ABSTRACT
INTRODUCTION: This paper seeks to quantify the reliability of the assessment of students' answers to essay-type questions, in an attempt to define the role of such questions in University examinations. METHODS: The marks awarded for essay-type questions during three consecutive final undergraduate examinations in surgery were analyzed. The mean scores, 95% confidence intervals and the standard error of the mean were calculated to determine the distribution of the marks. Statistical analysis was used to determine the correlation of the marks awarded for the same answer by different markers and deduce the dependability of this method of testing. RESULTS: The marks awarded to 233 answer papers were available for analysis. The marks awarded by each pair of examiners for student answers to individual questions coincided on only 46.3% of occasions, but varied within just ± 5% on 90.7% of occasions. Use of the kappa index to determine the agreement between markers produced a value of just 0.385, well short of the ideal of 1.0. Assessment of the overall reliability of this type of examination by Cronbach's reliability coefficent gave a value of 0.672. CONCLUSION: There was a significant variation among markers in the evaluation of answers to essay-type questions. However, the overall test reliability was acceptable enough to justify continuation of this type of assessment as a supplement to other methods.
INTRODUCCIÓN: Este trabajo busca cuantificar la confiabilidad de la evaluación de las respuestas de los estudiantes a las preguntas de ensayo, en un intento por definir el papel de este tipo de preguntas en los exámenes de la Universidad. MÉTODOS: Se analizaron las notas otorgadas en cirugía a las preguntas de ensayo durante los tres exámenes finales consecutivos de pregrado. Se calcularon los puntajes promedio, intervalos de confianza de 95%, y el error estándar de la media, con el fin de determinar la distribución de las notas. Se usó el análisis estadístico para determinar la correlación de las notas dadas a las mismas respuestas por diferentes evaluadores, y para deducir la confiabilidad de este método de evaluación. RESULTADOS: Las notas otorgadas a 233 pruebas respondidas fueron puestas a disposición para su análisis. Las notas dadas por cada par de examinadores a las respuestas de los estudiantes a las preguntas individuales, coincidieron sólo en 46.3% de las ocasiones, pero variaron en justamente ± 5% en 90.7% de las ocasiones. El uso del índice de Kappa para determinar el acuerdo entre evaluadores, produjo un valor de sólo 0.385, bien lejos del ideal 1.0. La evaluación de la confiabilidad general de este tipo de examen, mediante el coeficiente de confiabilidad de Cronbach, arrojó un valor de 0.672. CONCLUSIÓN: Hubo una variación significativa entre los evaluadores a la hora de calificar las respuestas a las preguntas de ensayo. Sin embargo, la confiabilidad de la prueba en general fue suficientemente aceptable para justificar que se continúe con este tipo de evaluación como un complemento de otros métodos.
Subject(s)
Female , Humans , Male , Young Adult , Education, Medical, Undergraduate , Educational Measurement/methods , Writing , Reproducibility of Results , Schools, Medical , West IndiesABSTRACT
OBJECTIVE: This study was carried out to compare the density of the interstitial cells of Cajal (ICCs) in the bowel wall of children with Hirschsprung's disease (HD), anorectal malformations (ARM) and normal controls in Trinidad and Tobago. SUBJECTS AND METHOD: Segments of bowel wall excised from eight children with HD, three controls and two children with ARM were immunostained with c-Kit primary antibody. Cells with features of ICCs were counted. RESULTS: All three controls and the two children with ARM had dense distribution of ICCs. Most children (6/8;75%) with HD had markedly reduced counts in aganglionic bowel. Two (25%) also had a decrease in ganglionic bowel. Possible influences were patient age and gender and the level of bowel sectioned. CONCLUSION: Analysis of this sample suggests that immunostaining for c-Kit positive cells might be a useful screening test in the assessment of bowel motility disorders. The possible effects of age, gender and the level of bowel sampled await determination.
