Tricuspid Regurgitant Jet Velocity Point-of-Care Ultrasound Curriculum Development and Validation

Introduction: The American College of Emergency Physicians (ACEP) recommends that Emergency Medicine physicians with advanced training can evaluate right ventricular (RV) pressures via point-of-care ultrasound (POCUS) by measuring a tricuspid regurgitant jet (TRJ). We were unable to find a published curriculum to deliver education for this at any skill level. Therefore, we developed, delivered, and evaluated a curriculum for the assessment of TRJ for novice physician sonographers. Methods: We designed an educational intervention for novice physician sonographers. The curriculum was created using a modified Delphi methodology. All novice sonographers participated in the educational intervention which consisted of a didactic lecture followed by hands-on-deliberate practice on healthy medical student volunteers with expert feedback in a simulated setting. Sonographer’s knowledge was assessed at 3 time points: pre-intervention, immediately post-intervention, and 3 months post-intervention (retention assessment) by multiple choice exam. Results: Nine novice physician sonographers participated in the intervention. Mean exam performance increased from 55.6% [standard deviation (SD) 11.3%] on the pre-intervention exam to 94.4% (SD 7.3%) on the post-intervention exam and 92.9% (SD 12.5%) on the retention exam. The mean improvement between the pre- and post- exam was +38.9% (95% CI 31.8 - 46.0), and between the pre-exam and retention exam +37.1% (95% CI 22.3 - 52.0). Conclusion: Sonographer knowledge of TRJ assessment improved following a brief educational intervention as measured by exam performance. Given the expanding role of POCUS it is increasingly important to provide effective resources for teaching these skills. This work establishes the basis for further study and implementation of our TRJ curriculum.

T ransitioning a L arge Biology Class from a n i n Person t o a n Online Exam During the COVID 19 Pandemic

As occurred in many Universities worldwide, the response to the COVID-19 pandemic required us, professors at Western University (London, Canada), to quickly convert a first-year biology course with over 1200 enrolled students from an in-classroom format to an on-line format. This transition included the course exams. While the first multiple-choice exam in February 2020 was in-person and proctored, we changed the second multiple-choice exam in March 2020 so that it was completed by students online at home without a proctor. We had concerns about this online conversion, including whether the grades would represent student understanding of the course material when access to peers and other resources during the exam was not monitored. In this report we show student scores on the online exam were highly correlated with their prior in-person exam. A similar correlation was observed with prior first-year students who took similar exams in February and March 2019 which were both in-person and proctored. These results provide some reassurance that it is possible to rapidly transition the delivery of an exam from an in-person format to an online format without compromising the exam process.

A Signal Detection Model for Multiple-Choice Exams

A model for multiple-choice exams is developed from a signal-detection perspective. A correct alternative in a multiple-choice exam can be viewed as being a signal embedded in noise (incorrect alternatives). Examinees are assumed to have perceptions of the plausibility of each alternative, and the decision process is to choose the most plausible alternative. It is also assumed that each examinee either knows or does not know each item. These assumptions together lead to a signal detection choice model for multiple-choice exams. The model can be viewed, statistically, as a mixture extension, with random mixing, of the traditional choice model, or similarly, as a grade-of-membership extension. A version of the model with extreme value distributions is developed, in which case the model simplifies to a mixture multinomial logit model with random mixing. The approach is shown to offer measures of item discrimination and difficulty, along with information about the relative plausibility of each of the alternatives. The model, parameters, and measures derived from the parameters are compared to those obtained with several commonly used item response theory models. An application of the model to an educational data set is presented.

Replacing a Veterinary Physiology Endocrinology Lecture with a Blended Learning Approach Using an Everyday Analogy

Understanding scientific concepts and processes is critical for veterinary education. This article outlines the impact of blended learning and the use of an analogy on student understanding of the hypothalamic-pituitary-target gland axis over a three-year period. The first-year veterinary physiology course at our institution was modified to incorporate a blended learning approach. An analogy centered around a fast-food restaurant was introduced via an animated video to explain key concepts using an online module. Students completed the module on their own time and class time was optional for asking questions or obtaining clarification as needed. Learning was assessed using the same set of multiple-choice exam questions (MCQs). As hypothesized, students using the online module performed equally well (significantly better for those in the lower quartile) on three summative MCQs to those who received the same information delivered by traditional lecture. Student feedback identified positive aspects regarding blended learning using the analogy, including dynamic visuals, ability to work at their own time and pace, and ease of repeating information. Students cited lack of discipline and poor time management as obstacles to completing the module. Changing the anatomy and physiology of the hypothalamus and pituitary gland from static images and text to an animated video significantly improved student’s preference for the blended learning approach. Blended learning and the analogy was preferred by 47% of students over the traditional lecture format (21% preferred traditional lecture and 32% were indifferent) and it was more effective in helping students master this important physiological concept.

