Cumulative assessment:Strategic choices to influence students' study effort

BACKGROUND: It has been asserted that assessment can and should be used to drive students’ learning. In the current study, we present a cumulative assessment program in which test planning, repeated testing and compensation are combined in order to influence study effort. The program is aimed at helping initially low-scoring students improve their performance during a module, without impairing initially high-scoring students’ performance. We used performance as a proxy for study effort and investigated whether the program worked as intended. METHODS: We analysed students’ test scores in two second-year (n = 494 and n = 436) and two third-year modules (n = 383 and n = 345) in which cumulative assessment was applied. We used t-tests to compare the change in test scores of initially low-scoring students with that of initially high-scoring students between the first and second subtest and again between the combined first and second subtest and the third subtest. During the interpretation of the outcomes we took regression to the mean and test difficulty into account. RESULTS: Between the first and the second subtest in all four modules, the scores of initially low-scoring students increased more than the scores of initially high-scoring students decreased. Between subtests two and three, we found a similar effect in one module, no significant effect in two modules and the opposite effect in another module. CONCLUSION: The results between the first two subtests suggest that cumulative assessment may positively influence students’ study effort. The inconsistent outcomes between subtests two and three may be caused by differences in perceived imminence, impact and workload between the third subtest and the first two. Cumulative assessment may serve as an example of how several evidence-based assessment principles can be integrated into a program for the benefit of student learning

The clinical relevance of assessing advanced glycation endproducts accumulation in diabetes

Cardiovascular disease is the major cause of morbidity and mortality associated with diabetes. There is increasing evidence that advanced glycation endproducts (AGEs) play a pivotal role in atherosclerosis, in particular in diabetes. AGE accumulation is a measure of cumulative metabolic and oxidative stress, and may so represent the "metabolic memory". Furthermore, increased AGE accumulation is closely related to the development of cardiovascular complications in diabetes. This review article will focus on the clinical relevance of measuring AGE accumulation in diabetic patients by focusing on AGE formation, AGEs as predictors of long-term complications, and interventions against AGEs

Additional simulation training:does it affect students' knowledge acquisition and retention?

Introduction Teaching medical skills during clinical rotation is a complex challenge, which often does not allow students to practise their skills. Nowadays, the use of simulation training has increased to teach skills to medical students. However, transferring the learnt skills from one setting to the other is challenging. In this study, we investigated whether adding a simulation training before the clinical rotation would improve students’ acquisition and retention of knowledge.Methods Two subsequent cohorts were compared. Group A followed the traditional curriculum without additional simulation training. Group B attended an additional simulation training, in which history taking, physical examination and procedures for the primary survey in emergency situations were taught. Both groups answered the same knowledge test before entering their clinical rotation and after 6 months. To analyse students’ scores over time, we conducted a repeated measure analysis of variance. To investigate the difference between knowledge, we conducted a t-test.Results Group B scored significantly higher in both tests and all subscores, except in the Trauma topic in the first measurement point. Students in group A showed decay in knowledge whereas group B showed an increase in knowledge.Conclusions Adding a simulation training, before students entered their clinical rotation, improves students’ knowledge acquisition and retention compared with those who did not receive the additional simulation training

Added Value of Transluminal Attenuation Gradient to Qualitative CCTA Ischemia Detection as Determined by N-13-ammonia PET Quantitative Myocardial Perfusion

Transluminal attenuation gradient (TAG) represents the slope of intraluminal contrast that decreases along a coronary vessel during coronary computed tomography angiography (CCTA). The aim of this study was to determine the added value of TAG to qualitative CCTA assessment of significant stenosis (>50%) detecting ischemia as determined by stress myocardial blood flow (MBF) or myocardial flow reserve (MFR) measured by positron emission tomography (PET). Individual contributions of TAG, qualitative assessment and the impact of calcium score were also investigated. METHODS: We studied 38 consecutive patients that were referred due to suspected or known coronary artery disease (CAD). All patients underwent a two-phase hybrid 13N-ammonia PET/CT and CCTA. RESULTS: TAG and presence of qualitatively assessed significant stenosis, but not calcium score, were associated with stress myocardial blood flow (MBF) and myocardial flow reserve (MFR). The area under the curves (AUC) of the linear predictor model including qualitative assessment and TAG was superior to the AUC of separate qualitative assessment or TAG for the detection of ischemia according to stress MBF (AUCs were: 88% vs. 79% and 77%; p = 0.01 and p = 0.01, respectively). CONCLUSIONS: TAG combined with qualitative CCTA assessment improved ischemia detection

