Self-assessment differences between genders in a low-stakes objective structured clinical examination (OSCE).

OBJECTIVE: Physicians and medical students are generally poor-self assessors. Research suggests that this inaccuracy in self-assessment differs by gender among medical students whereby females underestimate their performance compared to their male counterparts. However, whether this gender difference in self-assessment is observable in low-stakes scenarios remains unclear. Our study's objective was to determine whether self-assessment differed between male and female medical students when compared to peer-assessment in a low-stakes objective structured clinical examination. RESULTS: Thirty-three (15 males, 18 females) third-year students participated in a 5-station mock objective structured clinical examination. Trained fourth-year student examiners scored their performance on a 6-point Likert-type global rating scale. Examinees also scored themselves using the same scale. To examine gender differences in medical students' self-assessment abilities, mean self-assessment global rating scores were compared with peer-assessment global rating scores using an independent samples t test. Overall, female students' self-assessment scores were significantly lower compared to peer-assessment (p < 0.001), whereas no significant difference was found between self- and peer-assessment scores for male examinees (p = 0.228). This study provides further evidence that underestimation in self-assessment among females is observable even in a low-stakes formative objective structured clinical examination facilitated by fellow medical students.

A student-initiated objective structured clinical examination as a sustainable cost-effective learning experience.

BACKGROUND: The objective structured clinical examination (OSCE) has gained widespread use as a form of performance assessment. However, opportunities for students to participate in practice OSCEs are limited by the financial, faculty and administrative investments required. OBJECTIVES: To determine the feasibility and acceptability of a student-run mock OSCE (MOSCE) as a learning experience for medical students of all 4 years. DESIGN: We conducted a five-station MOSCE for third-year students. This involved fourth-year students as examiners and first-/second-year students as standardized patients (SPs). Each examiner scored examinees using a checklist and global rating scale while providing written and verbal feedback. MOSCE stations and checklists were designed by students and reviewed by a faculty supervisor. Following the MOSCE, participants completed surveys which elucidated their perceptions on the roles they took during the MOSCE. RESULTS: Fifty examinees participated in the MOSCE. Of these, 42 (84%) consented to participate in the study and submitted completed questionnaires. Twenty-four examiners participated in the OSCE and consented to participate in the study, with 22 (92%) submitting completed questionnaires. Fifty-three of 60 SPs (88%) agreed to take part in this study, and 51 (85%) completed questionnaires. The internal consistency of the five-station OSCE was calculated as a Cronbach's alpha of 0.443. Students commented positively on having the opportunity to network and engage in mentorship activities and reinforce clinical concepts. CONCLUSIONS: Examinees, examiners, and SPs all perceived the MOSCE to be a beneficial learning experience. We found the MOSCE to be a feasible and acceptable means of providing additional OSCE practice to students prior to higher-stakes evaluations.

Cellular insulin resistance disrupts hypothalamic mHypoA-POMC/GFP neuronal signaling pathways.

POMC neurons play a central role in the maintenance of whole-body energy homeostasis. This balance requires proper regulation of POMC neurons by metabolic hormones, such as insulin. However, the heterogeneous cellular population of the intact hypothalamus presents challenges for examining the molecular mechanisms underlying the potent anorexigenic effects of POMC neurons, and there is currently a complete lack of mature POMC neuronal cell models for study. To this end, we have generated novel, immortalized, adult-derived POMC-expressing/α-MSH-secreting cell models, mHypoA-POMC/GFP lines 1-4, representing the fluorescence-activated cell-sorted POMC population from primary POMC-eGFP mouse hypothalamus. The presence of Pomc mRNA in these cell lines was confirmed, and α-MSH was detected via immunofluorescence. α-MSH secretion in the mHypoA-POMC/GFP-1 was found to increase in response to 10  ng/ml ciliary neurotrophic factor (CNTF) or 10  nM insulin as determined by enzyme immunoassay. Further experiments using the mHypoA-POMC/GFP-1 cell line revealed that 10  ng/ml CNTF increases Pomc mRNA at 1 and 2  h after treatment, whereas insulin elicited an increase in Pomc mRNA level and decreases in insulin receptor (Insr (Ir)) mRNA level at 4  h. Furthermore, the activation of IR-mediated downstream second messengers was examined by western blot analysis, following the induction of cellular insulin resistance, which resulted in a loss of insulin-mediated regulation of Pomc and Ir mRNAs. The development of these immortalized neurons will be invaluable for the elucidation of the cellular and molecular mechanisms that underlie POMC neuronal function under normal and perturbed physiological conditions.