Very Short Answer Questions in Team-Based Learning: Limited Effect on Peer Elaboration and Memory.

Introduction: In team-based learning (TBL), single best answer questions (SBAQs) are traditionally used because immediate computer-assisted feedback facilitates team discussions. Recent improvements in digital marking systems and criticisms of non-analytical strategies in SBAQs have prompted the consideration of very short answer questions (VSAQs) as an alternative to SBAQs. We aim to compare the effect of VSAQs and SBAQs on peer elaboration and knowledge retention in TBL. Materials and Methods: Twenty-four second-year students from the Lee Kong Chian School of Medicine participated in a mixed-methods study that included a randomised controlled crossover trial with two intervention arms (TBL-VSAQs and TBL-SBAQs). Two TBL sessions were conducted, with one topic covered each. Students were randomly allocated into six teams of four members. Individual and team scores and completion times were measured, and students were surveyed on their TBL experience. A follow-up quiz on the same topics was administered two weeks later to assess knowledge retention. Results: Individuals scored lower for VSAQs than SBAQs in the second TBL topic (7.17 ± 1.52 versus 8.25 ± 1.48; p = 0.046), while findings in other metrics were non-significant. Follow-up quiz scores showed no significant difference in knowledge retention, although effect size and power were low. Students perceived VSAQs as more authentic and challenging, though most preferred the continued use of SBAQs for TBL. Discussion: VSAQs have a limited impact on peer elaboration and knowledge retention versus SBAQs in TBL. Conclusions: We should be circumspect about implementing VSAQs in TBL especially for medical students at the pre-clinical level. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01716-5.

Acute appendicitis-advances and controversies.

Being one of the most common causes of the acute abdomen, acute appendicitis (AA) forms the bread and butter of any general surgeon's practice. With the recent advancements in AA's management, much controversy in diagnostic algorithms, possible differential diagnoses, and weighing the management options has been generated, with no absolute consensus in the literature. Since Alvarado described his eponymous clinical scoring system in 1986 to stratify AA risk, there has been a burgeoning of additional scores for guiding downstream management and mortality assessment. Furthermore, advancing literature on the role of antibiotics, variations in appendicectomy, and its adjuncts have expanded the surgeon's repertoire of management options. Owing to the varied presentation, diagnostic tools, and management of AA have also been proposed in special groups such as pregnant patients, the elderly, and the immunocompromised. This article seeks to raise the critical debates about what is currently known about the above aspects of AA and explore the latest controversies in the field. Considering the ever-evolving coronavirus disease 2019 situation worldwide, we also discuss the pandemic's repercussions on patients and how surgeons' practices have evolved in the context of AA.