Computer-based clinical examination (CCE) in surgery: would It complement or replace the OSCE in the post-COVID-19 era?

Objectives: Surgical clinical assessment of medical students is confronted by many challenges particularly the increasing numbers of students with limited resources, and pandemics. The search for new tools of assessment continues. Our objectives were: (1) To develop a computer-based clinical exam (CCE) and identify its characteristics (2) To assess its acceptability of the students. Method: The study was conducted at the Surgical Department, Alzaiem Alazhari University (AAU) between February and August, 2017. We used the modular object oriented dynamic learning environment (MOODLE) program as a platform to upload and deliver the exam. The exam consisted of 45 questions (stations). Each consisted of a clinical scenario accompanied by a photograph (of a patient or investigation) or short video followed by multiple choice questions (MCQs). A questionnaire was designed to get the students' feedback. We analyzed the questionnaire and scores obtained by the students and compared them to their performance in other tools of the surgical exam, using SPSS statistical program. Results: The study included 188 final year medical students. There was a highly significant correlation of the CCE scores of each student with their final result (r= 0.67), and with other tools of the surgery exam particularly the objective structured clinical examination (OSCE). Students' acceptability was high. Conclusion: The CCE is valid and practicable. It saves time and is popular with the students and tutors. It complements the OSCE in the assessment of clinical competency and allows wide coverage of the curriculum. It is expected to gain importance and popularity in the post-COVID-19 era.

Pilot implementation of a computer-based training course on newborn hearing screening and teleaudiology among primary healthcare providers in low resource settings

Objective@#Newborn hearing screening (NHS) in the Philippines has been mandated by law since 2009. However, lack of awareness and knowledge about NHS remains a challenge, especially among healthcare providers. This paper describes the pilot implementation of a computer-based training (CBT) course on NHS and teleaudiology among primary healthcare providers (PHCPs) in rural Philippines. @*Methods@#A four-module web-based training course on newborn hearing screening and teleaudiology in an online learning management system (LMS) was field-tested among PHCPs from eight rural communities in the Philippines. Participants were given four weeks to complete the course. @*Results@#Forty-two PHCPs participated in the CBT. Thirty-four (81%) completed the whole course (mean attrition rate of 4.8% per module) at a mean duration of 10.2 days. Baseline data shows that participants had no NHS training, although the majority (83%) had information and communications technology (ICT) training. Comparison of preand post-test mean scores showed a 24.0% (p<0.001) significant increase in the post-test in all four modules. Passing rates (i.e., score ≥70%) from pre- to post-test increased by 54.6% (range: 38-80% increase). Usability of the CBT was rated high with a mean score of 4.32 out of 5 (range: 4.13 to 4.47), covering all eight parameters. Participants expressed general satisfaction and a positive attitude on CBT to improve knowledge on NHS and teleaudiology. @*Conclusion@#Even in low resource settings where gaps in ICT infrastructure exist, eLearning can be used as an alternative approach to increase awareness and support training of healthcare providers on newborn hearing screening.

Design of a blended learning course for training community healthcare providers on ehealth-enabled newborn hearing screening

Objectives@#We present in this article the design and evaluation of a blended learning approach for training community healthcare providers in performing newborn hearing screening (NHS).@*Methods@#We developed a blended learning course for training community healthcare providers on eHealth-enabled NHS, following Bloom’s revised taxonomy of educational objectives. The training involved three components: computer-based training (CBT), face-to-face (FTF) training, and on-site coaching. We used surveys and post-training interviews following Level 1 Kirkpatrick’s training evaluation model to get initial feedback on the training program. @*Results@#Thirty-one community healthcare providers from five rural health units and a private hearing screening center, with a mean age of 42.2 ± 12.0 years, participated in the pilot. 93.5% of the participants agreed that the program content met stated objectives and was relevant to their practice. The length of the course was perceived to be adequate. Overall satisfaction with the program was rated at 8.5 ± 0.9 (with ten as the highest). The majority expressed that the CBT and FTF course were satisfactory at 93.5% and 100%, respectively. All participants agreed that the course enhanced their knowledge of newborn hearing screening and telehealth. Positive reviews were received from participants on the use of CBT to improve theoretical knowledge before FTF training. Participants declared that FTF training and on-site coaching helped improved NHS skills and implementation. @*Conclusion@#Competent community healthcare providers are critical to strengthening the performance of the health system, and advances in the education and technology sectors offer promising potential in upskilling local healthcare providers. The increasing access of Filipino healthcare providers to improved information and communications technology (ICT) is a significant catalyst for pedagogical innovation, like the use of blended learning in the continuous professional development of health practitioners. As ICTs gradually penetrate the health sector, the challenge we now face is not whether but how we can use innovations in education strategies to benefit healthcare providers.

