Twelve tips for institutional approach to outcome-based education in health professions programmes.

Outcome-based education (OBE) has brought along a significant development in health professions education in the past decade. The shift from a process-driven to product-driven model of education is valuable for ensuring graduate quality and facilitating global movement of healthcare workers. Such a model can align the expectations of key stakeholders in an era of rapid knowledge expansion and technological advancement. Nevertheless, the experienced benefits of OBE depend on the effectiveness of its implementation. This article therefore provides practical tips and strategies for implementing OBE in order to maximize its potential.

Neuroprotective effects of alpha lipoic Acid on haloperidol-induced oxidative stress in the rat brain.

Haloperidol is an antipsychotic drug that exerts its' antipsychotic effects by inhibiting dopaminergic neurons. Although the exact pathophysiology of haloperidol extrapyramidal symptoms are not known, the role of reactive oxygen species in inducing oxidative stress has been proposed as one of the mechanisms of prolonged haloperidol-induced neurotoxicity. In the present study, we evaluate the protective effect of alpha lipoic acid against haloperidol-induced oxidative stress in the rat brain. Sprague Dawley rats were divided into control, alpha lipoic acid alone (100 mg/kg p.o for 21 days), haloperidol alone (2 mg/kg i.p for 21 days), and haloperidol with alpha lipoic acid groups (for 21 days). Haloperidol treatment significantly decreased levels of the brain antioxidant enzymes super oxide dismutase and glutathione peroxidase and concurrent treatment with alpha lipoic acid significantly reversed the oxidative effects of haloperidol. Histopathological changes revealed significant haloperidol-induced damage in the cerebral cortex, internal capsule, and substantia nigra. Alpha lipoic acid significantly reduced this damage and there were very little neuronal atrophy. Areas of angiogenesis were also seen in the alpha lipoic acid-treated group. In conclusion, the study proves that alpha lipoic acid treatment significantly reduces haloperidol-induced neuronal damage.

Training simulated patients: evaluation of a training approach using self-assessment and peer/tutor feedback to improve performance.

BACKGROUND: Most medical schools use simulated patients (SPs) for teaching. In this context the authenticity of role play and quality of feedback provided by SPs is of paramount importance. The available literature on SP training mostly addresses instructor led training where the SPs are given direction on their roles. This study focuses on the use of peer and self evaluation as a tool to train SPs. METHODS: SPs at the medical school participated in a staff development and training programme which included a) self-assessment of their performance while observing video-tapes of their role play using a structured guide and b) peer group assessment of their performance under tutor guidance. The pre and post training performance in relation to authenticity of role play and quality of feedback was blindly assessed by students and tutors using a validated instrument and the scores were compared. A focus group discussion and a questionnaire assessed acceptability of the training programme by the SPs. RESULTS: The post-training performance assessment scores were significantly higher (p < 0.05) than the pre-training scores. The degree of improvement in the quality of feedback provided to students was more when compared to the improvement of role play. The acceptability of the training by the SPs was very satisfactory scoring an average of 7.6 out of 10. The majority of the SPs requested the new method of training to be included in their current training programme as a regular feature. CONCLUSION: Use of structured self-reflective and peer-interactive, practice based methods of SP training is recommended to improve SP performance. More studies on these methods of training may further refine SP training and lead to improvement of SP performance which in turn may positively impact medical education.

Formative feedback to students: the mismatch between faculty perceptions and student expectations.

BACKGROUND: Formative assessments and other learning tools are ineffective in the absence of formative feedback. METHODS: A study was carried out on preclinical students and teachers using mixed methods approach that included questionnaire surveys, focus group discussions and post survey discussions to determine perceptions and expectations of students on feedback and those of teachers. RESULTS: Students expected formative feedback to be incorporated into all teaching activities from the beginning of the course in medicine to promote self regulated and self directed learning. Students stated that provision of model answers and grades in assessments are inadequate but require teacher student dialogue sessions to clarify issues. Students considered immediate feedback or feedback within two weeks on a written activity, simple but focused, by a content expert would be the best form. In contrast, the teachers perceived the feedback provided using a model answer by a non content expert to be acceptable. Students also believed that formative feedback is of particular importance in salvaging poor performers. CONCLUSIONS: There is a need to create awareness among teachers on the usefulness of this tool in higher education and for moulding teaching practices by including training on this aspect of teaching-learning, in routine faculty development activities. The study showed the importance of including feedback as a generic feature in all learning activities, and this may require incorporating into institutional policy for successful implementation.