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Background: Healthcare professionals require many personal attributes in addition to cognitive abilities and psychomotor skills for competent practice. Multiple Mini- Interviews are being employed globally to assess personality attributes of candidates for selection in health professions education at all level of entry; these attributes are namely, communication skills, critical thinking, honesty, responsibility, health advocacy, empathy and sanctity of life. Considering the high stakes involved for students, faculty, institutions and the society, rigorous quality assurance mechanisms similar to those used for student assessment must be employed for student selection, throughout the continuum of medical education. It is a difficult undertaking as these psychological constructs are difficult to define and measure. Though considered to yield reliable and valid scores, studies providing multiple evidences of internal structure especially dimensionality of Multiple Mini-Interviews are sparse giving rise to questions if they are measuring a single or multiple constructs and even if they are measuring what they are purported to be measuring., Objective: The main objective is to provide statistical support of the multi-dimensional nature of our Multiple Mini Interviews, hypothesized a-priori, through CFA. Another objective is to provide multiple evidences for the internal structure. Our study highlights the link between content and internal structure evidences of the constructs, thus establishing that our Multiple Mini Interviews measure what they were intended to measure., Method: After securing permission from the Institutional review board, an a-priori seven factor-model was hypothesized based on the attributes considered most essential for the graduating student of the institution. After operationally defining the attributes through extensive literature search, scenarios were constructed to assess them. A 5-point rating scale was used to rate each item on the station. A total 259 students participated in the multiple mini interviews over a period of three days. A training workshop had been arranged for the participating faculty., Results: The reliability coefficient using Cronbach's alpha were calculated (range from 0.73 to 0.94), Standard Error of Measurement (ranged from 0.80 to1.64), and item to station-total correlation ranged from 0.43-0.50 to 0.75-0.83. Inter-station correlation was also determined. Confirmatory factor analysis endorsed the results of Exploratory factor analysis in the study revealing a seven model fit with multiple indices of Goodness-of-fit statistics such as Root mean square error of approximation (RMSEA) value 0.05, Standardized root mean square residual (SRMR) value with less than 0.08. All these indices showed that model fit is good. The Confirmatory factor analysis confirmed the multi-dimensional nature of our MMIs and also confirmed that our stations measured the attributes that they were supposed to measure., Conclusion: This study adds to the validity evidence of Multiple Mini-Interviews, in selection of candidates, with required personality traits for healthcare profession. It provides the evidence for the multi-dimensional structure of Multiple Mini interviews administered with multiple evidences for its internal structure and demonstrates the independence of different constructs being measured., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ayub et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: Accurate and convenient evaluation tools are essential to document endoscopic competence in Gastroenterology training programs. The Direct Observation of Procedural Skills (DOPS), Global Assessment of Gastrointestinal Endoscopic Skills (GAGES), and Assessment of Endoscopic Competency (ACE) are widely used validated competency assessment tools for gastrointestinal endoscopy. However, studies comparing these 3 tools are lacking, leading to lack of standardization in this assessment. Through simulation, this study seeks to determine the most reliable, comprehensive, and user-friendly tool for standardizing endoscopy competency assessment., Methods: A mixed-methods quantitative-qualitative approach was utilized with sequential deductive design. All nine trainees in a gastroenterology training program were assessed on endoscopic procedural competence using the Simbionix Gi-bronch-mentor high-fidelity simulator, with 2 faculty raters independently completing the 3 assessment forms of DOPS, GAGES, and ACE. Psychometric analysis was used to evaluate the tools' reliability. Additionally, faculty trainers participated in a focused group discussion (FGD) to investigate their experience in using the tools., Results: For upper GI endoscopy, Cronbach's alpha values for internal consistency were 0.53, 0.8, and 0.87 for ACE, DOPS, and GAGES, respectively. Inter-rater reliability (IRR) scores were 0.79 (0.43-0.92) for ACE, 0.75 (-0.13-0.82) for DOPS, and 0.59 (-0.90-0.84) for GAGES. For colonoscopy, Cronbach's alpha values for internal consistency were 0.53, 0.82, and 0.85 for ACE, DOPS, and GAGES, respectively. IRR scores were 0.72 (0.39-0.96) for ACE, 0.78 (-0.12-0.86) for DOPS, and 0.53 (-0.91-0.78) for GAGES. The FGD yielded three key themes: the ideal tool should be scientifically sound, comprehensive, and user-friendly., Conclusion: The DOPS tool performed favourably in both the qualitative assessment and psychometric evaluation to be considered the most balanced amongst the three assessment tools. We propose that the DOPS tool be used for endoscopic skill assessment in gastroenterology training programs. However, gastroenterology training programs need to match their learning outcomes with the available assessment tools to determine the most appropriate one in their context., Competing Interests: All authors report no conflicts of interest in this work., (© 2024 Ismail et al.)

