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Agreement between two raters' evaluation for integrated Traditional Prosthodontic Practical Exam with Directly Observed Procedural Skills in Egypt.

ABSTRACT: PURPOSE:It aimed to determine the agreement between two raters evaluating students at prosthodontic clinical practical exam integrated with directly observed procedural skills (DOPS). METHODS:A sample of 76 students was monitored by two raters to evaluate the process and the final registered maxillomandibular relation for completely edentulous patient in Mansoura Dental School, Egypt at practical exam of the Bachelor students on May 15, till June 28, 2017. Each registered relation was evaluated from total 60 marks subdivided to three score-categories: occlusal plane orientation (OPO), vertical dimension registration (VDR), and centric relation registration (CRR). The marks of each category included mark of DOPS. The marks of OPO and VDR for both raters were compared by graph method to measure reliability using the Bland and Altman analysis. The reliability of CRR marks was evaluated by Krippendorff's alpha ratio. RESULTS:The results revealed similarity between raters for OPO (mean = 18.1) and closes of limits of agreement (0.73 and -0.78). For VDR, there were closeness of means (mean= 17.4 and 17.1 for examiner 1 and 2 respectively); with limits of agreement (2.7and-2.2). There was a strong correlation (Krippendorff's alpha ratio= 0.92; 95% CI [0.79-0.99]) among raters at evaluating CRR. CONCLUSION:The two raters' evaluation of clinical traditional practical exam integrated with directly observed procedural skills revealed not to be different to evaluate candidate at the end of the clinical prosthodontic course. The limits of agreement between raters would be optimum at exclusion subjective evaluation parameters and complicated cases from examination procedures.

SUBMITTER: Khalifa AK

PROVIDER: S-EPMC6249138 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Agreement between two raters' evaluation for integrated Traditional Prosthodontic Practical Exam with Directly Observed Procedural Skills in Egypt.

Khalifa Ahmed Khalifa AK Hegazy Salah S

Journal of educational evaluation for health professions 20180927

<h4>Purpose</h4>It aimed to determine the agreement between two raters evaluating students at prosthodontic clinical practical exam integrated with directly observed procedural skills (DOPS).<h4>Methods</h4>A sample of 76 students was monitored by two raters to evaluate the process and the final registered maxillomandibular relation for completely edentulous patient in Mansoura Dental School, Egypt at practical exam of the Bachelor students on May 15, till June 28, 2017. Each registered relation ...[more]

PMID: 30257540

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Project description:ObjectiveThis study aimed to compare two methods of feedback: verbal face-to-face feedback after direct observation (F2F-feedback) versus electronic-written feedback after observation of recorded-VDO of student's performance (VDO-feedback), in terms of effectiveness in improving skill, effects on motivation and satisfaction.BackgroundMedical schools are responsible for teaching and ensuring proficiency of basic surgical skills. Feedback is effective in developing psychomotor skills; by providing information of learner's current performance, how to improve, and enhancing motivation.Materials and methodFifty-eight medical students (3rd- 4th year) were trained to perform vertical mattress suture in small groups. Then, during 6-week period of self-directed practice, students were randomized into group1 VDO-feedback (male:female = 21:8) and group 2 F2F-feedback (male:female = 20:9). Feedbacks were provided once every 2 weeks (Week2, Week4). End-of-rotation OSCE was at Week6, and retention tested was at Week8. Performance checklist (Cronbach's Alpha 0.72) was used to assess skill at 4 timepoints; pre- and post- small group learning, OSCE, and retention phase. Questionnaire was used to assess motivation, learning strategies and satisfaction (Cronbach's Alpha 0.83).ResultAfter in-class learning, further significant improvement of skills could be gained by both F2F- and VDO- feedbacks (p < 0.0001). Both could similarly retain skill for at least 4 weeks later without additional practice. Self-efficacy, test anxiety, and cognitive strategies scores were significantly increased in both groups (p < 0.05). Extrinsic motivation was increased in VDO-feedback group. No difference in satisfaction between groups was observed.Discussion and conclusionVDO-feedback could be alternative to F2F-feedbacks for basic surgical skill training when limitation for simultaneous meeting of teacher and students occurs.Trial registrationThis study has been registered to Thai Clinical Trial Registry (WHO International Clinical Trial Registry Platform) on 11/07/2023 (TCTR20230711005).

