Examiner workload comparison: three structured oral examination formats for the European diploma in anaesthesiology and intensive care.

The COVID-19 pandemic triggered transformations in academic medicine, rapidly adopting remote teaching and online assessments. Whilst virtual environments show promise in evaluating medical knowledge, their impact on examiner workload is unclear. This study explores examiner's workload during different European Diploma in Anaesthesiology and Intensive Care Part 2 Structured Oral Examinations formats. We hypothesise that online exams result in lower examiner's workload than traditional face-to-face methods. We also investigate workload structure and its correlation with examiner characteristics and marking performance. In 2023, examiner's workload for three examination formats (face-to-face, hybrid, online) using the NASA TLX instrument was prospectively evaluated. The impact of examiner demographics, candidate scoring agreement, and examination scores on workload was analysed. The overall NASA TLX score from 215 workload measurements in 142 examiners was high at 59.61 ± 14.13. The online examination had a statistically higher workload (61.65 ± 12.84) than hybrid but not face-to-face. Primary contributors to workload were mental and temporal demands, and effort. Online exams were associated with elevated frustration. Male examiners and those spending more time on exam preparation experienced a higher workload. Multiple diploma specialties and familiarity with European Diploma in Anaesthesiology and Intensive Care exams were protective against high workload. Perceived workload did not impact marking agreement or examination scores across all formats. Examiners experience high workload. Online exams are not systematically associated with decreased workload, likely due to frustration. Despite workload differences, no impact on examiner's performance or examination scores was found. The hybrid examination mode, combining face-to-face and online, was associated with a minor but statistically significant workload reduction. This hybrid approach may offer a more balanced and efficient examination process while maintaining integrity, cost savings, and increased accessibility for candidates.

Feasibility of an Online Acute Stressor in Preschool Children of Mothers with Depression.

Maternal depression is a risk factor for future mental health problems in offspring, with stress-system function as a candidate vulnerability factor. Here we present initial validation of an online matching-task (MT) paradigm in young children exposed to maternal depression (N = 40), a first in stressor-paradigm research for this age group. Investigations of stress-system reactivity that can be conducted online are an innovative assessment approach, accelerated by the COVID-19 pandemic. Results indicate high feasibility, with a >75% data collection success rate across measures, similar-to or better-than in-person success rates in young children. Overall, the online MT elicited significant heart rate but not cortisol reactivity. Individual differences in child mental health symptoms were a moderator of reactivity to the stressor such that children with lower, but not higher, behavioral problems exhibited the typical pattern of cortisol reactivity to the online MT. Results are aligned with allostatic load models, which suggest downregulation of stress-system reactivity as a result of experiencing adversity and mental health vulnerability. Consistent with in-person research, this suggests that an early phenotype for the emergence of behavior problems may be linked to altered stress-system reactivity. Results hold potential clinical implications for intervention development and the future of online stress-system research. Trial Registration: Clinical Trial Registration: NCT04639557; (Building Regulation in Dual Generations-Telehealth Model [BRIDGE]).

Development of an assessment tool for designated medical institutions in China--Based on the application of an online assessment system.

Background: Due to the expanding coverage of medical insurance and the growth of medical expenses, the ability to assess the performance of designated medical institutions (DMIs) in supporting the delivery of high-quality patient care and the standardized use of funds represents a priority in China. Despite such interest, there has yet to be an operable standard and labor-saving method for assessing DMIs in China. Objective: The main objectives include two aspects: (1) establishing an evaluation index system for DMIs based on contracts; (2) designing and developing an online evaluation platform. Methods: A group of 20 experts with theoretical and practical expertise in medical insurance regulation and performance evaluation were invited to select available indicators. A combination weighting method based on analytic hierarchy process and entropy method was used to determine the weight coefficient. Shanghai was taken as the sample area, and 760 DMIs were included in the empirical research. The test-retest reliability method and criterion-related validity method was used to test the reliability and the validity of the evaluation result. Results: An assessment index system that included 6 domains and 56 indicators was established in this study. Furthermore, we developed an online platform to assist in the implementation of the assessment. The results showed that the average score of assessment was 94.39, the median was 96.92. The test-retest reliability value was 0.96 (P ≤ 0.01), which indicated high stability of the assessment. In addition, there was a significant negative relationship between assessment score and the penalty amount of DMIs (R = -0.133, P < 0.001). After adjusting for the basic characteristics of medical institutions, the number of visits and revenue, the negative relationship was still significant (B = -0.080, P < 0.05). These results are consistent with expectations, indicating that the assessment had good criterion-related validity. Conclusions: This study established an operable assessment measure and developed an online platform to assess the performance of DMIs. The results showed good feasibility and reliability in empirical research. Our research findings provided an operable Chinese solution for DMI assessment that saves manpower and time, which would have good enlightening significance in other regions of China and in low-income and middle-income countries internationally.

