Detecting and isolating false negatives ofSARS-CoV-2 primers and probe sets among the Japanese Population: A laboratory testing methodology and study

ObjectivesIn this study, a comparative study between primers from Japans and USs disease control centers was conducted. As further investigation, virus sequence alignment with primers oligonucleotide was analyzed. Design or methods11,652 samples from Japanese population were tested for SARS-CoV-2 positive using recommended RT-PCR primer-probe sets from Japan National Institute of Infectious Disease (NIID) and US Centers for Disease Control and Prevention (CDC). ResultsOf the 102 positive samples, 17 samples (16.7% of total positives) showed inconsistent results when tested simultaneously for the following primers: JPN-N2, JPN-N1, CDC-N1, and CDC-N2. As a result, CDC recommended primer-probe sets showed relatively higher sensitivity and accuracy. Further virus sequence alignment analysis showed evidences for virus mutation happening at primers binding sites. ConclusionsThe inconsistency in the RT-PCR results for JPN-N1, JPN-N2, CDC-N1, and CDC-N2 primer-probe sets could be attributed to differences in virus mutation at primers binding site as observed in sequence analysis. The use of JPN-N2 combined with CDC-N2 primer produces the most effective result to reduce false negatives in Japan region. In addition, adding CDC-N1 will also help to detect false negatives.

Comparison of student Self-Evaluations and Teacher Evaluations During Pediatric Bedside Learning / 医学教育

Student self-evaluations in pediatric bedside learning based on a problem-oriented system (POS) were compared with teacher evaluations of the same items. Self-evaluations were also compared with two different methods: unsigned and signed submissions. Students evaluated themselves poorly in the ability to recall pediatric knowledge and highly in the ability to investigate and summarize suggested topics. They evaluated themselves more highly on signed submissions than on unsigned submissions left in a box. Evaluations by teachers were higher than or equal to student self-evaluations. There were few critical evaluations or complaints about POS-bedside learning, but the ratio of criticism was four-fold higher on unsigned submissions. Bedside learning based on POS was accepted willingly by students.

Analysis and Evaluation of Problem Lists During Pediatric Bedside Learning / 医学教育

We analyzed and evaluated problem lists compiled by students during bedside learning. Ninety percent of the items on problem lists were medical problems, 4% were psychological problems, and 6% were social problems. Among medical problems, items related to laboratory data were most prominent, followed by data from physical examination, symptoms, and complications. Highly evaluated problem lists contained items related to psychological problems and social problems, while poorly evaluated lists did not include such items. Students with good scores on problem lists also achieved good scores in problem-oriented system fields other than compiling problem lists. It was extremely useful for students to write problem lists on problem-oriented system bedside learning.

Analysis of Student Self-evaluations on Bedside Learning and Comparison with Teacher Evaluations / 医学教育

The learning of problem-solving skills at the bedside in our department was investigated by comparing the results of student self-evaluations with teacher evaluations before and after the bedside learning (BSL) course. Students evaluated their behavior highly in terms of 1) positiveness, 2) motivation, and 3) bedside manner. However, they evaluated their medical competence poorly in terms of the ability to 4) perform physical examinations, 5) analyze medical histories and clinical findings, 6) interpret ECG and X-ray films, and 7) gather data, and 8) recall medical knowledge.<BR>The results of the student self-evaluations on items 5) to 8) were compared to those of the teacher evaluations before the BSL course (term examination in the fourth year) and after the BSL course. The student self-evaluations were not correlated with the two teacher evaluations, but there was a very close correlation between the two teacher evaluations.

Evaluation of Medical Records Written by Students During Pediatric Bedside Learning / 医学教育

Participation of students in the management of patients was evaluated by analyzing medical records written by the students. Sixty-four percent of the students wrote in the medical chart everyday, however the amount of data was on average only 5.6 lines per day. Descriptions of subjective data were scant. Physical complaints were described for 65% of patients, but were insufficient in detail. Psychic and social complaints were rarely described. Objective data on the physical examination comprised the main body of chart notes recorded by the students, although only 37% of these were judged to be sufficient. Laboratory and radiological data were described less thoroughly than data from the physical examination, and were completely absent from 64% of charts. Assessments were incomplete, and patient problems were not clearly elucidated for most patients. These undergraduate students failed in their assessment of patient problems during their one week of bedside learning.