Development of an e-learning portal for pediatric endocrinology: educational considerations

Background: Global accessibility and dissemination of developments in pediatric endocrinology prompted to examine how to develop an educational interactive e-SPE web portal. Methods: A systematic approach was used to identify the relevant aspects of accessibility and dissemination. An orientation at the big idea was made, executed by an analysis of the needs of student and teacher pediatric endocrinologists, a definition of the learning objectives, a research in educational literature and an exploration of ICT design specifications. Results: The intensive collaboration between medical, educational and information technology disciplines resulted in a portal design. The portal meets requirements of adult learning, stresses interaction between partners in learning and offers direct feedback during the learning process. The portal supports the development of not only knowledge but also competences both at junior and advanced levels. Conclusion: When the e-SPE portal is completed, the options for summative assessment will be examined as a medium for international certification in conjunction with local and national requirements (http://espe.elearning.nl). Copyrigh

Comparison between Long-Menu and Open-Ended Questions in computerized medical assessments. A randomized controlled trial

BACKGROUND: Long-menu questions (LMQs) are viewed as an alternative method for answering open-ended questions (OEQs) in computerized assessment. So far this question type and its influence on examination scores have not been studied sufficiently. However, the increasing use of computerized assessments will also lead to an increasing use of this question type. Using a summative online key feature (KF) examination we evaluated whether LMQs can be compared with OEQs in regard to the level of difficulty, performance and response times. We also evaluated the content for its suitability for LMQs. METHODS: We randomized 146 fourth year medical students into two groups. For the purpose of this study we created 7 peer-reviewed KF-cases with a total of 25 questions. All questions had the same content in both groups, but nine questions had a different answer type. Group A answered 9 questions with an LM type, group B with an OE type. In addition to the LM answer, group A could give an OE answer if the appropriate answer was not included in the list. RESULTS: The average number of correct answers for LMQs and OEQs showed no significant difference (p = 0.93). Among all 630 LM answers only one correct term (0.32%) was not included in the list of answers. The response time for LMQs did not significantly differ from that of OEQs (p = 0.65). CONCLUSION: LMQs and OEQs do not differ significantly. Compared to standard multiple-choice questions (MCQs), the response time for LMQs and OEQs is longer. This is probably due to the fact that they require active problem solving skills and more practice. LMQs correspond more suitable to Short answer questions (SAQ) then to OEQ and should only be used when the answers can be clearly phrased, using only a few, precise synonyms. LMQs can decrease cueing effects and significantly simplify the scoring in computerized assessment

A new framework for designing programmes of assessment

Research on assessment in medical education has strongly focused on individual measurement instruments and their psychometric quality. Without detracting from the value of this research, such an approach is not sufficient to high quality assessment of competence as a whole. A programmatic approach is advocated which presupposes criteria for designing comprehensive assessment programmes and for assuring their quality. The paucity of research with relevance to programmatic assessment, and especially its development, prompted us to embark on a research project to develop design principles for programmes of assessment. We conducted focus group interviews to explore the experiences and views of nine assessment experts concerning good practices and new ideas about theoretical and practical issues in programmes of assessment. The discussion was analysed, mapping all aspects relevant for design onto a framework, which was iteratively adjusted to fit the data until saturation was reached. The overarching framework for designing programmes of assessment consists of six assessment programme dimensions: Goals, Programme in Action, Support, Documenting, Improving and Accounting. The model described in this paper can help to frame programmes of assessment; it not only provides a common language, but also a comprehensive picture of the dimensions to be covered when formulating design principles. It helps identifying areas concerning assessment in which ample research and development has been done. But, more importantly, it also helps to detect underserved areas. A guiding principle in design of assessment programmes is fitness for purpose. High quality assessment can only be defined in terms of its goals

Long-menu questions in computer-based assessments: a retrospective observational study

Background: Computer based assessments of paediatrics in our institution use series of clinical cases, where information is progressively delivered to the students in a sequential order. Three types of formats are mainly used: Type A (single answer), Pick N, and Long-menu. Long-menu questions require a long, hidden list of possible answers: based on the student's initial free text response, the program narrows the list, allowing the student to select the answer. This study analyses the psychometric properties of Long-menu questions compared with the two other commonly used formats: Type A and Pick N. Methods: We reviewed the difficulty level and discrimination index of the items in the paediatric exams from 2009 to 2015, and compared the Long-menu questions with the Type A and Pick N questions, using multiple-way analyses of variances. Results: Our dataset included 13 exam sessions with 855 students and 558 items included in the analysis, 212 (38 %) Long-menu, 201 (36 %) Pick N, and 140 Type A (25 %) items. There was a significant format effect associated with both level of difficulty (p = .005) and discrimination index (p < .001). Long-menu questions were easier than Type A questions(+5.2 %; 95 % CI 1.1–9.4 %), and more discriminative than both Type A (+0.07; 95 % CI 0.01–0.14), and Pick N (+0.10; 95 % CI 0.05–0.16) questions. Conclusions: Long-menu questions show good psychometric properties when compared with more common formats such as Type A or Pick N, though confirmatory studies are needed. They provide more variety, reduce the cueing effect, and thus may more closely reflect real life practice than the other item formats inherited from paper-based examination that are used during computer-based assessments