OBJETIVO: Este estudio se llevó a cabo con el propósito de comparar la densidad de las células intersticiales de Cajal (CIC) en las paredes intestinales de niños con la enfermedad de Hirschprung (EH), y malformaciones anorectales (MAR), frente a controles normales en Trinidad Tobago. SUJETOS Y MÉTODOS: Segmentos de las paredes intestinales les fueron extirpados a ocho niños con EH; tres controles y dos niños con MAR fueron inmunoteñidos con anticuerpo primario c-kit. Se contaron las células con características de CIC. RESULTADOS: Los tres controles y los dos niños con MAR presentaban una distribución densa de CICs. La mayor parte de los niños (6/8; 75%) con EH tuvieron conteos marcadamente reducidos de intestino agangliónico. Dos niños (25%) también tuvieron una disminución de intestino gangliónico. Entre las influencias posibles se cuentan la edad y el género del paciente así como el nivel de intestino seccionado. CONCLUSIÓN: El análisis de esta muestra sugiere que la inmunotinción para células c-kit positivas podría ser un útil test de pesquisaje a la hora de evaluar desórdenes en la motilidad intestinal. Los efectos posibles de la edad, el género y el nivel de intestino muestreado, están pendientes de determinación.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Anal Canal/abnormalities , Gastrointestinal Motility/physiology , Hirschsprung Disease/pathology , Interstitial Cells of Cajal/cytology , Intestines/abnormalities , Anal Canal/cytology , Anal Canal/pathology , Case-Control Studies , Cell Count , Hirschsprung Disease/diagnosis , Interstitial Cells of Cajal/pathology , Intestines/cytology , Intestines/pathology , Mass Screening , Muscle, Smooth/abnormalities , Muscle, Smooth/cytology , Muscle, Smooth/pathology , Proto-Oncogene Proteins c-kit , Trinidad and TobagoABSTRACT
A case report is presented of an infant who developed a large barium concretion proximal to a jejunal anastomosis. A brief literature review outlines the issues involved in the indications for, and choice of, contrast material for use in the precise radiological diagnosis of upper intestinal obstruction in infants.
Se presenta el reporte de un caso de un neonato que desarrolló una concreción grande de bario cercana a una anastomosis yeyunal. Una breve revisión de la literatura esboza los problemas involucrados en las indicaciones y selección del material de contraste para uso en un diagnóstico radiológico preciso de la obstrucción intestinal superior en los neonatos.
Subject(s)
Humans , Female , Infant, Newborn , Anastomosis, Surgical , Bezoars/diagnosis , Barium/adverse effects , Jejunum/surgery , Contrast Media/adverse effects , Intestinal Obstruction/diagnosis , Bezoars , Bezoars/surgery , Risk FactorsABSTRACT
A case report is presented of a malignant rhabdoid tumour occurring in the kidney of a 23-month-old boy. Important differences between this and the conventional Wilms' tumour include the histological demonstration of sheets or cords of large cells resembling myoblasts, a tendency to frequent clinical relapse, and a high mortality rate despite multimodal therapy. In this child, an encouraging initial response to pre-operative chemotherapy, followed by surgical excision and postoperative triple chemotherapy, was not sustained. Recurrence of pulmonary metastases did not respond to further chemotherapy and whole lung irradiation.
Subject(s)
Humans , Infant , Male , Rhabdoid Tumor , Kidney Neoplasms , Rhabdoid Tumor , Kidney NeoplasmsABSTRACT
A review of 391 children in the first decade of life admitted to surgical ward with soft tissue infections revealed predisposing factors in 34.8 per cent of cases, mainly trauma and adjacent skin sepsis. Superficial abscess formation occurred in 90 per cent of cases, muscle abscess in 9.4 per cent, and necrotizing fascitis in less than 1 per cent. The most frequent organism isolated was the staphylococcus aureus which was found in 52.8 per cent of the available cultures. Coliform organisms were found in 14.6 per cent, and haemplytic streptococci in just over 10 per cent. A study of the culture and sensitivity profiles obtained made it possible to formulate a programme for the empirical treatment of soft tissue infections based on the region of the body involved.