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Background and objectives Considering the increasing utilization of online educational tools in medical education, it is essential to evaluate the reliability and validity of online assessments to accurately assess student proficiency and predict academic success. This study investigated the predictive efficacy of different online assessment methods in comparison to standard offline methods within the medical educational setting. Methods This study utilized a mixed-methods crossover design, involving 125 first-year medical students who were randomly assigned to either online or traditional examinations. The students then crossed over to the other type of assessment. The assessments consisted of multiple-choice questions (MCQs), viva voce, objective structured clinical examinations, and written theory examinations. Quantitative data on results, finishing times, and academic metrics were analyzed, along with qualitative data from student interviews exploring perceptions of each format. Results The online MCQs had the highest average scores and a moderately positive correlation with performance on the theory examination (r=0.326). Regression models indicated that online and offline MCQs were moderate positive predictors of theoretical marks (R2=0.106 and 0.107, respectively). Qualitative responses emphasized advantages such as flexibility and accessibility for online examinations but also concerns regarding technological challenges, interaction, and integrity compared to traditional formats. Conclusions Online MCQ assessments showed promise as indicators of medical student academic performance. However, additional online forms require improvement to match conventional assessments reliably. As medical education involves digital technologies, cautious implementation of online evaluations substantiated by further research is needed to preserve educational quality standards.
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Objectives: Plasticity of neural synapses is known to be involved in the complications in bipolar disorder (BD) patients. Matrix metalloproteinases (MMPs) play a role in synaptic plasticity and memory. Even though elevated MMP-9 levels are reported in neuropsychiatric disorders, there is limited data about MMP-9 gene polymorphism in BD. The objectives of the study was to investigate genotype frequency and allele frequency of MMP-9 genetic variant (rs 17576) in BD and its association with disease severity. Materials and Methods: Eighty BD cases and 80 controls were recruited in the study. MMP-9 genotyping and allele frequency and plasma MMP-9 levels were analyzed in both the groups. Hamilton depression rating scale and Young's Mania Rating Scale (YMRS) were used to evaluate severity of BD. Results: The genotype and minor allele (G allele) frequency were not significant between BD and controls. MMP-9 levels were significantly increased in BD patients with AG (P < 0.001) and GG (P = 0.022) genotypes compared to controls. BD patients with GG genotype (P = 0.038, OR: 3.26 (1.16-9.09), and G (mutant) allele (P = 0.013, OR 2.03(1.18-3.48) confer increased risk of depressive symptoms. MMP-9 was positively correlated with YMRS scale (r = 0.227, P = 0.043) in BD. Conclusion: MMP-9 gene polymorphism (rs 17576) is linked with depressive symptoms in BD.
