FORMATIVE ELECTRONIC ASSESSMENTS DURING COVID-19 LOCKDOWN IN SECOND PHASE MEDICAL UNDERGRADUATES

Objective: Electronic learning and assessment was embraced in medical education worldwide following the COVID-19 pandemic. This study was done to determine the perceptions of medical undergraduates on formative electronic assessments conducted during COVID-19 lockdown and to estimate the mean marks scored in these assessments. Methods: This was a descriptive study done for a period of 3 months on online platform. Six online formative assessments were conducted on Google Forms or Kahoot. A questionnaire was administered as Google Form to collect the perceptions of the participants on perceived ease of use of platform, attitude, and practice adopted in online assessments. Data were analyzed using SPSS 16. Results: The response rate was 97.7%. Kahoot was perceived to be easier with lesser technical glitches and privacy concerns as compared to Google, while it was equivocal in terms of access assessment links, output storage, display clarity, overall user interface, network issues, need for computer literacy, and eyestrain caused. The participants had a positive attitude regarding the usefulness of online assessments however majority liked the traditional assessments more than the online assessments. While less than one-third (22%) had copy pasted some answers, more than half (54.4%) had referred to internet and more than three quarter (79.6%) had referred to textbooks/power points/notes while attending online assessments. Conclusion: The participants felt that Google Forms and Kahoot were comparable online assessment tools except for difficulty in filling, privacy concerns, and technical issues on Google Forms. The usefulness of online assessments was embraced by the participants but they felt that the traditional assessments were to be continued, while attending online assessments some students had referred to the internet or study materials

Reliability and validity of short answer questions in Pharmacology

Background: Short answer question (SAQ) is an excellent tool for assessment. Objective of this study was to understand the practices adopted in answering SAQ, assessment of reliability and validity of SAQ and faculty feedback on valuing SAQs.Methods: A cross-sectional study was done in the Department of Pharmacology of a Government Medical College in Central Kerala from December 2018-January 2019. The study participants were given 10 minutes to answer the two chosen SAQs after which the response sheets were collected and valued by 2 independent examiners. Feedback on correction of the same questions was sought from Pharmacology faculties of various Medical Colleges through online survey. The data were analysed using SPSS software.Results: 100% participants attempted to answer the SAQ ‘Definition of a drug’ but none of them came out with the World Health Organisation definition of drug. For the second SAQ, ‘Two uses of atropine’ around 25(20.8%) participants had written two uses of the drug correctly. The reliability was 0 for ‘definition of a drug’ and 0. 50 (95% CI 0.082-0.702) for ‘Two uses of atropine’ and both the questions had no validity. The feedback on valuing definition and two use of atropine was variable.Conclusions: None of the students wrote definition of a drug correctly and majority gave multiple responses to uses of atropine instead of two valid responses. The short answer questions we tested were found to have moderate to no reliability and no validity. The faculties had variable perceptions in valuing the two short answer questions

CLINICAL TRIALS: PERSPECTIVES OF MEDICAL COMMUNITY

Objective: The objective of the study was to determine the knowledge, attitude, and perception about clinical trials (CTs) among medical community of a tertiary care institution. Methodology: This was a questionnaire-based cross-sectional study conducted in the Department of Pharmacology, Government Medical College in Central Kerala for a period of 1 year. In a sample population of 690 comprising medical undergraduates (3rd phase), residents, and doctors in Medical Education Service (MES), 309 questionnaires were distributed randomly assuming 80% response to achieve the sample size of 247. Knowledge, attitude, and perceptions were quantified with a cumulative score with a scoring scheme of +1 for a correct response/positive attitude/positive perception and 0 for an incorrect response/no response/negative attitude/negative perception. The data were analyzed using SPSS 16, the knowledge, attitude, and perception were expressed as mean score as well as proportion. Results: The response rate was 95.79%. Of the 296 completed responses, 158 (53.4%) were from medical undergraduates, 62 (20.9%) from residents, and 76 (25.7%) from doctors in MES. The mean knowledge was 14.8±3.79 (maximum score 25). The mean attitudinal score was 7.07±1.82 (maximum score 10). The mean score of the participants on perception (maximum score=10) about CTs conducted in India was 4.11±2.02 which denoted a negative perception. Conclusion: The participants had good knowledge and positive attitude about CTs, however, all the three groups of participants had negative perception about CTs currently conducted in India

Post-operative atrial fibrillation in off pump coronary artery bypass graft: association with medication