The development of a computer-based teaching simulation tool to aid medical imaging educators in teaching pattern recognition / Desarrollo de una herramienta de simulación computacional de enseñanza de apoyo a los educadores de imagen médica en la enseñanza del patrón de reconocimiento

SUMMARY: The aim of this exploratory design science research (DSR) study was to design a computer-based teaching simulation tool (CBTST) for training medical imaging (MI) students in chest pattern recognition. A DSR methodology used in the design of the CBTST entailed the following phases: 1) awareness of the problem (proposal design); 2) suggestion; 3) development; 4) evaluation; and 5) conclusion. The CBTST was designed using Microsoft Visual Studio which operates on the Structured Query Language server. The designed CBTST was evaluated using the System Usability Scale (SUS) and MI educators. The designed CBTST evaluation yielded an average score of 70.1 which exceeded the score of 68 which is generally accepted to indicate that the CBTST has good usability. The CBTST proved to be an authentic tool that is user-friendly and allows communication and feedback between the educator and the students. It is envisaged that the implementation of this tool will enhance the future training of MI students in pattern recognition while contributing immensely to the current development of the use of computer-based simulation.

RESUMEN: El objetivo de este estudio de investigación en ciencias de diseño (DSR) fue desarrollar una herramienta de simulación de enseñanza basada en computadora (CBTST) para capacitar a los estudiantes en el reconocimiento de patrones de tórax a través de la imagenología médica. Una metodología DSR utilizada en el diseño del CBTST implicaba las siguientes fases: 1) conciencia del problema (diseño de la propuesta); 2) sugerencia; 3) desarrollo; 4) evaluación; y 5) conclusión. El CBTST se diseñó con Microsoft Visual Studio, que opera en el servidor de Structured Query Language. El CBTST diseñado se evaluó utilizando la escala de usabilidad del sistema (SUS) y educadores de IM. La evaluación CBTST diseñada arrojó un puntaje promedio de 70,1 que excedió el puntaje de 68 que generalmente se acepta para indicar que el CBTST tiene buena usabilidad. El CBTST demostró ser una herramienta auténtica, fácil de usar y que permite la comunicación y la retroalimentación entre el educador y los estudiantes. Se prevé que la implementación de esta herramienta mejorará la formación futura de los estudiantes de IM en el reconocimiento de patrones y contribuirá de manera importante al desarrollo actual del uso de la simulación basada en computadora.

Computer Based Learning Modalities In Anatomy Dissection

Background: Cadaveric dissection has been used for centuries for teaching gross anatomy all over the world. Ithas been considered as a necessity to learn gross anatomy and helps the medical students in understanding thethree-dimensional relationship of different anatomical structures and variations. But the paucity of cadaversand high financial cost has considerably contributed to the development of alternative teaching techniques.Advancement in web-based medical technology leads to the development of virtual dissection programs. Theseprograms have been found to be an effective way to teach anatomy and are being preferred over cadavericdissection. Is cadaveric dissection simply a rite of passage or is it a necessity? The aim of our study was todetermine whether cadaveric dissection is a necessity in medical education, and if it can be replaced by neweralternative techniques like computer based dissection procedure.Materials and Methods: A batch of 150, 1st MBBS students of Malla Reddy Institute of Medical Sciences, Hyderabadwere studied by dividing them into 2 groups of 75 each after subjecting them to Conventional based Learning(CNVL) of dissection versus Computer Based Learning (CBL). A questionnaire was given to both the students andthe faculty. Based on the response to the questionnaire statistical analysis was done.Results: The present study indicated that the Computer Based Learning in dissection (CBL) method was found tobe more effective method for teaching anatomy by 79% of the students and 84% of faculty doctors. The valuer=0.89 shows the pre & post score has correlated positively and has an effect of study. (Paired Two Sample t-test:p=3.24E-29<0.05). As well the results were found to be increased with the pre (35%) to post test (65%) and p<0.05implies the effect.Conclusion: The three dimensional (3D) modeling of anatomical structures in the human body was presented indetailed step by step cadaveric dissections. It also provided detailed human anatomical training for students,where there is a lack of cadaver facility and where there are more students to cadaver ratio. Thus, the multimediaequipped interactive anatomical laboratory software enhance both memorization and visual learning skills ofthe medical students

