Changing Undergraduate Medical Students’ Perception of Online Learning and Assessment During the Covid-19 Pandemic: a One Year Follow-up Study

@#Introduction: Like most educational institutions, our medical school transitioned to online learning during the COVID-19 pandemic in March 2020. An initial survey of 192 undergraduate medical students conducted in June 2020 revealed a low acceptance of online assessments, lack of work-readiness, perception of online discussions as being inferior to face-to-face, and prevalent anxiety. Following this, we implemented pedagogic changes to encourage independent learning, improve patient contact, and increase social interactions between students. Methods: A follow-up study was conducted 12 months later in the same student population, excluding those who had graduated. The same 14-item anonymized survey questionnaire was administered, and comparisons were made between the follow-up and initial responses. Results: At follow-up, 45.6% of participants felt that online assessments can adequately and fairly assess students’ performance compared to the initial study (26.2%, p = 0.002). Participants at follow-up were generally more agreeable that discussion using an online learning platform was as effective as faceto-face learning compared to before (p = 0.017). Subgroup analysis showed that this was only true for Year 2 – 4 students. Year 5 students perceived online learning as less effective then face-to-face, reported lower confidence in their ability to apply their knowledge, and an increased in anxiety compared to before. Conclusion: While perception of online learning and assessment had improved at follow-up, the ramifications from restrictions to medical education over the past two years are now being felt most severely by the current final year students, emphasizing the importance of anticipating and addressing these concerns much earlier.

Comparison of lactose breath hydrogen test and milk breath hydrogen test in the diagnosis of lactose malabsorption

In both clinical and field situations, breath hydrogen analysis has been widely used in evaluating lactose malabsorption. It is as accurate as other tolerance tests and has an advantage of being noninvasive. The use of milk (360 ml) as a test meal for breath hydrogen test was evaluated in 16 adult subjects (8M:8F), age ranging from 20 to 50 years. Lactose (17.6 g) breath hydrogen test was used as standard test. Of 16 subjects tested, 5 subjects were found to be lactose absorbers and 11 subjects were lactose malabsorbers by lactose breath hydrogen test. In milk breath hydrogen test, the same 5 subjects were found to be lactose absorbers and 8 out of 11 subjects (lactose malabsorbers) were detected as lactose malabsorbers. The present study demonstrates that breath hydrogen test using milk (360 ml) as a test meal has a sensitivity of 73 per cent and a specificity of 100 per cent and could be used as an alternative test in the diagnosis of lactose malabosorption.

Serum calcium in normal and preeclamptic pregnant Myanmar women

To study the changes during normal pregnancy and in preeclampsia, serum calcium concentration was measured in 26 apparently healthy pregnant Myanmar women and in 15 preeclamptic patients. They were 20-40 years of age. In healthy pregnant women, serum total calcium levels measured at 24th week, 28th week, 32nd week and 36th week of gestation were 2.45 + or - 0.30 mmol/1, 2.47 + or - 0.29 mmol/1, 2.41 + or - 0.29 mmol/1 and 2.46 + or - 0.29 mmol/1 respectively and ionized calcium levels at these periods were 1.24 + or - 0.15 mmol/1, 1.23 + or - 0.14 mmol/1, and 1.20 + or - 0.16 mmol/1 respectively. In preeclamptic patients, the mean serum total calcium level (2.26 + or - 0.24 mmol/1) was significantly lower than that (2.52 + or - 0.23 mmol/1) of 0.27 mmol/1) and ionized calcium level (1.23 + or - 0.14 mmol/1) of preeclamptic patients were not significantly different from those (2.43 + or - 0.24 mmol/1 and 1.24 + or - 0.13 mmol/1 respectively) of control.

