Prediction of Graduate Learners' Academic Achievement in an Online Learning Environment Using a Blended Trauma Course.

Background: The concepts of online and blended education came into the limelight in the 19th century. Over time, the concepts expanded and reached a peak in 2021 in response to the COVID-19 lockdown. One of the challenges is the monitoring of the performance of distant learners. In face-to-face courses, an instructor can easily identify struggling learners during the regular meetings. Aim of the Study: This study explored variables that can predict the academic achievement of learners early in online learning environments. Although there was no consensus, the factors were still hypothesized as predictors for academic achievement. Methods: A quasi-experimental study was conducted to test the hypothesis. Thirty-three graduate learners were enrolled in a blended trauma course. The learners' age, their previous experiences in online education, pre-test scores, and the number of logs to the online platform were studied. These elements were considered as predictors of academic achievement in the online aspect of the course. Results: The findings revealed that there was no statistically significant correlation between the age, the previous experience in online education, the pre-test scores, and the number of logs in the first two weeks. However, there was a statistically significant correlation between the number of logs into the online platform in the first three weeks of study and the learners' academic achievement. Additionally, the number of logs in the first three weeks was a statistically significant predictor for academic achievement in online education. This early prediction can help instructors to identify and support struggling learners. Conclusion: The records of the online activity of learners in the first three weeks of study can help in early prediction of their academic achievement. Age, previous online education, and pretest scores were not statistically significant predictors.

Do entrustment scales make a difference in the inter-rater reliability of the workplace-based assessment?

BACKGROUND: A workplace-based assessment (WBA) is used to assess learners' competencies in their workplaces. Many workplace assessment tools are available and validated to assess various constructs. The implementation of workplace-based assessment requires proper training of the staff. OBJECTIVE: This study aimed to explore the impact of staff training on WBA practices and evaluate the inter-rater reliability of these practices while using entrustment scales, performance descriptors, and personal judgment. DESIGN: A quasi-experimental study, in which the staff members of the orthopedic department were invited to participate in a training program on the use of entrustment scales and assessment descriptors within the WBA tools. As a response to the training, subjective judgment was replaced by entrustment scales and performance descriptors in a trauma course offered by the orthopedic department. The inter-rater reliability of the WBA was evaluated using various rating scales. RESULTS: The entrustment scales had higher inter-rater reliability of the assessment tools than performance descriptors and the personal judgment. CONCLUSION: The inter-rater reliability was highest when using entrustment scales for WBAs, which could indicate that the entrustment scales achieve good psychometric properties as regards consistency among different raters. Thus, they decrease the confounding effect of differences in assessors. They may also give a clearer image of the actual academic level of the learners.

The outcome of the uncemented acetabular component in delayed total hip arthroplasty following acetabular fractures.

AIMS: After failed acetabular fractures, total hip arthroplasty (THA) is a challenging procedure and considered the gold standard treatment. The complexity of the procedure depends on the fracture pattern and the initial fracture management. This study's primary aim was to evaluate patient-reported outcome measures (PROMs) for patients who underwent delayed uncemented acetabular THA after acetabular fractures. The secondary aims were to assess the radiological outcome and the incidence of the associated complications in those patients. METHODS: A total of 40 patients underwent cementless acetabular THA following failed treatment of acetabular fractures. The postoperative clinical and radiological outcomes were evaluated for all the cohort. RESULTS: The median (interquartile range (IQR)) Oxford Hip Score (OHS) improved significantly from 9.5 (7 to 11.5), (95% confidence interval (CI) (8 to 10.6)) to 40 (39 to 44), (95% CI (40 to 43)) postoperatively at the latest follow-up (p < 0.001). It was worth noting that the initial acetabular fracture type (simple vs complex), previous acetabular treatment (ORIF vs conservative), fracture union, and restoration of anatomical centre of rotation (COR) did not affect the final OHS. The reconstructed centre of rotation (COR) was restored in 29 (72.5%) patients. The mean abduction angle in whom acetabular fractures were managed conservatively was statistically significantly higher than the surgically treated patients 42.6° (SD 7.4) vs 38° (SD 5.6)) (p = 0.032). We did not have any case of acetabular or femoral loosening at the time of the last follow-up. We had two patients with successful two-stage revision for infection with overall eight-year survival rate was 95.2% (95% CI 86.6% to 100%) with revision for any reason at a median (IQR) duration of follow-up 50 months (16 to 87) months following THA. CONCLUSION: Delayed cementless acetabular THA in patients with previous failed acetabular fracture treatments produces good clinical outcomes (PROMS) with excellent survivorship, despite the technically demanding nature of the procedure. The initial fracture treatment does not influence the outcome of delayed THA. In selected cases of acetabular fractures (either nondisplaced or with secondary congruency), the initial nonoperative treatment neither resulted in large acetabular defects nor required additional acetabular reconstruction at the time of THA. Cite this article: Bone Jt Open 2021;2(12):1067-1074.

