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The significance of assessment in driving learning is undeniable, particularly in oral assessments like viva voce where students express themselves verbally. However, traditional viva voce examinations' challenges include reliability, objectivity, content validity, time constraints, varying question difficulty levels, inconsistency in questioning among students, the influence of the "halo" effect, and issues with the test environment. Thus the study aimed to evaluate the effectiveness of Objective, Integrated, Clustered Examination Software (VOICES) compared to traditional viva voce methods. Using a mixed-method design with 103 students, questions were framed using VOICES software created by the National Informatics Center (NIC), Chhattisgarh State Center, Government of India, and students responded through voice messages. Faculty graded students based on personalized videos created by the app. Then, feedback was given, and a focused group discussion was conducted for the students. Traditional viva voce examinations were conducted as part of internal assessments, and the marks obtained from these assessments were compared to evaluate their effectiveness in comparison to the VOICES app. There was no significant difference in the marks obtained using both methods indicating that viva voce using an oral assessment app is equally effective. Students responded positively to the VOICES method. The formative oral assessment conducted through the use of the VOICES app successfully addresses the challenges typically associated with traditional viva voce examinations. NEW & NOTEWORTHY Traditional viva voce examination encounters challenges including reliability, objectivity, content validity, time constraints, varying question difficulty levels, inconsistency in questioning among students, the influence of the "halo" effect, and issues with the test environment. Formative oral assessment conducted through the use of the Objective, Integrated, Clustered Examination Software (VOICES) app developed by the National Informatics Center (NIC) successfully addresses the challenges typically associated with traditional viva voce examinations.

Background: This study aimed to evaluate perception of medical students regarding online mode of assessments and to compare the academic outcomes of various methodologies adopted for online formative assessments., Methods: This was a descriptive cross-sectional study. This study was conducted in the department of biochemistry at the constituent medical college of Health University in India and included 150 first year medical undergraduates of either gender. The institutional ethical clearance and written informed consent was taken prior to the study from all the enrolled participants. A series of online formative assessments were designed in the form of multiple choice, short answer questions, case-based learning, and viva-voce to satisfy each learning outcome. Google platform was used for conducting online formative assessment. The participants were asked to fill questionnaire based on 5-point Likert scale to obtain information on challenges and perceptions related to OFA. Academic performance was evaluated and compared for various modes of assessments., Results: The mean age of the participants was 19.34±0.947 years. Most of the students were from urban areas and majority (73.33%) preferred MCQs. 60.67% respondents favored conduction of e-assessments. 80.67% of students agreed that solving clinical cases in the online assessments contributed to clinical learning., Conclusions: Formative online assessment can be used as an intervention to reshape medical education sector during times when infection controls and physical isolation measures are crucial to avoid spread of disease.

Background: Dental education in India predominantly relies on traditional lecture-based learning (LBL), which may hinder student engagement and learning outcomes. To address these limitations, innovative learning methodologies, such as spaced repetition learning (SRL), are imperative. SRL prioritizes active recall and can enhance long-term knowledge retention. This study aims to assess the effectiveness of SRL delivered through a mobile flashcard application, in enhancing knowledge retention among dental undergraduates., Methods: This single-blind randomized controlled trial (CTRI/2023/10/059347), conducted in Belagavi, India, involved 90 dental students who were equally distributed into control (LBL) and test (lecture followed by SRL demonstration) groups after randomization. Rigorous expert review ensured the quality of PowerPoint presentation and mobile flashcard contents. Knowledge assessments were conducted at baseline, first, and third months using a validated and reliable questionnaire. A perception survey on learning techniques was administered after the first month. Analysis methods included descriptive analysis, Pearson's chi-square test, independent t-test, and repeated measures ANOVA with Bonferroni's post hoc test., Results: The pre- and post-intervention knowledge showed no significant differences, but the SRL group exhibited significantly higher retention at both first month (p ≤ 0.001) and third months (p ≤ 0.001) than the LBL group. Repeated measures ANOVA revealed significant pairwise differences in mean knowledge scores in SRL group. Students had significantly favorable perception toward SRL than LBL group., Conclusion: SRL delivered through mobile flashcards significantly enhances knowledge retention compared to LBL among dental students. Positive student perceptions support SRL's integration into dental curricula, with implications for improving knowledge retention among them., (© 2024 American Dental Education Association.)

Objectives: The primary objective of the study was to assess the factors that influenced the increased failure rate among first-year Indian medical students who appeared for the Maharashtra University of Health Science (MUHS) summative university examination, having experienced the competency-based medical education (CBME) curriculum for the first time amid the coronavirus disease (COVID-19) pandemic., Methods: A retrospective cross-sectional online questionnaire-based study was undertaken between July 2021 and November 2021, in which first-year Indian medical students who were enrolled in the Bachelor of Medicine, Bachelor of Surgery (MBBS) program in the year 2019 and appeared for the MUHS summative university examination in February 2021 were invited to participate. Analysis was done using JASP (v0.16.0.0), and the odds ratio for failure was calculated at a significance level of P < 0.05., Results: Responses were obtained from 360 individuals, of whom 74.5% had passed and 25.5% had failed (n = 360). The odds of failure in first-year MBBS summative university examination was higher in students with irregular Internet access, irregular device access, an unsupportive peer environment in college, a National Entrance cum Eligibility Test score below 500, an unsupportive family environment during the lockdown, severe stress, severe depression, testing positive for COVID-19 before the exam, death in the family during the exam, and failing in terms and prelims and students of male gender ( P < 0.01)., Conclusion: The total failure rate of 27% in the MUHS examination was mainly attributed to interplay between the student's mental health, lack of devices or Internet, and the changed assessment part of the CBME curriculum. Surprisingly, lecture frequencies, teaching patterns, and study resources did not influence the failure rate. These results can be used to formulate interventions that will help to improve academic performance and mental health students and thus help them adapt to the new curriculum., (Copyright © 2024 Copyright: © 2024 Journal of Postgraduate Medicine.)