Engineering Oxidative Stress Resistance in CHO Cell Factories

Oxidative stress is a phenomenon created by an imbalance in the amount of Reactive Oxygen Species (ROS) created within a cell, and the ability of its defence mechanisms to effectively deal with ROS. Oxidative stress is extremely deleterious to the cell, and is known to cause damage to DNA, proteins and lipids (Turrens, 2003). Mitochondria are the cell’s predominant producer of ROS (Murphy, 2009), but it has also been shown that increased protein folding in the Endoplasmic Reticulum (ER) results in an increase in ROS levels (Malhotra, 2008), an issue particularly pertinent as developers move towards hard-to-express proteins. As well as many enzymes dedicated to the eradication of ROS, such as caspases, peroxidases and superoxide dismutases (SODs) the cell maintains a glutathione pool to buffer the increase of ROS (Lu, 2009). Design of Experiment models were designed and implemented using the growth, productivity and ROS content data from batch experiments in order to design anti-oxidant supplementation strategies. Two rounds of fed-batch screening were performed and a feeding strategy identified that improved the growth and ROS burden of three cell lines producing the same recombinant MAb product. A directed evolution strategy was employed to engineer oxidative stress resistant host cell lines through chronic exposure to Hydrogen Peroxide. Following transfection with a recombinant MAb product, the novel engineered cell line consistently outperformed the original cell line in terms of growth and ROS content, in both transient and stable transfection processes. Doubling time of stably transfected evolved cell line was reduced to 23 hours, a substantial time frame reduction. A link between ROS level reduction and improvement in cell line performance was demonstrated, with further investigation needed to unpick the mechanistic underpinnings of the oxidative stress resistance as well as to attempt to address the imbalance of improvements in growth compared to productivity

The educational impact of assessment: a comparison of DOPS and MCQs

Aim: To evaluate the impact of two different assessment formats on the approaches to learning of final year veterinary students. The relationship between approach to learning and examination performance was also investigated. Method: An 18-item version of the Study Process Questionnaire (SPQ) was sent to 87 final year students. Each student responded to the questionnaire with regards to DOPS (Direct Observation of Procedural Skills) and a Multiple Choice Examination (MCQ). Semi-structured interviews were conducted with 16 of the respondents to gain a deeper insight into the students’ perception of assessment. Results: Students’ adopted a deeper approach to learning for DOPS and a more surface approach with MCQs. There was a positive correlation between an achieving approach to learning and examination performance. Analysis of the qualitative data revealed that deep, surface and achieving approaches were reported by the students and seven major influences on their approaches to learning were identified: motivation, purpose, consequence, acceptability, feedback, time pressure and the individual difference of the students. Conclusions: The format of DOPS has a positive influence on approaches to learning. There is a conflict for students between preparing for final examinations and preparing for clinical practice

Frequency and isostericity of RNA base pairs

Most of the hairpin, internal and junction loops that appear single-stranded in standard RNA secondary structures form recurrent 3D motifs, where non-Watson–Crick base pairs play a central role. Non-Watson–Crick base pairs also play crucial roles in tertiary contacts in structured RNA molecules. We previously classified RNA base pairs geometrically so as to group together those base pairs that are structurally similar (isosteric) and therefore able to substitute for each other by mutation without disrupting the 3D structure. Here, we introduce a quantitative measure of base pair isostericity, the IsoDiscrepancy Index (IDI), to more accurately determine which base pair substitutions can potentially occur in conserved motifs. We extract and classify base pairs from a reduced-redundancy set of RNA 3D structures from the Protein Data Bank (PDB) and calculate centroids (exemplars) for each base combination and geometric base pair type (family). We use the exemplars and IDI values to update our online Basepair Catalog and the Isostericity Matrices (IM) for each base pair family. From the database of base pairs observed in 3D structures we derive base pair occurrence frequencies for each of the 12 geometric base pair families. In order to improve the statistics from the 3D structures, we also derive base pair occurrence frequencies from rRNA sequence alignments

Changing the culture of assessment: the dominance of the summative assessment paradigm

Background Despite growing evidence of the benefits of including assessment for learning strategies within programmes of assessment, practical implementation of these approaches is often problematical. Organisational culture change is often hindered by personal and collective beliefs which encourage adherence to the existing organisational paradigm. We aimed to explore how these beliefs influenced proposals to redesign a summative assessment culture in order to improve students’ use of assessment-related feedback. Methods Using the principles of participatory design, a mixed group comprising medical students, clinical teachers and senior faculty members was challenged to develop radical solutions to improve the use of post-assessment feedback. Follow-up interviews were conducted with individual members of the group to explore their personal beliefs about the proposed redesign. Data were analysed using a socio-cultural lens. Results Proposed changes were dominated by a shared belief in the primacy of the summative assessment paradigm, which prevented radical redesign solutions from being accepted by group members. Participants’ prior assessment experiences strongly influenced proposals for change. As participants had largely only experienced a summative assessment culture, they found it difficult to conceptualise radical change in the assessment culture. Although all group members participated, students were less successful at persuading the group to adopt their ideas. Faculty members and clinical teachers often used indirect techniques to close down discussions. The strength of individual beliefs became more apparent in the follow-up interviews. Conclusions Naïve epistemologies and prior personal experiences were influential in the assessment redesign but were usually not expressed explicitly in a group setting, perhaps because of cultural conventions of politeness. In order to successfully implement a change in assessment culture, firmly-held intuitive beliefs about summative assessment will need to be clearly understood as a first step