A case-controlled trial evaluating the summative performance of the 3-D skills Model.

BACKGROUND: Near-peer teaching is a popular pedagogical teaching tool however many existing models fail to demonstrate benefits in summative OSCE performance. The 3-step deconstructed (3-D)skills near-peer model was recently piloted in undergraduate medicine showing short term improvement in formative OSCE performance utilising social constructivist educational principles. This study aims to assess if 3-D skills model teaching affects summative OSCE grades. METHODS: Seventy-nine third year medical students attended a formative OSCE event at the University of Glasgow receiving an additional 3-minutes per station of either 3-D skills teaching or time-equivalent unguided practice. Students' summative OSCE results were compared against the year cohort to establish whether there was any difference in time delayed summative OSCE performance. RESULTS: 3-D skills and unguided practice cohorts had comparable demographical data and baseline formative OSCE performance. Both the 3-D skill cohort and unguided practice cohort achieved significantly higher median station pass rates at summative OSCEs than the rest of the year. This correlated to one additional station pass in the 3-D skills cohort, which would increase median grade banding from B to A. The improvement in the unguided practice cohort did not achieve educational significance. CONCLUSION: Incorporating the 3-D skills model into a formative OSCE is associated with significantly improved performance at summative OSCEs. This expands on the conflicting literature for formative OSCE sessions which have shown mixed translation to summative performance and suggests merit in institutional investment to improve clinical examination skills.

Development and implementation of the Capstone Program on integrating career exploration and medical humanities at a medical school in Korea.

PURPOSE: This study aimed to implement and evaluate the outcomes, perceptions, and satisfaction of the Capstone Program developed at the Catholic University of Korea, which integrates career exploration and medical humanities. METHODS: This study was conducted with fourth-year medical students from 2017 to 2019. First, the study analyzed the trends in the results of Capstone Projects conducted by students as part of their career exploration, where they independently explored areas of interest and selected topics. Second, it qualitatively analyzed the content of individual reports in which students reflected on their experiences from a "medical humanities perspective" through the Capstone Program. Third, it examined students' perceptions and satisfaction with the Capstone Program. RESULTS: The analysis revealed that students chose research topics from a wide range of fields, including basic medicine, clinical medicine, global healthcare, and integrated healthcare systems and innovation. The students reported positive perceptions of their career exploration and research experiences through the Capstone Program, particularly valuing sessions like "Meetings with Seniors" within the conference framework. Students indicated that the Capstone Program enhanced their ability to think introspectively from a humanities perspective, deepening their understanding of their roles and responsibilities as medical professionals. CONCLUSION: The Capstone Program provides a significant opportunity for medical students to explore their career paths and engage in introspective reflection from the viewpoint of medical humanities and social sciences. Thus, the integration of programs like capstone into the broader medical curriculum, focusing on career guidance and the reinforcement of medical humanities education, is imperative.

The effectiveness of competency-based global health education programs for medical students.

PURPOSE: This study aimed to develop a competency-based global health education (GHE) program for medical students and analyze its effectiveness. METHODS: The study had a pretest-posttest control group design. The program was developed based on the eight global health competency domains for medical students and implemented for 18 hours over 6 weeks beginning in September 2023. The intervention and control groups comprised 34 students and 41 students, respectively. The analytical methods used were t-test, chi-square test, and analysis of covariance. RESULTS: Experience with global health activities and pretest scores were controlled as covariates to exclude the effects of participants' general characteristics and pretest scores. The intervention group had outscored the control group on interest in a global health career and the necessity of GHE and also showed significantly higher posttest scores on global competence, global citizenship, and global health competence. Students were generally satisfied with the GHE program. CONCLUSION: A global health competency-based GHE program effectively increases medical students' interest in global health careers, their understanding of the need for GHE, and their global competence, global citizenship, and global health competence. This study is expected to promote GHE program development and research.

Enhancing medical students' documentation skills: the impact of an assessment and feedback program.

