ABSTRACT
The COVID-19 pandemic posed many disruptions to higher education assessment in 2020. At James Madison University (JMU), ensuing modifications to long-standing, university-wide assessment necessitated unproctored remote testing instead of the typically proctored, onsite assessment. Applying such modifications to low-stakes educational assessment raises validity concerns. JMU’s assessment model allowed us to explore the effect of the different test administrations, taking into account pre-existing trends in cohorts’ performance. We compared assessment results on three tests (history, global issues, and scientific reasoning) between the 2020 entering class (tested remotely) and the previous four cohorts (tested in-person). Our results revealed lower test performance and a bimodal distribution of effort scores in students tested remotely in 2020, but only on the more cognitively demanding scientific reasoning test, compared to the less arduous tests, history and global issues. Implications and limitations are discussed.
ABSTRACT
OBJECTIVE: The coronavirus disease (COVID-19) pandemic has disrupted healthcare systems worldwide, resulting in decreased and delayed hospital visits of patients with non-COVID-19-related acute emergencies. We evaluated the impact of the COVID-19 pandemic on the presentation and outcomes of patients with non-COVID-19-related medical and surgical emergencies. METHOD: All non-COVID-19-related patients hospitalized through emergency departments in three tertiary care hospitals in Saudi Arabia and Bahrain in June and July 2020 were enrolled and categorized into delayed and non-delayed groups (presentation ≥/=24 or <24 h after onset of symptom). Primary outcome was the prevalence and cause of delayed presentation; secondary outcomes included comparative 28-day clinical outcomes (i.e., 28-day mortality, intensive care unit (ICU) admission, invasive mechanical ventilation, and acute surgical interventions). Mean, median, and IQR were used to calculate the primary outcomes and inferential statistics including chi-square/Fisher exact test, t-test where appropriate were used for comparisons. Stepwise multivariate regression analysis was performed to identify the factors associated with delay in seeking medical attention. RESULTS: In total, 24,129 patients visited emergency departments during the study period, compared to 48,734 patients in the year 2019. Of the 256 hospitalized patients with non-COVID-19-related diagnoses, 134 (52%) had delayed presentation. Fear of COVID-19 and curfew-related restrictions represented 46 (34%) and 25 (19%) of the reasons for delay. The 28-day mortality rates were significantly higher among delayed patients vs. non-delayed patients (n = 14, 10.4% vs. n = 3, 2.5%, OR: 4.628 (CI: 1.296-16.520), p = 0.038). CONCLUSION: More than half of hospitalized patients with non-COVID-19-related diagnoses had delayed presentation to the ED where mortality was found to be significantly higher in this group. Fear of COVID-19 and curfew restrictions were the main reasons for delaying hospital visit.