The relationship between classical item characteristics and item response time on computer-based testing / 한국의학교육

PURPOSE: This study investigated the relationship between the item response time (iRT) and classic item analysis indicators obtained from computer-based test (CBT) results and deduce students' problem-solving behavior using the relationship. METHODS: We retrospectively analyzed the results of the Comprehensive Basic Medical Sciences Examination conducted for 5 years by a CBT system in Dankook University College of Medicine. iRT is defined as the time spent to answer the question. The discrimination index and the difficulty level were used to analyze the items using classical test theory (CTT). The relationship of iRT and the CTT were investigated using a correlation analysis. An analysis of variance was performed to identify the difference between iRT and difficulty level. A regression analysis was conducted to examine the effect of the difficulty index and discrimination index on iRT. RESULTS: iRT increases with increasing difficulty index, and iRT tends to decrease with increasing discrimination index. The students' effort is increased when they solve difficult items but reduced when they are confronted with items with a high discrimination. The students' test effort represented by iRT was properly maintained when the items have a 'desirable' difficulty and a 'good' discrimination. CONCLUSION: The results of our study show that an adequate degree of item difficulty and discrimination is required to increase students' motivation. It might be inferred that with the combination of CTT and iRT, we can gain insights about the quality of the examination and test behaviors of the students, which can provide us with more powerful tools to improve them.

Computer-Based Auditory Training Programs for Children with Hearing Impairment - A Scoping Review

Abstract Introduction Communication breakdown, a consequence of hearing impairment (HI), is being fought by fitting amplification devices and providing auditory training since the inception of audiology. The advances in both audiology and rehabilitation programs have led to the advent of computer-based auditory training programs (CBATPs). Objective To review the existing literature documenting the evidence-based CBATPs for children with HIs. Since there was only one such article, we also chose to review the commercially available CBATPs for children with HI. The strengths and weaknesses of the existing literature were reviewed in order to improve further researches. Data Synthesis Google Scholar and PubMed databases were searched using various combinations of keywords. The participant, intervention, control, outcome and study design (PICOS) criteria were used for the inclusion of articles. Out of 124 article abstracts reviewed, 5 studies were shortlisted for detailed reading. One among them satisfied all the criteria, and was taken for review. The commercially available programs were chosen based on an extensive search in Google. The reviewed article was wellstructured, with appropriate outcomes. The commercially available programs cover many aspects of the auditory training through a wide range of stimuli and activities. Conclusions There is a dire need for extensive research to be performed in the field of CBATPs to establish their efficacy, also to establish them as evidence-based practices.

Evaluation of Two-Channel Source Separation Using Exploratory Projection Pursuit Technique / Jurnal Sains Kesihatan Malaysia