Time usage and energy expenditure of volleyball players during training

Fifteen male Myanmar national volleyball players, selected for 11th Asian Games, 1990, were studied during training. This is the first assignment of energy expenditure on Myanmar volleyball players. The average daily training period of the players was 4.23 h. They utilized 1508.8 kcal for training activities out of the 24 h energy expenditure of 3088.6 kcal. The mean + or - SD energy intake was 3965.3+ or - 469.4 kcal per cent day and was found to be sufficient for twenty four-h energy expenditure. The individual training activities belonged to heavy type of activities but the daily training period was short compared to those of other countries.

Serum uric acid level as predicting sign of preeclampsia

Serum uric acid levels were measured in 19 pregnant Myanmar women clinically diagnosed as preeclampsia, before any treatment was given. The subjects were in the perid of 36 + or - 2 weeks gestation and their ages ranged from 20 to 40 years. Out of 90 cases, 12 had mild preeclampsia and 7 had severe preeclampsia. All cases became normotensive and proteinuria ceased after puerperium. The serum uric acid level of severe preeclampsia varied widely from 4.9 to 11.9 mg/dl while that of mild preeclampsia ranged from 3.4 to 7.9 mg/dl. The mean serum uric acid level of severe preeclampsia (9.3 + or - 2.36 mg/dl) was significantly higher than that of apparently healthy pregnant women of the same age and gestational period. The mean value of mild preeclampsia (5.5 + or - 1.38 mg/dl) was not significantly different from the normal. Therefore, a single uric acid level of a pregnant women is of little use as a predicting sign of preeclampsia.

Hospital based in vivo monitoring of the degree of resistance of P.Falciparum to standard anti-malarials

This preliminary study was done to monitor the changing trend in sensitivity of anti-malarials at a fixed hospital in central Burma near Pegu Mountain Range. During 1986 malarial season out of 15 patients treated with chloroquine (6.6per cent) was resistant at R2 level and (73.3 per cent) were resistant at R1 level. Remaining 20 per cent of patients were either S (sensitive)of R1 (resistant). Out of 29 patients treated with amodiaquine (6.9 per cent) were resistant at R2 level and (51.7 per cent) were resistant at R1 level. (13.8 per cent) patients were proved as sensitive and the remaining (27.6 per cent) patients were either S (sensitive) or R1 (resistant). Out of 24 patients treated with sulphadoxine pyrimethamine (16.7 per cent) were resistant at R2 level. 50 per cent were resistant at R1 level. (20.8 per cent) cases were sensitive to the drug. The remaining 12.5 per cent of patients were either S (sensitive) or R1 (resistant). Out of 31 patients treated with quinine (6.5 per cent) were resistant at R2 llevel. (9.7 per cent) were resistant at R1 level. (48.3 per cent) were sensitive to the drug. Remaining (35 per cent) were either S (sensitive) or resistant at R1 level. Out of 35 patients treated with mefloquine sulphadoxine pyrimethamine (3.0 per cent) was resistant at R2 level. (12.1 per cent) were resistant at R1 level. (69.6 per cent) were sensitive to the drug and the remaining (15.2 per cent) of patients were either S or R1 resistant. The problems faced with the present method of drug monitoring will be discussed. Although re-infection during the follow up period could not be totally excluded it may be concluded that significant resistance to quinine exists and mefloquine resistance may also become a problem in the not too distant future.

A study of enteric pathogens in stools of infants and children in an urban community

69 children of the urban community, Rangoon was surveyed for isolation of enteric pathogens 53 of which belonged to under 1 year and the rest 16 belonging to 1-2 years age. Stool samples of 3 infants revealed presence of enteropathogenic Escherichia coli 0119 B14, 1000 B4 and 0128 B12 respectively. The incidence of ascariasis in 1-2 year group was higher than the under 1 year group as shown in Table I. Eggs of H.na na was found in an infant and larva of Strongyloides stercoralis in one of the 1-2 year age group. Other enteric pathogens viz. Salmonella, Shigella and Vibrio species were not isolated. The egg count of the intestinal helminths done by Stolls method would enlighten us, as to the worm load and thus the intensity of parasitosis which will be useful in assessing the response to treatment.