Comparison between MCQ, Extended matching questions (EMQ) and Script concordance test (SCT) for assessment among first-year medical students - A pilot study.

BACKGROUND: Single-best response types of MCQs are commonly used tools in medical assessment. However, these are not particularly apt for the assessment of higher-order thinking skills (HOTS) among students. Assessment of HOTS and clinical reasoning skills requires unexplored tools like extended matching questions (EMQs) and SCTs. The aim is to assess HOTS and clinical reasoning skills during formative assessment among medical students post a simulation-based education (SBE) using EMQ and SCT on the topic of shock and collect student perceptions regarding new assessment tools. METHODS AND MATERIAL: The research is an observational descriptive study. Fifty-two first-year medical students were asked to take a formative assessment consisting of 20 MCQs, 6 EMQs, and 2 SCT post a SBE during July 2022 on the topic of shock. MCQs were categorized into themes of aetiology, pathophysiology, and management of shock. These categorized MCQs were compared and analyzed with EMQs and SCTs prepared on the same themes. The data analysis by a one-way analysis of variance (ANOVA) was conducted to compare the difference in per cent mean scores of MCQ with EMQ and MCQ with SCT. RESULTS: The overall mean scores and also under the theme of aetiology and management, the student's score in MCQ were higher than EMQ and SCT and the difference was statistically significant with the P value (≤0.001). CONCLUSIONS: Students scored better in familiar assessment tools like MCQ, but majority of the students were of the opinion that EMQ tested the delivered content better and SCT tested the clinical application better.

A comparative study of knowledge, attitude, and practices about organ donation among blood donors and nonblood donors.

INTRODUCTION: Shortage of organs by donation is a national problem which needs a multipronged approach for its strengthening. Educating the people and increasing the awareness of the need for donation would be of the foremost priority. Identifying the target population who are more likely to respond would be very important to reap the maximum results. There is speculation that blood donors would be more amenable and likely to accept the idea and thought of organ donation. This study is being designed to study the same. METHODOLOGY: This was a cross-sectional comparative questionnaire-based study among two groups: blood donors and nonblood donors. Donors were defined as aged above 18 years and have made at least one whole blood/apheresis donation. Nondonors were the ones who were aged above 18 years and have not donated whole blood/apheresis blood products in the past. All the responses were entered in the Microsoft Excel sheets, and statistical analysis was carried out using Statistical Package for Social Sciences. RESULTS: A total of 829 participated in the study. Among the 829 participants, 416 were donors, and 413 were nondonors. There was no difference in knowledge regarding organ donation among the groups except for perceived risks of organ donation among nondonors. Concerning attitudes, they were more favorable among blood donors, and it was statistically significant at a P < 0.05. CONCLUSION: There was no difference with respect to knowledge between donors and nondonors. However, donors had a more favorable attitude toward organ donation. Factors like concerns about misuse of donated organs, lack of clarity on their religion's policy toward organ donation, and potential for harm for the organ donor seem to account for the unfavorable attitude of nondonors toward organ donation.

Huge mediastinal mass with minimal symptoms: thymolipoma.

A 35-year-old Indian working in Dubai had come to India for his annual vacation. He presented with a shortness of breath and mild chest discomfort of 3 months duration. Routine investigations gave normal results, except for his chest x-ray that showed homogenous opacity in the right mid and lower zones. Chest CT scan revealed a huge mass with fat and soft tissue involving the anterior mediastinum predominantly on the right side extending into the pericardiac region. The mass was pushing the right hemidiaphragm inferiorly and was compressing the right lung superiorly with atelectasis. The patient underwent surgical excision of the mass and recovered uneventfully. Gross specimen showed an encapsulated mass weighing 2.585 kg. Histopathological examination revealed lobules of mature adipose tissue interspersed with islands of mature thymic tissue and prominent Hassal's corpuscles suggesting thymolipoma. There was no evidence of malignancy.

Population pharmacokinetics of methotrexate in Indian cancer patients.

AIMS: A population pharmacokinetic model was developed to describe dose-response Relationships of methotrexate (MTX) in adults with breast cancer; this is done in order to explore interindividual variability in relationships with different pathophysiological variables. METHODS: Forty-five patients receiving 122 courses of MTX (2-3 per patient) were included and data were analyzed using NONMEM software. A linear two-compartment model with linear elimination best described the data. The predictive performance was evaluated by comparing the predicted and observed concentrations and the population estimated parameters with the individual estimated parameters. RESULTS: The population pharmacokinetic parameters CL ,V1,Q, V2,K,K12 and K21 generated in NONMEM, using the FO method were 3.5 L/h,1.25 L,8.43 L/h,6.45 L, 2.8,6.74 and 1.30 h-1 respectively. No covariate had significant effects on CL and VD. CONCLUSIONS: The results of this study combine relationships between the pharmacokinetic parameters of MTX and patient covariates that may be useful for dose adjustment, with a convenient sampling procedure that may aid in optimizing cancer patient care.