Project description:Quality of health care needs to be improved in rural China. The Chinese government, based on the 1999 Law on Physicians, started implementing the Rural Doctor Practice Regulation in 2004 to increase the percentage of certified physicians among village doctors. Special exam-targeted training for rural doctors therefore was launched as a national initiative. This study examined these rural doctors' perceptions of whether that training helps them pass the exam and whether it improves their skills.Three counties were selected from the 4 counties in Changzhou City in eastern China, and 844 village doctors were surveyed by a questionnaire in July 2012. Chi-square test and Fisher exact test were used to identify differences of attitudes about the exam and training between the rural doctors and certified (assistant) doctors. Longitudinal annual statistics (1980-2014) of village doctors were further analyzed.Eight hundred and forty-four village doctors were asked to participate, and 837 (99.17%) responded. Only 14.93% of the respondents had received physician (assistant) certification. Only 49.45% of the village doctors thought that the areas tested by the certification exam were closely related to the healthcare needs of rural populations. The majority (86.19%) felt that the training program was "very helpful" or "helpful" for preparing for the exam. More than half the village doctors (61.46%) attended the "weekly school". The village doctors considered the most effective method of learning was "continuous training (40.36%)" . The majority of the rural doctors (89.91%) said they would be willing to participate in the training and 96.87% stated that they could afford to pay up to 2000 yuan for it.The majority of village doctors in Changzhou City perceived that neither the certification exam nor the training for it are closely related to the actual healthcare needs of rural residents. Policies and programs should focus on providing exam-preparation training for selected rural doctors, reducing training expenditures, and utilizing web-based methods. The training focused on rural practice should be provided to all village doctors, even certified physicians. The government should also adjust the local licensing requirements to attract and recruit new village doctors.

Project description:BackgroundWe consider the problem of assessing inter-rater agreement when there are missing data and a large number of raters. Previous studies have shown only 'moderate' agreement between pathologists in grading breast cancer tumour specimens. We analyse a large but incomplete data-set consisting of 24,177 grades, on a discrete 1-3 scale, provided by 732 pathologists for 52 samples.Methodology/principal findingsWe review existing methods for analysing inter-rater agreement for multiple raters and demonstrate two further methods. Firstly, we examine a simple non-chance-corrected agreement score based on the observed proportion of agreements with the consensus for each sample, which makes no allowance for missing data. Secondly, treating grades as lying on a continuous scale representing tumour severity, we use a Bayesian latent trait method to model cumulative probabilities of assigning grade values as functions of the severity and clarity of the tumour and of rater-specific parameters representing boundaries between grades 1-2 and 2-3. We simulate from the fitted model to estimate, for each rater, the probability of agreement with the majority. Both methods suggest that there are differences between raters in terms of rating behaviour, most often caused by consistent over- or under-estimation of the grade boundaries, and also considerable variability in the distribution of grades assigned to many individual samples. The Bayesian model addresses the tendency of the agreement score to be biased upwards for raters who, by chance, see a relatively 'easy' set of samples.Conclusions/significanceLatent trait models can be adapted to provide novel information about the nature of inter-rater agreement when the number of raters is large and there are missing data. In this large study there is substantial variability between pathologists and uncertainty in the identity of the 'true' grade of many of the breast cancer tumours, a fact often ignored in clinical studies.

Project description:BACKGROUND:Paramedic education has evolved in recent times from vocational post-employment to tertiary pre-employment supplemented by clinical placement. Simulation is advocated as a means of transferring learned skills to clinical practice. Sole reliance of simulation learning using mannequin-based models may not be sufficient to prepare students for variance in human anatomy. In 2012, we trialled the use of fresh frozen human cadavers to supplement undergraduate paramedic procedural skill training. The purpose of this study is to evaluate whether cadaveric training is an effective adjunct to mannequin simulation and clinical placement. METHODS:A multi-method approach was adopted. The first step involved a Delphi methodology to formulate and validate the evaluation instrument. The instrument comprised of knowledge-based MCQs, Likert for self-evaluation of procedural skills and behaviours, and open answer. The second step involved a pre-post evaluation of the 2013 cadaveric training. RESULTS:One hundred and fourteen students attended the workshop and 96 evaluations were included in the analysis, representing a return rate of 84%. There was statistically significant improved anatomical knowledge after the workshop. Students' self-rated confidence in performing procedural skills on real patients improved significantly after the workshop: inserting laryngeal mask (MD 0.667), oropharyngeal (MD 0.198) and nasopharyngeal (MD 0.600) airways, performing Bag-Valve-Mask (MD 0.379), double (MD 0.344) and triple (MD 0.326,) airway manoeuvre, doing 12-lead electrocardiography (MD 0.729), using laryngoscope (MD 0.726), using Magill® forceps to remove foreign body (MD 0.632), attempting thoracocentesis (MD 1.240), and putting on a traction splint (MD 0.865). The students commented that the workshop provided context to their theoretical knowledge and that they gained an appreciation of the differences in normal tissue variation. Following engagement in/ completion of the workshop, students were more aware of their own clinical and non-clinical competencies. CONCLUSIONS:The paramedic profession has evolved beyond patient transport with minimal intervention to providing comprehensive both emergency and non-emergency medical care. With limited availability of clinical placements for undergraduate paramedic training, there is an increasing demand on universities to provide suitable alternatives. Our findings suggested that cadaveric training using fresh frozen cadavers provides an effective adjunct to simulated learning and clinical placements.

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Agreement between two raters' evaluation for integrated Traditional Prosthodontic Practical Exam with Directly Observed Procedural Skills in Egypt.

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Agreement between two raters' evaluation for integrated Traditional Prosthodontic Practical Exam with Directly Observed Procedural Skills in Egypt.

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