Medical science is a dynamic field of knowledge that is constantly broadening with upcoming clinical research and analysis. Traditional medical education has been focused on textbook-based recall assessments-closed book assessment (CBA). However, the availability of newer technologies has made the accessibility to encyclopedic knowledge expeditious, which demands for a new approach for medical education. As medical professionals, the purpose of learning should be higher cognitive skills such as interpretation and synthesis. So, analyzing students' ability to comprehend the concepts and learning to apply it in a realistic context than merely recalling the facts has come into attention. In this study, we aimed to evaluate and compare the performance of 250 first-year MBBS students at Maulana Azad Medical College, New Delhi, India, between closed book and open book method for biochemistry. Students were divided into two groups, Group A and Group B, based on their average monthly internal assessment marks. CBA was followed by open book assessment (OBA) 1 week apart with similar questionnaire pattern and allotted time. A significant difference in average marks obtained by the two groups was observed in CBA. Group A scored better in CBA, but performance was comparable with Group B in OBA. OBA and CBA can contribute to an assessment program in part because of their complementary pros and cons, and OBA should not be thought of as an alternative to CBA, but their value may be in expanding beyond what is measured by CBA., (© 2024 International Union of Biochemistry and Molecular Biology.)

India introduced competency-based medical education (CBME) in the year 2019. There is often confusion between terms like ability, skill, and competency. The provided curriculum encourages teaching and assessing skills rather than competencies. Though competency includes skill, it is more than a mere skill, and ignoring the other aspects like communication, ethics, and professionalism can compromise the teaching of competencies as well as their intended benefits to the patient and the society. The focus on skills also undermines the assessment of relevant knowledge. This paper clarifies the differences between ability, skill, and competency, and re-emphasizes the role of relevant knowledge and its assessment throughout clinical training. It is also emphasized that competency assessment is not a one-shot process; rather, it must be a longitudinal process where the assessment should bring out the achievement level of the student. Many of the components of competencies are not assessable by purely objective methods and there is a need to use expert subjective judgments, especially for the formative and classroom assessments. A mentor adds to the success of a competency-based curriculum.

Aim: To determine the knowledge of pressure injury among Indian nurses using PZ-PUKT questionnaire and to evaluate the effect of an educational intervention on knowledge scores., Materials and Methods: A Quasi-experimental study design was used to test the Pressure injury knowledge of 273 nurses in a tertiary care teaching hospital. The Pieper Zulkowski Pressure Ulcer Knowledge Test questionnaire was given as a pre-test prior to education session and re-administered after the activity was completed., Results: The mean score of the pre-test was 48.58 ± 6.75 (C·I 47.8-49.4) and post-test 54.14 ± 7.69 (C·I 53.3-55.1), which showed a statistically significant improvement. In the pre-test, nurses had highest score in the prevention subset while wound subset had the greatest improvement in the post-test. Female participants had a better understanding about Pressure injuries when compared to males. Also, the Assistant Nursing Superintendents and ward in Charge nurses had better knowledge as compared with other nurses., Conclusions: The knowledge of pressure injury among nurses is limited. Knowledge deficits should be identified and targeted educational interventions should be administered to all the nurses irrespective of their educational level and work experience. Wound certification courses should be instituted so that it gives the nurses a better opportunity to learn about pressure injuries at a certified level. All nurses should undergo periodic training in this ever-evolving field so as to provide the best care to their patients., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Dental education is considered as a complex, challenging and often stressful educational procedure. Acquisition of psychomotor skills by undergraduate students is an important step in many health professions to become a successful professional. During under graduation, class II cavity preparation exercise is of utmost important in dentistry., Objective: To compare class II cavities prepared by students after hands-on live demonstration and pre-recorded video demonstration using well-organised evaluation rubrics., Method: Preclinical dental students (n= 50) were divided into two groups. The students in group I (n= 25) attended a hands-on live demonstration performed by one faculty while students in group II (n= 25) watched a 15-minute pre-recorded procedural video on the projector. Both groups were appealed to prepare class II cavity for amalgam involving disto-occlusal surface of mandibular second molar articulated on jaw model (TRU LON study model, Jayna industries, Ghaziabad U.P., India). Following completion of the preparations, all teeth were collected, and labelled grades of prepared cavities were given according to prespecified rubrics. The data of scores were presented as means and standard deviation. Statistical analysis of data was executed using SPSS software. A paired t-test was used to compare scores between groups., Results: The study shows that the video-supported demonstration of a cavity preparation was better than the live hands-on demonstration. A higher mean response for the procedural video group was found compared to the live demonstration group (p= 0.000133)., Conclusion: Pre-recorded video-supported demonstration along with guidance by a tutor may be a viable alternative to hands-on live demonstration in cavity preparation procedures during undergraduate dental training. Moreover, rubric methods can be implemented in the teaching of various preclinical exercises for conservative dentistry and endodontics.