Objective: This study aims to assess the effectiveness of integrating simulation for teaching pediatric clinical examination skills to undergraduate, MBBS Year-IV medical students at The Aga Khan University, Karachi, Pakistan., Methods: In this mixed method study, the Objective Structured Clinical Examination (OSCE) scores of the students who were taught using simulation (batch 2017-2018) were compared with the batch of the academic year 2016 -2017 (taught via traditional methods). In order to explore the experiences of the intervention group, a questionnaire with four open-ended questions was administered at the end of the clerkship., Results: Students who were taught by simulation, scored significantly higher on the clinical skills stations in Objective Structured Clinical Examination, than in the pre-intervention group (p-value <0.01). The students quoted safety of the learning environment, opportunities for deliberate practice, debriefing and facilitation skills maximized quoted that their experience of learning through simulation, however, some challenges were identified for future improvement., Conclusion: The result of the study suggested simulation as a useful instructional strategy for teaching examination skills to students in their early years. The student gained confidence through deliberate practice and feedback without compromising patient safety, which translated into improved performance in the high-stakes OSCE examination at the end of the clerkship., Competing Interests: Competing interests: None declared., (Copyright: © Pakistan Journal of Medical Sciences.)

Background: The spread of COVID-19 pandemic in early 2020 compelled all the educational activities, including medical education to be shifted from face-to-face interaction to a virtual platform. This shift provided opportunities for exploring online assessment modalities. One such assessment method is an online open book exam which is a unique concept in medical education of Pakistan. Limited information is available in literature regarding open book exam for the basic science subjects. Hence, the objective of the study was to determine the quality of the open book exam administered as a pilot project to the first-year medical students., Methods: It was a cross-sectional analytical study that included 99 students of first year MBBS. The students were administered an online unrestricted type of open book exam as a formative assessment. The exam consisted of 30 open-ended, short answer type questions. The scores of the exam were analyzed for psychometric quality., Results: The mean score was 47.24 ± 15.30 SD %. The reliability of the exam was 0.79. The majority (66.6%) of items were found to be moderately difficult with their difficulty index ranging from 31 to 80%. The majority (86.6%) items were in the range of moderate to high discrimination. There were no questions with negative discrimination., Conclusions: The exam was found to be reliable and can be implemented with training of faculty and students. Online open book exam provides a good format for remote and formative assessment of students with minimum proctoring during times of constraints such as COVID-19 pandemic., (© 2022. The Author(s).)

Objective: To assess the skill level of residents regarding central venous catheterisation insertion, and to assess the reliability of scores in a simulated situation., Methods: The quasi-experimental study with pre- and post-test design was conducted from February to June 2013 at the Aga Khan University, Karachi, and comprised four workshops attended by residents. The workshops were video-recorded for feedback and self-assessment. At the end of the workshops, knowledge and procedural skills were assessed using a self-generated 38-item, task-specific instrument after ensuring its content validity. Data was analysed using SPSS 19., Results: There were 40 residents in the sample. The self-generated instrument was reliable with Cronbach's alpha value 0.83 and inter-rater coefficient 0.79. There was significant improvement in the skills level post-intervention compared to the baselines mean values (p=0.001). The subjects were satisfied with the workshops, as indicated by a mean score of 8.83±1.367., Conclusions: The workshops appeared to improve the central venous catheterisation insertion skills of the residents.