PURPOSE: We not only developed a clinical practice program for the assessment and feedback vis-à-vis medical students' medical records but also evaluated the effectiveness of this program via a self-assessment of medical students' competence in writing medical records pre- and post-program. METHODS: In 2022, 74 third-year medical students were divided into four groups and participated in a 2-week program. The students' medical records were graded on a scale ranging from 1 to 3 daily, and the mean scores for 2 weeks were compared. Pre- and post-program, the students' self-assessment survey was conducted. RESULTS: The mean scores increased from 1.30 in the first week to 2.14 in the second week. The mean score of self-assessment showed significant improvements, increasing from 2.43 to 4.00 for medical record, 2.64 to 4.08 for write present illness, 2.08 to 3.89 for initial orders, 2.35 to 4.34 for signature, and 2.38 to 3.97 for consent (all p<0.001). CONCLUSION: We found that providing students with real-time assessment and feedback on their medical records increased their skills and confidence in medical records writing.

Quantifying Efficacy of Video Interventions about Adverse Events in Medical Student Education.

OBJECTIVES: The coronavirus disease 2019 pandemic catalyzed a rapid shift toward remote learning in medicine. This study hypothesized that using videos on adverse events and patient safety event reporting systems could enhance education and motivation among healthcare professionals, leading to improved performance on quizzes compared with those exposed to standard, in-person lectures. METHODS: Participants were randomly assigned to a group both watching the video and attending an in-person lecture or a group that received only the in-person lecture in this study performed in 2022. Surveys gathered demographic information, tested knowledge, and identified barriers to reporting adverse events. RESULTS: A total of 83 unique participants responded to the survey out of the 130 students enrolled (64%; 83/130). Among the students completing all of the surveys, the group who watched the Osmosis video had a higher average quiz score (6.46/7) than the lecture group (6.31/7) following the first intervention. Only 25% of respondents agreed or strongly agreed that they knew what to include in a patient safety report and only 10% agreed or strongly agreed that they knew how to access the reporting system. CONCLUSIONS: This study suggests virtual preclass video learning can be a beneficial tool to complement traditional lecture-based learning in medical education. Further research is needed to determine the efficacy of long-term video interventions in adverse events.

Comparison of In-person VS remote learning modalities for ultrasound-guided knee arthrocentesis training using formalin-embalmed cadavers.

OBJECTIVES: This study aims to compare the efficacy of remote versus in-person training strategies to teach ultrasound guided knee arthrocentesis using formalin embalmed cadavers. METHODS: 30 first-year medical student participants were randomly assigned to remote or in-person training groups. Pre- and post- training surveys were used to evaluate participant's self-confidence in their ability to perform the procedure. Participants were asked to watch a 30-minute training video and then attend a skills training workshop. The workshops consisted of 20 min of hands-on instruction followed by a skills assessment. RESULTS: Following training, participant self-confidence increased significantly across all survey items in both groups (p = 0.0001). No significant changes in participant self-confidence were detected between the groups. Skills and knowledge-related metrics did not differ significantly between the groups with the exception of the "knowledge of instruments" variable. CONCLUSIONS: Our data suggests that remote ultrasound-guided procedure training, although logistically complex, is a viable alternative to traditional in-person learning techniques even for a notoriously hands on skill like ultrasound guided knee arthrocentesis. Novice first-year medical student operators in the remote-training group were able to significantly increase their confidence and demonstrate competency in a manner statistically indistinguishable from those trained in-person. These results support the pedagogical validity of using remote training to teach ultrasound guided procedures which could have implications in rural and global health initiatives where educational resources are more limited.

Examining the influence of team-based learning on medical students' comprehension and attitudes regarding psychedelic therapies.

INTRODUCTION: This study evaluates the impact of a two-hour team-based learning (TBL) curriculum on medical students' knowledge, comprehension, ethical understanding, and attitudes towards psychedelic therapies. METHODS: Sixty-three pre-surveys and fifty post-surveys assessed students' perceived knowledge and attitudes using Likert scales. Forty-eight matched pre/post-knowledge tests with multiple-choice questions quantified changes in comprehension. The TBL approach featured independent learning, team readiness assessments, and application exercises. RESULTS: Post-curriculum, students demonstrated significantly improved test scores (mean 41.4% increase, p < 0.0001) and more positive attitudes across 16 of 18 items (p ≤ 0.0495). Overall attitude scores increased 23% (p < 0.0001). Qualitative feedback reflected enhanced comfort discussing psychedelics clinically. While some students expressed support for psychedelic-assisted therapy, others cited reservations. DISCUSSION: This innovative curriculum bridged an important education gap given the increasing relevance of psychedelic medicine. Findings suggest TBL enhances medical student preparedness in this emerging field. Continued curricular development is warranted to ensure proper psychedelic education aligns with patient needs and legislative policies. As psychedelic research progresses, maintaining instructional excellence is crucial for future healthcare professionals.