Background At Sri Balaji Vidyapeeth, a competency-based learning and training (CoBaLT©) model for postgraduate (PG) curriculum, within the regulatory norms, was implemented in 2016 after adequate faculty development programmes. This focused on well-defined outcomes. Methods A review of the outcomes was undertaken in 2018 as part of internal quality assurance receiving feedback from all stakeholders, viz. students, alumni and faculty. Recent publications were also reviewed. A major problem identified was lack of clarity in definition of levels leading to subjectivity in assessment while grading. It was also noted that the process needed to be aligned with the programme outcomes. Further refinements were, therefore, made to align and objectivize formative assessment using entrustable professional activities (EPA) with the aid of descriptive rubrics of sub-competencies and milestones. Addition of detailed rubrics for objectivity takes assessment a step beyond the Dreyfus model, aligning overall to the programme outcomes. Results Achievement of appropriate grades in EPAs by individual candidates ensures entrustability in professional activities by the time of completion of the PG programme. The modification was found more transparent and objective with reference to grading by the teachers and more conducive to reflections by the residents on their performance and how to improve it. Conclusions The use of descriptive rubrics along with EPAs brings transparency and plays a key role as an objective assessment tool, which can lend direction to individual resident learning and entrustability. This is an important component of outcome-based education.

COVID-19 pandemic has had a profound impact on the delivery of medical education, training and examination schedule across the world both at undergraduate and at postgraduate (PG) levels. The novel coronavirus SARS-CoV-2 outbreak has resulted in the cancellation of traditional in-person meetings and clinical examination assessments, learning and education activities because of concern of viral transmission. Various medical universities, Royal Medical and Surgical Colleges in the UK have suspended delivery of qualifying examinations until they can be resumed safely with updated social distancing guidelines. This article evaluates the role and the possibility of virtual PG practical examination template based on authors' own recent experience of conducting successful virtual practical PG orthopaedic qualifying examinations during the COVID-19 pandemic in New Delhi, India. Advances in telecommunication technology can enable academic institution and orthopaedic educators to develop such a model and act as a blueprint for the future., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectively Structured Clinical/Practical Examination (OSCE/OSPE) has been the backbone of the assessment system of graduate medical education for over three decades. We have developed an electronic Objectively Structured Practical Examination (e-OSPE) in Medical Biochemistry using the freely available Google forms to mitigate the academic disruption posed by COVID-19 pandemic in our resource-poor setting. Ten e-OSPE stations created, interlinked, and time-restricted. Fifty undergraduate students appeared for the e-OSPE examination on a prefixed date and time. Learner feedback was collected immediately after the completion of the examination. Facilitator feedback was also collected. Students' mean scores in e-OSPE and traditional OSPE were 78.15% and 74.56%, respectively. Their difference was not statistically significant (paired t-test two-tailed p-value 0.0979). Thus, the results of e-OSPE are reliable as compared to traditional OSPE. Bland Altman Plot revealed 92% of students had scores that were in the agreeable limit of both traditional OSPE and e-OSPE. Both the learners and facilitators were in consensus that the online format of e-OSPE is a good alternative for assessment (0.67 and 0.82); their experience was good (0.72 and 0.92) and conduction was well organized (0.73 and 0.86). Several suggestions were also received to make e-OSPE even more effective. In conclusion, this pilot study showed e-OSPE can be an effective alternative to traditional OSPE when "in-person" evaluation is not possible such as in the current era of COVID-19 even in resource-limited settings., (© 2021 International Union of Biochemistry and Molecular Biology.)

Purpose: COVID 19 pandemic has brought crucial changes in the field of medical education. Ad mist university examinations in India medical schools have switched to online assessment methods to avoid student gatherings. In this context, we conducted online anatomy practical evaluation and we have aimed at quantifying the students' experience on virtual assessment., Methods: A total of 250 first year MBBS students appeared for online anatomy practical examinations. Immediately after the completion of exams electronic feedback about their experience, in questionnaire format was obtained after getting informed consent. Their feedback was analysed and quantified., Results: Completed feedback forms were submitted by 228 students. More than 50% of students favoured online anatomy spotter examinations. Only 32.8% of students were comfortable with soft parts discussion using images. For image based viva voce 61.4%, 80% & 82% of students responded that the features and orientation of osteology, radiology and embryology images, respectively, were good. For surface marking 55% of the participants preferred online verbal evaluation. Finally, more than 60% of the students preferred the conventional over online assessment methods., Conclusions: The inclination of students' preference for traditional anatomy examination methods mandates adequate training of both students and teachers for virtual examination. The superiority of conventional anatomy practical examination methods is unbiased but pandemic situations warrant adequate preparedness. In the future the anatomy teaching and evaluation methodology in Indian medical schools have to be drastically reviewed in equivalence with global digitalization.

