Web-based conversational learning provides an opportunity for shared knowledge base creation through collaboration and collective wisdom extraction. Usually, the amount of generated information in such forums is very huge, multidimensional (in alignment with the desirable preconditions for constructivist knowledge creation), and sometimes, the nature of expected new information may not be anticipated in advance. Thus, concept maps (crafted from constructed data) as “process summary” tools may be a solution to improve critical thinking and learning by making connections between the facts or knowledge shared by the participants during online discussion This exploratory paper begins with the description of this innovation tried on a web-based interacting platform (email list management software), FAIMER-Listserv, and generated qualitative evidence through peer-feedback. This process description is further supported by a theoretical construct which shows how social constructivism (inclusive of autonomy and complexity) affects the conversational learning. The paper rationalizes the use of concept map as mid-summary tool for extracting information and further sense making out of this apparent intricacy.

Professionalism is the attributes, behaviors, commitments, values, and goals that characterize a profession. In medical professional, it encompasses strong societal role and involves emotional component too. On the other hand, ethics is the study of morality – careful and systematic analysis of moral decisions and behaviors and practicing those decisions. Medical ethics focuses primarily on issues arising out of the practice of medicine. It is generally believed that professionalism and ethics are caught by watching your teachers and seniors and not taught formally. Professionalism and ethics are previously diffused passively to the students through “the hidden curriculum,” leaving a lot to chance. However, over the time, it has been advocated that graduates need to be formally trained in the concepts of professionalism and ethics. In this paper, we propose a formal curriculum on professionalism and ethics, tailor-made for Indian medical graduates.

Tooth carving is an important practical preclinical exercise in the curriculum in Indian dental education setup. It forms the basis of introduction to tooth anatomy, morphology and occlusion of primary and permanent teeth through practical approach. It requires enormous time and manpower to master the skill. Therefore, there is an imminent necessity to incorporate computer-based learning of the art of tooth carving for effective teaching and efficient student learning. This will ensure quality time to be spent on other academic and research activities by students and faculty in addition to adding value as a teaching aid.

Background: To know the individual's current level of readiness and to manage self-directed learning (SDL) not only help learners but also the instructors. The objectives of this study were to find SDL readiness among 4^th year medical student and to analyze the effect of weekly assessment of SDL topics. Methodology: This was a cross-sectional study to analyze the effect of weekly assessment of SDL topics in fostering SDL. The 51 4^th year students during a clinical posting in ophthalmology participated for this study. Each recruited student was tested for SDL readiness through the SDL readiness scale (SDLRS) developed by Lucy Guglielmino (1978), which was validated in our local setting and responses were collected from students on the 1^st day of the clinical posting. The students chose SDL topics which were assessed on a weekly basis in the form of scenario-based multiple choice questionnaires. Written feedback was collected from each student regarding such activity during their clinical posting, especially to know the actual utilization of SDL hours provided in teaching schedule, satisfaction on the type of questions and motivation for SDL. Results: The mean SDLRS score in male students were 214.15 ± 19.73 and in female 207.95 ± 17.983, which falls under average score as defined in Guglielmino scale. The majority of study population expressed better utilization of SDL study hours because of weekly assessment than when they had no assessment for SDL. Conclusions: Majority of the study population were found to be ready for SDL. The weekly assessment of SDL topics was found to stimulate proper utilization of SDL slots in teaching schedule thereby fostering SDL habits.

Background: Multiple choice questions (MCQs) are a common method of assessment of medical students. The quality of MCQs is determined by three parameters such as difficulty index (DIF I), discrimination index (DI), and distracter efficiency (DE). Objectives: The objective of this study is to assess the quality of MCQs currently in use in pharmacology and discard the MCQs which are not found useful. Materials and Methods: A class test of central nervous system unit was conducted in the Department of Pharmacology. This test comprised 50 MCQs/items and 150 distracters. A correct response to an item was awarded one mark with no negative marking for incorrect response. Each item was analyzed for three parameters such as DIF I, DI, and DE. Results: DIF of 38 (76%) items was in the acceptable range (P = 30–70%), 11 (22%) items were too easy (P > 70%), and 1 (2%) item was too difficult (P < 30%). DI of 31 (62%) items was excellent (d > 0.35), of 12 (24%) items was good (d = 0.20–0.34), and of 7 (14%) items was poor (d < 0.20). A total of 50 items had 150 distracters. Among these, 27 (18%) were nonfunctional distracters (NFDs) and 123 (82%) were functional distracters. Items with one NFD were 11 and with two NFDs were 8. Based on these parameters, 6 items were discarded, 17 were revised, and 27 were kept for subsequent use. Conclusion: Item analysis is a valuable tool as it helps us to retain the valuable MCQs and discard the items which are not useful. It also helps in increasing our skills in test construction and identifies the specific areas of course content which need greater emphasis or clarity.

