity, wide coverage in less time. However only the Quality Items gives a valid and reliable assessment. The quality of an Item is determined by difficulty index (DIF I), Discrimination Index (DI) and Distractor efficiency (DE). Aim of the study was to know the quality of Items in pharmacology by Item analysis and to develop a MCQs bank with quality Items.Methods: The present study was conducted on 150 II MBBS students of Guntur Medical College, AP, India. A class test containing 50 Items with 150 distractors from topic chemotherapy was conducted. Item with the correct choice/response was awarded with one mark and with the wrong choice zero marks, no negative marks. Each test Item was analysed with DIF I, DI and DE and the results were tabulated and tested statistically, with unpaired "t" test.Results: Mean DIF I, DI, DE values with standard deviations in the present study are 44.72+17.63%, 0.30+0.12%, 84.48+24.65 respectively. DIF I of 32 (64%) items was good to excellent range (31%-60%) 9 (18%) Items were easy (>61%) and 9(18%) Items were difficult (>30%). DI of 10 (20%) Items was good (0.15 to 0.24.) 29 (58%) Items were excellent with DI > 0.25 and 11 (22%) Items were poor with DI <0.15. Among 150 distractors, 127 (85%) were functional distractors (FDs) and 23 (15%) were non-functional distractors (NFDs). DE of 33 (66%) items with nil NFDs was 100%, for 12 (24%) Items with one NFD, was 66.6%, for 4 (8%) items with 2 NFDs was 33.3% and for 1 (2%) Item with 3NFDs DE was 0%. When unpaired "t" test was applied to the means of "difficult" and "easy" Items, 96.22+11.33% SD, 51.44+29.31% SD respectively, the p-value obtained was 0.00058, which was highly significant.Conclusions: The study showed that Item analysis is a valid tool to identify quality Items, which assess, the students’ knowledge abilities and discriminate different levels of performance abilities of students effectively.

scholarly journals The IFRS 17 contractual service margin: a life insurance perspective

2021 ◽  
Vol 26 ◽  
Author(s):  
W. Yousuf ◽  
J. Stansfield ◽  
K. Malde ◽  
N. Mirin ◽  
R. Walton ◽  
...  
Keyword(s):  
Life Insurance ◽  
Market Value ◽  
Financial Statements ◽  
Insurance Contract ◽  
Accounting Standard ◽  
Insurance Contracts ◽  
Ifrs 4 ◽  
Insurance Perspective ◽  
To Come

Abstract IFRS 17 Insurance Contracts is a new accounting standard currently expected to come into force on 1 January 2023. It supersedes IFRS 4 Insurance Contracts. IFRS 17 establishes key principles that entities must apply in all aspects of the accounting of insurance contracts. In doing so, the Standard aims to increase the usefulness, comparability, transparency and quality of financial statements. A fundamental concept introduced by IFRS 17 is the contractual service margin (CSM). This represents the unearned profit that an entity expects to earn as it provides services. However, as a principles-based standard, IFRS 17 results in entities having to apply significant judgement when determining the inputs, assumptions and techniques it uses to determine the CSM at each reporting period. In general, the Standard resolves broad categories of mismatches which arise under IFRS 4. Notable examples include mismatches between assets recorded at current market value and liabilities calculated using fixed discount rates as well as inconsistencies in the timing of profit recognition over the duration of an insurance contract. However, there are requirements of IFRS 17 that may create economic or accounting mismatches of its own. For example, new mismatches could arise between the measurement of underlying contracts and the corresponding reinsurance held. Additionally, mismatches can still arise between the measurement of liabilities and the assets that support the liabilities. This paper explores the technical, operational and commercial issues that arise across these and other areas focusing on the CSM. As a standard that is still very much in its infancy, and for which wider consensus on topics is yet to be achieved, this paper aims to provide readers with a deeper understanding of the issues and opportunities that accompany it.

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