Identification of technical item flaws leads to improvement of the quality of single best multiple choice questions

The purpose of the study was to identify technical item flaws in the multiple choice questions submitted for the final exams for the years 2009, 2010 and 2011. This descriptive analytical study was carried out in Islamic International Medical College [IIMC]. The Data was collected from the MCQ's submitted by the faculty for the final exams for the year 2009, 2010 and 2011. The data was compiled and evaluated by a three member assessment committee. The data was analyzed for frequency and percentages the categorical data was analyzed by chi-square test. Overall percentage of flawed item was 67% for the year 2009 of which 21% were for testwiseness and 40% were for irrelevant difficulty. In year 2010 the total item flaws were 36% and 11% testwiseness and 22% were for irrelevant difficulty. The year 2011 data showed decreased overall flaws of 21%. The flaws of testwisness were 7%, irrelevant difficulty were 11%. Technical item flaws are frequently encountered during MCQ construction, and the identification of flaws leads to improved quality of the single best MCQ's

Role of Early Range of Motion Exercises in Reduction of Scar Formation and Prevention of Contracture in Sub-acute Stage of Burn Patients

To determine the role of early passive range of motion exercises in the reduction in scar formation and prevention of Contracture in sub-acute Burn Patients. Study Design: Randomized Control Trail [RCT]. Burn Centre Pakistan Institute of Medical Sciences Islamabad, from January to December, 2010. Thirty patients were selected from the burn center at Pakistan Institute of Medical sciences [PIMS] Islamabad, age ranging from 12-60 years, and were randomly placed into two groups, 15 patients in each group. The anti-contracture positioning program was applied on group A with early passive range of motion [PROM] exercises of the involved areas and in group B only anticontracture positioning program was applied. The Vancouver Scar Scale [VSS] was used as an assessment tool and 4 variables were assessed including vascularity, height/thickness, pliability, and pigmentation. Data was analyzed on SPSS version-20 and independent t-test was applied at 90% level of significance to calculate the p-value for group A and B. The results show that the anti-contracture positioning with early passive range of motion [PROM] exercises reduced scar formation and prevent contractures more significantly in group A [P-value =0.002] with average VSS score 6, as compare to the anticontracture positioning alone in group B [P-value=0.435] with VSS score 10, as assessed at the completion of physical therapy management program in all the 30 patients of subacute stage of burn. It was concluded that the early passive range of motion exercises with anti-contractures positing can reduce the amount of scar formation, prevent contractures and increase the quality of physical therapy management in sub-acute stage of burn patients

Comparison of Self-Assessment with Peer and Student Assessment in Evaluating the Overall Performance of the Faculty

To evaluate the overall faculty performance by comparison of Self-assessment with peer and student assessment. A comparative cross sectional survey. Study was conducted from January to June 2012 in Riphah College of Rehabilitation Sciences, Riphah International University Islamabad. This research study was conducted among students of Doctor of physical therapy [DPT], post-professional Doctor of physical Therapy [PPDPT], and Master of Science in speech language pathology [MS-SLP], and faculty members at Riphah College of Rehabilitation Science [RCRS], Riphah International University Islamabad. The total sample size was 730, including 700 students and 30 faculty members. A questionnaire was developed according to likert scale, and after a pilot study on 20 student and 10 faculty member to determine the reliability. The questionnaire was circulated among all the 30 faculty members and 700 students, including 500 undergraduate and 200 post graduate students of all the 3 programs. The data was analyzed and Wilcoxon [Kruskal-Wallis] was applied at 95% level of significance for all the 3 groups. The group [A] included assessment of the performance of the faculty members done by the students, group [B] done by other faculty members, and group [C] included self assessment done by faculty members. The averages were calculated to determine the overall performance of the faculty members as assessed by themselves, other faculty members, and the by students as well, afterwards the averages of 3 groups were compared. the overall performance of the faculty members was graded as 71% [P=0.015] as evaluated by the students, 77% [P=0.009] as evaluated by other faculty members, and 73% [P=0.011] as evaluated by the faculty members through self assessment. It is concluded that there was no significant difference in the performance of the faculty members, as assessed themselves, by the students and the other faculty members

Does PBL Make Medical Students Life long learners?