Medical student learning on a distributed training platform in rural district hospitals.

BACKGROUND:  Decentralising medical school training enhances curriculum relevance, exposing students to generalist patient care in diverse contexts. AIM:  The aim of the study was to understand the student experiences of learning during their 7-week Family Medicine rural rotation. SETTING:  Final year medical students who had completed their Family Medicine rotation in November 2022. METHODS:  A qualitative study involving 24 final year students (four semi- structured interviews and four focus group discussions [4 x 5 students]). All interviews were recorded, transcribed verbatim and analysed thematically. RESULTS:  Analysis revealed positive learning experiences and identified the following themes: taking responsibility for learning, the generalist context, teaching and learning in context and managing the learning environment. CONCLUSION:  Active participation in hospital activities, exposure to disorientating dilemmas that challenged assumptions and reflection on these experiences led to transformative learning and knowledge co-construction.Contribution: The study contributes to the discussion and reinforces the advantages of distributed, experiential training, highlighting the positive impact of meaningful participation and transformative learning opportunities.

Pathology students' perceptions of virtual learning: A case study of students in Saudi Arabia.

BACKGROUND: Pathology laboratory classes are traditionally conducted using a conventional light microscope. The Coronavirus Disease 2019 (COVID-19) pandemic and recent technological advances necessitated remote learning through online classes using virtual slides (VS) instead of glass slides (GS). AIM: The purpose of this study was to gauge the perception of learning pathology using virtual slides (VS) as opposed to glass slides (GS) for medical students in Saudi Arabia. This study would help modify teaching methods with the advancement of the application of newer methods in online teaching. METHODS: This two-phased study evaluated learning outcomes and perceptions in pathology online education for medical students. Using a questionnaire, Phase one analyzed second and third-year students' perceptions of the teaching methods after an online pathology course. Phase Two assessed the learning outcomes of third-year students during online practical sessions using a pretest and post-test design. Statistical data were collected using a simple additive approach. Statistical tools were used to determine the factors affecting students' perceptions. RESULTS: The accessibility of VS at any possible time, location, or device was the most advantageous trait of virtual learning (mean = 2.94±0.9). Students agreed the least with virtual slides as the only optimal method of learning pathology (mean = 2.25±0.9). Most enjoyed the virtual lab experience (51.7%) but still prefer both laboratory-GS and virtual-VS classes (83.5%). CONCLUSIONS: VS had the benefit of accessibility and efficiency. The acceptance of VS was significantly affected by the orientation prior to the online class. Findings showed that VS cannot completely replace GS and more aspects such as technical difficulties and prior VS experience should be explored.

A study on the impact of open source metaverse immersive teaching method on emergency skills training for medical undergraduate students.

BACKGROUND: In recent years, the traditional simulation-based medical teaching approach has faced challenges in meeting the requirements of practical emergency medicine education. This study utilized open-source tools and software to develop immersive panoramic videos using virtual reality technology for emergency medical teaching. It aims to investigate the efficacy of this novel teaching methodology. This transformation shifted the focus from physical simulation to virtual simulation in medical education, establishing a metaverse for emergency medical teaching. METHODS: In accordance with the curriculum guidelines, the instructors produced panoramic videos demonstrating procedures such as spinal injury management, humeral fracture with abdominal wall intestinal tube prolapse, head and chest composite injuries, cardiopulmonary resuscitation, and tracheal intubation. Using Unity software, a virtual training application for bronchoscopy was developed and integrated into the PICO4 VR all-in-one device to create a metaverse teaching environment. Fourth-year medical undergraduate students were allocated into either an experimental group (n = 26) or a control group (n = 30) based on student IDs. The experimental group received instruction through the metaverse immersive teaching method, while the control group followed the traditional simulation-based medical teaching approach. Both groups participated in theoretical and practical lessons as usual. Subsequently, all students underwent a four-station Objective Structured Clinical Examination (OSCE) to assess the effectiveness of the teaching methods based on their performance. Additionally, students in the experimental group provided subjective evaluations to assess their acceptance of the new teaching approach. RESULTS: Before the training commenced, there were no significant statistical differences in the first aid test scores between the experimental and control groups. Following the training, the experimental group outperformed the control group in the four-station OSCE examination, with all P-values being less than 0.05. The satisfaction rate among the experimental group regarding the new teaching method reached 88.46%, reflecting levels of satisfaction and extreme satisfaction. CONCLUSION: The open-source metaverse immersive teaching method has demonstrated a positive impact on enhancing the emergency skills of medical undergraduate students, with a high level of acceptance among students. In comparison to traditional simulated medical teaching methods, this approach requires less time and space, incurring lower costs, and is deemed worthy of wider adoption.