@#Difficulty of understanding speech in noise among the elderly necessitates the need for Auditory Training which has made a renewal of interest in the last decade with the auditory training applications. This interest is perhaps spurred by advances in computer-based technology. In computer-based auditory training, speech signals are considered as auditory training stimuli where input speech signals need to be verified prior to training as the speech signals are mixed with noise signals. Computer-based Auditory Training System can be embedded with input speech verifying module. Input speech verifying module is employed with speech and noise separator simulator. This simulator needs to guarantee accurate separation of speech from noise signals. Therefore, in this research, Exploratory Projection Pursuit (EPP) technique under semi-Blind Source Separation (BSS) method is intended to separate the speech source signals which are mixed with competing speech (multitalker speech babble). This training uses Malay language based sentences which differ in word length and hence number of sample values. The experimental simulation considers two-channel random, linear mixing of speech sources and competing speech. The aim of this study is to evaluate the performance of source separation using the anticipated EPP technique for various sample values of speech signals which varies in time duration due to word length dissimilarity. Simulation results show that EPP technique is feasible for source separation. As a consequence, high correlation value of r ≥ 0.99 is obtained between extracted speech signal and original speech signal for all categories of speech signals. It is further verified by the maximum nongaussianity of extracted speech signal which has high kurtosis value of 32 approximately.

Improvement of Cognitive Function after Computer-Based Cognitive Training in Early Stage of Alzheimer's Dementia

BACKGROUND AND PURPOSE: Cognitive training is known to be an effective tool in enhancing cognitive functioning. Research has also shown that playing video game improves certain aspects of visual attention and cognitive processing speed. The effect of computer-based cognitive training has not been demonstrated so far. This study therefore evaluated whether computer-based cognitive training improved the cognitive abilities in patients with early stage of Alzheimer's dementia. METHODS: Totally, 20 participants (early stage of Alzheimer's dementia) participated in this study. To test the effectiveness of computer-based cognitive training programs to cognition, all patients were randomly allocated to either an intervention group (n=10) or a control group (n=10). The intervention group regularly received 24 sessions of computer-based cognitive training, over a 12 week period. Neuropsychological examinations were conducted before and after this training period. RESULTS: After 12 weeks, the intervention group showed a significant change in language of Korean version of the Mini-Mental State Examination (K-MMSE), compared with the baseline cognitive examinations. Also, there was greater improvement in language, attention, calculation, verbal memory, and frontal function for the experimental group, as compared with controls. CONCLUSIONS: Computer-based cognitive training might have beneficial effects on the general cognitive functions in early stage of Alzheimer's dementia.

Usefulness of ubiquitous-based testing for evaluations in medical education / 한국의학교육

PURPOSE: The purpose of this study was to evaluate the suitability (convenience, objectiveness, and satisfaction) of ubiquitous-based testing (UBT) as a medical education evaluation tool. METHODS: UBT was administered using a smart pad in our medical school in May 2012. A questionnaire was given twice. The pre-UBT questionnaire examined possession of a tablet computer, skillfulness of smart devices, the convenience of UBT, and the usefulness of a medical educational assessment tool. The post-UBT questionnaire evaluated the satisfaction, convenience, and preference of UBT and the usefulness of a medical educational assessment tool, as in the pre-UBT test. The survey was measured on a 4-point scale: 1 is "strongly disagree" and 4 is "strongly agree." RESULTS: One hundred three students (male, 55.3%) participated in the UBT. The mean age was 29.2+/-2.4 years. In the pre-UBT questionnaire analysis, students responded affirmatively to the items about the skillfulness of smart devices, clinical skill assessment, and achievement of educational objectives. The responses to the items on the convenience and satisfaction with the UBT were positive in the post-UBT. The factors that affected the post-UBT questionnaire were as follows: knowledge assessment (p=0.041) and achievement of educational objectives (p=0.015) were significant, based on gender, and satisfaction with the UBT (p=0.002) was significant, based on possession of a tablet computer. The relationship between the ranks of this UBT and the average ranks of the three previous semesters was statistically significant (p<0.001). CONCLUSION: Convenience, objectiveness, knowledge assessment, and composition and completion were useful items in the UBT.

Intubation training by video-laryngoscope among novice residents:digital video versus intubation model simulator / 基础医学与临床

Objective To compare the effectiveness of training with a digital video disc ( DVD)-based instruction ver-sus intubation model simulator in placement of endotracheal tube by video -laryngoscope .Methods Sixty patients un-dergoing elective gynecology surgeries and twenty residents of Dept .of anesthesiology were randomized to place a en-dotracheal tube by video-laryngoscope .Results Compared with intubation model simulator , intubation time [ (68 ± 14)s vs (69 ±7)s], score of performance (8.24 ±0.64 vs 8.31 ±0.58), failure rate (3 times/11 vs 1time/9 resi-dents), and instruction rate (5times/11 vs 4times/9 residents) were no statistic difference .Conclusions Digital video disc ( DVD)-based instruction is an alternative way to intubation model simulator in training .