A Gaia early DR3 mock stellar catalog: Galactic prior and selection function

We present a mock stellar catalog, matching in volume, depth and data model the content of the planned Gaia early data release 3 (Gaia EDR3). We have generated our catalog (GeDR3mock) using galaxia, a tool to sample stars from an underlying Milky Way (MW) model or from N-body data. We used an updated Besan\c{c}on Galactic model together with the latest PARSEC stellar evolutionary tracks, now also including white dwarfs. We added the Magellanic clouds and realistic open clusters with internal rotation. We empirically modelled uncertainties based on Gaia DR2 (GDR2) and scaled them according to the longer baseline in Gaia EDR3. The apparent magnitudes were reddened according to a new selection of 3D extinction maps. To help with the Gaia selection function we provide all-sky magnitude limit maps in G and BP for a few relevant GDR2 subsets together with the routines to produce these maps for user-defined subsets. We supplement the catalog with photometry and extinctions in non-Gaia bands. The catalog is available in the Virtual Observatory and can be queried just like the actual Gaia EDR3 will be. We highlight a few capabilities of the Astronomy Data Query Language (ADQL) with educative catalog queries. We use the data extracted from those queries to compare GeDR3mock to GDR2, which emphasises the importance of adding observational noise to the mock data. Since the underlying truth, e.g. stellar parameters, is know in GeDR3mock, it can be used to construct priors as well as mock data tests for parameter estimation. All code, models and data used to produce GeDR3mock are linked and contained in galaxia_wrap, a python package, representing a fast galactic forward model, able to project MW models and N-body data into realistic Gaia observables.Comment: 22 pages, 20 figures, accepted by PASP, catalog info and download and ADQL interface: http://dc.g-vo.org/tableinfo/gedr3mock.main ; relevant github repositories: https://github.com/jan-rybizki/Galaxia_wrap ; https://github.com/jan-rybizki/gdr2_completenes

Learn+Fun! Social Media and Gamification sum up to foster a community of practice during an Emergency Medicine Rotation

Purpose: Medical students and clinical teachers thrive to establish meaningful learning relationships in overwhelmed and ever-shorter clinical rotations. The challenge for medical educators is to design pedagogical approaches capable of bonding students and teachers into the same community of practice (CoP). In this work, the authors explored how Social Media and Gamification strategies sum up to boost medical students’ participation in a blended learning strategy to teach Emergency Medicine. Method: Final year medical students (n = 462) from 5 consecutive years were included in a longitudinal study with historical controls and were divided into three groups. The first group (CONTROL; n = 125) had access to a blended learning strategy; the second group (FACE; n = 179) had access to the blended learning strategy and interacted with a fictional facilitator in Social Media; and the third group (GAME; n = 158) had access to the former strategies plus a gamification approach. Results: Social media and gamification progressively increased students’ participation in the online course as measured by the number of hours logged on from an average of 60 h in CONTROL to 87 h in FACE and 140 h in GAME (P < 0.01). There was a positive and significant correlation between students’ grades on cognitive tests and OSCEs exams with the online participation. Both strategies nurtured students’ sense of belonging to the community of Emergency Medicine and improved their self-regulation to study. Discussion: Social Media and Gamification catalyzed the consolidation of a shared identity for students and teachers, which fostered the creation of a community of practice and increased the participation of students in learning activities. Keywords: Community of practice, Social media, Medical education, Gamificatio

Comparison of formula and number-right scoring in undergraduate medical training: a Rasch model analysis

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background Progress testing is an assessment tool used to periodically assess all students at the end-of-curriculum level. Because students cannot know everything, it is important that they recognize their lack of knowledge. For that reason, the formula-scoring method has usually been used. However, where partial knowledge needs to be taken into account, the number-right scoring method is used. Research comparing both methods has yielded conflicting results. As far as we know, in all these studies, Classical Test Theory or Generalizability Theory was used to analyze the data. In contrast to these studies, we will explore the use of the Rasch model to compare both methods. Methods A 2 × 2 crossover design was used in a study where 298 students from four medical schools participated. A sample of 200 previously used questions from the progress tests was selected. The data were analyzed using the Rasch model, which provides fit parameters, reliability coefficients, and response option analysis. Results The fit parameters were in the optimal interval ranging from 0.50 to 1.50, and the means were around 1.00. The person and item reliability coefficients were higher in the number-right condition than in the formula-scoring condition. The response option analysis showed that the majority of dysfunctional items emerged in the formula-scoring condition. Conclusions The findings of this study support the use of number-right scoring over formula scoring. Rasch model analyses showed that tests with number-right scoring have better psychometric properties than formula scoring. However, choosing the appropriate scoring method should depend not only on psychometric properties but also on self-directed test-taking strategies and metacognitive skills