Exploring the experiences of content experts with item vetting during item bank development.

Objective: To explore content experts' experiences with item vetting during item bank development at a public sector medical university of Rawalpindi, Pakistan. Methods: An exploratory study was carried out from December 2022 to February 2023 at a public sector medical college of Rawalpindi. A purposive sampling technique was employed to collect data from all content experts of the study institute who participated in item vetting activity during pre-exam moderation in the university. A pilot-tested semi-structured interview guide was utilized, interviews were audio recorded and later transcribed. Participants' anonymity was ensured. Various quality assurance strategies were employed to ensure the trustworthiness of the findings. Thematic analysis was performed on the transcribed data and themes were finalized by achieving consensus among all authors. Results: Six themes overarching the fourteen subthemes emerged from the data. Participants expressed a profound sense of satisfaction and valued their experience in refining expertise in constructing multiple-choice questions (MCQs). It was widely acknowledged that such activities not only contribute to the enhancement of item development skills but also improve quality of items. Conclusions: The consistent implementation of item vetting routines, in conjunction with diligent adherence to item writing protocols, contributes to quality assurance measures in assessment. Item bank development for fair and transparent assessment ensures production of competent healthcare professionals filtering incompetent ones hence improving health care services in the community.

Exploring developmental assignments shaping experience-driven acquisition of leadership competencies in young clinicians.

BACKGROUND: Experiential leadership development is well documented in the corporate sector, but those models cannot be applied as is, in the healthcare domain. The current study proposes a framework for the healthcare sector to enable experiential leadership development for young clinicians. The authors identify developmental assignments (DAs) and explore those characteristics [developmental assignment characteristics; DACs] therein that help develop leadership competencies in young clinicians. METHODS: As part of a qualitative exploratory study in Pakistan, the authors conducted 16 semi-structured interviews with senior clinicians in leadership positions with post-graduate residents under their supervision from different medical specialties. The participants were selected through purposive sampling, ensuring a maximum variation sample. Focusing on participants' experiences and perspectives related to experience-driven leadership development, the authors used a multi-level theoretical framework for analysis. RESULTS: The thematic analysis resulted in 19 subthemes with four overarching themes for both objectives. The authors categorized the developmental assignments (DAs) into clinical, academic, and administrative assignments. These assignments can be utilized for leadership development by ensuring that they have the requisite characteristics built into their context and structure. These developmental assignment characteristics (DACs) can range from learner-driven to supervisor-driven. The learner-driven characteristics include autonomy, high levels of responsibilities, unfamiliar assignments, working across boundaries, managing diversity, making a commitment, and creating change. The supervisor-driven characteristics include briefing, debriefing, accountability, and learner-assignment matching. The authors also developed a learner-assignment matching (LAM) framework to guide supervisors in customizing and adjusting the level of each DAC in a DA. CONCLUSION: A modern healthcare educational system can utilize studies like this to enable supervisors to develop required leadership skills in young clinicians along with clinical skills.

Impact Of Covid-19: Faculty Suggestions Regarding Online Medical Teaching.

BACKGROUND: As a result of the SARS-CoV-2 related government lockdown, academic institutions in Pakistan, including medical and dental colleges and universities, had to forgo on-site classes and make an emergency shift to online teaching. This study explores the perspective of the faculty, as a key stakeholder, on ways to increase the effectiveness of online teaching and learning at these medical and dental colleges and universities. METHODS: A descriptive cross-sectional qualitative survey was conducted in April-July 2020 in 32 medical and dental colleges of Pakistan. The sample size was not pre-determined and the participants included teaching faculty of both clinical and basic sciences. Data were iteratively collected and analyzed till data and time saturation were achieved. Thematic analysis of data was done by running two coding cycles. All authors ensured analytical triangulation by analyzing the data independently before developing consensus on the subthemes and themes. RESULTS: One hundred and thirty-two medical teachers responded. Data analysis revealed three themes regarding suggestions to improve teaching methods improve assessment and increase the effectiveness of online teaching and learning. The participants suggested supplementing real-time classes with recorded lectures, providing broadband internet services, using assignment-based and active learning strategies, continuous formative assessment, faculty training, and standardization of online teaching by higher authorities. CONCLUSIONS: The current study offers actionable steps to decision makers at medical colleges and universities to make online teaching and learning more efficient and valuable, based on the suggestions from their faculty.

Atypical Polypoid Adenomyoma (APAM).

Atypical polypoid adenomyoma (APAM) is a rare polypoidal benign tumor of uterus, which usually presents with irregular vaginal bleeding in women of reproductive age. It has the potential of malignant transformation but does not metastasise. It may coexist with endometrial hyperplasia and adenocarcinoma; and so, is usually misdiagnosed. It is composed of atypical endometrial glands along with bundles of smooth muscle fibres. It has a high incidence of recurrence. We describe a case of APAM, which was managed at a tertiary care hospital. A 25-year woman with irregular vaginal bleeding and abdominal mass had total abdominal hysterectomy (TAH) on suspicion of endometrial sarcoma.  Histopathology specimen revealed APAM. On follow-up so far, she is in stable condition and asymptomatic. Key Words: Atypical polypoid adenomyosis, Adenosarcoma, Endometrial carcinoma.