our medical school has switched from traditional to integrated modular spiral outcome based curriculum. Problem based learning has been introduced as one of the main teaching/learning strategies. One of the major benefits of PBL mentioned in the literature is to make student a lifelong learner. However it is not easy to assess that PBL imparts this basic feature of adult learning in students. PBL is used as learning strategy in the first 02 years of medical curriculum, so that the lifelong learning capability can be assessed in the last three years of medical school. To determine the role of PBL in developing lifelong learning ability among medical students. A quantitative cross sectional co-relational study. The study was conducted in Islamic International Medical College in April 2012. Three hundred students from 3rd to final year MBBS were distributed Revised Jefferson scale of Physician Lifelong learning [JeffSPLL] at the start of the lecture. The questionnaire was collected at the end of the lecture. Data was collected from JeffSPLL inventory. This was entered into SPSS 18. Both non parametric and parametric analysis were done. Non parametric analysis included mean, median and mode of ages and gender of the participants. Parametric analysis was based on Pearson Co relation analysis to find a relationship between the PBL and developing the capability of Lifelong learning. Lifelong learning is multidimensional idea. Factors associated with lifelong learning include need recognition, undertaking research, self-motivation, practical abilities and personal motivations. The discussion will be based on the relationship between the development of lifelong learning skill and the process of Problem based learning. The process of PBL makes the students lifelong learners

role of early mobilization in the prevention of post operative wound infection after lower extremity orthopedic surgeries

To determine effects of early mobilization in reducing post operative wound infection after lower extremity orthopedic surgeries. Quasi Experimental Study. This study was carried out at department of orthopedics Pakistan Railway General Hospital Rawalpindi, from August 2010 to July 2012. Eighty nine patients who had undergone lower extremity surgery were conveniently placed into early mobilization group A and delayed mobilization group B. All the patients mobilized within first week after surgery were included in group A, and those mobilized after one week of surgery were included in group B. Patients' wound infection was defined as local redness, pain, and pus discharge within three weeks after surgery. Results were analyzed using Chi-square test with SPSS-16.0. Minimum age of patients in this study was 10 and maximum 90 years with a mean of 45 in group A and 44 in group B. The total number of the cases of wound infections was 6 [6.74%]; 2 [4.4%] in the early mobilized group and 4 [9%] in the delayed mobilized group. Statistical analysis showed significant difference in the number of wound infections in both groups and the result for group A was statistically more significant [p value=0.03] as compared to result] for group B [p value =0.06]. We conclude that after lower extremity orthopedic surgeries, early mobilization is needed, as it significantly reduces the postoperative wound infection rates, and early mobility is achieved

Removable subcuticular skin sutures in open appendicectomy; surgeons fear

To determine the frequency of wound infection with skin closure by removable subcuticular sutures in non complicated open appendectomy wound. Descriptive case series. Department of Surgery Railway Hospital Rawalpindi, Seven months and ten days, from 1[st] Nov, 2009 to 10[th] June, 2010. The study was carried out after taking approval from the hospital ethics committee. Seventy three adult patients of either sex admitted in department of surgery with diagnosis of acute appendicitis were included in the study by non probability consecutive sampling. All the patients were explained about the procedure and an informed written consent was obtained. Right grid iron abdominal incision centred over the Me Burney's point was used to open the abdomen. Appendicectomy was done. In all patients subcuticular stitches by using polypropylene 2/0 were applied to close the skin. All the patients were followed on 3[rd], 7th and 30[th] post operative day for examination of wound. Data was entered in the predesigned Proforma [annexed] for analysis. Out of 73 patients 6 [8.2%] suffered from wound infection. Successful open management of the infected wounds was done. Rest of the patients had uneventful recovery. Frequency of wound infection is negligible with removable subcuticular skin suture in non complicated open appendicectomy wound

Fluid volume measurement reliability of commercially available drainage bags

[1] To measure the difference between the actual and observed volumes of fluids as measured by the commercially available drainage bags. [2] To find out reliability of fluid volume measurements as observed in commercially available drainage bags. Surgical Unit II, IIMCT Railway Hospital, Rawalpindi. Descriptive. Commercially available drainage bags were used to observe the volume of fluid contained in it. The fluid [tap water] was introduced in the bag with a 50 cc syringe in 50 cc increments starting from 50 cc to 1050 cc. and the difference between observed volume and actual volumes were recorded. Data was analyzed with SPSS. A total of twenty-one observations were made in 02 different commercially available urine bags. Major differences were found in the observed and measured volume with minimum difference of 50 -230 ml and maximum difference of 200-520ml. Significant differences were found between the actual volumes and the volumes observed by the marks on the drainage bags. It is noted that the observed value of the fluid volume contained in a drainage bag is highly unreliable and should not be used for clinical decision making