Background: Although prescription writing is a part of the medical students' curriculum, their prescribing skills are still poor either as a part of their examinations or as they go out as qualified health professionals which may be due to inadequate training. Educational intervention like patient-based teaching in pharmacology offers lifelike preparation and provides more relevance, easier recall, and help in improving prescribing skills. This study aims to determine the role of patient-based teaching in improving the prescribing skill of II year medical students compared to conventional case-based teaching. Materials and Methods: This prospective, comparative study was carried out after giving orientation to prescription writing as per the WHO prescribing guidelines (N = 50). The 25 students in control group were given case-based teaching and 25 students in test group were given patient-based teaching of prescription writing for the same five common clinical conditions. The prescription writing skill (knows how level) was assessed by evaluating the prescriptions written in the prescribed format and scored by a 14-point scoring system. Results: The mean scores obtained by the control (9.6) and test (12.04) groups were compared by unpaired Student's t-test (P < 0.001). On comparing the individual parameters in the 14-point scoring by Chi-square test, significant difference was found regarding patient and doctor's particulars, diagnosis, quantity, duration of therapy, and signature between study groups. Student feedback revealed that patient-based teaching enhanced responsibility, focus, and memory. Conclusion: Patient-based approach for prescription writing enables students to develop prescribing skills in a complete and professional way.

Background: Evaluation is an integral part of medical education. Although there are various methods of teachers' evaluation, student's feedback is considered as the most effective and reliable method albeit a controversial one. In this study, we have tried to evaluate the effectiveness of the students' feedback in teachers' evaluation in an upcoming medical college. Aim: The aim of this study was to improve the quality of teaching by introducing students' feedback as a teachers' evaluation system in a new medical college. Materials and Methods: A feedback of second professional teachers was obtained from the fourth-semester students. This feedback was obtained through a proforma which was validated through peer review. Based on the feedback, teachers were informed about their strengths and weaknesses in a confidential manner. A uniform opportunity was then provided to these teachers for 3 months to improve their teaching skills. At the end of the period, again a questionnaire was administered to both the students and the teachers to assess the effectiveness of the feedback system. Results: More than two-third of the students and teachers alike agreed that the student's feedback is an effective tool for the faculty development. Majority of the teachers were satisfied with the present format of the feedback system and agreed that it sensitized them toward the students need. Conclusions: Student's feedback is an effective tool for teachers' evaluation resulting in faculty development. However, other sources of feedback may also be utilized for the overall assessment of a teacher.

Background: Development of health professionals with ability to integrate, synthesize, and apply knowledge gained through medical college is greatly hampered by the system of delivery that is compartmentalized and piecemeal. There is a need to integrate basic sciences with clinical teaching to enable application in clinical care. Aim: To study the benefit and acceptance of vertical integration of basic science in final year MBBS undergraduate curriculum. Materials and Methods: After Institutional Ethics Clearance, neuroanatomy refresher classes with clinical application to neurological diseases were held as part of the final year posting in two medical units. Feedback was collected. Pre- and post-tests which tested application and synthesis were conducted. Summative assessment was compared with the control group of students who had standard teaching in other two medical units. In-depth interview was conducted on 2 willing participants and 2 teachers who did neurology bedside teaching. Results: Majority (>80%) found the classes useful and interesting. There was statistically significant improvement in the post-test scores. There was a statistically significant difference between the intervention and control groups' scores during summative assessment (76.2 vs. 61.8 P< 0.01). Students felt that it reinforced, motivated self-directed learning, enabled correlations, improved understanding, put things in perspective, gave confidence, aided application, and enabled them to follow discussions during clinical teaching. Conclusion: Vertical integration of basic science in final year was beneficial and resulted in knowledge gain and improved summative scores. The classes were found to be useful, interesting and thought to help in clinical care and application by majority of students.