Effectiveness of the flipped classroom method using clinical scenarios and Educational Technology versus Subject-Based Lectures in a gastrointestinal physiology course for medical students.

BACKGROUND: Medical education is evolving towards more practical, active, effective, and student-centered approaches that address the limitations of traditional lecture methods. Recently, the flipped classroom method has been considered to support these reforms. However, research on the use of flipped classroom methods in medical education, particularly related to clinical scenarios and educational technology, is still in its early stages. This study aims to evaluate the effectiveness of the flipped classroom method using clinical scenarios and educational technology versus subject-based lectures in the course of gastrointestinal physiology for medical students. METHODS: A total of 60 medical students participated in this study. The control group (n = 30) received traditional subject-based lectures and participated in question-and-answer sessions. The intervention group (n = 30) received non-attendance educational content and participated in small group discussions based on clinical scenarios. Course satisfaction was measured using an 18-item questionnaire, and learning outcomes were assessed with a 20-question multiple-choice test, corresponding to levels 1 and 2 of Kirkpatrick's model. Data were analyzed using descriptive and analytical statistical tests with SPSS software version 24. RESULTS: The findings indicated that the post-test scores in the intervention group were significantly higher compared to the control group. However, according to the student satisfaction questionnaire, satisfaction was significantly lower in the intervention group compared to the control group. CONCLUSION: This study demonstrated that the flipped classroom method, compared to traditional lectures, improved the learning and performance of medical students at Hamadan University of Medical Sciences in the course of gastrointestinal physiology.

A randomised controlled trial study on the effectiveness of high-fidelity simulation in enhancing skills among undergraduate medical students.

INTRODUCTION: High-fidelity simulation (HFS) provides a high level of interactivity and realistic experience for the learner by means of using full scale computerised patient simulators. It imitates clinical experience in a controlled and safe environment that closely resembles reality. The purpose of this study was to compare the efficacy of HFS versus video-assisted lecture (VAL) based education in enhancing and consolidating retention of skills among undergraduate medical students. MATERIALS AND METHODS: A randomised controlled trial (RCT) study involving 111 undergraduate medical students was conducted where the competency of skills was assessed by objective structured clinical examination (OSCE) in the first, fourth and seventh/eighth weeks. A cohort of 12-14 students was enrolled for each session. The randomisation of the participants into control (VAL-based teaching) and intervention (HFS-based teaching) groups was achieved by implementing the computer-based random sequence generation method. VAL-based teaching module was a fully interactive face-to-face teaching session where a prerecorded video clip was used. The video clip detailed the diagnosis of tension pneumothorax in an acute medical emergency and its management by performing needle decompression on a high-fidelity patient simulator (METIman). HFS-based teaching module was delivered as a fully interactive hands-on training session conducted on the same METIman to demonstrate the diagnosis of tension pneumothorax in an acute medical emergency and its management by performing needle decompression. OSCE scores were compared as the denominator of learning (enhancement and retention of skills) between two groups who underwent training with either VAL-based or HFS-based teachings. The OSCE assessments were used to evaluate the participants' performance as a group. These scores were used to compare the enhancement and medium-term retention of skills between the groups. The outcome was measured with the mean and standard deviation (SD) for the total OSCE scores for skills assessments. We used General Linear Model two-way mixed ANOVA to ascertain the difference of OSCE marks over assessment time points between the control and the intervention groups. ANCOVA and two-way mixed ANOVA were used to calculate the effect size and the partial Eta squared. p value less than 0.05 was taken to be statistically significant. RESULTS: The two-way mixed ANOVA showed no statistically significant difference in mean OSCE scores between intervention and control groups (p=0.890), although the mean score of the intervention group was better than the control group. CONCLUSION: Our study demonstrated that HFS was not significantly effective over VAL-based education in enhancing skills and consolidating retention among undergraduate medical students. Further research is needed to determine its suitability for inclusion in the course curriculum considering the cost-effectiveness of implementing HFS that may supplement traditional teaching methods.