COVID-19 is an unprecedented pandemic threatening global health, and variants were discovered rapidly after the pandemic. The two variants, namely the SARS-CoV-2 B.1.1.7 (Alpha) and P.1 (Gamma), were formed by the mutations in the receptor binding domain of spike glycoprotein (SGP). These two variants are known to possess a high binding affinity with the angiotensin-converting enzyme 2. Amidst the rapid spread of these mutant strains, research and development of novel molecules become tedious and labour-intensive. Imidazole and benzimidazole scaffolds were selected in this study based on their unique structural features and electron-rich environment, resulting in increased affinity against a variety of therapeutic targets. In the current study, imidazole- and benzimidazole-based anti-parasitic drugs are repurposed against SARS-CoV-2 Alpha and Gamma variant spike glycoproteins using computational strategies. Out of the screened 15 molecules, flubendazole and mebendazole have exhibited promising binding features to the two receptors (PDB ID: 7NEH and 7NXC), as evidenced by their glide score and binding free energy. The results are compared with that of the two standard drugs, remdesivir and hydroxychloroquine. Flubendazole and mebendazole have become convenient treatment options against mutant lineages of SARS-CoV-2. The edge of the flubendazole was further established by its stability in MD simulation conducted for 100 ns employing GROMACS software. Further, in vitro and in vivo studies are essential to understand, if flubendazole and mebendazole indeed hold the promise to manage SARS-CoV-2 mutant stains., Supplementary Information: The online version contains supplementary material available at 10.1007/s11696-021-01900-8., Competing Interests: Conflict of interestThe authors declare that there are no conflicts of interest in this study. The authors alone are responsible for the content and writing of the paper., (© Institute of Chemistry, Slovak Academy of Sciences 2021.)

The atomic and molecular properties of the title compounds were calculated by Jaguar using a basis set B3LYP/6-31G** ++ with hybrid DFT in the gas phase, to determine the chemical reactivity. Analysis of quantum chemical features such as HOMO and LUMO explained that the electronic charge transfer occurred within the system through conjugated paths of the selected compounds. The nucleophilic and electrophilic reactive sites are recognized from the molecular electrostatic potential plot. Electrophilic and nucleophilic attack-prone molecular sites were predicted by mapping ALIE value to the molecular surface. The bond dissociation energy of the high active compound 15 (2-chloro-N-(2-(2-(2-(2-chlorobenzoyl)hydrazineyl)-2-oxoethoxy)phenyl)acetamide) was calculated to assess the probability of compound autoxidation or degradation. Further, molecular docking, binding free energy calculations, and ADMET profile of the degradation products (DPs) of compound 15 was carried out to determine the binding affinity and toxicity profile of the formed DPs compared with the parent compound. A 150-ns molecular dynamics (MD) simulation was performed to evaluate the binding stability of the compound 15/4URL complex using Desmond. Binding free energy and binding affinity of the complex were computed for 100 trajectory frames using the MM-GBSA approach., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

In this unprecedented situation of COVID-19 era, the educational institutions have to attune not only the teaching strategies but also the assessment. Similarly, just as COVID precautions have become the "new normal" practice, hence implementation changes during face-to-face examinations may become standard practice in the Post- COVID era. The Objective structured clinical exams (OSCEs) which usually require a face-to-face assessment of skills, posed a special challenge to health professionals in COVID 19. This commentary paper is written on shared experiences of the examination cell principal resource faculty for OSCE and exam coordinators. It addresses how to plan and implement objective, valid, feasible and reliable clinical skills examinations (OSCEs) keeping in place COVID precautions to ensure the utmost wellbeing of all stakeholders involved., (Copyright: © Pakistan Journal of Medical Sciences.)

