Journal of Medical Education
Volume:19 Issue: 1, Feb 2020

Multiple-choice questions (MCQs) are the most frequently accepted tool for the evaluation of comprehension, knowledge, and application among medical students. In single best response MCQs (items), a high order of cognition of students can be assessed. It is essential to develop valid and reliable MCQs, as flawed items will interfere with the unbiased assessment. The present paper gives an attempt to discuss the art of framing well-structured items taking kind help from the provided references. This article puts forth a practice for committed medical educators to uplift the skill of forming quality MCQs by enhanced Faculty Development programs (FDPs).

The objective of the study is also to test the quality of MCQs by item analysis.

In this study, 100 MCQs of set I or set II were distributed to 200 MBBS students of Late Shri Lakhiram Agrawal Memorial Govt. Medical College Raigarh (CG) for item analysis for quality MCQs. Set I and Set II were MCQs which were formed by 60 medical faculty before and after FDP, respectively. All MCQs had a single stem with three wrong and one correct answers. The data were entered in Microsoft excel 2016 software to analyze. The difficulty index (Dif I), discrimination index (DI), and distractor efficiency (DE) were the item analysis parameters used to evaluate the impact on adhering to the guidelines for framing MCQs.

The mean calculated difficulty index, discrimination index, and distractor efficiency were 56.54%, 0.26, and 89.93%, respectively. Among 100 items, 14 items were of higher difficulty level (DIF I < 30%), 70 were of moderate category, and 16 items were of easy level (DIF I > 60%). A total of 10 items had very good DI (0.40), 32 had recommended values (0.30 - 0.39), and 25 were acceptable with changes (0.20 - 0.29). Of the 100 MCQs, there were 27 MCQs with DE of 66.66% and 11 MCQs with DE of 33.33%.

In this study, higher cognitive-domain MCQs increased after training, recurrent-type MCQ decreased, and MCQ with item writing flaws reduced, therefore making our results much more statistically significant. We had nine MCQs that satisfied all the criteria of item analysis.

One of the essential considerations while designing an OSCE exam is “standard-setting”, which refers to the score with which a student could be considered to pass or fail an exam. The selection of proper standard-setting method is based on different criteria, including the applicability of the method, the university bylaws, and the purpose of the test.

To examine the difference between four different standard-setting

the modified Cohen’s, borderline regression, Hofstee methods, and the fixed 60% arbitrary method in determining the passing score in ophthalmology OSCE exam.

Two periodic ophthalmology OSCE were selected to examine the differences in failure rates and pass scores. The four standard setting methods were applied with a sample size that included 38 (year 5 undergraduate) students at the Faculty of Medicine, Suez Canal University.

Modified Cohen’s method resulted in the lowest passing score (54% and 58%), while the Hofstee method led to the highest passing score (69.2% and 75%). Comparing the percentage of students who are supposed to pass the exam, we can observe that there is no statistically significant difference among these standard-setting methods were used except for the Hofstee method.

There is no single best method for setting the passing mark of an exam. We could obtain more practical outcomes if we considered more than one method and the average pass mark.

In modern-day medicine, there is plenty of evidence-based communication studies implying that good physician-patient communication provides better diagnosis and treatment, as well as patient satisfaction and compliance with the therapeutic plan. Medical educators who promote better communication to strengthen the physician-patient relationship believe that shared decision-making is the most favorable model after the era of paternalistic and consumeristic models as the dominant types of interpersonal communication between doctors and their patients. On the other hand, different media, especially medical dramas, if properly targeted, can be used as an educational tool for health workers and a cultural factor for the whole society to ameliorate the current difficulties in the physician-patient relationship.

Therefore, this study aimed to determine how the Iranian national TV medical drama represents the physician-patient relationship.

We used a qualitative inquiry to analyze a medical drama about hospital affairs, named The Nurses, which was produced by the Iranian national television with the cooperation and sponsorship of Iran’s Ministry of Health and broadcasted as a two-season television drama in 46 episodes during 2016 - 2017. In this regard, all aspects of physician-patient communication were analyzed based on the thematic deductive content analysis method.