Teaching methodologies in the undergraduate teaching of radiology.

After introducing what is understood by teaching innovation and its requirements, various methodologies that can be applied in university and radiological teaching are presented, such as: the flipped classroom focuses on the student's previous study and the teacher's subsequent contribution to resolve doubts or highlight important aspects. Team learning or cooperative teaching allows learning among the students themselves. Problem-based or case-based learning encourages students, in teams or individually, to carry out structured learning based on learning objectives. Teaching based on games or simulation can facilitate knowledge acquisition playfully and practically. Personalized tutoring allows the transmission of knowledge in an individualized way. Various evaluation modalities that can be used for training purposes are also shown.

[The application of problem-based learning in extracurricular research practices among medical undergraduates].

Problem-based learning is a practical problem-oriented and learner-centered inquiry teaching method, which is aimed at guiding students to analyze and solve problems and developing their ability to learn independently. This research explores the optimization of chimeric antigen receptor T (CAR-T) cell therapy in treating non-small cell lung cancer as an example to fully demonstrate the application of problem-based learning in extracurricular research among medical undergraduates. It provides a potential reference for developing second-classroom teaching among undergraduates.

Assessing the Ability of a Large Language Model to Score Free-Text Medical Student Clinical Notes: Quantitative Study.

Background: Teaching medical students the skills required to acquire, interpret, apply, and communicate clinical information is an integral part of medical education. A crucial aspect of this process involves providing students with feedback regarding the quality of their free-text clinical notes. Objective: The goal of this study was to assess the ability of ChatGPT 3.5, a large language model, to score medical students' free-text history and physical notes. Methods: This is a single-institution, retrospective study. Standardized patients learned a prespecified clinical case and, acting as the patient, interacted with medical students. Each student wrote a free-text history and physical note of their interaction. The students' notes were scored independently by the standardized patients and ChatGPT using a prespecified scoring rubric that consisted of 85 case elements. The measure of accuracy was percent correct. Results: The study population consisted of 168 first-year medical students. There was a total of 14,280 scores. The ChatGPT incorrect scoring rate was 1.0%, and the standardized patient incorrect scoring rate was 7.2%. The ChatGPT error rate was 86%, lower than the standardized patient error rate. The ChatGPT mean incorrect scoring rate of 12 (SD 11) was significantly lower than the standardized patient mean incorrect scoring rate of 85 (SD 74; P=.002). Conclusions: ChatGPT demonstrated a significantly lower error rate compared to standardized patients. This is the first study to assess the ability of a generative pretrained transformer (GPT) program to score medical students' standardized patient-based free-text clinical notes. It is expected that, in the near future, large language models will provide real-time feedback to practicing physicians regarding their free-text notes. GPT artificial intelligence programs represent an important advance in medical education and medical practice.

The effect of promoting factors on learning by four different delivery modes.