Context: Active learning has received considerable attention over the past several years, often presented or perceived as a radical change from traditional instruction methods. Current research on learning indicates that using a variety of teaching strategies in the classroom increases student participation and learning. Aim and Objectives: To introduce active learning methodology, i.e., “jigsaw technique” in undergraduate medical education and assess the student and faculty response to it. Subjects and Methods: This study was carried out in the Department of Physiology in a Medical College of North India. A topic was chosen and taught using one of the active learning methods (ALMs), i.e., jigsaw technique. An instrument (questionnaire) was developed in English through an extensive review of literature and was properly validated. The students were asked to give their response on a five-point Likert scale. The feedback was kept anonymous. Faculty also provided their feedback in a separately provided feedback proforma. The data were collected, compiled, and analyzed. Results: Of 150 students of MBBS- first year batch 2014, 142 participated in this study along with 14 faculty members of the Physiology Department. The majority of the students (>90%) did welcome the introduction of ALM and strongly recommended the use of such methods in teaching many more topics in future. 100% faculty members were of the opinion that many more topics shall be taken up using ALMs. Conclusion: This study establishes the fact that both the medical students and faculty want a change from the traditional way of passive, teacher-centric learning, to the more active teaching-learning techniques.

Introduction: The Department of Community Medicine and Family Medicine (CMFM) has been started as a new model for imparting the components of family medicine and delivering health-care services at primary and secondary levels in all six newly established All India Institute of Medical Sciences (AIIMS), but there is no competency-based curriculum for it. The paper aims to share the experience of Delphi method in the process of developing consensus on core competencies of the new model of CMFM in AIIMS for undergraduate medical students in India. Methods: The study adopted different approaches and methods, but Delphi was the most critical method used in this research. In Delphi, the experts were contacted by e-mail and their feedback on the same was analyzed. Results: Two rounds of Delphi were conducted in which 150 participants were contacted in Delphi-I but only 46 responded. In Delphi-II, 26 participants responded whose responses were finally considered for analysis. Three of the core competencies namely clinician, primary-care physician, and professionalism were agreed by all the participants, and the least agreement was observed in the competencies of epidemiologist and medical teacher. The experts having more experience were less consistent as responses were changed from agree to disagree in more than 15% of participants and 6% changed from disagree to agree. Conclusion: Within the given constraints, the final list of competencies and skills for the discipline of CMFM compiled after the Delphi process will provide a useful insight into the development of competency-based curriculum of the subject.

Context: Student-led seminars (SLS) are adopted as a teaching-learning (T-L) method in pharmacology. Previous studies assessing the feedback on T-L methods in pharmacology points out that the traditional seminars consistently received poor feedbacks as they were not favorite among the students. Aims: This study aimed to obtain feedback on traditional SLS, introduce modified SLS and compare the modified seminars with the traditional ones. Settings and Design: This was a prospective interventional study done for 2 months in medical undergraduates of fifth semester attending Pharmacology seminars at a Government Medical College in South India. Subjects and Methods: Structured questionnaire was used to elicit feedback from participants. The responses were coded on 5-point Likert scale. Modifications in seminar sessions such as role plays, quiz, tests, group discussion, and patient-oriented problem-solving exercises were introduced along with SLS. Statistical Analysis Used: The data were analyzed using SPSS version 16. The descriptive data were expressed using frequencies and percentages. Wilcoxon signed rank test, and Friedman tests were used to compare traditional with modified seminars. Results: The participants identified interaction as the most important component of a seminar. Majority opined that the teacher should summarize at the end of SLS. Student feedback shows that modified seminars created more interest, enthusiasm, and inspiration to learn the topic when compared to traditional SLS. They also increased peer coordination and group dynamics. Students opined that communication skills and teacher-student interactions were not improved with modified seminars. Conclusions: Interventions in the form of modified SLS may be adopted to break the monotony of traditional seminars through active participation, peer interaction, and teamwork.