Children's communication repair strategies: Online versus face-to-face interaction.

INTRODUCTION: One's ability to repair communication breakdown is an important pragmatic language skill. The present study examined children's communication repair strategies between online and face-to-face interactions using a reading comprehension task designed to probe for persistent clarification requests. METHODS: 4-6-year-old typically developing children (Age: M = 5.5years) completed a communication repair task. Online group (n = 17) completed the task online, face-to-face group(n = 22) met researchers in person. Children's responses were then categorized into verbal strategies, supplementary strategies, and nonresponses. RESULTS: Our results showed that children can effectively employ repair strategies when a communication breakdown occurs, regardless of the communication setting in response to a series of clarification requests. However, types and patterns of communication repair strategies varied between online and face-to-face interactions. Children in online interaction showed higher use of repetition and suprasegmental strategies than did their face-to-face peers. In contrast, children in face-to-face interaction demonstrated more frequent use of revision and addition. Also, we examined the relationship between repair strategy and children's language skills. The results showed that children with better language skills used more addition, which is a more complex strategy than suprasegmental and nonresponse, and tried to use repair strategies effectively in an attempt to repair their statements as clarification requests proceeded. CONCLUSION: It is important to understand different trends of pragmatic skills of children across online and face-to-face interaction. Guidance on the effective strategy to repair communication breakdowns depending on the different contexts needs to be considered for the successful use of online learning and telepractice.

Demystifying anxiety and demotivation in on-line assessment: a focus on the impacts on academic buoyancy and autonomy.

Test anxiety is a combination of a confluence of physiological hyperarousal, tension, and bodily manifestations, with apprehension, trepidation, fear of inadequacy, and the tendency to magnify negative outcomes, which manifest before or during evaluative assessments. Online evaluation might potentially exacerbate anxiety and demotivation among learners. When students' psychological and emotional well-being are taken into account, it may be possible to improve their educational and evaluative experiences. This study set out to shed light on the interplay between anxiety, demotivation, academic buoyancy, and autonomy in online assessment. To achieve this objective, printed copies of the related questionnaires were distributed among 392 EFL university students in China. The association between anxiety, demotivation, academic buoyancy, and autonomy in online assessment was assessed by data screening utilizing confirmatory factor analysis (CFA) and structural equation modeling (SEM). The findings indicated that students who experienced less anxiety and demotivation were more buoyant and autonomous. Possible improvements in language education and assessment are considered, as are the study's broader implications.

Assessing time-based prospective memory online: A comparison study between laboratory-based and web-based testing.

Prospective memory (PM, i.e., the ability to remember and perform future intentions) is assessed mainly within laboratory settings; however, in the last two decades, several studies have started testing PM online. Most part of those studies focused on event-based PM (EBPM), and only a few assessed time-based PM (TBPM), possibly because time keeping is difficult to control or standardise without experimental control. Thus, it is still unclear whether time monitoring patterns in online studies replicate typical patterns obtained in laboratory tasks. In this study, we therefore aimed to investigate whether the behavioural outcome measures obtained from the traditional TBPM paradigm in the laboratory-accuracy and time monitoring-are comparable with an online version in a sample of 101 younger adults. Results showed no significant difference in TBPM performance in the laboratory versus online setting, as well as no difference in time monitoring. However, we found that participants were somewhat faster and more accurate at the ongoing task during the laboratory assessment, but those differences were not related to holding an intention in mind. The findings suggest that, although participants seemed generally more distracted when tested remotely, online assessment yielded similar results in key temporal characteristics and behavioural performance as for the laboratory assessment. The results are discussed in terms of possible conceptual and methodological implications for online testing.