BACKGROUND: In the digital era, developing effective teaching methods is crucial due to the challenges of maintaining students' concentration amidst distractions. This study assessed the effects of learning-promoting factors both across group boundaries and within RCT learning groups examined in our previous study on the effectiveness of online versus live teaching. METHODS: The participants' experiences in the domains of Concentration, Anticipation, Liking and Desire to reuse were evaluated online immediately after a lesson on diagnosing pediatric respiratory issues implemented either in a Live, Live-stream, Vodcast or Podcast setting. The students rated their experiences on a scale of 1-10 with scores above a median of 8 indicating high experience levels in each factor. Learning was evaluated using a Webropol e-Test immediately and five weeks after the teaching session. The 15-minute test, comprised of 10 multiple-choice questions and real-life video scenarios, measured both theoretical and diagnostic skills. The test score scale ranged from - 26 to 28 points. RESULTS: High concentration was experienced by 70/72 (97.2%) students in the Live, 41/75 (54.7%) students in the Live-stream, 53/72 (73.6%) students in the Vodcast and 36/79 (45.6%) students in the Podcast teaching groups (P < 0.01). High concentration promoted learning the most, resulting in a 1.93 score improvement in the short-term test and a 1.65 score improvement in the long-term test. Among those with high concentration, the average test scores ranged from 21.9 to 23.4, while the range for low concentration was 18.3-20.0. CONCLUSION: In our study, good concentration promoted higher test scores in comparison with low concentration across all the learning modalities, both in digital and live settings. However, the live teaching modality resulted in the highest levels of concentration. Our results suggest that teachers should use various teaching modalities and utilize related special features to engage learners and maintain their concentration.

High-fidelity simulation versus case-based tutorial sessions for teaching pharmacology: Convergent mixed methods research investigating undergraduate medical students' performance and perception.

INTRODUCTION: Medical educators strive to improve their curricula to enhance the student learning experience. The use of high-fidelity simulation within basic and clinical medical science subjects has been one of these initiatives. However, there is paucity of evidence on using simulation for teaching pharmacology, especially in the Middle East and North Africa region, and the effectiveness of this teaching modality, relative to more traditional ones, have not been sufficiently investigated. Accordingly, this study compares the effects of high-fidelity simulation, which is designed in alignment with adult and experiential learning theories, and traditional case-based tutorial sessions on the performance and perception of undergraduate Year 2 medical students in pharmacology in Dubai, United Arab Emirates. METHODS: This study employed a convergent mixed methods approach. Forty-nine medical students were randomly assigned to one of two groups during the 16-week pharmacology course. Each group underwent one session delivered via high-fidelity simulation and another via a case-based tutorial. A short multiple-choice question quiz was administered twice (immediately upon completion of the respective sessions and 5 weeks afterwards) to assess knowledge retention. Furthermore, to explore the students' perceptions regarding the two modes of learning delivery (independently and in relation to each other), an evaluation survey was administered following the delivery of each session. Thereafter, the iterative joint display analysis was used to develop a holistic understanding of the effect of high-fidelity simulation in comparison to traditional case-based tutorial sessions on pharmacology learning in the context of the study. RESULTS: There was no statistically significant difference in students' knowledge retention between high-fidelity simulation and case-based tutorial sessions. Yet, students expressed a greater preference for high-fidelity simulation, describing the corresponding sessions as more varied, better at reinforcing learning, and closer to reality. As such, the meta-inferences led to expansion of the overall understanding around students' satisfaction, to both confirmation and expansion of the systemic viewpoint around students' preferences, and lastly to refinement in relation to the perspective around retained knowledge. CONCLUSION: High-fidelity simulation was found to be as effective as case-based tutorial sessions in terms of students' retention of knowledge. Nonetheless, students demonstrated a greater preference for high-fidelity simulation. The study advocates caution in adapting high-fidelity simulation, where careful appraisal can lend itself to identifying contexts where it is most effective.

Triple therapy: Three departments collaborating to train medical students in rural settings.

The primary healthcare (PHC) rotation places medical students in rural district hospitals for 4 weeks during their 4th or 5th year. This rotation is a collaboration among three academic units at Stellenbosch University's Faculty of Medicine and Health Sciences. Learning activities during this rotation include participation in a longitudinal community-oriented primary care project, conducting rehabilitation-oriented home visits to persons with disabilities, and assessing and treating patients presenting with undifferentiated problems on an in- and outpatient basis. Working in rural contexts for a month affords students opportunities to foster meaningful relationships with the healthcare team, patients and the community, while learning about collaborative teamwork and communities. Critical reflections about the interprofessional care of patients and a community evaluation are key components of the students' learning and assessment. Demonstrating the importance of interprofessional collaboration in PHC, this integrated training model has received, and continues to receive, positive feedback from students and the clinicians involved. Attention to logistics and academic support plays a crucial role in ensuring optimal learning for students. An integrated approach that involves multiple academic units, various healthcare professions and communities is strongly recommended for those who are considering training students in rural PHC environments.