Objectives: Blended learning (BL) combines conventional face to face (F2F) sessions with online educational resources. This method includes the advantages of online course delivery without the omission of conventional F2F interaction. The purpose of the present study was to evaluate students' satisfaction and educational outcomes in a BL course compared to traditionally administered dental anatomy course., Methods: A prospective non-randomized study was conducted to compare the outcomes and perception of BL for teaching dental anatomy to dental students. First year dental anatomy students (n = 98) were included (48 in the conventional F2F learning and 50 in the BL group). Multiple choice questions were used to assess the achievement of learning outcomes and the Dundee Ready Education Environment Measure (DREEM) to determine the educational environment during the course., Results: There was no significant difference in the pre-test scores of both groups; however the mean post-test score for the BL group (31.5 ± 4.5) was significantly higher than the F2F group (27.2 ± 4.9). The post-test scores were comparable across both genders in the BL group while females secured significantly higher scores than males in the F2F group. The DREEM scores were also significantly higher in the BL group (147.3 ± 15.5) than the F2F group (134.5 ± 15.1) (p < 0.002). A similar pattern was observed in DREEM subscales., Conclusions: The BL course is associated with improved students' satisfaction and learner achievement compared to a conventionally administered dental anatomy course. In addition, BL enhanced students' accessibility, self-assessment, and higher level of engagement compared to F2F delivery of the course., (© 2021 American Dental Education Association.)

Antibacterial resistance (ABR) is a major life-threatening problem worldwide. Rampant dissemination of ABR always exemplified the need for the discovery of novel compounds. However, to circumvent the disease, a molecular target is required, which will lead to the death of the bacteria when acted upon by a compound. One group of enzymes that have proved to be an effective target for druggable candidates is bacterial DNA topoisomerases (DNA gyrase and ParE). In our present work, phenylacetamide and benzohydrazides derivatives were screened for their antibacterial activity against a selected panel of pathogens. The tested compounds displayed significant antibacterial activity with MIC values ranging from 0.64 to 5.65 μg/mL. Amongst 29 title compounds, compounds 5 and 21 exhibited more potent and selective inhibitory activity against Escherichia coli with MIC values at 0.64 and 0.67 μg/mL, respectively, and MBC at onefold MIC. Furthermore, compounds exhibited a post-antibiotic effect of 2 h at 1× MIC in comparison to ciprofloxacin and gentamicin. These compounds also demonstrated the concentration-dependent bactericidal activity against E. coli and synergized with FDA-approved drugs. The compounds are screened for their enzyme inhibitory activity against E. coli ParE, whose IC 50 values range from 0.27 to 2.80 μg/mL. Gratifyingly, compounds, namely 8 and 25 belonging to the phenylacetamide series, were found to inhibit ParE enzyme with IC 50 values of 0.27 and 0.28 μg/mL, respectively. In addition, compounds were benign to Vero cells and displayed a promising selectivity index (169.0629-951.7240). Moreover, compounds 1, 7, 8, 21, 24, and 25 (IC 50 : <1 and Selectivity index: >200) exhibited potent activity in reducing the E. coli biofilm in comparison with ciprofloxacin, erythromycin, and ampicillin. These astonishing results suggest the potential utilization of phenylacetamide and benzohydrazides derivatives as promising ParE inhibitors for treating bacterial infections., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Yele, Sanapalli, Wadhwani and Mohammed.)

The alarming rise of bacterial resistance is occurring worldwide and endangering the efficacy of antibiotics. Therefore, development of new and efficient antibacterial agents remains paramount. In the present work, we designed and synthesized a series of N'-(1,3-benzothiazol-2-yl)-substituted aryl/aralkyl hydrazides C1-C27 and evaluated them in vitro for their antibacterial activity. Among all tested compounds, C10, C15, and C24 showed potent activity against Staphylococcus aureus ATCC 43300 (MRSA). Minimum bactericidal concentration studies of synthesized compounds are performed against selected bacterial strains. Time kill kinetics showed that the compounds C10 and C15 possess bactericidal activity against MRSA ATCC 43300, while compound C24 possess bactericidal activity against S. aureus NCIM 5022. In the extra-precision docking, compounds C1-C27 exhibited interactions mainly with the N-terminal and central domains of S. aureus GyrB catalytic pocket. Binding free energy (ΔG bind ) of compounds C1-C27/3U2K complexes were computed by MM-GBSA approach. Free energy components indicated Coulomb energy term as favorable for binding, while van der Waals and electrostatic solvation energy terms strongly disfavored the binding. ADMET properties of synthesized compounds C1-C27 are also computed., (© 2021 Wiley-VHCA AG, Zurich, Switzerland.)

