Measuring medical students' professional competencies in a problem-based curriculum: A reliability study

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 < 0.01), but not with the other two competency domains (interpersonal and professionalism). 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.Scopu

Measuring medical students' professional competencies in a problem-based curriculum: A reliability study

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 < 0.01), but not with the other two competency domains (interpersonal and professionalism). 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

The philosophy of energy consumption in North Africa, contribution of artificial intelligence

Some people in North Africa have been accustomed to getting everything, from the consumption of various goods, to luxurious housing, to travel from one country to another, unaware that the necessities of this way of life are very energy intensive. These countries, too, are unaware of the importance and necessity of opening up to each other in order to work together to raise awareness of energy consumption. Through this research, which is based on a scientific approach combining technology, human and social sciences and statistical studies, we have tried to highlight the importance of logical energy consumption while explaining that the consequences will be unexpected in the future in the event of an energy shortage in North Africa

A program evaluation reporting student perceptions of early clinical exposure to primary care at a new medical college in Qatar

Background: Though common practice in Europe, few studies have described the efficacy of early clinical exposure (ECE) in the Middle East. The barriers to clinical learning experienced by these novice medical students have not been reported. This evaluation reports on introducing ECE in primary care, supported by Experiential Review (ER) debriefing sessions. The evaluation explores students' experiences of their acquisition of clinical and non-technical skills, sociocultural issues commonly encountered but underreported and barriers to clinical learning experienced. Methods: We conducted a cross-sectional study of three student cohorts in 2017-19: All second and third-year students at the new College of Medicine were invited to participate. The primary outcome was students' perceptions of the aims of the Primary Health Centre Placement (PHCP) programme and how it facilitated learning. Secondary outcome measures were students' perceptions of their learning in ER sessions and perceived barriers to learning during PHCPs. Student perceptions of the PHCPs were measured using a Likert scale-based questionnaire. Results: One hundred and fifty-one students participated: 107 in year 2 and 44 in year 3; 72.3% were female. Overall, most students (> 70%) strongly agreed or agreed with the purposes of the PCHPs. Most students (71%) strongly agreed or agreed that the PCHPs allowed them to learn about patient care; 58% to observe doctors as role models and 55% to discuss managing common clinical problems with family physicians. Most students (year 2 = 62.5% and year 3 = 67%) strongly agreed/agreed that they were now confident taking histories and examining patients. Student barriers to clinical learning included: Unclear learning outcomes (48.3%); faculty too busy to teach (41.7%); lacking understanding of clinical medicine (29.1%); shyness (26.5%); and finding talking to patients difficult and embarrassing (25.8%). Over 70% reported that ER enabled them to discuss ethical and professional issues. Conclusions: Overall, our Middle Eastern students regard ECE as beneficial to their clinical learning. PHCPs and ER sessions together provide useful educational experiences for novice learners. We recommend further exploration of the barriers to learning to explore whether these novice students' perceptions are manifesting underlying cultural sensitivities or acculturation to their new environment.Scopu

Impact of glucocorticoid receptor density on ligand-independent dimerization, cooperative ligand-binding and basal priming of transactivation: a cell culture model

Glucocorticoid receptor (GR) levels vary between tissues and individuals and are altered by physiological and pharmacological effectors. However, the effects and implications of differences in GR concentration have not been fully elucidated. Using three statistically different GR concentrations in transiently transfected COS-1 cells, we demonstrate, using co-immunoprecipitation (CoIP) and fluorescent resonance energy transfer (FRET), that high levels of wild type GR (wtGR), but not of dimerization deficient GR (GRdim), display ligand-independent dimerization. Whole-cell saturation ligand-binding experiments furthermore establish that positive cooperative ligand-binding, with a concomitant increased ligand-binding affinity, is facilitated by ligand-independent dimerization at high concentrations of wtGR, but not GRdim. The down-stream consequences of ligand-independent dimerization at high concentrations of wtGR, but not GRdim, are shown to include basal priming of the system as witnessed by ligand-independent transactivation of both a GRE-containing promoter-reporter and the endogenous glucocorticoid (GC)-responsive gene, GILZ, as well as ligand-independent loading of GR onto the GILZ promoter. Pursuant to the basal priming of the system, addition of ligand results in a significantly greater modulation of transactivation potency than would be expected solely from the increase in ligand-binding affinity. Thus ligand-independent dimerization of the GR at high concentrations primes the system, through ligand-independent DNA loading and transactivation, which together with positive cooperative ligand-binding increases the potency of GR agonists and shifts the bio-character of partial GR agonists. Clearly GR-levels are a major factor in determining the sensitivity to GCs and a critical factor regulating transcriptional programs

RICE HUSK ASH AS A NANO-FILLER TO SYNTHESIZE THERMOSETTING POLYMER NANOCOMPOSITES AND EVALUATION OF ITS TRIBOLOGICAL BEHAVIOR

This paper deals with synthesizing of nanocomposites of unsaturated polyester (UP) filled with nano silica and investigation the effect of silica content on the tribological behavior of UP and nanocomposites . Silica nanoparticles were prepared by burning rice husk ash (RHA) as an agricultural waste material. Three different percentages as 2%, 6% and 10% of nano silica were added to the unsaturated polyester and dispersed by using ultrasonic waves method. As a result of agglomeration and sedimentation of nano RHA particles, dispersing by ultrasonic waves was very effective to terminate these challenges. X-Rays diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR) and scanning electron microscopy (SEM) technics were used for characterization of materials. RHA-UP nanocomposites were tested for their tribo-performance by pin-on-disc machine. XRD demonstrated that white rice husk ash consists of amorphous silica. SEM demonstrated that silica particles were distributed uniformly and well embedded within the polyester matrix. Results showed an improvement in wear resistance with relatively stable friction coefficient with the addition of 10% nano silica. Adding 2 wt% nano RHA negatively affected the wear resistance of RHA-UP nanocomposite .The best tribological performance of 10% RHA-UP nanocomposites achieved at load 10N. Incorporation of RHA with unsaturated polyester has advantages of reducing pollution, making the pollutant RHA as a valuable material to produce low cost and lightweight products with modified properties. Silica enriched RHA could prove to be cheaper anti-wear additives for producing high performance unsaturated polyester composites such as brake pads

The philosophy of energy consumption in North Africa, contribution of artificial intelligence

Some people in North Africa have been accustomed to getting everything, from the consumption of various goods, to luxurious housing, to travel from one country to another, unaware that the necessities of this way of life are very energy intensive. These countries, too, are unaware of the importance and necessity of opening up to each other in order to work together to raise awareness of energy consumption. Through this research, which is based on a scientific approach combining technology, human and social sciences and statistical studies, we have tried to highlight the importance of logical energy consumption while explaining that the consequences will be unexpected in the future in the event of an energy shortage in North Africa