Background: Our existing undergraduate curriculum lacks developing competency for endotracheal intubation. Even though it is a lifesaving procedure, interns are exposed only during their posting in anesthesia or emergency medicine and so, when need arises, they fail to perform endotracheal intubation and it leads to catastrophes. Aims and Objectives: The aim of this study was to develop competency in interns for endotracheal intubation. Materials and Methods: A study was conducted on fifty interns of medical college. Lecture and demonstration were used for cognitive domain and one-to-one training and practice on manikin for affective and psychomotor domains, respectively. Live demonstration on patients was done whenever possible. Gain in knowledge was evaluated by pre- and post-test using standardized validated questionnaire. Skills were assessed by direct observation of procedural skill on manikin, split in steps: Laryngoscopy, intubation, and ventilation. Session was evaluated using feedback questionnaire and Likert scale. Results: Interns showed mean marks of 8.12 ± 1.63 in pretest compared to 13.86 ± 1.06 of posttest with a gain of 34.8% (P = 0.0001), which is highly significant. Twenty-two percent interns completed all steps correctly in the first attempt, 62% in the second attempt, while 16% required third attempt to correctly complete all steps. Conclusion: This training developed competency for basic knowledge and practice of endotracheal intubation in interns adequately on manikin. Training for endotracheal intubation should be carried out at the beginning of internship before they go for clinical practice and repeated during their rotation of Anesthesia and Emergency Medicine Department, so they can retain their competency for it and can do later on whenever required.

Objectives: To find out the impact of teaching clinical pharmacology and rational therapeutics (CPT) to medical undergraduates (UGs) and interns. Materials and Methods: This cross-sectional, prospective study was conducted on three UGs batches and interns using two pretested validated structured questionnaires, modified from the work of Tobaiqy et al. The study was approved by the Institutional Ethics Committee. ANOVA and Chi-square test were used for statistical analysis. The value of P< 0.05 was considered statistically significant. Results: A total of 379 UGs and 96 interns participated in this study. Mean knowledge score of interns was significantly reduced as compared to UGs (P < 0.0001). A significant increase in confidence for unsupervised prescribing of nonsteroidal anti-inflammatory drugs (99%), oral rehydration salt, iron salts was perceived among interns as compared to UGs (P < 0.05). However, 63.5% confessed problems in selection of drugs, drug–drug interactions, prescribing in special patient population. Although they were confident prescribing fixed dose combination for adult patients (89.5%), majority were hesitant to prescribe opioids (77%), steroids (76%), vaccines (75%), and antihypertensives (62%). Conclusion: The theoretical CPT teaching transfers knowledge to UGs; however, it is not retained in internship and does not adequately prepare interns to prescribe safe and rational drugs.

Context: There is a need to shift from the didactic lecture-based instruction to more student-centered active learning methods for undergraduate teaching in community medicine. Aims: To compare didactic and modular method of learning on Level 1 and 2 on Kirkpatrick's training evaluation model. Settings and Design: This was a two-arm educational intervention study for a small group of the 2^nd year MBBS students in their 4^th semester during clinical posting in the subject of community medicine. Subjects and Methods: The topic chosen was “rabies prophylaxis” in the 2^nd clinical posting during 4^th semester. With permission from Institutional Ethics Committee, first batch of 17 students was taught this topic by didactic method. Next batch of 22 students was taught by the modular method. A self-reading module was prepared for this study and validated by three teachers. What was different in modular teaching was a circular sitting arrangement, module reading by students, video presentation, and exercise using case vignettes. Statistical Analysis Used: Student's t-test was used for pre- and post-test score comparison and Mann–Whitney U-test for students' responses on Likert scale. Results: The mean gain in obtained marks after modular learning (7.9/15) was significantly higher as compared to gain after didactic teaching (5.9/15) (P = 0.0038); more students asserted to be confident to manage a case in modular group compared to the didactic group (P < 0.05) indicating a higher level of learning through modular teaching. Conclusions: Modular teaching fares better than didactic method and hence should be used more frequently in community medicine clinical posting.