Functional outcome and health-related quality of life following ipsilateral femoral and acetabular fractures: a retrospective analysis.

INTRODUCTION: The combination of ipsilateral femoral and acetabular fractures is known in the literature as the "Floating hip injury". The primary aim of this study is to assess both generic and specific patient-reported outcomes and the factors affecting the quality of life in patients sustaining this injury, while the secondary aim was to assess the injury patterns and the associated complications. METHODS: A retrospective study including 27 patients according to specific inclusion and exclusion criteria. EQ5D5L and Oxford hip score (OHS) were used. The mean age was 28 years (±10.1 SD) and 21 patients (77.8%) were males. The mean follow-up was 7 years (± 3.1 years SD). RESULTS: Median OHS was 46.5 (IQR: 31.5-48). The median EQ5D score was 0.919 (95% CI: 0.601-1). The mean EQ5D index value was 0.679 ± 0.442 (95% CI: 0.492-0.865). In this young cohort of patients, this drop in the mean EQ5D index value has led to a loss of a mean of 2.2 Quality-adjusted Life Years (QALYs). Through multivariate analysis, we found that the quality of life was mainly affected by the occurrence of end-stage arthritis, the presence of non-recovered traumatic sciatic nerve injury, and the occurrence of infection. CONCLUSIONS: Our findings show that the quality of life of those patients was significantly affected. These findings can be beneficial in counselling patients sustaining this complex injury and could be helpful in the discussion of the prognosis and in planning postoperative rehabilitation and support.

Lateral Compression Sacral Fractures Have Less Favourable Outcome Compared to Crescent Fractures in Patients Less Than 50 Years Old.

BACKGROUND: Lateral compression (LC) accounts for a wide spectrum of pelvic ring injuries (PRIs). The primary aim of this study was to assess the health-related quality of life outcomes of surgically fixed LC crescent versus sacral fractures in patients less than 50 years old after high energy trauma. MATERIAL AND METHODS: We retrospectively reviewed the database for PRIs treated surgically from Decem-ber 2011 to January 2019 at our tertiary level trauma centre. The EuroQoL-5D (EQ5D5L) questionnaire was elec-tronically sent to all patients. Multiple linear regression was conducted to determine the predictors of quality-adjusted life-years (QALYs). RESULTS: The study included 37 patients. The mean age was 26 SD 9.46 years. The mean duration of follow-up was 3.78 (r:1-9) years. Twenty-one (56.8%) and 16 (43.2%) patients sustained sacral fractures and crescent fractures, respectively. Multi-regression analysis showed that any patient with LC injury without a sacral fracture is expected to have a utility value of QALY= 0.876. A reduction of 0.072 units in QALYs is expected in the presence of sacral fracture. About 71% of patients with sacral fractures were able to return to work and this probability increased by 40% among patients with crescent fractures (RR=1.4, p=.015). CONCLUSIONS: 1. Younger patients with crescent fractures tend to have better quality of life (higher EQ5D and QALYs) compared to those with LC sacral fractures. 2. Moreover, patients with LC sacral fractures have less chan-ce to return to their pre-injury level of work compared to those with crescent fractures.

Functional outcome and health related quality of life after dual mobility cup total hip replacement for displaced femoral neck fractures in middle aged Egyptian patients.

AIM: This study was done to assess the functional and clinical results after one year of cemented THR with dual mobility cup for the treatment of fracture neck femur in active middle-aged patients in Egypt (Middle Eastern population). PATIENTS AND METHODS: This study included 31 patients (32 hips) with displaced femoral neck fractures that were admitted to El Hadara University Hospital, Alexandria, Egypt. Their mean age was 66.4 ±â€¯5.9 years. Fifteen patients were females. All the patients were treated with total hip replacement using a cemented dual mobility cup (Ecofit® 2 M, Implantcast GmbH, Germany) total hip replacement through the standard posterior approach. Functional assessment was done using Harris Hip Score (HHS), SF-36 questionnaire for health related quality of life (HRQoL) with assistance of a physiotherapist. RESULTS: The mean HHS improved over the follow up period from 79.04 ±â€¯7.9 at 12 weeks to an average of 92.8 ±â€¯11.1 at 1 year follow up. HRQoL measures showed a pattern of initial drop at 3 months postoperatively, then a steady rise to be restored at 1 year as compared to the preoperative baseline measures. There were no dislocations encountered in this series over one year follow up. The following complications were encountered; 1 deep infection, 2 deep vein thrombosis, 2 heterotopic ossifications, and 1 patient died within one year after surgery. CONCLUSIONS: Dual mobility cup total hip replacement is an acceptable method for treatment of displaced femoral neck fracture in active middle aged patients in Egypt as it provides pain relief and good function without compromising the stability.