ABSTRACT
Background: Adoption of competence-based medical education (CBME) is the need of the hour. Objectives: The objective of the study is to develop and validate appropriate assessment tools for the community medicine entrustable professional activities (EPAs) and to assess the usefulness of the validated tools in the assessment of postgraduate (PG) students. Methods: An interventional study for 14 months was done in the department of community medicine. After the sensitization of faculty members and PGs, three EPAs were selected through consensus between faculty members and appropriate assessment tools mini-clinical evaluation exercise (Mini-CEX), case-based discussion (CBD), and direct observation of procedural skills (DOPS). Rubrics of milestones were formulated for the selected tools, and the designed tools were validated. These three validated tools were used for the quarterly assessment. Results: The item-content validity index for all three assessment tools was one, while Scale Content Validity Index for Mini-CEX and CBD were 1, and for DOPS, it was 0.87. Three PG students were assessed using the validated tools thrice for the three selected EPAs. The PGs opined that assessment using rubrics made their task-specific, while faculties were quite satisfied with the assessment process as it removed subjectivity. Conclusions: The developed and selected tools of EPAs were found to have a substantial level of both face validity and content validity. The tools were also found to useful for periodic assessment in workplace settings and acceptable to both PG students and internal/external faculty members.
ABSTRACT
OBJECTIVE: The objective of the present study was to find out the appropriate BMI cut-off point in relation to type 2 diabetes mellitus (DM) in the population of Kavre district of Nepal. MATERIALS AND METHODS: Thirty-five "known type 2 diabetic" and Thirty-five "self-reported non-diabetic" subjects above thirty years of age were included in the present study. Height and weight were recorded for every subject. BMI was calculated by the standard formula. The data was analyzed using SPSS Version 11.5. RESULTS: Our results showed that the reference BMI range for both diabetic male (23.26 +/- 6.88 kg/m(2)) and diabetic female (22.51 +/- 6.28 kg/m(2)) subjects were within normal BMI range according to WHO. Odds ratio showed an irregular pattern at different BMI ranges indicating the risk of having diabetes did not increase constantly. Comparison of number and percentage of both diabetic and non-diabetic male and female subjects according to various recommended normal BMI categories showed gradual reduction in percentage of both diabetic and non-diabetic male and female subjects that were within normal ranges from BMI category 18.5-24.9 kg/m(2) to BMI category 18.5-21.9 kg/m(2). The BMI cut-off point was found 22 kg/m(2) using Receiver Operating Characteristic (ROC) curves. CONCLUSION: The appropriate BMI cut-off point for both men and women was found 22 kg/m(2) in the population of Kavre district of Nepal.
ABSTRACT
The objective of this study was to assess the extent of conductive hearing loss in relation to different sizes and sites of simple central tympanic membrane perforations. Total 100 cases attending ENT OPD, BPKIHS during period of April 2003 to Mar 2004 without any discrimination of sex, race and religion were taken for the cross sectional prospective study. Dry, clean central tympanic membrane perforations due to various causes like chronic suppurative otitis media-tubotympanic, post acute suppurative otitis media residual perforations or simple traumatic perforations with conductive hearing loss and without preexisting hearing loss were clinicoaudiologically evaluated and analyzed. Hearing loss was found to be directly proportional to the size of perforation irrespective of their cause, which was statistically significant. Hearing loss in the study was found to range from negligible to 53dB. Overall, perforations involving posterioinferior quadrant were found to have maximum hearing loss.