Validation of a computer based objective structured clinical examination in the assessment of undergraduate dermatology courses.

Many teaching centers have now adopted objective structured clinical examination (OSCE) as an assessment method for undergraduate dermatology courses. A modifi cation of the standard OSCE in dermatology is computer based or electronic OSCE (eOSCE). We attempted to validate the use of a computer-based OSCE in dermatology in a group of fi fth year medical students. The scores of the students in the computer-based OSCE showed a strong positive correlation with the scores on the clinical presentation (Pearson’s co-effi cient - 0.923, P value <0.000, signifi cant at the 0.01 level) and a good correlation with overall scores of the student (Pearson’s co-effi cient - 0.728, P value <0.000, signifi cant at the 0.01 level), indicating that this is a reliable method for assessment in dermatology. Generally, the students’ feedback regarding the methods was positive.

Using Computer-Based Programmed Instruction to Train Goal-Directed Systems Design / Usando Instrucción Programada por Computadora para el Entrenamiento de Diseños de Sistemas Orientados a Metas

The purpose of this study was to evaluate two versions of a programmed instruction training program designed to teach undergraduate college students a goal-directed systems approach to analyzing organizational systems (Malott & Garcia, 1987). The first version was a paper-based programmed instruction module that had previously been shown to be effective at training the basic knowledge of the concepts, however was ineffective at training the application of these concepts. A computer-based programmed instruction (CBPI) version was created to improve the application of these concepts, which was tested through a series of three open-ended posttests with increasingly explicit prompts for each successive test. The results of the study showed higher performance results for the CBPI versions across all three dependent variables. The results of a nonparametric global test showed a standardized effect size of .86 and a p-value of < .001.

El propósito de este estudio fue evaluar dos versiones de un programa de instrucción programada diseñado para enseñar a estudiantes no graduados una aproximación al diseño de sistemas dirigidos a metas para analizar sistemas organizacionales (Malott & Garcia, 1987). La primera versión consistió en un modulo de un programa de instrucción personalizada de papel que anteriormente había probado ser efectivo para enseñar conocimientos básicos de conceptos, pero que no obstante era ineficiente para entrenar en la aplicación de dichos conceptos. Se creó una versión computarizada de instrucción programada (CBPI) para mejorar la aplicación de los conceptos, la cual se probó a través de una serie de tres post-tests con respuestas libres que incluyeron pistas cada vez más explícitas en cada prueba sucesiva. Los resultados del estudio mostraron una mejor ejecución en las tres variables dependiente cuando se usaron las versiones del CBPI. Los resultados de una prueba no paramétrica global mostraron un tamaño del efecto estandarizado de .86 y un valor p < .001.

Preliminary application and evaluation of GAS MAN assisted instruction in anesthesiology residency training / 中华医学教育探索杂志

Objective To explore the effect of GAS MAN assisted instruction on theory learning of volatile anesthetics in anesthesiology residency training.Methods A total of 32 residents in the first stage of anesthesiology training were enrolled and randomly assigned to either study(S) or control (C) group.Theory-test l(Test-1) was conducted for all residents after the lecture-based learning (LBL).Next,reference book self-reading strategy was used in both groups while computer-based simulation(CBS) using GAS MAN was only developed in S group.Then,theory-test 2(Test-2)was conducted for residents in both groups and residents in S group completed the questionnaire smvey.In addition,thirty-four resident teachers observed the CBS courses and completed the questionnaire smvey.Results The mean scores of Test-1 did not differ significantly between the two groups(P=0.64).However,the mean Test-2 score of S group(81.3 ± 13.6) was significantly higher than that of C group(61.3 ± 15.4) (P=0.001).100％(16/16) residents believed that CBS was beneficial to the theoretical study of volatile anesthetics,93.8％(15/16) residents considered GAS MAN could help understand the concepts and improve efficiency during self-learning.97.1％ (33/34) and 91.2％ (31/34)resident teachers agreed that CBS was helpful for analyzing complex concepts and improving study effectiveness,respectively.Conclusions CBS using GAS MAN improves theory knowledge and study effectiveness for anesthesia residents.Both residents and resident teachers find GAS MAN highly ac ceptable.Therefore,GAS MAN has the potential to be the assistant teaching tool for LBL in anesthesiology residency-training program.

