Implementation of a Remote Fidelity Oversight Program for a Multi-Site Exercise Intervention

The STEP-HI exercise protocol is a supervised, 2 phase, multimodal, high-intensity exercise program that emphasizes resistance training. Exercise sessions are conducted at an exercise facility and occur on two non-consecutive days/week for 6 months. During specified exercises, the exercise interventionist targets the participant’s eight-repetition maximum (8-RM), defined as the greatest resistance that can be moved 8 times through full range of motion with good form. A rigorous, remote fidelity monitoring program maximizes consistency of the intervention across sites. This fidelity oversight program is a model for future exercise studies because of its unique remote, hierarchical structure. All exercise interventionists are initially certified by written examination and direct observations. Some exercise sessions are also video recorded and reviewed using fidelity checklists. After initial certification, repeated direct observation and video-based verification of fidelity are repeated at prescribed intervals for each interventionist to ensure sustained consistency of implementation across sites.

Performance of Graduation Examination of Standardized Residency Training in Zhejiang Province, China

Background Standardized residency training is an important part of post-graduation medical education for medical students in China, and the graduation examination is a necessary part to test the effect of residency training and an important measure to guarantee the quality of residency training. This study analyzed the graduation examination results of standardized residency training in Zhejiang Province in 2020. Methods This study calculated the pass rates for the practical skills examination and written examination for 5555 examinees and analyzed the relationship between examinees' demographic characteristics and pass rates. Results The pass rates for practical skills examination and written examination were 91.8% and 96.5%, respectively. Gender, age, education, and type of organizations were significantly associated with the pass rates. Examinees who retook the examination were less likely to pass the practical skills examination (AOR = 0.266, 95% CI = 0.189-0.377) and the written examination (AOR = 0.043, 95% CI = 0.025-0.074) than examinees who took the examination for the first time. If an examinee did not pass the practical skills examination initially, he or she was less likely to pass the written examination (AOR = 0.172, 95% CI = 0.120-0.249) Conclusion The pass rate of graduation examination of standardized residency training was not only influenced by the individual characteristics of the examinees but also related to the level of training hospitals and lead teachers. Therefore, it is necessary to take comprehensive measures to further improve the system of standardized residency training.

Content Analysis of Teaching Competency in CBSE Textbooks in Mathematics of VI Standard

Educational institutions are more concentrated on preferable measured outcomes rather than theoretical ones. Measuring subject knowledge obtains through written examination is easy, even as skills such as critical and logical thinking, decision making, problem-solving ability, creative thinking are difficult to measure. The education field is mostly based on students and teachers; teachers want to one kind of knowledge is competency, it is important for making the teachers professionally content and teaching competency is the ability to teach efficiently in clearing up the activities, manifesting activities, enjoin maintaining activities, documentation and record-keeping activities, task making activities, curriculum development activities and many kinds of activities. This study is analyzing the teaching competency in school textbooks. The main aim of the study is based on to compare the teaching competency dimensions to 6th standard CBSE mathematics textbook content.

Can online patient reviews be used to assess oncologist competency? RateMD as a cancer care evaluation tool.