The impact of systematically repairing multiple choice questions with low discrimination on assessment reliability: an interrupted time series analysis.

At our centre, we introduced a continuous quality improvement (CQI) initiative during academic year 2018-19 targeting for repair multiple choice question (MCQ) items with discrimination index (D) < 0.1. The purpose of this study was to assess the impact of this initiative on reliability/internal consistency of our assessments. Our participants were medical students during academic years 2015-16 to 2020-21 and our data were summative MCQ assessments during this time. Since the goal was to systematically review and improve summative assessments in our undergraduate program on an ongoing basis, we used interrupted time series analysis to assess the impact on reliability. Between 2015-16 and 2017-18 there was a significant negative trend in the mean alpha coefficient for MCQ exams (regression coefficient -0.027 [-0.008, -0.047], p = 0.024). In the academic year following the introduction of our initiative (2018-19) there was a significant increase in the mean alpha coefficient (regression coefficient 0.113 [0.063, 0.163], p = 0.010) which was then followed by a significant positive post-intervention trend (regression coefficient 0.056 [0.037, 0.075], p = 0.006). In conclusion, our CQI intervention resulted in an immediate and progressive improvement reliability of our MCQ assessments.

Dans notre centre, nous avons introduit une initiative d'amélioration continue de la qualité (ACQ) au cours de l'année académique 2018-19 ciblant la correction des questions à choix multiples (QCM) dont l'indice de discrimination (D) est < 0,1. Le but de cette étude était d'évaluer l'impact de cette initiative sur la fiabilité/cohérence interne de nos évaluations. Nos participants étaient des étudiants en médecine au cours des années académiques 2015-16 à 2020-21 et nos données provenaient d'évaluations sommatives par QCM au cours de cette période. Comme l'objectif était de revoir et d'améliorer systématiquement les évaluations sommatives dans notre programme prégradué sur une base continue, nous avons utilisé une analyse basée sur des séries chronologies interrompues pour évaluer l'impact sur la fiabilité. Entre 2015-16 et 2017-18, il y a eu une tendance négative significative dans le coefficient alpha moyen pour les examens utilisant des QCM (coefficient de régression -0,027 [-0,008, -0,047], p = 0,024). Au cours de l'année académique suivant l'introduction de notre initiative (2018-19), il y a eu une augmentation significative du coefficient alpha moyen (coefficient de régression 0,113 [0,063, 0,163], p = 0,010) qui a été suivie d'une tendance positive significative après l'intervention (coefficient de régression 0,056 [0,037, 0,075], p = 0,006). En conclusion, notre intervention d'ACQ a entraîné une amélioration immédiate et progressive de la fiabilité de nos évaluations par QCM.

The undergraduate virtual grand teaching ward round: Perceptions from the subcontinent.

Background Grand ward rounds are an integral component of undergraduate medical education. Covid-19 prevented the conduct of conventional grand ward rounds (CWRs) prompting a 'virtual' grand ward round (VWR). With restrictions lifted should future grand ward rounds remain virtual? Undergraduate perceptions on the two formats were sought to explore the feasibility of the VWR as a teaching ward round for medical students. Methods Our study was done during April 2021 to April 2022. The weekly grand ward round was converted to a VWR during April-November 2021. Following lifting of restrictions, it was reverted to a CWR. All patients provided informed consent. A Zoom-based, secure, online platform was created with the use of smartphones to share audiovisuals and patient discussions. An online anonymised feedback survey was conducted for undergraduates during both VWR and CWR phases. Results The response rate was 71% (182/258). VWR was considered more advantageous than the CWR in terms of time efficiency (p=0.03), space restrictions (p=0.01), improved audibility (p=0.02) and better opportunity to engage in discussions (p=0.1). Most students (80%) felt that the VWR provides a more 'ideal' grand ward. Overall preference was towards VWR across safety (92%), efficacy (72%), communication (85%), information availability (84%) and training opportunity (73%). Again 80% of students preferred future ward rounds to be virtual. Conclusions VWR is an innovative approach. While not a substitute for bedside teaching it appears safer, efficient, thought/discussion-provoking and more satisfactory. Successful elements of the VWR can be adopted in future, to develop a more ideal undergraduate grand ward round.