Immersive 3D Experience of Osmosis Improves Learning Outcomes of First-Year Cell Biology Students

An immersive 320° 3D experience of osmosis was perceived by cell biology students to be fun, useful, and educational. Performance of all students improved on a multiple-choice exam question, and those students with moderate to high base-level knowledge also performed better on short-answer questions.

THE EFFECT OF TIME CONSTRAINT ON STUDENT READING COMPREHENSION TEST PERFORMANCE IN NARRATIVE TEXT

The objective of this study was to know whether there is any effect between the time constraints of students when doing exams using (extended time) with students who take exams using (non-extended time). The sample used in this study amounted to 60 grade 11 students in SMA 03 Kaur. The method used in this research was the quantitative method and uses ex post facto design. In collecting data the author gives multiple-choice exam questions consisting of 50 questions, these are questions in the form of narrative texts. In analyzing the data, the authors used the Mann Whitney U-Test in SPSS 16.0. The results of this study indicate that the influence of time constraints on student examinations using extended time.

Sweat so you don’t forget: Establishing the feasibility of exercise breaks during university lectures

It is critical that principles of laboratory-based studies with implications for academic performance be tested in naturalistic learning environments to gauge their feasibility. In a study by Fenesi, B., Lucibello, K., Kim, J. A., & Heisz, J. J. (2018), research participants were assigned to an aerobic exercise, video game playing, or lecture as usual group while watching a single, videotaped on-line lecture. Participants in the exercise group were more likely to be on task towards the end of the lecture and performed significantly better on a multiple choice exam compared to the other groups. In the current article, the laboratory approach by Fenesi et al. is adapted to establish the feasibility of integrating student-led exercise breaks during a 80 min in-person lecture in a large university setting. Practical guidelines for implementation are provided. The approach was implemented at The Ohio State University for the duration of the semester in three courses: two upper level Health Psychology undergraduate courses with enrollments of 93 and 73 students and a combined undergraduate/graduate course in Cognitive Aging with 13 undergraduate and 7 graduate students. Overall, based on anonymous qualitative feedback from students and peer evaluators, the exercise breaks were reported to be a strength of the course and a positive experience. The current approach establishes the feasibility of integrating exercise breaks in a large, in-person university lecture environment for the duration of a semester.

MSK30: a validated tool to assess clinical musculoskeletal knowledge

BackgroundMusculoskeletal (MSK) complaints comprise a large proportion of outpatient visits. However, multiple studies show that medical school curriculum often fails to adequately prepare graduates to diagnose and manage common MSK problems. Current standardised exams inadequately assess trainees’ MSK knowledge and other MSK-specific exams such as Freedman and Bernstein’s (1998) exam have limitations in implementation. We propose a new 30-question multiple choice exam for graduating medical students and primary care residents. Results highlight individual deficiencies and identify areas for curriculum improvement.Methods/ResultsWe developed a bank of multiple choice questions based on 10 critical topics in MSK medicine. The questions were validated with subject-matter experts (SMEs) using a modified Delphi method to obtain consensus on the importance of each question. Based on the SME input, we compiled 30 questions in the assessment. Results of the large-scale pilot test (167 post-clerkship medical students) were an average score of 74 % (range 53% – 90 %, SD 7.8%). In addition, the tool contains detailed explanations and references were created for each question to allow an individual or group to review and enhance learning.SummaryThe proposed MSK30 exam evaluates clinically important topics and offers an assessment tool for clinical MSK knowledge of medical students and residents. It fills a gap in current curriculum and improves on previous MSK-specific assessments through better clinical relevance and consistent grading. Educators can use the results of the exam to guide curriculum development and individual education.