Background: Multisource feedback (MSF) is increasingly being used to assess trainee performance, with different assessor groups fulfilling a crucial role in utility of assessment data. However, in health professions education, research on assessor behaviors in MSF is limited. When assessing trainee performance in work settings, assessors use multidimensional conceptualizations of what constitutes effective performance, also called personal performance theories, to distinguish between various behaviors and sub competencies., This may not only explain assessor variability in Multi Source Feedback, but also result in differing acceptance (and use) of assessment data for developmental purposes. The purpose of this study was to explore performance theories of various assessor groups (residents and nurses) when assessing performance of residents., Methods: A constructivist, inductive qualitative research approach and semi-structured interviews following MSF were used to explore performance theories of 14 nurses and 15 residents in the department of internal medicine at Aga Khan University (AKU). Inductive thematic content analysis of interview transcripts was used to identify and compare key dimensions in residents' and nurses' performance theories used in evaluation of resident performance., Results: Seven major themes, reflecting key dimensions of assessors' performance theories, emerged from the qualitative data, namely; communication skills, patient care, accessibility, teamwork skills, responsibility, medical knowledge and professional attitude. There were considerable overlaps, but also meaningful differences in the performance theories of residents and the nurses, especially with respect to accessibility, teamwork and medical knowledge., Conclusion: Residents' and nurses' performance theories for assessing resident performance overlap to some extent, yet also show meaningful differences with respect to the performance dimensions they pay attention to or consider most important. In MSF, different assessor groups may therefore hold different performance theories, depending on their role. Our results further our understanding of assessor source effects in MSF. Implications of our findings are related to implementation of MSF, design of rating scales as well as interpretation and use of MSF data for selection and performance improvement.

The number of citations an article receives is an important indicator to quantify its influence in its field. The aim of this study was to identify and analyze the characteristics of the 50 top-cited articles addressing dental education published in two journals dedicated to dental education ( European Journal of Dental Education and Journal of Dental Education ). The Web of Science database was searched to retrieve the 50 most-cited articles from the two journals in December 2018. The top-cited articles were analyzed for journal of publication, number of citations, institution and country of origin, year of publication, study type, keywords, theme and subtheme, and international collaborations. The results showed the 50 top-cited articles were cited between 24 and 146 times each. The majority of these top-cited articles (n=34) were published in the Journal of Dental Education Half (n=25) of the articles were by authors in the U.S. The most common study types were surveys (n=26) and reviews (n=10). The main themes of these top-cited articles were curriculum and learner characteristics. This bibliometric analysis can serve as a reference for recognizing studies with the most impact in the scholarship of dental education.

Infections due to resistant bacteria are the life-threatening and leading cause of mortality worldwide. The current therapy for bacterial infections includes treatment with various drugs and antibiotics. The misuse and over usage of these antibiotics leads to bacterial resistance. There are several mechanisms by which bacteria exhibit resistance to some antibiotics. These include drug inactivation or modification, elimination of antibiotics through efflux pumps, drug target alteration, and modification of metabolic pathway. However, it is difficult to treat infections caused by resistant bacteria by conventional existing therapy. In the present study binding affinities of some glitazones against ParE and MurE bacterial enzymes are investigated by in silico methods. As evident by extra-precision docking and binding free energy calculation (MM-GBSA) results, rivoglitazone exhibited higher binding affinity against both ParE and MurE enzymes compared to all other selected compounds. Further molecular dynamic (MD) simulations were performed to validate the stability of rivoglitazone/4MOT and rivoglitazone/4C13 complexes and to get insight into the binding mode of inhibitor. Thus, we hypothesize that structural modifications of the rivoglitazone scaffold can be useful for the development of an effective antibacterial agent., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: To investigate the predictive validity of Uniform Entrance Test for academic performance in the first two years in various health science degree programs., Methods: A retrospective analysis of admissions data and academic performance of students admitted in under-graduate programs of medicine, dentistry and pharmacy of three cohorts was taken. The independent and dependent variables were entry test scores and semester scores respectively. Spearman's Correlation co-efficient was computed to determine the association between entrance test scores and semester scores for three groups., Results: Majority of the students were from the MBBS degree program (61%) with majority of female students (65%) in all three programs. In MBBS the highest correlation coefficient between entry test and semester scores was observed for semester one rs = 0.334 and lowest in semester four rs = 0.208. In BDS degree program both highest and lowest correlations were in semester one. In the Pharm-D degree program, a significant correlation was only seen in cohort 1 but not in the subsequent cohorts., Conclusion: The uniform entrance test has an incremental predictive validity for the MBBS and BDS programs as compared to Pharm-D. Better performance in the entrance test predicts higher semester scores and more likelihood of achieving higher scores in the first year as compared to the second year.