The uncertainty in all spheres of higher education due to the COVID-19 pandemic has had an unprecedented impact on teaching-learning and assessments in medical colleges across the globe. The conventional ways of assessment are now neither possible nor practical for certifying medical graduates. This has necessitated thoughtful considerations in making adjustments to the assessment system, with most institutions transitioning to online assessments that so far have remained underutilized. Programmatic assessment encourages the deliberate and longitudinal use of diverse assessment methods to maximize learning and assessment and at present can be utilized optimally as it ensures the collection of multiple low-stake assessment data which can be aggregated for high-stake pass/fail decisions by making use of every opportunity for formative feedback to improve performance. Though efforts have been made to introduce programmatic assessment in the competency-based undergraduate curriculum, transitioning to online assessment can be a potential opportunity if the basic tenets of programmatic assessment, choice of online assessment tools, strategies, good practices of online assessments and challenges are understood and explored explicitly for designing and implementing online assessments. This paper explores the possibility of introducing online assessment with face-to-face assessment and structuring a blended programmatic assessment in competency-based medical education., Competing Interests: None

With the introduction of competency-based undergraduate curriculum in India, a paradigm shift in the assessment methods and tools will be the need of the hour. Competencies are complex combinations of various attributes, many of which being not assessable by objective methods. Assessment of affective and communication domains has always been neglected for want of objective methods. Areas like professionalism, ethics, altruism, and communication-so vital for being an Indian Medical Graduate, can be assessed longitudinally applying subjective means only. Though subjectivity has often been questioned as being biased, it has been proven time and again that a subjective assessment in expert hands gives comparable results as that of any objective assessment. By insisting on objectivity, we may compromise the validity of the assessment and deprive the students of enriched subjective feedback and judgement also. This review highlights the importance of subjective assessment in competency-based assessment and ways and means of improving the rigor of subjective assessment, with particular emphasis on the development and use of rubrics., Competing Interests: None

Purpose: To assess the awareness and knowledge about diabetic retinopathy (DR) and associated factors among patients visiting the tertiary health center in Goa., Methods: A cross-sectional descriptive study was conducted using a standard predesigned and pretested closed-ended structured questionnaire to assess the awareness, knowledge, attitude and practice about DR among patients visiting a tertiary health center., Results: Three hundred and fifty-eight subjects participated in the study. Only 125 (34.9% [95% CI: 30.0-40.1]) subjects were aware of DR and 122 (34.1% [95% CI: 29.2-39.2]) had adequate knowledge about DR. Awareness and knowledge of DR were significantly high among the subjects who completed college level of education (66.7%, OR = 2.78; 95% CI: 1.73-4.48, P < 0.001 and 55.9%, OR = 3.92; 95% CI: 2.41-6.38, P < 0.001) and who spoke English (52.5%, OR = 3.37; 95% CI: 2.14-5.30, P < 0.001 and 50.4%, OR = 3.26; 95% CI: 2.07-5.14, P < 0.001). Christians reported better knowledge about DR compared to other religions (48.8%, OR = 2.27; 95% CI: 1.38-3.75, P = 0.005). Negative association was noted between the knowledge of DR and presence of diabetes (29.4%, OR = 0.64; 95% CI: 0.41-0.99, P = 0.048). The practice pattern was strongly associated (OR = 7.47; 95% CI: 4.51-12.38, P < 0.001) with the knowledge of DR. Attitude was not influenced by any of the factors., Conclusion: We found that awareness and knowledge about DR were unsatisfactory; literacy contributed significantly toward it. These findings also suggest that there is an immediate need to enhance the awareness and knowledge of diabetic eye diseases in order to reduce the burden of visual impairment., Competing Interests: None

Background: Adoption of competence-based medical education (CBME) is the need of the hour., Objectives: The objective of the study is to develop and validate appropriate assessment tools for the community medicine entrustable professional activities (EPAs) and to assess the usefulness of the validated tools in the assessment of postgraduate (PG) students., Methods: An interventional study for 14 months was done in the department of community medicine. After the sensitization of faculty members and PGs, three EPAs were selected through consensus between faculty members and appropriate assessment tools mini-clinical evaluation exercise (Mini-CEX), case-based discussion (CBD), and direct observation of procedural skills (DOPS). Rubrics of milestones were formulated for the selected tools, and the designed tools were validated. These three validated tools were used for the quarterly assessment., Results: The item-content validity index for all three assessment tools was one, while Scale Content Validity Index for Mini-CEX and CBD were 1, and for DOPS, it was 0.87. Three PG students were assessed using the validated tools thrice for the three selected EPAs. The PGs opined that assessment using rubrics made their task-specific, while faculties were quite satisfied with the assessment process as it removed subjectivity., Conclusions: The developed and selected tools of EPAs were found to have a substantial level of both face validity and content validity. The tools were also found to useful for periodic assessment in workplace settings and acceptable to both PG students and internal/external faculty members., Competing Interests: None