Comparing remote and face-to-face assessments of physical performance in older adults: A reliability study.

INTRODUCTION: Older people often experience a decline in their physical performance. Tests have been approved to evaluate this performance in person. Yet, the constraints associated with in-person assessments (e.g. lack of medical facilities, pandemic lockdown, and contagion risk) are making us contemplate setting up assessments remotely. OBJECTIVES: To determine whether remote physical performance measurements of older adults are reliable and valid compared to face-to-face measurements. METHODS: Forty-five subjects aged 65 and over completed the normal/fast speed test (NWT/FWT), the unipodal balance test (UBT), the normal/fast timed up and go test (NTUG/FTUG), the 5 and 10 rep sit to stand test (5STS and 10STS), the 30 sec chair stand (30CS), the 2 minute step test (2MST) and the flexibility before standing (SAD) once face-to-face and twice remotely, by two different observers. The intraclass correlation coefficients (ICC), the standard errors of measurement (SEM%) and minimum detectable changes (MDC%) were calculated for both intra- and inter-observer conditions, to assess the relative and the absolute reliability. An ICC value exceeding 0.90 indicates a very high reliability, while an ICC between 0.70 and 0.89 signifies a high reliability. In clinical practice, a SEM % of less than 10% is considered acceptable. A smaller MDC % indicates a measurement that is more sensitive to detecting changes. RESULTS: Intra-observer relative reliability was very high (ICC>0.9) for the UBT, NWT, NTUG, FTUG, 5STS, 10STS, 30CS and the SAD; and high (ICC>0.7) for the 2MST and FWS. SEM% values ranged from 0% to 24.03% and MDC from 0% to 9.93%. Inter-observer relative reliability was considered very high (ICC>0.9) for all tests. SEM% values ranged from 0% to 17.68% and MDC from 0% to 7.32%. CONCLUSION: Our findings demonstrate that remote assessments exhibited consistently high to very high levels of intra- and inter-observer relative reliability when compared to face-to-face assessments. Additionally, certain remote evaluations showed acceptable absolute reliability, making them viable alternatives for healthcare professionals when in-person assessments are not feasible in clinical practice.

Understanding online assessment continuance intention and individual performance by integrating task technology fit and expectancy confirmation theory.

This study delves into online assessments, focusing on their numerous advantages, including reducing paper usage and alleviating concerns surrounding the security of traditional examinations. The purpose of this study was to develop and test a model delineating the interplay between factors influencing the continuance intention to use online assessments and the influence on individual performance. A quantitative approach using an online survey was used to collect data from 222 graduate students from three major Palestinian universities. The research instrument was developed based on the finding of previous studies. Confirmatory factor analysis was employed to construct and validate the proposed model. The findings of this study revealed that perceived usefulness has a significant influence on the intention to continue using online assessment. The proposed model indicated that there is no direct or indirect relationship between perceived ease of use and the continuance intention to use online assessment. The main limitation of this study was its reliance on a purely quantitative approach. Therefore, a sequentional mixed methods approach van be a suggestion for future research and include all the higher education institutions in the Palestinian context.

Development of higher-order thinking skills in nursing students through online problem-based assessment.

Background: The development of higher-order thinking skills (HOTS) in problem-based learning (PBL) is not confined to teaching and learning but extends to authentic assessment methods, similar to real-life situations. The assessments aligned to PBL attempt to eliminate the students' tendency towards memorisation. Rather, it instils and encourages their ability to analyse, interpret, synthesise, and evaluate knowledge and its sources. Aim: The study had two primary aims: (1) to describe undergraduate nursing students' experiences of an online problem-based assessment (PBA), and (2) to explore how online PBA assessment contributed to the development of undergraduate student nurses' HOTS. Setting: An urban-based South African higher education institution (HEI) in KwaZulu-Natal, Durban, South Africa. Methods: A descriptive, exploratory qualitative approach was used. The target population was 4th-year psychiatric nursing students (N = 39) studying for the degree of Bachelor of Nursing at the preselected university, utilising two focus groups (n = 5, n = 7). Data were analysed through content analysis using the clinical reasoning model as a framework. Results: Three categories (trigger problem, re-visioning the cues, treatment direction) and seven sub-categories (trigger problem posing, early cue identification, cue interpretation and clustering, focussed cue investigation, information processing and interpretation, reprioritise hypotheses, and diverse intervention[s]) emerged. Conclusion: Psychiatry, Nursing and Midwifery practices require a practitioner skilled in HOTS to provide quality, efficient and cost-effective patient care. Contribution: The findings in this study can benefit nursing education, particularly learning interruptions in HEIs.