The study reviewed 46 out of 51 episodes. Each sene that represented the physician-patient relationship was analyzed based on a developed checklist. The checklist was prepared based on a literature review, and its content validity was approved by the medical ethics experts.

The findings of this study showed that this medical drama paradoxically represented the paternalistic model of the physician-patient relationship that was inconsistent with the formal views of Iranian authorities.

Simulation-based education has become more prominent in recent years. In our university, we have begun to use simulation at various levels in the curriculum.

We decided to utilize simulation to meet the challenges of teaching medical students in the operating theatre, which have slowly risen over the years at our place of practice.

A total of 120 final year medical students posted to anesthesia were divided into two groups and exposed to two different operating theatre (OT) teaching environments: Group I: Actual OT and group 2: Simulated OT. The performance of the two groups on 25 MCQs was compared using the chi-square test and independent t-test.

The chi-square test showed no significant difference between the groups in the number of students who passed the test at the end of the posting [χ2 (2, N = 119) = 2.375, P > 0.05]. An independent t-test carried out on the test scores showed that the actual OT group (M = 10.15, SD = 2.284) performed better than the simulated OT group (M = 9.04, SD = 2.528), and it was statistically significant [t (112) = 3.265, P = 0.001].

There was no difference in terms of pass or fail between the two groups suggesting that OT learning could be simulated. However, the actual OT group had overall better scores statistically. Thus the depth of learning may be better with actual OT teaching, especially because the teaching and learning occur in the real environment. Until further research suggests that simulated OT can replace actual OT learning for undergraduates, we plan to use the simulated OT as a bridge towards actual OT learning.

Though India’s position in research is notable, it is poor in medical research, barring four centers of excellence. Where the priority for the Government is providing universal health care and for a postgraduate (PG) is becoming a busy clinician, the research remains a low priority. Getting published is an incentive for researchers, and its experience during the training period will be valuable. Research by practitioners in the field is a need in low-and middle-income (LAMI) countries to find workable solutions to local problems.

The objectives of this study were to develop a system for sustained support and evaluation of the dissertation and to examine its impact on getting published by PG students.

In this prospective study, all 27 PG students of 2015 Batch were given support throughout their six-semester course. Participants were PG students registered for the course in 2015. This included orientation for guides, research methodology (RM) for students and pre-submission (synopsis) external review in the first semester; mid second-year review in the fourth semester and pre-submission (final dissertation), and selection for award and workshop for paper submission in the fifth semester.

Before appearing for the final examination in 2018, all 27 students prepared papers out of their dissertations and submitted them to the journals. From April 2019, 19 papers were published, and eight were in various stages of publication.

Given sustained guidance and support from the institution, students perform very well, leading to improved publication status.

The importance of using modern electronic and virtual education in medical sciences, which can be used without any time limit, is increasingly increasing.

The current study aimed to provide a framework for distance education based on the Electronic Learning Management System for the staff of the Deputy for Public Health.

This study had three phases. First, the level of preparedness of the staff of the health department (trainers and learners) was assessed through a descriptive-survey using a questionnaire. In the second phase, the analysis of the educational programs that were implemented during the last year was carried out. Finally, in the third phase, to manage the e-learning process based on the selected Instructional design model, considering the newness, a structure was proposed, guaranteeing quality while taking into consideration the deputy’s current facilities and staff.

According to the results, 84.4% of the trainers and 87.4% of the learners were agreed with E-learning. 72.2% of trainers noted that their educational programs could be held electronically, and 84.4% of trainers and 64.4% of learners believed that moving toward E-learning is necessary. 82.6% of the goals of the curriculum were cognitive, and 92.4% were theoretical. The design of the structure of E-learning was carried out in the areas of planning, content creation, course implementation, evaluation, and electronic loading. Besides, the tasks of each area were tailored to the Instructional Design Model of Gagne and were based on the capabilities of the Deputy for Public Health.

The present study showed that trainers and learners are ready to conduct E-learning and that educational programs also can be held electronically, and a structure that incorporates the quality and proper management of this department is designed based on the potential and personnel resources of the department.