Introduction: Diabetes knowledge has a large impact on glycemic control. There is a pressing need for creation of validated tests of knowledge for different ethnic groups., Objective: To create and validate a diabetes knowledge test (DKT) for young Indians with type 1 diabetes mellitus (T1DM)., Methods: We created a 34 item Hindi language DKT, with basic (19-questions) and advanced (15-questions) components. It was administered to 77 consecutive patients who had previously received in-hospital diabetes education. We hypothesized that the test scores would be higher for patients residing in urban regions, for patients with higher maternal education, and those with lower HbA1c. Cronbach's alpha (α) was used to calculate the test reliability., Results: The DKT score was significantly higher in families with higher (>class 12th) maternal formal education compared with lower [70.0 (95% C.I. 67.2-73.5) vs 54.2 (95% C.I. 44.0-57.3), p<0.001] and urban residence compared with rural [68.5 (95% C.I. 63.4-70.6) vs 54.5 (95% C.I. 42.5-61.7), p<0.001]. It had negative correlation with HbA1c (r=-0.268, p=0.019). The Cronbach's α was 0.87 for the entire test, and for the basic and advanced components was 0.78 and 0.74 respectively., Conclusion: The DKT India is a valid and reliable instrument to evaluate diabetes knowledge in Hindi speaking Indian children, adolescents and young adults with T1DM., (Copyright © 2018 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Purpose: The spotter's (objectively structured practical examination) is an assessment tool which is widely used to test the practical knowledge of anatomy extensively. In Indian context it is used as an inclusive model in the gross anatomy practical examination and the marks allotted to it varies. The traditional spotter examination often has been blamed for only incorporating the initial levels of revised Bloom's taxonomy. This study retrospectively analysed the pre-professional spotter's examination score and tested its efficacy in terms of reliability, internal consistency, validity, educational impact, and resource intensiveness., Methods: The summative data of student's score on four different days of unrepeated spotter's examination and final theory examination score was collected and tabulated. These four group of students acted as independent cohorts. The difficulty index (DI), point biserial correlation (PBC), Cronbach α (CA) and descriptive statistics of each cohort were calculated. Revised bloom taxonomy rating was applied to spotter's., Results: We found heterogenous distribution of spotter's in each cohort according to DI. The PBCs and CA of each cohort were acceptable. The majority of spotter's tested the cognitive and comprehension domain of revised bloom's taxonomy. There was nonsignificant difference between mean scores of cohorts but we found low positive significant correlation between theory and spotter's score., Conclusion: We concluded that the construct of spotter's was reliable, internally consistent, had fair validity, variable educational impact, and sustainable resource intensiveness. We propose urgent redesigning of spotter's to include higher level of taxonomy to comply with emerging curricular changes.

Background: Workshops on research methodology impart skills of research among medical students. Both qualitative and quantitative evaluation of an academic programme is essential to enhance the effectiveness and quality improvement. We assessed the gain in learning and effect of a workshop on research methodology among medical students., Methods: We did a quasi-experimental, single-group study at a tertiary care hospital and research institute in southern India. It included 33 students enrolled in various residency positions of the institute. The Kirkpatrick 4-level model was used to assess the effectiveness of the workshop on research methodology. Paired t-test was used to compare pre- and postworkshop scores., Results: Twenty-five students rated the academic sessions as excellent. The score before the workshop ranged from 0 to 17 with mean (SD) 9.27 (4.2). The post-workshop score had a minimum to maximum score of 10-26 with mean (SD) of 16.18 (3.7) (p<0.005). The effect size d cohen (confidence interval [CI]) was 1.743 (0.942-2.545). The mean (SD) of absolute and relative gain was 10.8 (3.8) and 1.41 (0.07), respectively. 66.7% medical students showed a 30% rise in their post-workshop scores, the cut-off for effectiveness of the workshop., Conclusion: The evaluation of a workshop on research methodology provided insights into the outcomes and modifications required for their future improvement., Competing Interests: None

The mental health of Indian school children could be expected to be a major topic of research. More people below 15 years are living in India than in any other country in the world, and India has undergone rapid social, economic, and demographic changes that have greatly increased the pressures on children to do well in school. Yet there is a striking dearth of research in this field. In this article we present the first-ever study focused on child psychiatrists in India. Based on long-term fieldwork and interviews with psychiatrists in the Kolkata metropolitan area, we present a habitography of how psychiatrists experience young people's problems. Child psychiatrists are greatly concerned about the nexus between heightened expectations of educational success and a rise of mental problems among young people. At the same time, they wonder why not many more children are coming to them with school-related complaints. To date, there is not enough research that could either confirm or disconfirm the psychiatrists' analysis of social changes, but some conclusions on the plausibility of their views can be drawn., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The objectives of the present study were to 1) assess student attitudes to physiology, 2) evaluate student opinions about the influence of an objective structured practical examination (OSPE) on competence, and 3) assess the validity and reliability of an indigenously designed feedback questionnaire. A structured questionnaire containing 16 item statements, 8 items on an Osgood's 5-point semantic differential scale and 8 items on a Likert's 5-point scale, was used. Options were assigned scores of 1-5 according to weightage. For Osgood's semantic differential scale items, a χ(2)-test was done to analyze student attitudes toward the subject. For Likert scale items, mean score and SD were calculated to analyze student opinions of the OSPE. Item validity was assessed by item analysis, and reliability was assessed by calculating Crohnbach's α. The subject as a whole was interesting to 82% of the students (n = 135). The theory was interesting to 75% of the students (n = 132) but complex to 42% (n = 118). The practical was interesting to 93% of the students (n = 134); 76% of the students (n = 104) felt that the practical was simple, whereas 4% felt it was complex. The OSPE was interesting to 79% of the students (n = 131); 57% of the students (n = 116) felt it was simple, whereas 24% found it complex. Components of the subject, intricateness, and student interests were strongly associated. Students chose options on a higher weight scale, favoring the OSPE. Items were found to be valid and reliable. In conclusion, the subject of physiology was interesting but not simple to understand. Student interests varied with the components of the subject, and the components of the subject had varied intricateness. Students were in favor of the OSPE for assessment. The questionnaire used for the study was valid and reliable., (Copyright © 2015 The American Physiological Society.)