Context: Over the years with advancement of science and technology, each subject has become highly specialized. Teaching of medical students has still remained separate in various departments with no scope of integration in majority of medical institutes in India. Study was planned to have an experience of integration in institute and sensitize faculty for integrated teaching–learning (TL) method. Aims: To prepare and test effectiveness of integrated teaching module for 2^nd year MBBS student in pharmacology and to sensitize and motivate faculties toward advantages of implementing integrated module. Settings and Design: Education intervention project implemented 2^nd year MBBS students of Government Medical College and New Civil Hospital, Surat. Subjects and Methods: Students of second MBBS were divided into two groups. One group was exposed to integrated teaching sessions and another to traditional method. Both the groups were assessed by pre- and post-test questionnaire, feedback and focus group discussions were conducted to know their experience about process. Results: A total of 165 students of the 2^nd year MBBS were exposed to the integrated teaching module for two topics in two groups. One group was taught by traditional teaching, and another group was exposed to the integrated TL session. Both the groups have shown a significant improvement in posttest scores but increase in mean score was more in integrated group. During analysis of feedback forms, it was noted that students preferred integrated TL methods since they help in better understanding. Faculty feedback shows consensus over the adaptation of integrated TL methods. Conclusions: Integrated TL sessions were well-appreciated by students and faculties. To improve the critical reasoning skills and self-directed learning of students, integrated TL is highly recommended for must know areas of curriculum.

Introduction: Feedback is a divalent bond between the supplier (teacher) and the recipient (student). The strength of the bond depends on the instructional design of the feedback. Feedback is central to medical education in promoting self-directed learning in students. In the present study, a structured verbal feedback module was prepared, implemented, and evaluated. Methods: The study was done on 280 students from four consecutive batches (2011 to 2014) of the 1^st year MBBS students exposed to different types and modes of feedback. Analysis was done using student feedback questionnaire for the perception of students to verbal feedback. Quantitative analysis using post hoc test and ANOVA for the impact of type of feedback (verbal or written) and effect of modes (individual or group) of verbal feedback on test score performance were done. Result: In this study, ≥95% of the students preferred verbal feedback of both positive and negative attributes in student questionnaires. It was observed that verbal feedback sessions made a difference of up to 2–2.4 grade points in the mean score of batch when compared to the written feedback. The initial mean test score (T1) of 2011 + 2012 and 2013 + 2014 was not statistically significant (P = 0.113). But, in all subsequent tests (T2, T3, and T4), there was a statistically significant difference in the mean test scores (P = 0.000). Conclusion: (1) Students prefer verbal one-to-one feedback over written feedback. (2) Verbal feedback changes learning process and causes sustained improvement in learning strategies.

Context: Tutor assessment is sometimes also considered as an exercise of power by the assessor over assesses. Student self-assessment is the process by which the students gather information about and reflect on their own learning and is considered to be a very important component of learning. Aim: The primary objective of this study was to analyze the impact of self-assessment by undergraduate medical students on their subsequent academic performance. The secondary objective was to obtain the perception of students and faculty about self-assessment as a tool for enhanced learning. Materials and Methods: The study was based on the evaluation of two theory tests consisting of both essay type and short answer questions, administered to students of the 1^st year MBBS (n = 89). They self-assessed their performance after 3 days of the first test followed by marking of faculty and feedback. Then, a nonidentical theory test on the same topic with the same difficulty level was conducted after 7 days and assessed by the teachers. The feedback about the perception of students and faculty about this intervention was obtained. Results: Significant improvement in the academic performance after the process of self-assessment was observed (P < 0.001). There was a significantly positive correlation between student and teacher marking (r = 0.79). Both students and faculty perceived it to be helpful for developing self-directed learning skills. Conclusions: Self-assessment can increase the interest and motivation level of students for the subjects leading to enhanced learning and better academic performance, helping them in development of critical skills for analysis of their own work.

Introduction: Embalmed cadavers are the primary tool for teaching anatomy. However, difficulties are encountered due to changed color/texture of organs, hardening of tissues, and smell of formaldehyde. To overcome these difficulties, dissections on a fresh human body were shown to the 1^st year MBBS students, and their perception was noted. Materials and Methods: After taking universal precautionary measures, postmortem dissections were shown to students on voluntary donated bodies in the dissection hall, in addition to the traditional teaching on embalmed cadavers. Feedback was taken from students and faculty regarding the utility of these sessions. Results: Better appreciation of texture, orientation, location, and relations of organs in fresh body, integration of teaching, awareness of the process and laws related to body donations were the outcomes of the study. However, the smell and sight of blood was felt to be nauseating by some students, and some students were worried about the spread of infectious diseases. Conclusions: Visualizing single fresh body dissection during 1^st year professional MBBS is recommended either on medicolegal autopsy or on voluntarily-donated bodies.