Learning styies; learners and their career choice

1. To study the prevalence of learning styles in intermediate level students in Rawalpindi according to Kolb's Learning Style Inventory. 2. To study the correlation of learning types with career choices of intermediate level students in Rawalpindi. 3. To compare the results of the study with the learning styles of clinical students of a medical college. Cross sectional. Descriptive. The study was done on the intermediate level students of Government College of Rawalpindi. It included the Pre-Medical, Pre-Engineering and humanities students. All students were given a questionnaire based on Kolb's learning style inventory, and responses collected. Instructions to fill the questionnaire were given verbally to all students. Each student was also instructed to present three career choices in order to priority. Data was collected. Prevalence of different learning styles in medical students and intermediate level students is shown in table-I and table-II respectively. The prevalence and pattern of learning styles of intermediate level learners and medical students is different. Majority of intermediate level learners have the converger learning styles in contrast with the medical students in whom accommodators are in overwhelming majority. Most learners choosing "Doctor" as their preferred career among intermediate level learners were of assimilator style, followed by convergers. Accommodators were on third place in choosing "Doctor" as preferred career. The most preferred career among intermediate level learner was "Teacher"

Stress; a cross sectional study at islamic international medical college [IIMC], Rawalpin

To assess different level of stress and reaction to those stressors among undergraduate medical students and also observe an association between different academic years, if any exists. Cross-sectional study. Islamic International medical college- a private medical college in Rawalpindi. Period: From 2006 to 2007. Questionnaire used was a stress inventory called students life stress inventory. It was distributed to all registered MBBS students at IIMC in years 1- 5 who voluntarily participated. 403 out of 500 students completed the questionnaire with response rate 81.6%. Data was analyzed through SPSS by applying different statistical tests, which were ANOVA, and t test. Results reveal that 21.53% students were mildly stressed, 39.12% students were moderately stressed and 12.64% students were severely stressed. Significant gender differences were found on almost all the sub-scales. The findings reveal that females face more stressors especially conflicts, emotional and behavioral [p < .01], stress was more significant between boarders as compare to non-boarders. One Way Analyses of variance [ANOVA] was computed to check the significance of differences on mean scores. An analysis of variance on Student Life Stress Inventory is significant, F = [3.774], p <.01. Mean difference indicates that prevalence of stress is higher in first year and final year MBBS students. This study presents pragmatic evidence regarding the psychological health of students in our college. These findings suggest that high levels of stress exist in our students especially significant during first and final years of their course. It is important for us to know the prevalence and causes of student stress, which not only affects their health, but also their academic achievement. Information from this study can be used to develop appropriate intervention programs for medical students, in order to decrease their stress levels

study of students' learning styles in medical institution in Pakistan

To determine the learning styles of medical students in a medical college in Pakistan and to match the learning styles of students with the instructional strategies in clinical classes. The cross-sectional descriptive study involved medical students of the Islamic International Medical College [IIMC], in clinical classes. Both male and female students were administered a questionnaire based on Kolb's learning style inventory. Instructions to fill the questionnaire were given verbally to all students. Majority of students had the accommodators learning style [N=83, 54.6%] while convergers, divergers and assimilators were less in number. The learning scheme consists mainly of lecture based learning [42 hours per week] and case based learning [31 hours per week] Majority of students of clinical classes of IIMC had the accommodator learning style, followed by converger, diverger, and assimilator learning styles. The learning scheme of IIMC provided learning opportunities for all styles of learning and consisted of adequate instructional strategies

Patient satisfaction; An experience at HMC-T railway hospital

To study the degree of patient satisfaction with various aspects of care in Islamic International Medical College Trust [IIMC-T] Railway Hospital, Rawalpindi. cross-sectional, descriptive. All the patients admitted to IIMC-T Railway Hospital were given a questionnaire form at the time of discharge. They were requested to give feedback regarding different aspects of services at the hospital and suggestions for improvements of services. This information is part of the hospital management information system. The data for this study was obtained from these feedback responses. Responses of patients regarding different aspects of services of the hospital were graded as excellent, good and unsatisfactory. Out of 2,709 responses, 34% were excellent, 60% good and 6% unsatisfactory. Best aspect of service was the availability of doctors in wards [84% excellent and good] and worst aspect was cleanliness of wards [12% unsatisfactory]. An anonymous satisfaction survey is a low cost, valid and reliable method of obtaining information about patient satisfaction with the services of the hospital. IIMC-T Railway Hospital is providing services to patients with a reasonable degree of patient satisfaction