The objective of the present study was to know the perceptions of students regarding objective structured practical examination (OSPE) as a tool for assessment in Forensic Medicine. The present study was conducted in the Department of Forensic Medicine and Toxicology, Mahatma Gandhi Medical College and Research Institute (MGMCRI), Pondicherry, India. Undergraduate medical students of the 4th semester were enrolled in the study to know their perceptions regarding OSPE. The students were briefed regarding OSPE with a PowerPoint presentation and interaction. An examination was conducted using OSPE with10 stations and a total of 74 students participated in the study. The feedback was collected using a preformed proforma consisting of 12 items and analyzed. Most of the participants (82.4%) agreed that OSPE is a better method of examination than the conventional/traditional practical examination. The majority of the participants (77.0%) said that the OSPE covered wide range of knowledge than the conventional practical examination. A large number of students (63.5%) were of the opinion that the OSPE may be exhausting and stressful if number of stations are increased. Overall a larger proportion of the participants preferred OSPE over the conventional practical examination considering the various attributes examined in the study., (Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Background: Small group sessions are regarded as a more active and student-centered approach to learning. Item analysis provides objective evidence of whether such sessions improve comprehension and make the topic easier for students, in addition to assessing the relative benefit of the sessions to good versus poor performers. Self-assessment makes students aware of their deficiencies. Small group sessions can also help students develop the ability to self-assess. This study was carried out to assess the effect of small group sessions on item analysis and students' self-assessment., Methods: A total of 21 female and 29 male first year medical students participated in a small group session on topics covered by didactic lectures two weeks earlier. It was preceded and followed by two multiple choice question (MCQ) tests, in which students were asked to self-assess their likely score. The MCQs used were item analyzed in a previous group and were chosen of matching difficulty and discriminatory indices for the pre- and post-tests., Results: The small group session improved the marks of both genders equally, but female performance was better. The session made the items easier; increasing the difficulty index significantly but there was no significant alteration in the discriminatory index. There was overestimation in the self-assessment of both genders, but male overestimation was greater. The session improved the self-assessment of students in terms of expected marks and expectation of passing., Discussion: Small group session improved the ability of students to self-assess their knowledge and increased the difficulty index of items reflecting students' better performance.

Background: Lifelong learning is a skill that must be acquired by medical graduates and proposes that students take the responsibility for learning process. The present study was carried out to measure readiness for self-directed learning among fifth semester MBBS studentsin a tertiary care teaching hospital., Methods: Readiness assessment was carried out among 87 fifth semester MBBS students using Fishers' 40-item self-directed learning readiness score (SDLRS) instrument after taking informed written consent. A total of 40 items were classified into three domains: Self-management (9 items), desire for learning (16 items) and self-control (15 items). Institute scientific society and ethical committee clearance was obtained. The data were entered and analyzed using IBM-SPSS version 21. Chi-square test was used to elicit relationship between readiness assessment and gender, presence of a physician in family and area of residence., Results: Out of 87 students, 64 (73.5%) students consented to be assessed for readiness toward self-directed learning. The mean SDLRS score was 140.4 ± 24.4, with 19 students (30%) scoring more than 150 indicating high readiness.The mean scores in the three domains of self-management, desire for learning and self-control were 38.8 ± 9.8, 47.3 ± 6.9 and 54.3 ± 10.4, respectively. Males had a higher readiness for self-directed learning than females (P = 0.045)., Discussion: Self-directed learning scores were lower among our MBBS students than reported elsewhere in the literature.

Background: Some assessment methods of clinical learners have limitations so that students might not reflect their performance in actual clinical situations. Educational research has so far not yielded a single 'gold-standard' performance assessment tool. Mini-CEX (clinical evaluation exercise) is an instrument intended for work-based assessment of actual clinical performance, including a range of skills like communication and humanistic qualities. It involves direct observation of real patient encounters followed by one-on-one structured feedback sessions between assessors and the trainees. Mini-CEX has already found wide acceptance in medical education but is largely untested in dental education., Methods: Twelve dental undergraduate students underwent one mini-CEX encounter each. Four teachers performed the roles of assessors, directly observing the students and rating their performance using the standardized mini-CEX rating form. A systematic feedback session then took place, following which students' and teachers' perception of the mini-CEX was sought through structured questionnaires., Results: Almost all students appreciated that their communication skills were assessed, but some felt that the presence of a teacher was intimidating. They felt that the constructive feedback helped them reinforce the skills that they did well. The assessors found planning for mini-CEX time consuming and also felt that that their presence had an impact on the students' performance. However, teachers reported that the mini-CEX allows them to assess students' professionalism and communication skills, which are important in dentistry., Discussion: Data from this pilot study supports the use of mini-CES in dental education, but still the need for wider studies remains. It also explains the ways in which undergraduate dental students and teachers find the mini-CEX useful and how it could be improved and used more effectively.