The Effect of Computer-Based Cognitive Training Program On Cognition

BACKGROUND: Effective non-pharmacological cognitive program to prevent Alzheimer's dementia or slow its progression are an urgent international priority. The effect of computer-based cognitive training program has not been demonstrated yet in dementia. The purpose of this study is to know whether the computer-based cognitive training improved cognitive abilities in patients with mild cognitive disorder and early stage of dementia. METHODS: Totally 20 participants (14 with MCI and 6 with mild Alzhiemer dementia) participated in this study. To test the effectiveness of computer-based cognitive training programs to cognition, all patient were randomly allocated to an intervention group (n=10) or a control group (n=10) An intervention group received regularly computer-based cognitive training totally 20 times for 10 weeks. Neuropsychological examinations were conducted before and after this period. RESULTS: After 10 weeks, intervention group showed a significant change in language of K-MMSE compared with baseline cognitive examinations. Also, there was improvement in attention (backward digit span), calculation, memory, and frontal function for the intervention group as compared with controls. Patients with mild cognitive disorder showed marked improvements in language and visuospatial capacity, while patients with dementia showed no or slight improvement in these fields. CONCLUSIONS: Computer-based cognitive training program might have beneficial effect on general cognitive function in both mild cognitive disorder and dementia. Especially, conspicuous effectiveness showed in patients with mild cognitive disorder.

Evidências de validade da Bateria Informatizada de Linguagem Oral com prova de raciocínio / Evidence of validity of Computerized Oral Language Battery with reasoning assessment

Este estudo buscou relacionar a compreensão da linguagem oral com a habilidade de raciocinar, visando evidenciar validade correlacional para a Bateria Informatizada de Linguagem Oral por meio da associação com a Escala de Maturidade Mental Colúmbia. Participaram do estudo 82 alunos com idade entre 5 e 9 anos (M=7,05; DP=1,25), sendo 47,6% do sexo feminino. Frequentavam o pré (31,7%) e a 1ª (32,9%) e 2ª (35,4%) séries do Ensino Fundamental de escola pública do interior paulista. Aplicou-se coletivamente a Bateria e individualmente a Escala de Maturidade Mental Colúmbia. A Análise de Variância, por série, indicou diferença significativa para as provas de Compreensão Morfossintática, Sequência Lógica, Organização Lógico-Verbal e escore total da Bateria. A análise de regressão revelou que o raciocínio geral representa 29% das habilidades necessárias para um bom desempenho na Bateria. Verificou-se correlação baixa entre escores totais da Bateria e do Colúmbia, porém muito significativa. Constataram-se evidências de validade correlacional e de critério, para a Bateria.

The aim of this study was to relate the understanding of oral language to the ability to reason, in order to seek correlational validity evidence of the Computerized Oral Language Battery (Bateria Informatizada de Linguagem Oral) by association with the Columbia Mental Maturity Scale. The participants were 82 schoolchildren between 5 and 9 years of age (M=7.05, SD=1.25). They attended pre-school (31.7%),1st (32.9%) and 2nd (35.4%) grades of elementary public school in São Paulo and 47.6% of whom were girls. The Bateria Informatizada de Linguagem Oral was applied collectively in the school informatics laboratory and the Columbia Mental Maturity Scale, individually. Analysis of Variance for the series, indicated significant statistics differences for the scores of Morphosyntactic prove, Logical sequence prove, Logical Organization prove and for the total score of Bateria Informatizada de Linguagem Oral. Regression analysis revealed that general reason represents 29% of the skills needed to perform well in Bateria Informatizada de Linguagem Oral. There was low, but very significant correlation between total scores of Bateria Informatizada de Linguagem Oral and Columbia Mental Maturity Scale. These results indicated validity evidences to Bateria Informatizada de Linguagem Oral.

