ABSTRACT
The disruptions caused by COVID-19 pandemic has significantly affected the assessment component of the undergraduate medical curriculum. The lack of physical ascertainment of the learning outcomes has forced the medical educators across the world to adopt online modes of assessment. Though multiple options like true / false, short answers and viva were available, the most common tool for many was multiple choice questions as they could be arranged according to the cognitive hierarchy of Miller's pyramid. The present study was undertaken to analyze the effect of incorporating images while framing MCQs for online anatomy assessment among first year medical students. The study was planned in a quasi-controlled design where a batch of 150 students were subjected to a set of 40 multiple choice questions (20 text based and 20 image based MCQs). The questions were designed following Ebel and Frisbie guidelines of MCQs and validated by three investigators independently. Three cycles of assessments were conducted, and the scores were analyzed. At the end of 3 cycles of assessment feedback was taken from the students regarding this method of assessment. The performance of students was better in image based MCQs compared to traditional MCQs in all regions. Upon documenting the percipience, students had felt that image based MCQs were interesting, improved their clinical reasoning skills, lateral thinking abilities and quest for learning applied anatomy. Thus, we postulate that image based MCQs could be considered as better assessment tool in the era of online learning. © 2022, IMED Research Publications. All rights reserved.
ABSTRACT
Aim and background: Coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a high incidence of patients with the severe acute respiratory syndrome (SARS). Many of these patients require admission to an intensive care unit (ICU) for invasive ventilation and are at very high risk of developing ventilator-associated pneumonia (VAP).1-3 Objectives: To study the incidence and mortality of VAP of ventilated COVID-19 patients. Materials and methods: We retrospectively collected data on all patients hospitalized for COVID-19 during the first phase of the epidemic in a 9 bed ICU who were on invasive mechanical ventilation for >48 h. We studied the characteristics of VAP in these patients. VAP was diagnosed based on official recommendations. Results: Data of 55 patients was analyzed. Of these 23 (41.8%) had VAP. Patients with VAP required a greater number of ventilatory days (13.6 ± 6.2 vs 6 ± 4) and underwent more tracheostomies [9 (39.13%) vs 1 (3.13%)]. Length of ICU and hospital stay were significantly prolonged in COVID-19 VAP group 17.9 ± 11 vs 9.18 ± 6.11 days (p = 0.0002) and 18.3 ± 11 vs 9.9 ± 6.4 days (p = 0.0004), respectively. Also, organ involvement was significantly higher in the VAP group. Patients in both group had similar mortality, VAP - 15 (65.2%) vs non VAP - 18 (56.25%). Conclusion: COVID-19 is associated with an increased risk of VAP, which is not fully explained by the prolonged duration of ventilation. Complications like organ involvement and prolonged ventilatory days are common in COVID-19 VAP patients and need to focus on general supportive treatment and organspecific treatment.