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BACKGROUND: Since 2012 the Ethiopian Federal Ministry of Health and Education implemented a new medical curriculum in 13 institutions. The new curriculum introduced some questions on its admission policy: students can join with different educational backgrounds. Students' performance on qualifying exams and grade point average are lower than desired. Therefore, the aim of the study was to investigate what factors predict the academic performance of students in the New Medical Education Initiative in Ethiopia.METHODS: A concurrent mixed method of survey and qualitative was used; for the survey, a structured self-administered questionnaire was distributed to students of four randomly selected medical schools from December 2018 to January 2019. The questionnaire includes questions about socio-demographic and educational background of participants. Multiple linear regression analysis was used in order to identify the factors associated with academic performance. In-depth interviews were conducted with 15 key informants to explore qualitatively.RESULTS: In the multiple linear regressions, stress was associated with lower academic performance. Students with prior education in the field of health science outperformed students with other bachelors. The cumulative grade point average of the previous bachelor degree and the score on the entrance exam to join medicine also significantly predicted performance. Although some more variables are identified from the qualitative interviews, its findings supported the survey results.CONCLUSIONS: Of the number of predictor variables analyzed in the model, only stress, prior educational degree, performance in the prior degree and entrance exam score were significantly correlated with the performance of students in their preclinical medical engagement.

Educators use entrustment, a common framework in competency-based medical education, in multiple ways, including frontline assessment instruments, learner feedback tools, and group decision making within promotions or competence committees. Within these multiple contexts, entrustment decisions can vary in purpose (i.e., intended use), stakes (i.e., perceived risk or consequences), and process (i.e., how entrustment is rendered). Each of these characteristics can be conceptualized as having 2 distinct poles: (1) purpose has formative and summative, (2) stakes has low and high, and (3) process has ad hoc and structured. For each characteristic, entrustment decisions often do not fall squarely at one pole or the other, but rather lie somewhere along a spectrum. While distinct, these continua can, and sometimes should, influence one another, and can be manipulated to optimally integrate entrustment within a program of assessment. In this article, the authors describe each of these continua and depict how key alignments between them can help optimize value when using entrustment in programmatic assessment within competency-based medical education. As they think through these continua, the authors will begin and end with a case study to demonstrate the practical application as it might occur in the clinical learning environment.

Resumo: Efetua-se uma análise preliminar dos dados obtidos por meio de pesquisa sobre aprendizagem no Curso de Medicina da Universidade Estadual de Maringá, na qual estudantes foram inquiridos acerca da avaliação de disciplinas do curso e da metodologia adotada pelos professores. Nos resultados de 1997, os alunos apontaram dificuldades em sua formação, sobretudo pela dicotomia entre teoria e prática, excesso de aulas teóricas em detrimento da prática, estratégias de ensino tradicionais, como aulas expositivas, seminários e avaliações pautadas apenas na memorização de fragmentos de conteúdo. Essas dificuldades, em nossa visão, têm a ver com a construção de novas abordagens para o conhecimento e a formação médica. Abstract: The purpose of this article is to provide a preliminary analysis of data obtained through a study on teaching in the School of Medicine at the State University in Maringá, Paraná, Brazil, in which students were asked to evaluate the course contents and methodologies adopted by professors.

Background Rubrics are frequently used to assess competencies in outcome-based medical education (OBE). The implementation of assessment systems using rubrics is usually realised through years of involvement in projects with various stakeholders. However, for countries or specialities new to OBE, faster and more simplified processes are required. In March 2019, Japan introduced nine competencies and generic rubrics of competencies for medical residents. We explored the local adaptation of these generic rubrics and its consequences for assessors. Methods The study followed three steps. First, we locally adapted the generic rubrics. This was followed by conducting mixed-method research to explore the effect of the local adaptation. In step two, we examined the correlations between the scores in the locally adapted assessment sheets for supervising doctors and generic rubrics. In step three, we conducted interviews with supervising doctors. The study was conducted in the General Internal Medicine Department of Nagoya University, Japan. In the first step, doctors in the Medical Education Center and other medical departments, clerks, and residents participated. Supervising doctors in the General Internal Medicine Department participated in the second and third steps. Results A locally adapted assessment system was developed and implemented in seven months. The scores of the generic rubrics and the adapted assessment tool completed by the supervising doctors showed good correlations in some items as opposed to others, assessed mainly with other tools. Participant interviews revealed that local adaptation decreased their cognitive load leading to consistent ratings, increased writing of comments, and promoting reflection on instruction. Conclusions This adaptation process is a feasible way to begin the implementation of OBE. Local adaptation has advantages over direct use of generic rubrics.