e18656 Background: Medical oncology (MEDONC) requires a combination of skills in collaboration, communication, and professionalism, ultimately delivering technical and clinical knowledge in practice. Standard assessment tools (e.g. written examination, OSCE) are not effective in evaluating competencies beyond technical skills and fail to define the cancer care experience holistically. This explorative, descriptive study aims to identify the potential of unstructured, unsolicited, open access online patient reviews (OPRs) as a tool to assess physician competency. Methods: University-affiliated MEDONCs in Ontario (Canada) were selected. All OPRs were identified on RateMD using every name permutation; physician names and institutional affiliations were removed from comments. A descriptive analysis of the cohort was completed. The CanMEDS Framework, defining physician standards, was used with its hierarchy of roles, concepts, and competencies. Two reviewers, a communication studies researcher and a healthcare professional, independently assessed comments and identified common themes. Competency-level assessments were evaluated using kappa with linear weights. Results: 473 OPRs were identified for 49 MEDONCs (71% male, 29% female). Of these, 23% were written by care providers. Competencies defining roles of Medical Expert, Communicator, and Professional were most prevalent (64%, 38%, and 27% respectively). Agreement levels were high in all roles (wK = 0.71 - 1.00). Themes identified were similar in positive and negative evaluations. Most commonly discussed positive themes were knowledge translation and compassionate interpersonal skills. Most common negative themes centered on lack of humility, compassion, and communication skills. 38% of comments were marked helpful, indicating engagement with other OPRs as a key characteristic of rating tools. In addition to the physician in question, 21% of OPRs reported on healthcare delivery by staff. Conclusions: OPRs emphasize experiential competencies related to interpersonal skills and suggest an alternative format to evaluating such aspects of MEDONC competencies.[Table: see text]

Applying visual mapping techniques to promote learning in community-based medical education activities

Background Teaching and learning Community-Based Medical Education (CBME) requires the active engagement of students in various activities to cover planned curricular content. CBME being multifaceted involves careful application and formation of links when attending to community health problems and public health issues. Students often depend on factual recall rather than ‘engaging in’, to counteract the broad and comprehensive nature of CBME. This study was conducted to assess the effectiveness of Visual mapping techniques as a learning tool in a CBME program for the subject Community Medicine and thereby assist medical undergraduate students in overcoming identified learning challenges. Methodology An interventional study was conducted where medical undergraduates were randomly assigned to two different groups (each group = 30). After sensitization, a broad theme was taught to both the groups as a part of community-based teaching (CBT), each week for a month. The students in the intervention group were given the assignment to draw visual maps using the mind mapping & concept mapping techniques, after each CBT session, while the control group had Question-Answer session with built-in discussion (Conventional method) by an equally qualified, experienced faculty with no mapping assignments. A surprise written examination was conducted on the topics taught, and scores of both the groups were compared. Feedback was obtained from the intervention group. Results Mean score of the examination by the intervention group (29.85 ± 3.22) was significantly higher than and that of the control group (23.06 ± 4.09) (t = 7.14 and p < 0.05). The students shared that the assignment of drawing mind and concept maps for topics taught helped in attempting questions of the written examination by facilitating easy recall of the information learned. It aided to frame the answers to descriptive questions in a structured way with the use of keywords. However, identifying the concepts and establishing relationship between them was slightly challenging. Conclusion ‘Visual mapping’ in the form of Mind and Concept mapping was found to be an effective learning tool for multifaceted CBME especially in promoting meaningful learning and facilitating rational thinking by the medical undergraduates.

Teachers’ Opinion about Pharmacology Written Question Papers of MBBS Professional Examinations

Written examination is an important method for juddering the learning of medical students. Short Answer Questions (SAQ) and multiple choice questions (MCQ) are introduced in MBBS curriculum to assess student cognitive domain. This cross sectional descriptive study was conducted to get the teachers’ opinion about Pharmacology professional written short answer question papers of different Universities of Bangladesh. For this purpose, opinion of total 56 purposively selected teachers of the Department of Pharmacology & Therapeutics of 20 Medical Colleges were collected through self-administered semi-structured questionnaire. Most of the teachers (66% & 61%) were in favour of existing distribution of different types of question in curriculum (recall-60%, understanding -30% and problem based-10%) for short answer question paper (SAQ). Majority of the teachers (66% & 54%) were satisfied with the present coverage of recall and understanding type questions respectively but only 41% teachers were satisfied with the coverage of problem based type questions. Seventy-seven percent teachers were satisfied with content coverage in SAQ papers. Eighty-seven percent teachers were satisfied with present marking scheme on SAQ paper. Findings of this study may be used to redefine the distribution of different types question in SAQ papers and to improve the quality of question papers by ensuring their coverage. Bangladesh Journal of Medical Education Vol.12(1) 2021: 40-49