Background: The use of simulated patients in student assessment is supported by the Best Evidence Medical Education and U.S. Agency for Healthcare Research and Quality, and it provides a safe and effective alternative to real patients in many situations. To assess the validity and feasibility of moulage technique-where a cosmetically constructed rash is used on simulated patients-two dermatologic rashes were developed using moulage simulation on standardized patients at Aga Khan University Hospital for 3rd year medical summative Objective Structured Clinical Examination (OSCE)., Methods: Checklists for cases that focused on history taking of a skin rash were developed. These also included a description and identification of lesions, differential diagnosis, and basic management. Cases were first reviewed and approved by the Educational Committee and a dermatologist content expert. Stations were piloted to assess validity and feasibility. Simple nontoxic materials were used to develop the rash by faculty familiar with moulage simulation., Results: Sixty-four students were assessed on a Herpes Zoster case and 32 students on a Herpes Simplex case in morning and afternoon sessions. The total mean score obtained at all OSCE stations was 64.82 ± 10.22. Mean scores on the morning and afternoon dermatology stations were 62.72 ± 9.74 and 69.03 ± 9.98, respectively. Face validity for both stations was established through input of content experts. The internal reliability as measured by Cronbach's alpha between the checklist items on the morning and afternoon stations was acceptable at 0.60 (20 items) and 0.65 (18 items), respectively., Discussion: The use of moulage technique to develop dermatologic lesions on simulated patients may be utilized for student assessment.

Lectures have been a cornerstone of medical education since the introduction of a discipline based curricular model more than two hundred years ago. Recently this instructional strategy has come under criticism because of its reliance on passive learning. There are still many medical schools that cover content predominantly through lectures due to its feasibility. With the introduction of the flipped classrooms, lectures have been given a new lease of life. Improving cognitive imprinting during lectures would enhance retrieval and promote long term storage. Simplifying the content reduces the cognitive load of the information being received and makes it more meaningful hence more memorable. To make learning memorable, rehearsal should be built into the sessions. With the exponential increase in online learning, the need for online learning technologies will require a generation of a large amount of asynchronous video content which should ideally be truly meaningful and memorable, and inspirational to our students.

Background: Preparation of some novel heterocyclic compounds with long alkyl and alkenyl chain of cytotoxic activity., Methods: Gamma linolenic acid, a poly unsaturated fatty acid and stearic acid, a saturated fatty acid were isolated from the microalga Spirulina platensis. Some novel gamma linolenic acid and stearic acid analogues having 1,3,4-oxadiazole and 1,2,4-triazole were synthesized and characterized by IR, 1H NMR, 13C NMR and mass spectral analysis. Cytotoxicity of these compounds was evaluated by the growth inhibition of A-549 cells in-vitro., Results: Compound 1 and 3 showed comparable cytotoxicity against the human lung carcinoma A-549 cell lines.

All types of attribution based on which learners make their judgement (i.e., self efficacy), about academic success or failure or about a specific task usually affect their performance and their capabilities to deal with different realities. It is perhaps the most distinctive capability of self-reflection. Many of the cognitive theorists have defined it as a meta-cognitive capability. This judgement influence learners choose what to do, how much effort to be invested in the activity, how long to carry the phase of disappointment, and whether to approach the task anxiously or with assurance.