A model to integrate pathology teaching using technology.

Purpose: Use of technology to integrate pathology teaching in the third year of medical training. The teaching of pathology and disease includes several sections that have been taught by separate departments of immunology, haematology, microbiology, histopathology and biochemistry. It has been noted that students are not able to integrate the teaching from all these departments. To address this problem we have developed a model to integrate the teaching of the different sections by providing additional cases and materials in the computer laboratory. Methods: The eight week course of general pathology has been chosen for this model as it is the first section of pathology and the availability of teaching materials in the server of the computer. Three practical sessions are given to each section, histopathology, microbiology, haematology, immunology and clinical chemistry. Additional information was made available to students in the new thin client computer laboratory. A questionnaire was administered at the end of the course to half of the students. The responses which targeted in three areas, content, relevance, and acceptance and analyzed. Results: The eight week course was received enthusiastically by the students. The data indicated that the students generally accepted a computer-based instruction in teaching pathology. There was no improvement in performance of the class at the end of the term examinations as compared to the previous year. Conclusions: Computer-based instruction is possible in low resource countries. Use of technology can address challenges relating to integration of teaching .This model could serve as a nucleus for more extensive restructuring of teaching in the entire Medical School as well in other Medical Schools in Kenya and the rest of Africa.

The design and application of CCS examination system based on ASP.NET technology / 中华医学教育探索杂志

To examine the actual clinical diagnosis capability,the import of computer-based case simulations ( CCS ) technology in medical education is very important.The CCS examination system that integrated the ASP.NET and CCS technology can simulate doctor's clinical course more realistically and realize the students' practical skills evaluation.The system has a good prospect in medical education and clinical skills training.

Experiences with Establishing and Implementing Learning Management System and Computer-Based Test System in Medical College / 한국의학교육

PURPOSE: The purpose of this study was to establish an e-learning system to support learning in medical education and identify solutions for improving the system. METHODS: A learning management system (LMS) and computer-based test (CBT) system were established to support e-learning for medical students. A survey of 219 first- and second-grade medical students was administered. The questionnaire included 9 forced choice questions about the usability of system and 2 open-ended questions about necessary improvements to the system. RESULTS: The LMS consisted of a class management, class evaluation, and class attendance system. CBT consisted of a test management, item bank, and authoring tool system. The results of the survey showed a high level of satisfaction in all system usability items except for stability. Further, the advantages of the e-learning system were ensuring information accessibility, providing constant feedback, and designing an intuitive interface. Necessary improvements to the system were stability, user control, readability, and diverse device usage. CONCLUSION: Based on the findings, suggestions for developing an e-learning system to improve usability by medical students and support learning effectively are recommended.

Can computerized tests be introduced to the Korean Medical Licensing Examination?

In November 2011, the standing Committee of the Korean Medical Licensing Examination (KMLE) recommended that the National Health Personnel Licensing Examination Board introduce computerized testing to the KMLE. Therefore this article contextualizes and explores the possibility of applying computerized testing to the KMLE. Computerized testing comprises computer-based testing (CBT), ubiquitous-based testing (UBT), internet-based testing (IBT), and computerized adaptive testing (CAT). CBT refers to testing administered via a computer as the user interface, while testing with a smart phone or smart pad as the user interface is known as UBT. IBT is testing done online, and CAT is testing tailored so that each item provided fits the examinee's ability level. The benefits and drawbacks of each computerized testing option were surveyed. Among them, I propose CAT as the final goal for KMLE. In order to implement the computerized testing more effectively, it is recommended that items contain multimedia data and should involve interpretation or problem-solving. More evidence is needed to support the positive impact of computerized testing for undergraduate medical education and primary health care. Since the rapid progress of information technology such as internet bandwidth and human-computer interface methods, the introduction of computerized testing to KMLE will soon be plausible. It is possible to increase the quality of the KMLE with the introduction of computerized testing. Medical schools should prepare for the new testing environment of the KMLE by recruiting or training specialists in this field.