How reliable is assessment of children's sentence comprehension using a self-directed app? A comparison of supported versus independent use.

This study reports on the feasibility of using the Test of Complex Syntax- Electronic (TECS-E), as a self-directed app, to measure sentence comprehension in children aged 4 to 5 ½ years old; how testing apps might be adapted for effective independent use; and agreement levels between face-to-face supported computerized and independent computerized testing with this cohort. A pilot phase was completed with 4 to 4;06-year-old children, to determine the appropriate functional app features required to facilitate independent test completion. Following the integration of identified features, children completed the app independently or with adult support (4-4;05 (n = 22) 4;06-4;11 months (n = 55) and 5 to 5;05 (n = 113)) and test re-test reliability was examined. Independent test completion posed problems for children under 5 years but for those over 5, TECS-E is a reliable method to assess children's understanding of complex sentences, when used independently.

The ANTI-Vea-UGR Platform: A Free Online Resource to Measure Attentional Networks (Alertness, Orienting, and Executive Control) Functioning and Executive/Arousal Vigilance.

The Attentional Networks Test for Interactions and Vigilance-executive and arousal components (ANTI-Vea) is a computerized task of 32 min duration in the standard format. The task simultaneously assesses the main effects and interactions of the three attentional networks (i.e., phasic alertness, orienting, and executive control) and two dissociated components of vigilance with reasonable reliability (executive and arousal vigilance). We present this free and publicly accessible resource (ANTI-Vea-UGR; https://anti-vea.ugr.es/) developed to easily run, collect, and analyze data with the ANTI-Vea (or its subtasks measuring some attentional and/or vigilance components embedded in the ANTI-Vea). Available in six different languages, the platform allows for the adaptation of stimulus timing and procedure to facilitate data collection from different populations (e.g., clinical patients, children). Collected data can be freely downloaded and easily analyzed with the provided scripts and tools, including a Shiny app. We discuss previous evidence supporting that attention and vigilance components can be assessed in typical lab conditions as well as online and outside the laboratory. We hope this tutorial will help researchers interested in measuring attention and vigilance with a tool useful to collect data from large sample sizes and easy to use in applied contexts.

Redesign of online proctored exams for STEM learners in higher education institutions: proposal for incorporating higher-order thinking skills and democratic pedagogy via OPERHOT platform.

In response to the challenges presented by the COVID-19 pandemic, this paper proposes an exam system for STEM students that effectively test higher-order thinking skills, such as the ability to apply, create, evaluate, and analyse. Higher education institutions (HEIs) must incorporate all three strands of democratic STEM pedagogy, namely student voice, shared and transformational authority, and STEM criticality, according to empathy interviews with educators. It is imperative that these strands are reflected in the assessments of students within HEIs. During the pandemic, it became evident that the lack of a suitable proctored online examination system impeded the accurate and fair evaluation of students. This circumstance was in stark contrast to the offline mode of examination, which permitted monitoring and control. Notably, many students struggled to answer questions requiring higher-order thinking, with responses frequently identical in unproctored online examinations or settings with insufficient proctoring mechanisms, especially in contexts with limited resources. Consequently, there is an urgent need to redesign the online proctored test system in accordance with STEM criticality and student voice. To address this need, this paper proposes the creation of OPERHOT, a proctored online exam system integrated with random questions requiring higher-order thinking. This system employs a timed assessment methodology and requires students to keep their cameras on throughout the examination. By implementing OPERHOT, a proper and secure online evaluation of students can be made possible. In addition, this system will strengthen the online education and assessment systems in HEIs, thereby promoting integrity and enhancing the learning experience. In addition, the adoption of OPERHOT will also improve the assessment process and contribute to the enhancement of online education and assessment in HEIs as a whole. This reimagined system will catalyse the development of a robust and inclusive learning environment that encourages students' voices and equips educators to foster the growth of critical thinking and problem-solving skills. This perspective aims to address the pressing need for an updated and effective proctored assessment system in the online educational landscape while promoting STEM critical thinking and student voice. The OPERHOT platform is at the ideation stage, and once developed, it may be tested in a few HEIs. Based on the feedback from educators and other stakeholders, it can be further modified to make it more inclusive and accessible and can be offered to other HEIs for wider piloting.