Background: Internet-based distance learning combined with local hands-on skill enhancement can provide high-quality standardized education to in-service healthcare professionals in a wide geographical area., Objective: Primary objective of this study was to evaluate the efficacy of internet-based distance learning in conjunction with local hands-on skill enhancement in improving knowledge and skills of essential newborn care among in-service nursing health professionals., Methods: A total of 98 participants from seven health facilities in India and Maldives were enrolled in the study. Delivery of course material staggered over 5 weeks in the form of two lessons every week was moderated by two to three online tutors at each site. Participants managed actual case scenarios, participated in discussion forums and synchronous chat sessions within a closed group. Skill learning was administered by local tutor at the partnering health facilities. Knowledge and skill enhancement were evaluated by administering online multiple-choice questions (MCQs) test and on-site objective structured clinical evaluation (OSCE) stations before and after completion of the course. Participants' satisfaction was evaluated on a five-point Likert scale., Results: Among 98 participants enrolled in the study, 78 (79%) completed the post-test assessment. There was significant increase in knowledge and skills scores (MCQ test: mean difference: 6.4 (95% CI: 5.6-7.17), OSCE: mean difference: 15.4 (95% CI: 12.7-18.1). All the participants expressed satisfaction with content and delivery of the learning module., Conclusion: To conclude, online training and teaching in essential newborn care is feasible and acceptable for in-service nursing professionals and serves as a useful tool for professional development of their practical skills and knowledge.

In-training Assessment (ITA) has the potential to test a wide range of competencies which are not testable by the year-end examination. However, despite high validity, educational impact and feasibility; its implementation is flawed. This paper proposes a quarter model of intraining assessment for implementation in the undergraduate medical curriculum in India. The model proposes that assessments be carried out at least quarterly; no teacher should contribute more than 25% of the marks for any student; no single assessment tool should contribute more than 25% marks; and no assessment should contribute to more than 25% of the total marks. We believe that structuring the implementation using multiple tests on multiple content areas by multiple examiners using multiple tools in multiple settings in the proposed quarter model will not only improve the reliability and validity of internal assessment, but also its acceptability.

Background: Though formative assessments are popular in medical education, but data to establish their educational benefits are lacking. This study was conducted to determine whether participation and performance of MBBS students in regular formative assessments are associated with positive outcomes and has measurable effects on learning., Methods: One hundred and fifty MBBS students of semester II attending Biochemistry classes were studied by dividing into two groups till the completion of a topic. End-of-topic summative assessment marks were analysed with respect to the effect of participation and performance in formative assessments., Results: Participation in formative assessments had a statistically significant positive relationship with summative assessment marks. Mean difference in formative and summative assessment marks for group that participated in formative assessments is 1.6 (95% CI = 0.9-2.4, p < 0.001). The mean difference in summative assessment marks for two groups is 3.4 (95% CI = 2.3-4.6, p < 0.001). The mean difference in marks obtained by solving case studies given in Summative Assessment for two groups is 1.2 (95% CI = 0.7-1.6, p < 0.001)., Conclusions: Formative assessment not only assesses students' achievements but it also enables students to recognise the areas in which they are having difficulty and to concentrate their future efforts on those areas. Adequate frequency of formative assessment with immediate feedback is beneficial as it stimulates meaningful and multifaceted learning. The results of this study encourage the use of formative assessment as an educational tool in all MBBS subjects for they have significant positive effects on learning.

The purpose of this retrospective study was to evaluate the quantitative assessment of a structured essay and standardized oral examination and its correlation to the final-year graduating exam in the Department of Pediatric Dentistry, Meenakshi Ammal Dental College and Hospital, Chennai, India. The records of 531 students from 2005 to 2009 were collected. Students were categorized based on their "completion" and "grading" in a structured essay and standardized oral examination, which is a continuous assessment of dental students in the college. The grades obtained by continuous assessment were compared to students' final-year examination scores. The assessment showed that students who completed all tasks and had desirable performance in their written assessment and standardized oral examination also scored better on their final examination. Therefore, the continuous assessment by written assessment and standardized oral examination had a direct relationship to students' performance on the final examination and is useful for evaluation.

Teaching and learning activities in the dental clinic or hospital are a challenging area for students as well as teachers. With various teaching methodologies being used in dental schools around the world, gaining greater understanding of students' attitudes toward these methodologies would be useful for dental educators. The objective of this study was to explore the preferences of dental students in India about various aspects of lecture courses. A structured survey consisting of ten closed-ended questions was developed, and 2,680 undergraduate students from forty-three dental schools in India were approached via e-mail with a follow-up postal mailing. Of these, 1,980 students responded, for a response rate of 73.8 percent. Most of the students reported preferring lectures with the aid of PowerPoint and chalkboard. They preferred morning lectures from 8 am to 10 am for a maximum of thirty to forty minutes for each lecture, and they preferred to receive information about the lecture topic in advance. The students said that delivery of clinical demonstrations was beneficial after the lectures, and they preferred learning-based rather than exam-oriented education. The respondents also said that attendance should be made compulsory and that numerical marking of examinations should not be replaced by a grading system.