Background: Post-operative atrial fibrillation is a common post-operative complication and has significant morbidity and mortality. This study was done with an objective to determine the association of various medication use in patients undergoing coronary artery bypass graft (CABG) with post-operative atrial fibrillation (POAF).Methods: This was a prospective observational study done in the department of cardiovascular and thoracic surgery of GMC Kottayam from December 2019 to December 2020 after obtaining institutional review board clearance. A sample size of 334 was fixed and patients undergoing off pump (OP) CABG were consecutively recruited in the study. The association of intraoperative and postoperative medication use with occurrence of POAF were analysed using the univariate analysis with a p<0.05 using the SPSS 16 software.Results: Peri-operative inotrope use was found to be significantly associated with post operative atrial fibrillation odds ratio 1.08 (95% CI 1.02-1.13). We could not find any association with preoperative use of beta blockers/agonist, antidiabetics, levothyroxine, ACE inhibitors or antiplatelet drugs. All the patients 60 (18%) who developed POAF were given amiodarone as per protocol.Conclusions: Perioperative inotrope use was found to have significant association with the development of post operative atrial fibrillation following OPCABG. More multi-institutional studies with determination of association with individual drugs and doses with POAF need to be conducted in future

ASSIMILATING AND REPRODUCING CONCEPTS AFTER PHARMACOLOGY LECTURE - A QUESTIONNAIRE-BASED STUDY

Objective: Medical undergraduates learn pharmacology during the second phase of MBBS. Considering the expanding list of drugs and volatility associated with its learning, the objective of this study was to describe the factors that interfere with the assimilation and reproduction of the concepts in pharmacology. Methods: This was a descriptive study done in the Department of Pharmacology of a Government Medical College in Central Kerala for a period of 2 months. Five short answer questions were chosen to elicit responses from the participants in the form of a surprise test. A Google fill out form elicited the perception of the participants about learning during the pharmacology lecture. The data were sorted and entered into Statistical Package for the Social Sciences (SPSS) software version 16 (SPSS Inc, Chicago, USA). Descriptive data were expressed using frequencies and percentages. Results: Of the 148 students, 84 (56.75%) participated in the study. For the surprise test, the mean marks scored were 2.24±0.77 (maximum marks 5). Forty-seven (56%) participants claimed that they were attentive in pharmacology lectures only “sometimes.” The majority of the participants 82 (97.6%) “sometimes” found it difficult to imbibe the concepts in pharmacology. Seventy (83.3%) agreed that definitions are difficult to learn as such. Only 10 (11.9%) disagreed with the statement that a drug’s action cannot be interpreted as its use because sometimes actions can aggravate some diseases. Sixty-one (72.6%) participants had difficulty in understanding the word “rationale.” Five minutes break, continuity of topics, separate question-answer session at the end of class, summarization, a video demonstration of the mechanism of action, providing printed lecture notes, simple explanation, mnemonics to learn, clinical correlation, lectures during morning hours, and team-based quizzes were some suggestions to increase the assimilation of the subject. Conclusion: Participants had a mean score which was &lt;50% of the total score. While the scores for definitions varied the question on uses of drugs fetched similar marks; however, the students had poor performance on the question related to rationale. Ignorance about the meaning of the word “rationale” shows the importance of regular feedback and the use of simple language in understanding the problems faced by the participants in learning the concepts in pharmacology

Self-Medication Practices among First and Second Year Medical Undergraduates

Objective:&nbsp;The objectives of our study were to estimate prevalence of self medication, to assess knowledge, attitude, and practice (KAP) of self medication and to compare the risk factors of self medication practices amongst first and second year medical undergraduates, of a Government Medical College in Kerala, India. Methods:&nbsp;A questionnaire-based cross-sectional study was conducted among medical students after obtaining Institutional Ethics Committee approval and informed consent. A pre-validated questionnaires was used to collect data. Descriptive and analaytical statistics were performed and variables associated with self-medication were entered into multivariate logistic regression analysis to compute adjusted odds ratio (OR) and 95% confidence intervals (95% CI). Results:&nbsp;The response rate was 59.47% (233/375). &nbsp;More than three quarters of the participants responded correctly to the query on “what an over-the-counter drug is”. As compared to 46.8% of first years, 67.6% of second years had practiced self-medication in the past 6 months. The most common medical condition/symptom for consuming self-medication was for managing common cold and paracetamol was the most common medication. Risk of developing adverse drug reaction was considered as a serious threat after self-medication by around three quarters of the participants. There was a significant association of self-medication practice among the second years as compared to first years(p=0.009,OR-1.64(95% CI 1.16-2.31). Conclusion: Prevalence of self-medication was high among medical students and there was a greater risk &nbsp;of self-medication among the second years (1.64 times) as compared to the first year students. Study showed that the students had poor knowledge of adequate self-medication , positive attitude towards self-medication and common but inadequate &nbsp;practice. Knowledge of medicines obtained for similar previous illness and the feeling that there is no need to consult doctor for minor ailments were the main reasons for self medication