How Does Seating Arrangement Matter While Teaching in Small Groups?

A circular seating arrangement is best suited for small group discussions

Basic principles of constructing multiple choice questions

Multiple Choice Questions (MCQs) are one of the most important well established tools used for assessment and selection processes in medical education. Designing good assessment tools requires time and effort and ultimately determines the learning outcome. The quality of MCQ depends on the quality of items on the whole and presence of efficient distractors. Flawed MCQs interfere with assessment process and therefore it is vital to develop reliable and valid items that are free of such flaws. Basic criteria for constructing good quality MCQs include item content that is tested and well-structured, flawless items. Three areas that are addressed in this article include general guidelines of using MCQ inevaluation, principles of constructing effective MCQs, and constructing higher order MCQs. Characteristics of effective MCQs are determined by the overall item, the stem and distractors. Interpretation and problem-solving items like MCQs with data, diagrams and images, use of clinical or lab vignettes, formats like Extended Matching items, Key feature questions and assertion reason questions require higher order thinking skills like analysis, synthesis and evaluation. Significant commitment and technical knowhow is required to prepare MCQs that are of good quality, reliable, able to test higher order thinking skills and consistent with curriculum objectives. Constructing MCQs is an art which can be perfected with practice and it is essential for medical educators to be skilled in effective test item writing to assess the learner's knowledge

Quality of life and its determinants in people living with human immunodeficiency virus infection in Puducherry, India

Context: With anti-retroviral therapy (ART) for human immunodeficiency virus infection (HIV) coming into picture, quality of life (QOL) has gained importance. Knowledge on the factors affecting QOL would be helpful in making important policy decisions and health care interventions. Aims: The aim of this study is to assess the quality of life of people living with HIV (PLWH) and to identify the factors influencing their QOL. Materials and Methods: The study was done among 200 PLWH attending a tertiary care hospital, and three Non Governmental Organizations at Puducherry, India, from November 2005 to May 2007. QOL was assessed using HIV specific World Health Organization Quality Of Life scale (WHOQOL-HIV) - BREF questionnaire which has six domains (physical, psychological, level of independence, social relationships, environment and spirituality/religiousness/personal belief). Social support and stigma were measured using "Multidimensional Scale of Perceived Social Support" and "HIV Stigma Scale," respectively, using Likert Scale. Factors influencing QOL were identified using backward stepwise multiple linear regression with the six domain scores as the dependent variables. Results: Male: Female ratio was 1:1 and 58% were in early stage of the disease (stage I/II). Psychological and SRPB (Spirituality Religiousness and Personal Beliefs) domains were the most affected domains. All the regression models were statistically significant (P<0.05). The determination coefficient was highest for the social relationship domain (57%) followed by the psychological domain (51%). Disease stage and perceived social support significantly influenced all the domains of WHOQOL. Younger age, female gender, rural background, shorter duration of HIV, non-intake of ART and greater HIV related stigma were the high risk factors of poor QOL. Conclusion: Interventions such as ART, family, vocational and peer counseling would address these modifiable factors influencing QOL, thereby improving the QOL of PLWH

Community Based Medical Education (CBME): A collateral benefit to the society!

Community based medical education (CBME) is described as education that focuses on both population groups and individual persons and take into account the health needs of the community concerned. Now a days health professionals need to be more responsive to needs of the populations they serve, rather than the hospitals they serve, which requires medical students and doctors to imbibe abilities and perspectives consistent with the updated medical knowledge and capacity to promote health. In Community Based Medical Education, the majority of the clinical training of the students happens in the community setting in contrast to campus based teaching hospital in traditional teaching. CBME is a broad concept, providing students with opportunities to interact with people from a wide range of social, cultural, economic and ethnic back-grounds. It is often directed towards priority health needs of specific populations, and requires an amalgamation of clinical skills, command on subject, capabilities and inclination towards the community. Health is highly influenced by social and cultural factors such as socioeconomic status, race, gender roles, migration, poverty, social support, and environment. Community based education will make the graduates familiar how these factors influence health and give them the ability to act appropriately. CBME will go a long way to address the increasing demand on health care, as well as making the medical graduates more empathic, flexible and passionate for providing health to all

Correlates of human immunodeficiency virus (HIV) related knowledge among HIV infected people

Background: The current adult prevalence of HIV in India is 0.34%. HIV infected persons should have adequate knowledge about the modes of transmission of infection. This is essential for reducing the risk of secondary infection, preventing coinfection from other viruses such as hepatitis B and for protecting the uninfected. Identification of the correlates of poor knowledge among HIV positive subjects will aid in planning effective measures to improve their health knowledge about HIV. Aims: To explore HIV related knowledge among HIV positive subjects and to determine the correlates of their knowledge. Methods: The study was conducted between November 2005 and May 2007. Two hundred HIV positive subjects attending a tertiary care hospital and three non-governmental organizations in Puducherry, South India, were recruited for the study. They were interviewed using a pre-tested structured questionnaire regarding their knowledge about HIV and were divided into those with HIV knowledge score >90% and those with score ≤90%. The data were analyzed using Chi-square test and logistic regression. Odds ratio (OR) and 95% confidence intervals were also calculated. Results: The median knowledge score was 90%. Knowledge on the modes of HIV transmission was better than that on the modes by which it does not spread. Subjects who had received counseling (OR: 16.78), studied above class 10 (OR: 4.13), and those with duration of more than 1 year since diagnosis (OR: 3.12) had better HIV knowledge score (>90%). Persons counseled by HIV positive peers had a better knowledge. Conclusion: This study revealed the importance of counseling in improving the HIV related knowledge among HIV positive individuals. It also highlights the beneficial effect of peer counseling