The objective structured clinical examination (OSCE) is being widely used for assessment of skills in dental education around the world. In India, OSCE awareness is rising, and a few exploratory attempts have been made in its implementation. This article describes use of a five-station mini-OSCE for formative assessment of dental diagnostic and radiographic skills in an undergraduate curriculum. Besides gaining experience in OSCEs, the purpose of this project was to study their validity, objectivity, feasibility, acceptability to students and faculty, and impact on student performance. The mini-OSCE was found to be a fairly valid and reliable tool for formative assessment, though it required more planning, preparation, and resources than other means of assessment. A specially developed orientation module improved its feasibility. The nineteen students perceived it to be a meaningful examination and a fair method due to uniformity of tasks and time allocation; they found the scoring to be transparent and objective. The specific and immediate feedback received was appreciated by both students and faculty members.

Introduction: In India, there has been little effort to teach medical students about public health research. Few medical institutions in India and nearby Nepal formally offer exposure to field surveys or projects to medical undergraduates as a part of their training in community medicine. Little is known about the effect of such activity on students or how they apply what they learn. We implemented a systematic, hands-on experience in the public health research process with medical undergraduates in Puducherry, India to evaluate its effect on students., Material and Methods: Two groups, each with 30 third-semester (second year) medical undergraduates, participated in a 15-day, two and one-half hours per day course on the public health research process. At the end of course, a retrospective post-then-pre self-assessment of students skills was obtained. One year later, we resurveyed students with open-ended questions to assess their impressions of what they had gained from learning about the field survey process., Results: Out of the 60 students, 55 (91.6%) provided complete responses for analysis. The mean post-exposure Likert scores of students self-perceived skills and knowledge were significantly higher than their retrospective assessments of themselves prior to the course in areas such as being aware of the public health research process, their skills in interviewing and communicating with local villagers, and ability to collect, enter via computer and present gathered information (p < 0.005). Six categories of common responses, all positive, emerged from the open-ended feedback: 1) ability to apply learning to research work, 2) communication skills, 3) awareness about local epidemiology of injury, 4) awareness of local first-aid practices and health care seeking behavior, 5) awareness of survey techniques, and 6) anticipated application of this learning in the future and its effect on the student., Conclusions: Overall, the initial implementation of a program exposing medical students to the community survey research process was well received. Early exposure of medical undergraduates to the survey research process appears to help them be better clinicians, who are able to understand and use field level data.

To make higher education in India more dynamic and responsive to a fast-developing society and its aspirations, there has been widespread recognition of a need for reform. Among the proposed changes, expert committees and the National Knowledge Commission have recommended the introduction of a credits and semester system starting in undergraduate education. Technical institutions and some universities have already adopted this system. The country's dental schools are beginning to consider such a change, which would bring them more into alignment with the structure of dental education in North America and many countries in other parts of the world. Since dental schools in most developed countries follow a quarter/semester system, there is much evidence of the merits of such a system for dental education. After providing an overview of the present curriculum structure of dental education in India and the national move toward reform, this article presents the case for a new credits and semester system for undergraduate dental education in India.

Objective structured clinical examination (OSCE) was introduced in 1975 as a standardized tool for objectively assessing clinical competencies - including history-taking, physical examination, communication skills, data interpretation etc. It consists of a circuit of stations connected in series, with each station devoted to assessment of a particular competency using pre-determined guidelines or checklists. OSCE has been used as a tool for both formative and summative evaluation of medical graduate and postgraduate students across the globe. The use of OSCE for formative assessment has great potential as the learners can gain insights into the elements making up clinical competencies as well as feedback on personal strengths and weaknesses. However, the success of OSCE is dependent on adequacy of resources, including the number of stations, construction of stations, method of scoring (checklists and or global scoring), the number of students assessed, and adequate time and money. Lately, OSCE has drawn some criticism for its lack of validity, feasibility, practicality, and objectivity. There is evidence to show that many OSCEs may be too short to achieve reliable results. There are also currently no clear cut standards set for passing an OSCE. It is perceived that OSCEs test the students knowledge and skills in a compartmentalized fashion, rather than looking at the patient as a whole. This article focuses on the issues of validity, objectivity, reliability, and standard setting of OSCE. Presently, the Indian experiences with OSCE are limited and there is a need to sensitise the Indian faculty and students. A cautious approach is desired before it is considered as a supplementary tool to other methods of assessment for the summative examinations in Indian settings.

Background: There is hardly any structured study reporting the perspective of medical students, with regard to the medical education system in Maharashtra, which is facing challenges., Aim: A perception study of students was conducted to explore the situation, challenges, and consequent solutions of medical education in Maharashtra., Settings and Design: A descriptive perception study., Materials and Methods: A structured questionnaire was e-mailed to 92 students, and interviews with seven key-informants comprising of faculty, administrators, and policy makers were conducted, to gather qualitative insights., Results: Thirty-seven student replies were received and analyzed. The satisfaction level of student respondents for various factors was as follows: infrastructure 18/37 (48.6%), quality of teaching 14/37 (37.8%), patient population 22/37 (59.5%), and administration 8/37 (21.6%). Ninety-two percent (34/37) of the students stated that the fundamental problem was the inability of the system to attract good, quality teachers. The reasons stated were low salaries, low level of job satisfaction, high level of bureaucracy, and high work load., Conclusions: The medical education system in Maharashtra is viewed as being stagnant. The respondents emphasized an urgent need for educational reforms, which should include better compensation for teachers, sharing of facilities between government and private medical colleges, and improved efficiency of the Medical Council of India. In the long run a public-private mix with sharing of resources may be a plausible solution.