The Effectiveness of Simulation-based Ultrasound-guided Regional Anesthesia Training Programs for Anesthesia Residents: a Prospective Randomized Controlled Trial

BackgroundOptimizing educational programs for obtaining and maintaining competency in ultrasound-guided regional anesthesia (UGRA) is needed for anesthesia residents. This study aimed to assess the effectiveness of simulation-based training programs on the UGRA skills of senior anesthesia residents.MethodsThis prospective assessor-blind randomized controlled trial was conducted in a tertiary hospital in November 2019. Twenty anesthesia residents who had been in a clinical rotation in anesthesiology for 3-5 years were randomly allocated to either the workshop group (WG) or the control group (CG) for pretechnical procedure training on UGRA. Following didactic lectures for both groups, simulation-based workshops were performed only for the WG. All participating trainees were assessed by written examination, ultrasound scanning and anatomy recognition in live human models and ultrasound-guided target injections in porcine meat models. The written examination score, sonographic proficiency scores, time taken to perform the injections and errors were recorded and analyzed.ResultsThe simulation-based training program significantly reduced the time taken for target injections performed by trainees in the WG (183.9±44.8 seconds) compared with those in the CG (239.6±64.2 seconds): mean difference -55.8 (-107.7, -3.7), P=0.037. The error score was also significantly lower in the WG than in the CG. The sonographic proficiency scores of the thoracic paravertebral structures, brachial plexus and femoral nerve scanning were significantly higher for trainees in the WG than for those in the CG, as were the total scores for the four stations on live human models.ConclusionsFor senior anesthesia residents, the simulation-based training program can improve UGRA skills and might enhance clinical competence.Trial RegistrationChinese clinical trial registry, ChiCTR-IPR-1900027585, Principal investigator: Hong Zhang, Date of registration: November 19, 2019 URL: http://www.chictr.org.cn/

Assessing professional competence in optometry – a review of the development and validity of the written component of the competency in optometry examination (COE)

Background Credentialing assessment for overseas-educated optometrists seeking registration in Australia and New Zealand is administered by the Optometry Council of Australia and New Zealand. The aim was to review the validation and outcomes of the written components of this exam to demonstrate credentialing meets entry-level competency standards. Methods The Competency in Optometry Examination consists of two written and two clinical parts. Part 1 of the written exam comprises multiple choice questions (MCQ) covering basic and clinical science, while Part 2 has 18 short answer questions (SAQ) examining diagnosis and management. Candidates must pass both written components to progress to the clinical exam. Validity was evaluated using Kane’s framework for scoring (marking criteria, item analysis), generalization (blueprint), extrapolation (standard setting), and implications (outcome, including pass rates). A competency-based blueprint, the Optometry Australia Entry-level Competency Standards for Optometry 2014, guided question selection with the number of items weighted towards key competencies. A standard setting exercise, last conducted in 2017, was used to determine the minimum standard for both written exams. Item response theory (Rasch) was used to analyse exams, produce reliability metrics, apply consistent standards to the results, calibrate difficulty across exams, and score candidates. Results Data is reported on 12 administrations of the written examination since 2014. Of the 193 candidates who sat the exam over the study period, 133 (68.9%) passed and moved on to the practical component. Ninety-one (47.2%) passed both the MCQ and SAQ exams on their first attempt. The MCQ exam has displayed consistently high reliability (reliability index range 0.71 to 0.93, average 0.88) across all 12 administrations. Prior to September 2017 the SAQ had a set cutscore of 50%, and the difficulty of the exam was variable. Since the introduction of Rasch analysis to calibrate difficulty across exams, the reliability and power of the SAQ exam has been consistently high (separation index range 0.82 to 0.93, average 0.86). Conclusions The findings from collective evidence support the validity of the written components (MCQ and SAQ) of the credentialing of the competency of overseas-educated optometrists in Australia and New Zealand.