Formative Assessment of Diagnostic Testing in Family Medicine with Comprehensive MCQ Followed by Certainty-Based Mark.

INTRODUCTION: The choice of diagnostic tests in front of a given clinical case is a major part of medical reasoning. Failure to prescribe the right test can lead to serious diagnostic errors. Furthermore, unnecessary medical tests are a waste of money and could possibly generate injuries to patients, especially in family medicine. METHODS: In an effort to improve the training of our students to the choice of laboratory and imaging studies, we implemented a specific multiple-choice questions (MCQ), called comprehensive MCQ (cMCQ), with a fixed and high number of options matching various basic medical tests, followed by a certainty-based mark (CBM). This tool was used in the assessment of diagnostic test choice in various clinical cases of general practice in 456 sixth-year medical students. RESULTS: The scores were significantly correlated with the traditional exams (standard MCQ), with matched themes. The proportion of "cMCQ/CBM score" variance explained by "standard MCQ score" was 21.3%. The cMCQ placed students in a situation closer to practice reality than standard MCQ. In addition to its usefulness as an assessment tool, those tests had a formative value and allowed students to work on their ability to measure their doubt/certainty in order to develop a reflexive approach, required for their future professional practice. CONCLUSION: cMCQ followed by CBM is a feasible and reliable evaluation method for the assessment of diagnostic testing.

Three-Dimensional Printing Model Enhances Craniofacial Trauma Teaching by Improving Morphologic and Biomechanical Understanding: A Randomized Controlled Study.

BACKGROUND: Teaching about craniofacial traumas is challenging given the complexity of the craniofacial anatomy and the necessity for good spatial representation skills. To solve these problems, three-dimensional printing seems to be an appropriate educative material. In this study, the authors conducted a randomized controlled trial. The authors' main objective was to compare the performance of the undergraduate medical students in an examination based on the teaching support: three-dimensionally printed models versus two-dimensional pictures. METHODS: All participants were randomly assigned to one of two groups using a random number table: the three-dimensionally-printed support group (three-dimensional group) or the two-dimensionally-displayed support group (two-dimensional group). All participants completed a multiple-choice question evaluation questionnaire on facial traumatology (first, a zygomatic bone fracture; then, a double mandible fracture). Sex and potential confounding factors were evaluated. RESULTS: Four hundred thirty-two fifth-year undergraduate medical students were enrolled in this study. Two hundred six students were allocated to the three-dimensional group, and 226 were allocated to the two-dimensional group. The three-dimensionally printed model was considered to be a better teaching material compared with two-dimensional support. The global mean score was 2.36 in the three-dimensional group versus 1.99 in the two-dimensional group (p = 0.008). Regarding teaching of biomechanical aspects, three-dimensionally-printed models provide better understanding (p = 0.015). Participants in both groups exhibited similar previous student educational achievements and visuospatial skills. CONCLUSIONS: This prospective, randomized, controlled educational trial demonstrated that incorporation of three-dimensionally-printed models improves medical students' understanding. This trial reinforces previous studies highlighting academic benefits in using three-dimensionally-printed models mostly in the field of understanding complex structures.

Animal experimentation in transgenesis: evaluating course design in large classrooms.

Teachers are guided by an ethical code of conduct. Teacher behavior can be perceived as normative and can set standards; for example, in the field of animal experimentation. The importance of ethical standards raises the question of its transmission. This survey addressed the relevance of using large amphitheater teaching groups to educate students on the ethical aspects of animal experimentation. A course was built to include interactivity sequences to gather feedback from students about moral dilemmas or assertions about animal experimentation. To that end, surveys were conducted on third-year students, prior to the course, shortly after the course and at the end of the academic year. Students were asked to indicate whether the experimental protocols were satisfactory. Before the course, few students reported ethical dimensions in the proposed protocols; animals were considered scientific objects, not sentient beings. The situation was noticeably different for students on courses with an emphasis on the animal as the unit of study. Although large classrooms are not considered to be relevant places to question ethical issues, the proportion of students discussing ethical aspects of protocols increased shortly after the lecture, and this increased at the end of the academic year. These observations suggest that the effect of teaching on ethical considerations was sustainable despite the lectures being performed in a large classroom.

[Physiopathology and evolution of burns]. / Physiopathologie et évolution de la brûlure.

The skin is an impermeable physical barrier which protects the organism from external aggressions.With a burn, the different layers which make up the skin can be partially or totally affected. Significant physiological disturbances can put the patient's life at risk.

[Management of the patient with serious burns at admission]. / La prise en charge d'un brûlé grave à l'admission.

The first hours of care and treatment are determined by the quality of the preparation on a logistical, organisational and environmental level. The future of a patient with serious burns is at stake in these first few hours. The risk of threat to life is linked to potential vascular compressions, as well as cardio-respiratory failure.The occurrence of these complications can be prevented by the setting up of codified instrumental and clinical monitoring.