Online assessment techniques adopted by the university teachers amidst COVID-19 pandemic: A case study.

Assessing students' online learning is a vital constituent of the effective teaching-learning process in a virtual mode. This study addressed teachers' preparedness, challenges and effective practices for students' assessment in online learning during the COVID-19 pandemic. Online assessment at times of uncertainty has become arduous for university teachers as it is not in practice in Indian higher educational institutions (HEIs). This research reports a study of the Adamas University, teachers drawn-out through semi-structured interviews of individual teachers. The researchers employed a case study research method to attain the objectives of the study using thematic analysis for the qualitative data. Thirty-one faculty members were selected as a sample of the study. The study findings indicated that the University teachers used multiple online assessment techniques, some common, some extremely unique, viz. blogs and peer tutorial videos. The preparedness or readiness varied considerably as some were instead sceptical, whereas some were amusingly non-challant. The study found that teachers faced many problems while assessing students' performance during online classes, which were not just tech-based, but also due to their distressed state of mind.

Application of MPP database and artificial intelligence system in online evaluation of college students' mental health.

Based on MPP database, we have conducted research and investigation on big data processing and analysis, and provided a good solution for big data. However, due to the large data storage requirements in the local file system may not be fully met. Therefore, the storage and management of big data, reliability, availability and scalability are more and more adopted by distributed file system. Therefore, MPP database based on distributed file system has become a research hotspot. In this paper, in the network control, through the control algorithm based on two kinds of artificial intelligence system, through the fuzzy PID controller to reduce the impact of system control performance. The dynamic BP network error correction and predictive PID controller are introduced into the system to reduce the influence. College Students' mental health education is an important part of the current training. Rapid and accurate online evaluation and analysis of College Students' mental health can provide reference for college students and effective help for the follow-up activities and consultation of the school, At the same time, it provides some basis for the balance of psychological scale and the revision of item setting. In this paper, MPP database and artificial intelligence system are introduced into the application of mental health assessment, which can effectively assess the mental health of college students, and thus promote the continuous development of assessment application.

Computerised cognitive assessment in patients with traumatic brain injury: an observational study of feasibility and sensitivity relative to established clinical scales.

Background: Online technology could potentially revolutionise how patients are cognitively assessed and monitored. However, it remains unclear whether assessments conducted remotely can match established pen-and-paper neuropsychological tests in terms of sensitivity and specificity. Methods: This observational study aimed to optimise an online cognitive assessment for use in traumatic brain injury (TBI) clinics. The tertiary referral clinic in which this tool has been clinically implemented typically sees patients a minimum of 6 months post-injury in the chronic phase. Between March and August 2019, we conducted a cross-group, cross-device and factor analyses at the St. Mary's Hospital TBI clinic and major trauma wards at Imperial College NHS trust and St. George's Hospital in London (UK), to identify a battery of tasks that assess aspects of cognition affected by TBI. Between September 2019 and February 2020, we evaluated the online battery against standard face-to-face neuropsychological tests at the Imperial College London research centre. Canonical Correlation Analysis (CCA) determined the shared variance between the online battery and standard neuropsychological tests. Finally, between October 2020 and December 2021, the tests were integrated into a framework that automatically generates a results report where patients' performance is compared to a large normative dataset. We piloted this as a practical tool to be used under supervised and unsupervised conditions at the St. Mary's Hospital TBI clinic in London (UK). Findings: The online assessment discriminated processing-speed, visual-attention, working-memory, and executive-function deficits in TBI. CCA identified two significant modes indicating shared variance with standard neuropsychological tests (r = 0.86, p < 0.001 and r = 0.81, p = 0.02). Sensitivity to cognitive deficits after TBI was evident in the TBI clinic setting under supervised and unsupervised conditions (F (15,555) = 3.99; p < 0.001). Interpretation: Online cognitive assessment of TBI patients is feasible, sensitive, and efficient. When combined with normative sociodemographic models and autogenerated reports, it has the potential to transform cognitive assessment in the healthcare setting. Funding: This work was funded by a National Institute for Health Research (NIHR) Invention for Innovation (i4i) grant awarded to DJS and AH (II-LB-0715-20006).