The intelligence test consists of a series of exercises designed to measure intelligence. Intelligence is generally understood as mental capacity that enables a person to learn at school or, more generally, to reason, to solve problems, and to adapt to new (challenging) situations. There are many types of intelligence tests depending on the kind of person (age, profession, culture, etc.) and the way intelligence is understood. Some tests are general, others are focused on evaluating language skills, others on memory, on abstract and logical thinking, or on abilities in a wide variety of areas, such as, for example, recognizing and matching implicit visual patterns. Scores may be presented as an IQ (intelligence quotient), as a mental age, or simply as a point on a scale. Intelligence tests are instrumental in ordering, ranking, and comparing individuals and groups. The testing of intelligence started in the 19th century and became a common practice in schools and universities, psychotechnical institutions, courts, asylums, and private companies on an international level during the 20th century. It is generally assumed that the first test was designed by the French scholars A. Binet and T. Simon in 1905, but the historical link between testing and experimenting points to previous tests, such as the word association test. Testing was practiced and understood in different ways, depending not only on the time, but also on the concrete local (cultural and institutional) conditions. For example, in the United States and Brazil, testing was immediately linked to race differences and eugenic programs, while in other places, such as Spain, it was part of an attempt to detect “feebleness” and to grade students at certain schools. Since its beginning, the intelligence test received harsh criticism and triggered massive protests. The debate went through the mass media, leading to the infamous “IQ test wars.” Thus, nowadays, psychologists are aware of the inherent danger of cultural discrimination and social marginalization, and they are more careful in the promotion of intelligence testing. In order to understand the role the intelligence test plays in today’s society, it is necessary to explore its history with the help of well-documented case studies. Such studies show how the testing practice was employed in national contexts and how it was received, used, or rejected by different social groups or professionals. Current historical research adopts a more inclusive perspective, moving away from a narrative focused on the role testing played in North-America. New work has appeared that explores how testing was taking place in different national and cultural environments, such as Russia (the former Soviet Union), India, Italy, the Netherlands, Sweden, Argentina, Chile, and many other places.

Contains fulltext : 196821.pdf (Publisher’s version ) (Open Access) OBJECTIVES: Within programmatic assessment, the ambition is to simultaneously optimise the feedback and the decision-making function of assessment. In this approach, individual assessments are intended to be low stakes. In practice, however, learners often perceive assessments designed to be low stakes as high stakes. In this study, we explored how learners perceive assessment stakes within programmatic assessment and which factors influence these perceptions. METHODS: Twenty-six learners were interviewed from three different countries and five different programmes, ranging from undergraduate to postgraduate medical education. The interviews explored learners' experience with and perception of assessment stakes. An open and qualitative approach to data gathering and analyses inspired by the constructivist grounded theory approach was used to analyse the data and reveal underlying mechanisms influencing learners' perceptions. RESULTS: Learners' sense of control emerged from the analysis as key for understanding learners' perception of assessment stakes. Several design factors of the assessment programme provided or hindered learners' opportunities to exercise control over the assessment experience, mainly the opportunities to influence assessment outcomes, to collect evidence and to improve. Teacher-learner relationships that were characterised by learners' autonomy and in which learners feel safe were important for learners' believed ability to exercise control and to use assessment to support their learning. CONCLUSIONS: Knowledge of the factors that influence the perception of assessment stakes can help design effective assessment programmes in which assessment supports learning. Learners' opportunities for agency, a supportive programme structure and the role of the teacher are particularly powerful mechanisms to stimulate the learning value of programmatic assessment.

