Mapping session learning objectives to exam questions: How to do it and how to apply the results.

Background: The undergraduate pre-clerkship Population Health courses for University of Manitoba medical students underwent a mapping exercise to improve alignment between session learning objectives and the multiple choice questions (MCQs) used for learner assessment.Methods: Each learning objective was mapped to all related MCQs in the exam bank. Learning objectives not linked to any specific MCQs were identified. All MCQs in the exam bank were mapped back to the learning objectives and all MCQs not corresponding to a learning objective were identified. In total, 536 MCQ were mapped to 358 learning objectives.Results: Mapping results were shared with course leadership and instructors to affect practical changes in the Population Health courses, such as revisions and improvements to session learning objectives, and targeted development of new MCQs. Following the implementation of changes post-mapping exercise, our findings indicate a significant improvement in student satisfaction with the Population Health courses, although they did not have a discernable impact on exam performance.Conclusions: The mapping exercise required an initial investment of resources, but produced an MCQ database that can be regularly maintained to ensure alignment between learning objectives and assessment, thereby contributing to ongoing curriculum quality and improvement, and improved exam reliability and validity.

The burden of pneumococcal disease in the Canadian population before routine use of the seven-valent pneumococcal conjugate vaccine.

BACKGROUND: In the United States, implementation of the seven-valent conjugate vaccine into childhood immunization schedules has had an effect on the burden of pneumococcal disease in all ages of the population. To evaluate the impact in Canada, it is essential to have an estimate of the burden of pneumococcal disease before routine use of the vaccine. METHODS: The incidence and costs of pneumococcal disease in the Canadian population in 2001 were estimated from various sources, including published studies, provincial databases and expert opinion. RESULTS: In 2001, there were 565,000 cases of pneumococcal disease in the Canadian population, with invasive infections representing 0.7%, pneumonia 7.5% and acute otitis media 91.8% of cases. There were a total of 3000 deaths, mainly as a result of pneumonia and largely attributable to the population aged 65 years or older. There were 54,330 life-years lost due to pneumococcal disease, and 37,430 quality-adjusted life-years lost due to acute disease, long-term sequelae and deaths. Societal costs were estimated to be $193 million (range $155 to $295 million), with 82% borne by the health system and 18% borne by families. Invasive pneumococcal infections represented 17% of the costs and noninvasive infections represented 83%, with approximately one-half of this proportion attributable to acute otitis media and myringotomy. CONCLUSIONS: The burden of pneumococcal disease before routine use of the pneumococcal conjugate vaccine was substantial in all age groups of the Canadian population. This estimate provides a baseline for further analysis of the direct and indirect impacts of the vaccine.