Improving the resident assessment process: application of App-based e-training platform and lean thinking.

BACKGROUND: The assessment system for standardized resident training is crucial for developing competent doctors. However, it is complex, making it difficult to manage. The COVID-19 pandemic has also aggravated the difficulty of assessment. We, therefore, integrated lean thinking with App-based e-training platform to improve the assessment process through Define-Measure-Analyze-Improve-Control (DMAIC) cycles. This was designed to avoid unnecessary activities that generate waste. METHODS: Panels and online surveys were conducted in 2021-2022 to find the main issues that affect resident assessment and the root causes under the frame of waste. An online app was developed. Activities within the process were improved by brainstorming. Online surveys were used to improve the issues, satisfaction, and time spent on assessment using the app. RESULTS: A total of 290 clinical educators in 36 departments responded to the survey, and 153 clinical educators used the online app for assessment. Unplanned delay or cancellation was defined as the main issue. Eleven leading causes accounted for 87.5% of the issues. These were examiner time conflict, student time conflict, insufficient examiners, supervisor time conflict, grade statistics, insufficient exam assistants, reporting results, material archiving, unfamiliarity with the process, uncooperative patients, and feedback. The median rate of unplanned delay or cancellation was lower with use of the app (5% vs 0%, P < 0.001), and satisfaction increased (P < 0.001). The median time saved by the app across the whole assessment process was 60 (interquartile range 60-120) minutes. CONCLUSIONS: Lean thinking integrated with an App-based e-training platform could optimize the process of resident assessment. This could reduce waste and promote teaching and learning in medical education.

Emergency remote teaching of foreign languages at Saudi universities: Teachers' reported challenges, coping strategies and training needs.

Though considerable research has been reported on COVID-19-related distance education, some dimensions of remote foreign language teaching experiences during the pandemic crisis remain to be explored. The study reported in this paper investigated Saudi university foreign language teachers' accumulated experiences and reflective beliefs of emergency remote instruction. The study focused specifically on: a) the general educational challenges the teachers encountered and their attempts to overcome them; b) the teachers' perceived difficulties in remotely teaching and assessing foreign language areas and their strategies for coping with them; and c) their reflective evaluation of remote foreign language teaching after doing it for three academic terms. Questionnaire data was collected from 112 teachers of Arabic and English as foreign languages, and semi-structured interviews were conducted with 14 teachers. The analysis of both data types showed that the participants had a number of general educational and language-teaching-specific challenges in their COVID-19-related remote teaching. The teachers generally viewed the remote assessment of language areas is a more challenging task than teaching them. Reading was rated as the least difficult language area to teach and assess remotely, whereas writing was the most difficult one. The teachers reported using various coping strategies to overcome the educational and language teaching-specific challenges. They perceived their remote teaching experiences positively, but reported their needs for further training in developing better online assessment methods, using different teaching platforms and technological tools, and managing classroom interactions. The paper ends by discussing the results of the study and their implications.