BACKGROUND: Identification and assessment of professional competencies for medical students is challenging. We have recently developed an instrument for assessing the essential professional competencies for medical students in Problem-Based Learning (PBL) programs by PBL tutors. This study aims to evaluate the reliability and validity of professional competency scores of medical students using this instrument in PBL tutorials.METHODS: Each group of seven to eight students in PBL tutorials (Year 2, n = 46) were assessed independently by two faculty members. Each tutor assessed students in his/her group every five weeks on four occasions. The instrument consists of ten items, which measure three main competency domains: interpersonal, cognitive and professional behavior. Each item is scored using a five-point Likert scale (1 = poor, 5 = exceptional). Reliability of professional competencies scores was calculated using G-theory with raters nested in occasions. Furthermore, criterion-related validity was measured by testing the correlations with students' scores in written examination.RESULTS: The overall generalizability coefficient (G) of the professional competency scores was 0.80. Students' professional competencies scores (universe scores) accounted for 27% of the total variance across all score comparisons. The variance due to occasions accounted for 10%, while the student-occasion interaction was zero. The variance due to raters to occasions represented 8% of the total variance, and the remaining 55% of the variance was due to unexplained sources of error. The highest reliability measured was the interpersonal domain (G = 0.84) and the lowest reliability was the professional behavior domain (G = 0.76). Results from the decision (D) study suggested that an adequate dependability (G = 0.71) can be achieved by using one rater for five occasions. Furthermore, there was a positive correlation between the written examination scores and cognitive competencies scores (r = 0.46, P CONCLUSIONS: This study demonstrates that professional competency assessment scores of medical students in PBL tutorials have an acceptable reliability. Further studies for validating the instrument are required before using it for summative evaluation of students by PBL tutors.

To describe the development of the Dutch Radiology Progress Test (DRPT) for knowledge testing in radiology residency training in The Netherlands from its start in 2003 up to 2016. We reviewed all DRPTs conducted since 2003. We assessed key changes and events in the test throughout the years, as well as resident participation and dispensation for the DRPT, test reliability and discriminative power of test items. The DRPT has been conducted semi-annually since 2003, except for 2015 when one digital DRPT failed. Key changes in these years were improvements in test analysis and feedback, test digitalization (2013) and inclusion of test items on nuclear medicine (2016). From 2003 to 2016, resident dispensation rates increased (Pearson’s correlation coefficient 0.74, P-value

INTRODUCTION: Either a pass/fail approach or a seven-point grading scale are used to evaluate students at the Danish universities. The aim of this study was to explore any effect of the assessment methods on student performances during oral exams.METHODS: In a prospective study including 1,037 examinations in three medical subjects, we investigated the difference in the test scores between the spring- and autumn semester. In the spring semester, the students could either pass or fail the subject (pass/fail) while in the following autumn semester, the students were assessed by tiered grading (seven-point grading scale). Unknown to the students, the examiners assessed the students by the seven-point grading scale also in the spring semester. Students at the international classes who were officially assessed by the seven-point grading scale during both semesters served as control group.RESULTS: The grading scores were significantly higher among students who were aware of being evaluated with the seven-point grading scores compared with the pass/fail group (p < 0.0001). In comparison, no significant difference between the exam results was observed from the spring- to the autumn semester for the control group (p = 0.45). Moreover, the average mark was higher among the international students (mean = 10.3, on the seven-point grading scale) than in the Danish speaking classes (mean = 9.1).CONCLUSION: The seven-point grading scale seems to motivate students to yield a better performance; hence tiered-grading should probably be preferred to a simple pass/fail approach.FUNDING: none.TRIAL REGISTRATION: not relevant.

Background: Shared learning activities aim to enhance the collaborative skills of health students and professionals in relation to both colleagues and patients. The Readiness for Interprofessional Learning Scale is used to assess such skills. The aim of this study was to validate a Danish four-subscale version of the RIPLS in a sample of 370 health-care students and 200 health professionals. Methods: The questionnaire was translated following a two-step process, including forward and backward translations, and a pilot test. A test of internal consistency and a test-retest of reliability were performed using a web-based questionnaire. Results: The questionnaire was completed by 370 health care students and 200 health professionals (test) whereas the retest was completed by 203 health professionals. A full data set of first-time responses was generated from the 570 students and professionals at baseline (test). Good internal association was found between items in Positive Professional Identity (Q13-Q16), with factor loadings between 0.61 and 0.72. The confirmatory factor analyses revealed 11 items with factor loadings above 0.50, 18 below 0.50, and no items below 0.20. Weighted kappa values were between 0.20 and 0.40, 16 items with values between 0.40 and 0.60, and six items between 0.60 and 0.80; all showing p-values below 0.001. Conclusion: Strong internal consistency was found for both populations. The Danish RIPLS proved a stable and reliable instrument for the Teamwork and Collaboration, Negative Professional Identity, and Positive Professional Identity subscales, while the Roles and Responsibility subscale showed some limitations. The reason behind these limitations is unclear.

