Competency based assessment in pharmacology: implications of changed recommendations in viva voce and internal assessment

The competency based assessment (CBA) is an integral part of competency based medical education (CBME). It is important to discern the similarities and differences between CBME and traditional curriculum for developing effective implementation schedules and to identify opportunities for best use of the CBA in pharmacology training. CBA relies on assessment of core competencies and attitudes. The viva marks, to be decided at university level, are excluded from theory marks. An advantage of CBA is early entry of failed students into next phase of study. The areas of concern are, viva marks are included in practical marks further reducing ratio of practical to theory marks despite increase in total marks, and non-contribution of internal assessment marks to university marks for rank or grades. Multiple assessments using multiple tools in limited duration of 11 months would pose logistic problems and would require concerted efforts of faculty members for accomplishment.

Students’ feedback on the foundation course in competency based medical education curriculum

The Medical Council of India (MCI) has formulated a new Competency Based Medical Education (CBME) Curriculum for the Indian Medical Graduates with an objective of making medical education outcome based. A one month long Foundation Course (FC) is a hallmark of this CBME which is implemented during the first month of first professional MBBS studies. The objective is to acquaint, allay apprehension and prepare freshers for further studies using andragogical and heutagogical approaches. The MCI also released the guidelines for the medical colleges for uniform conduct of FC across the country. The FC was divided into six modules, i.e. Orientation Module, Skills Module, Community orientation module, Professional Development and Ethics Module (P and E), Enhancement of Language and Computer Skills Module, and Sports and extracurricular activities. A total of 175 hours were allotted to these modules. Like every institute, our institute also developed the implementation program and time-table of FC using MCI guidelines and taking into account the available resources.  The FC at our institute was conducted from 1st August 2019 to 31st August 2019 and was meticulously planned and implemented. The effective implementation  required committed efforts of 30 faculty members (12 Professors, 11 Associate Professors and 7 Assistant Professors), two language and one fine arts teacher,  and 4 non-teaching members  (Librarian, IT-personnel, Coach for sports and motivational Guru). The students were trained to write reflections daily in their log - books which are being analysed further.

A comparative evaluation of structured and unstructured forms of viva voce for internal assessment of undergraduate students in Pharmacology

Background: The study was designed to identify value of structured viva (SV) as an assessment tool, to ascertain its correlation with unstructured viva (UV) and to find relationship between viva and theory examination results.Methods: This prospective and observational study was conducted on a total of 135 students of the 2nd professional MBBS. All students faced two viva sessions (SV and UV), each of 10 marks on same topics in general pharmacology and autonomic nervous system. Time limit per student was 10 minutes. SV was conducted on pre-validated, standardized cards (n=40) with 5 questions in each card and 0.5 marks of each question. By draw of lots to be performed by students themselves, each student was given 4 cards. One week prior to the viva, the theory examination of 40 marks on same topics was conducted.Results: The mean marks of all students in SV (3.46�44) were significantly lower (P <0.0001) than those of UV (4.61�02). There was significant less deviation of mean marks in all groups of SV (P <0.05). The mean percentage marks of SV (34.63�.37%) had similarities with results of theory examination (34.67�.49%) (P=0.9720), while the difference between mean percentage marks of UV (46.15�.19%) and theory was statistically highly significant (P <0.0001).Conclusions: SV increases objectivity and reduces subjectivity as compared to UV because of similar pattern of questions, difficulty levels and standardised scoring system. SV provides an opportunity to measure how well students can apply knowledge. Thus, SV can be used for formative and summative assessment.

Learning Pharmacology by metaphors: a tale of NSAIDs

Metaphors are increasingly used for learning in medical education.1,2 Learning can be facilitated by giving homologous/analogous examples and story-telling.3-5 The undergraduate students are involved, and learning becomes enjoyable and stress-free. Here is a conversation between two NSAIDs while travelling in anthropomorphic forms (human beings) and discussing the detailed pharmacology and therapeutics of NSAIDs.

Prevalence of nomophobia and factors associated with it: a cross-sectional study

Background: Excessive use of mobile phones, including smart phones, is found to result in various health related, social and psychological problems. Nomophobia expands to ‘No Mobile Phobia’, i.e., fear of being out of mobile phone contact. Previous studies on nomophobia have focused on the student populations, since the younger generation is more technology savvy. This questionnaire-based study aimed to know the prevalence and factors leading to nomophobia in general population.Methods: This study was conducted in western Gujarat from September 2018 to October 2018. A prevalidated questionnaire, containing three parts, the demographic details, details about the characteristics of mobile phone use and the Nomophobia Questionnaire (NMP-Q), was sent through emails and WhatsApp to 1000 individuals. The responses were tabulated and analyzed.Results: Out of 331 respondents 192 (58%) were males and 139 (42%) females. There was no significant difference in average NMP scores with respect to gender (p = 0.401), age brackets (p = 0.135), marital status (p = 0.123) and profession (p = 0.055). However, NMP scores were significantly more in individuals who spent more time on mobile phones per day (p = 0.000), checked their mobile phones more frequently (p<0.000) and in whom phantom ringing syndrome was also present (p<0.000). 241 respondents (72.80%) felt that their mobile phone use was consuming time and affecting their other daily activities.Conclusions: Nomophobia is an emerging health related adverse effect of prolonged mobile phone use. Interventions are required to promote judicious use of mobile phones.

SGLT-2 inhibitors: The glucosuric antidiabetics.

Despite availability of a number of oral antidiabetics, a sizeable population of diabetics remains uncontrolled. Thus there is growing need of new group of drugs for diabetic control. Understanding renal conservation of glucose by efficient reabsorption through sodium glucose cotransporter-2 (SGLT-2) has paved way for development of an entirely new group of drugs, the SGLT-2 inhibitors. These glucosuric antidiabetic agents have shown promise in early clinical studies. Canagliflozin is recently approved for use in diabetes alone or along with other antidiabetics. Other highly selective inhibitors undergoing various stages of clinical developments are dapagliflozin, sergliflozin, remogliflozin, ipragliflozin, empagliflozin, luseogliflozin, tofogliflozin and desoxyrhaponticin. KGA-2727 (pyrazole-O-glucoside) is the first selective SGLT-1 inhibitor undergoing intense preclinical testing. There are safety issues associated with this group like urogenital infections (fungal), weight loss, initial osmotic diuresis and increased incidence of cardiovascular events. The long term safety remains to be established. Despite these limitations, SGLT-2 inhibition offers a unique target for achieving adequate control of diabetes in adults.

Anti vertigo drugs-revisited.

Vertigo is a sense of whirling and rotation and is frequently associated with nausea and vomiting. Vertigo is a cardinal manifestation of vestibular disorders. Pharmacotherapy is required for symptomatic treatment of vertigo and motion sickness irrespective of the aetiology. Drugs like cinnarizine, betahistine and scopolamine are time honoured drugs. Antihistaminics and phenothiazines are also useful agents. Surprisingly, very few newer agents have shown undisputed efficacy against vertigo. This review describes the neurotransmitters involved in the genesis of vertigo and current status and evolution of appropriate pharmacological options for the treatment.