An online case-based teaching and assessment program on clinical history-taking skills and reasoning using simulated patients in response to the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has created unprecedented challenges for medical students and educators worldwide. Groups 1, 2 and 3 of year 3, semester 2 medical students at the Royal College of Surgeons in Ireland (n = 275) had only completed 2, 5 and 7 weeks, respectively, of their scheduled 10-week clinical medicine and surgery attachments, prior to the Irish shutdown of all in-person non-essential activities, including medical student education. METHODS: We developed and delivered an online case-based program, focused on history-taking skills and clinical reasoning, using simulated patients and video technologies. 12 tutorials were delivered over 6 weeks to 35 subgroups of 8 students in line with program learning outcomes. Both simulated patients (n = 36), and tutors (n = 45, from retired clinical professors to newly graduated physicians), were rapidly upskilled in Blackboard Collaborate and Microsoft Teams, and also in the provision of constructive feedback. We evaluated this newly developed program by the following three criteria: student attendance, achieved grades, and student feedback. RESULTS: Attendance at the 12 tutorials was higher amongst group 1 and 2 students (75 and 73%) by comparison with group 3 students (60%) (p = < 0.001). Of the 273 students that sat the Year 3 Semester 2 online long case assessment, 93% were successful. Despite group 1 students having the least prior clinical experience, results were similar to those of groups 2 and 3 (1st honors, 2nd honors, pass, and fail grades for group 1, 39%, 33%, 23% and 6%; group 2, 34%, 41%, 17% and 8%; group 3, 39%, 25%, 28% and 7%) (p = 0.48). An increased attendance rate at tutorials was associated with higher numbers of honors grades (p = < 0.001). Anonymous feedback from the students demonstrated considerable satisfaction with program: > 85% agreed that the online program was interactive and very educational. CONCLUSIONS: Use of online video technology, tutors of varied experience, and simulated patients were demonstrated to replicate patient encounters, and to facilitate the development of clinical skills remotely during the COVID-19 pandemic.

An online tiered screening procedure to identify mental health problems among refugees.

BACKGROUND: Many refugees suffer from mental health problems due to stressful and traumatic events before, during, and after migration. However, refugees are facing a wide variety of barriers, limiting their access to mental health care. Internet-based tools, available in several languages, could be one way to increase the availability of mental health services for refugees. The present study aimed to develop and test a screening tool to screen for clinically relevant symptoms of psychiatric disorders common among refugees (i.e. Depression, Anxiety, Post-traumatic stress disorder, and Insomnia). We, designed, translated, and adapted an internet-based tiered screening procedure suitable for use with the largest refugee populations residing in Sweden. The tool aims to accurately identify symptoms of mental distress (Tier 1), differentiate between symptoms of specific psychiatric disorders (Tier 2), and assess symptom severity (Tier 3). We tested the overall efficiency of using a tiered screening procedure. METHODS: Seven hundred fifty-seven refugees residing in Sweden, speaking any of the languages Arabic, Dari, Farsi, English, or Swedish, completed an online questionnaire following a three-tiered procedure with screening instruments for each tier. In this study, the Tier 3 scales were used as reference standards for clinically relevant symptoms, to evaluate screening efficiency in terms of accuracy and reduction of item burden in previous tiers. RESULTS: The results show that the tiered procedure could reduce the item burden while maintaining high accuracy, with up to 86% correctly assessed symptoms and few false negatives with moderate symptoms and above (at most 9%), and very few with severe symptoms (at most 1.3%). DISCUSSION: This study generated an accurate screening tool that efficiently identifies clinically relevant symptoms of common psychiatric disorders among refugees. Using an adapted online tiered procedure to screen for multiple mental health issues among refugees has the potential to facilitate screening and increase access to mental health services for refugees. We discuss the utility of the screening tool and the necessity of further evaluation.

Not for Room 101.

The emergence of the COVID-19 pandemic in March 2020 disrupted learning and teaching and brought in-person teaching to an abrupt halt, leading to a rapid pivot towards online and technological solutions including in Anatomy where access to cadaveric specimens and labs were halted. But emerging from the pandemic and with the resumption of more in-person teaching, would these technological innovations find the metaphorical "Room 101" or could some of them successfully enhance the anatomy educators' toolkit? In this chapter, two such technological adaptations that we intend to continue to use in our institution are described. Their development and the pedagogy underpinning their successful use will also be described.The first of these is "Live from the Lab" which is a cadaveric demonstration livestreaming session. Teaching Anatomy through demonstration is not a new concept, however, beaming demonstrations of cadaveric material to students in remote locations need consideration of ethics and the Code of Conduct for students and teachers alike which will be described here along with how to set up such a session.Next, the use of an online assessment platform for spotter-type Anatomy assessments will be described along with their benefits. Both adaptations involve online use of images and/or videos of cadaveric material but have proven to be pedagogically useful.