[Quality improvement of multiple choice examinations: in psychiatry, psychosomatic medicine, psychotherapy, and neurology]. / Qualitätsverbesserung von Multiple-Choice-Prüfungen: In Psychiatrie, Psychosomatik, Psychotherapie und Neurologie.

We describe a continuous improvement process in planning, performance, and evaluation of multiple choice examination questions in psychiatry, neurology, psychosomatic medicine, and psychotherapy. We analyzed 640 multiple choice questions of 1,419 students during a period of 4 years. Crucial changes concerned the abolishment of problematic question types, implementation of validated new question formats, extension of case-based questions, elongation of question stems, quantitative evaluation of item difficulty, discriminatory value, and the introduction of a peer review system. Consequences of these improvements were greater item difficulty (average 18%) and discriminatory value (average 67%) and reduced post hoc analysis times. Introduction of peer reviews resulted in longer preparation time, which was however appreciated by the peers due to a clear improvement in item quality.

[E-learning about dementia: a randomized study]. / E-Learning Demenz: Eine randomisierte Untersuchung.

BACKGROUND: Curricular medical training on dementia at the Department of Psychiatry and Psychotherapy at the University of Erlangen comprises of a traditional lecture. This setting was compared with two different E-Learning formats using a randomized study design. METHODS: 104 students (average age 26.3 +/- 3.6 years) were randomized into 3 groups: Interactive e-Learning; virtual lecture (slides and audio) and standard lecture (control group; 90 minutes). RESULTS: Overall, the response rate was 40.4 %. Assessment of formal knowledge using a multiple-choice test yielded no differences between the three groups. In the students' evaluation, the interactive e-learning showed the best results (1.86 +/- 0.69), followed by the standard lecture (2.0 +/- 0.71) and the virtual lecture (2.6 +/- 0.8). Nevertheless, the students would not prefer e-learning to the standard lecture when both methods are directly compared. CONCLUSION: Our findings suggest that e-learning is equivalent to a standard lecture when formal knowledge is assessed. Evaluation results are best for interactive e-learning formats. The detailed reasons for the preference of different learning styles should be further investigated.

Salivary Gland Epithelial- Myoepithelial Carcinoma: behaviour, diagnosis and treatment.

Across the whole spectrum of the tumoral pathology in the maxillo-facial and cervical areas, we can find those tumours where the aetieology is in the salivary glands. The tumours in the salivary glands are subdivided in benign and malignant tumours whenever this theorical subdivision is possible. The Epithelial-Myoepithelial Carcinoma represents about the 1% of the malignant neoplasms in the salivary glands and also affect other anatomical areas where there are glands: lung, kidney, uterus and so on. We start from a clinical case of a Epithelial-Myoepithelial of salivary minor gland carcinoma doing a bibliographic review of this unusual histological lineage. So we present a case of Epithelial-Myoepithelial Carcinoma of a minor salivary gland in the right cheek. We'll review the clinical and histological features of this uncommon tumour. And we'll discuss about the best way for diagnosis, treatment and the differential diagnosis to similar clinical injuries.

Depressive symptoms and risk factors among perimenopausal women

BACKGROUND: Several studies indicate that approximately 4.6of the Puerto Rican Population has been affected by depression at some time in their life. Perimenopausal women have been one of the most frequently mentioned population in scientific literature prone to develop depression. Sociodemographic factors along with medical history have been hypothesized to be associated with the development of depression. This study has the purpose to know the prevalence of depressive symptoms in a sample of women age 40 to 55 years attending a gynecological outpatient clinic in the Medical Sciences Campus of the University of Puerto Rico. We also want to identify sociodemographic risk factors that can predispose these women to develop depressive symptoms. METHOD: A cross sectional study was done during the months of June 2000 thru December 2000. Female subjects age 40 to 55 selected by availability. The Zung Self-Rating Depression Scale (1995 Spanish Version) and a questionnaire were administered to each subject. Results. The overall prevalence of depressive symptoms in this sample of 64 women was 39.1. Among the variables considered as possible associated risk factors for the development of depressive symptoms, educational level, prior visit to a mental health professional or a spiritual guide, and prior diagnosis of depression and antidepressant use were of statistical significance. DISCUSSION: A high prevalence of depressive symptoms was found in this sample. As reported in other studies, higher educational level is a protective factor against depression. Contrary of other studies, no association is found between depression and other sociodemographic and medial factors.