Computer assisted Objective structured clinical examination versus Objective structured clinical examination in assessment of Dermatology undergraduate students.

BACKGROUND: The assessment of dermatology undergraduates is being done through computer assisted objective structured clinical examination at our institution for the last 4 years. We attempted to compare objective structured clinical examination (OSCE) and computer assisted objective structured clinical examination (CA-OSCE) as assessment tools. AIM: To assess the relative effectiveness of CA-OSCE and OSCE as assessment tools for undergraduate dermatology trainees. METHODS: Students underwent CA-OSCE as well as OSCE-based evaluation of equal weightage as an end of posting assessment. The attendance as well as the marks in both the examination formats were meticulously recorded and statistically analyzed using SPSS version 20.0. Intercooled Stata V9.0 was used to assess the reliability and internal consistency of the examinations conducted. Feedback from both students and examiners was also recorded. RESULTS: The mean attendance for the study group was 77% ± 12.0%. The average score on CA- OSCE and OSCE was 47.4% ± 19.8% and 53.5% ± 18%, respectively. These scores showed a mutually positive correlation, with Spearman's coefficient being 0.593. Spearman's rank correlation coefficient between attendance scores and assessment score was 0.485 for OSCE and 0.451 for CA-OSCE. The Cronbach's alpha coefficient for all the tests ranged from 0.76 to 0.87 indicating high reliability. LIMITATIONS: The comparison was based on a single batch of 139 students. Such an evaluation on more students in larger number of batches over successive years could help throw more light on the subject. CONCLUSIONS: Computer assisted objective structured clinical examination was found to be a valid, reliable and effective format for dermatology assessment, being rated as the preferred format by examiners.

Controlled trial comparing the efficacy of 88% phenol versus 10% sodium hydroxide for chemical matricectomy in the management of ingrown toenail.

BACKGROUND: Partial nail avulsion with lateral chemical matricectomy is the treatment of choice for ingrown toenails. Phenol (88%) is the most widely used chemical agent but prolonged postoperative drainage and collateral damage are common. Sodium hydroxide (NaOH) 10% has fewer side-effects. METHODS: Adult, consenting patients with ingrown toenails were alternately allocated into two treatment groups in the order of their joining the study, to receive either 88% phenol (Group 1, n = 26) or 10% NaOH (Group 0, n = 23) chemical matricectomy. The patients as well as the statistician were blinded to the agent being used. Post-procedure follow-up evaluated median duration of pain, discharge, and healing along with recurrence, if any, in both the groups. The group wise data was statistically analyzed. RESULTS: Both the groups responded well to treatment with the median duration of postoperative pain being 7.92 days in Group 0 and 16.25 days in Group 1 (P < 0.202). Postoperative discharge continued for a median period of 15.42 days (Group 0) and 18.13 days (Group 1) (P < 0.203). The tissue condition normalized in 7.50 days (Group 0) and 15.63 days (Group 1) (P < 0.007). LIMITATIONS: Limited postsurgical follow up of 6 months is a limitation of the study. CONCLUSION: Chemical matricectomy using NaOH is as efficacious as phenolisation, with the advantage of faster tissue normalization.