Simulations have become a common educational tool among nursing students; however, the impact of clinical simulations as tested using an experimental design is not yet well established. In a controlled intervention study, nursing students received either traditional classroom lessons (C) or traditional classroom lessons combined with simulation-based lessons at the hospital (I). The primary outcome variable was the basic knowledge of acute nursing measured by a multiple-choice questionnaire. Secondary outcome variables were grade point average, the students’ perception of the learning process, and self-efficacy. Seventy-four students participated in the study; C:n = 36 and I:n = 38. Regarding basic knowledge, there was no significant difference between the groups (I:11.8 ± 0.4, C:12.1 ± 0.4, p = 0.54). The I-group had a more positive perception of the learning process (Δ:6.0 ± 1.1,p < 0.002) and rated their self-efficacy higher (Δ:8.5 ± 2.3,p < 0.002). The students reported higher levels of self-efficacy, when combining the traditional lessons and simulation-based lessons. When combining the two approaches, their fundamental knowledge is not improved.

OBJECTIVE: The concept of the Objective Structured Assessment of Technical Skills (OSATS) is to quantify surgical skills in an objective way and, thereby, produce an additional procedure-specific assessment tool. Since 2005, a 2-day practical course for upcoming specialist registrars in vascular surgery has been obligatory. The aim of this study is to describe the results from a tailored OSATS test as a tool for the evaluation of practical skills during an intensive training session in a simple simulator box for vascular anastomoses. METHOD: Between 2005 and 2013, we registered the OSATS scores of all course participants. The following data were collected from the questionnaires: years as a candidate, months in vascular surgery or in another type of surgery, and the number of vascular anastomoses performed before the course. The assessment of surgical skills was conducted with an OSATS score template specifically made for this purpose. It consists of a 12-item table with a 5-point grading scale. OSATS score (points) and time for the procedure (OSATS time in min) were registered at baseline (OSATS I) and at the end of the course (OSATS II). RESULTS: OSATS scores were given in both OSATS I and OSATS II for the 83 trainees, and the mean difference was 8.1 points (95% CI: 6.7; 9.5, p

Research was conducted on the development, testing, and implementation of an original, evidence-based curriculum (Against the Grain) designed to reduce the frequency and severity of the most frequent types of injuries and fatalities involving young and beginning workers, ages 14-20, at grain storage and handling operations. This population has historically accounted for approximately 24% of documented entrapments, engulfments, asphyxiations, entanglements, falls, and electrocutions associated with grain handling and storage. This includes incidents during both workrelated and non-work or recreational activities. Curriculum contents were based upon data summarized from Purdue’s Agricultural Confined Spaces Incident Database (PACSID), review of relevant injury prevention research, related educational resources and standards, and the provisions of applicable federal workplace safety and health regulations. A standard curriculum development model (DACUM) was used to design the tested curriculum that includes supporting instructional resources and five PowerPointbased lessons. The process identified 27 prioritized learning outcomes upon which the curriculum was based. Contents were tested using sound educational measurement methods including pre- and post-testing, instructor evaluation and participant follow-up assessments. Three educational delivery techniques were utilized for implementation and testing: 1) face to face secondary classroom instruction, 2) face-to-face instruction in informal, out of school or workplace settings, and 3) webinar-based instruction. An independent online instruction option was explored, but not implemented or assessed. The curriculum contents were reviewed and approved by the Federal Occupational Safety and Health Administration (OSHA) under the provisions of the Susan Harwood Training Program. The economic viability or sustainability of each delivery strategy was considered and recommendations made. Findings indicate that the Against the Grain curriculum, as currently available at (www.agconfinedspaces.org), resulted in significant increases in knowledge gain regarding the hazards related to grain storage and handling when presented to secondary-school agricultural education and post-secondary-school agriculture students using face-to-face based instruction. Although students enrolled in secondary-school education programs received lower average pre-test scores, they still showed, as anticipated, greater knowledge gain compared to the post-secondary-school students who completed the training. There was a 31.4% increase in post-test scores received by secondary-school agricultural students, and an 8% increase in post-test scores documented from post-secondary school agricultural students. Initial findings also indicated that the target audiences were more familiar with the hazards associated with grain storage and handling than originally expected, leading to revision of the curriculum contents and test questions. To date, approximately 4,000 young and beginning workers have been exposed to the curriculum and over 1,141 educators have accessed the curriculum contents at the project website. In the year of 2017, additional 670 page views were added to the project website. It was recommended that the curriculum be nationally promoted, that additional curriculum improvement could include updating visuals to more accurately reflect current practices in the grain industry, further alignment with agricultural education standards including both Agricultural, Forestry and National Resources (AFNR) and individual state standards, and adding the five grain safety lessons to the Purdue University developed Gearing Up for Safety curriculum for youth employed in agriculture to increase the scope and utilization of the curriculum.