Kim David Whittlestone

Calculation of doses of drugs in solution: Are medical students confused by different means of expressing drug concentrations?

AbstractIntroduction: Our hypothesis was that clinical medical students find the different means of expressing the concentration of drugs in solution confusing. We are concerned that lack of formal teaching on this topic may make students liable to make drug dosing errors after they have qualified. Administering the wrong volume of a drug may have serious consequences for patient safety. Study design and participant group: Web-based electronic multiple-choice examination of clinical medical students. Methods: We asked clinical medical students at our university three multiple-choice questions concerning the concentration of lidocaine (lignocaine) and epinephrine (adrenaline) in solution and the maximal recommended dose of lidocaine. The incorrect options were wrong by factors of between 4 and 1000. Results: One hundred and sixty-eight clinical students out of 350 contacted responded to an invitation to participate (response rate 48%). Twenty-seven percent answered every question incorrectly and 10% answered all three correctly. The mean score for all students was only 1.24 out of 3 (standard error 0.96). However, final-year students performed significantly better (p = 0.016), implying that some knowledge had been acquired informally. Their higher mean score resulted from correctly identifying the amount of epinephrine (p = 0.005) and lidocaine (p = 0.018) more frequently. Only 27% knew the maximal recommended dose of lidocaine, with no difference between years (p = 0.724). Conclusions: A substantial majority of medical students are unable to calculate the mass of a drug in solution correctly. There is evidence that some students are picking up this skill during the course, because final-year students performed significantly better than first-year students. Modern medical student pharmacology teaching is highly sophisticated, encompassing genomics, molecular and cell biology. The ability to calculate drug doses safely appears to have been overlooked. Students should be familiar with these concepts, so as to avoid dose errors and associated morbidity, mortality and cost when they begin prescribing. To simplify calculations, drug packaging should express the concentration of drugs in solution solely as mass per unit volume, e.g. milligrams per millilitre.

Collusion detection in multiple choice examinations

To develop and test a novel method for collusion detection in multiple choice examinations.

Views of professionalism: a veterinary institutional perspective

In many western countries, there has been a marked change in the demographic profile of those entering the veterinary profession, with a shift from a predominantly male to a predominantly female intake. There have been parallel changes in society, with greater emphasis on human rights and work-life balance. It is, therefore, timely to consider what constitutes correct professional conduct for the profession, as there is the potential for problems to arise over the interpretation of ‘professionalism’ due to cultural and generational differences. A cross-section of staff and students within one veterinary institution were invited to take part in a survey exploring their prioritisation of 10 aspects of the professional role. A cluster analysis was performed, and four distinctly different profiles were established according to the views held by the cluster members. Cluster membership was found to significantly correlate to career stage, with altruism and social justice progressively giving way to professional autonomy and dominance. All four clusters in this educational environment prioritised technical and interpersonal competences above all other aspects of the professional role.

Communication skills training: what the vet schools are doing

Increasing emphasis is being placed on communication skills training in UK veterinary curricula, with changes and advances in teaching approaches and the assessment of skills. Here, Liz Mossop and colleagues describe how the different UK schools approach communication skills training and assessment, and consider how this teaching will continue to evolve to meet the needs of the profession and ensure students graduate ‘fit to practise’ in an ever more demanding environment.

Problems encountered with a pilot online attendance record and feedback scheme for medical students.

Lectures were traditionally optional for students in higher education with noregisters or records of attendance. This flexible approach was tolerated ifperformance in end of year or final examinations was satisfactory (Vinceneuxet al., 2000).This approach may still be possible in some subjects but in medicine muchhas changed. Students are increasingly required to verify attendance andparticipation as validation, appraisal and competence-based assessment areintroduced. Collecting and organizing written evidence is also becoming animportant part of postgraduate medical life.Resentment is caused by the ‘‘sign-up’’ system (Hrabak et al., 2004) becausestudents dislike being treated like school children when they are learning theattributes of a profession and some students can even resort to forgery(Beemsterboer et al., 2000). Signature sheets are easily lost and are rarelyinspected by faculty members while collecting signatures takes a dispropor-tionate amount of time. The acquisition of a signature only establishes astudent’s attendance, not whether they have learned anything.We perceive pressure from university authorities to account for students’attendance. Previously, students could choose to do something else if they

Examining the Use of Web-Based Reusable Learning Objects by Animal and Veterinary Nursing Students.

This intervention study examined the interaction of animal- and veterinary nursing students with reusable learning objects (RLO) in the context of preparing for summative assessment. Data was collected from 199 undergraduates using quantitative and qualitative methods. Students accessed RLO via personal devices in order to reinforce taught sessions. Interviewees reported that the RLO helped them meet the requirements of the curriculum. Quantitative data supported two valid points; the lack of engagement of students when given a free-choice and reluctance for self-assessment. The practical significance of the qualitative outcomes lies with how first year undergraduates on animal and veterinary nursing-related courses use RLO designed to address equine management and health topics, where the students have mixed equine experience.