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Today one of my lecturers issued an in class MCQ examinations, you get four choices of answers.
Out of 26 questions.
1 of her answers was totally wrong.
1 of her questions was so badly worded it didn't make sense.
3 questions were effectively trick questions who's choice of answers were open to interpretation - eg "What's the most important aspect of evidence based medicine..... data or patient care" Errrr data because you can't give patients good care without good evidence. That's the whole point of EBM. Her answer was patient care, apparently I'm on a nursing course not a Med Stats course.
1 question had two answers that were exactly the same.
I was very very close to interrupting her feedback session on the exam with a torrent of abuse, it seems a few felt the same way.
To top this off the exam was negatively marked.
The appeals process is really slow and utterly ridiculous as well, so has anyone else got any advice as to what else I can do? Should I kick up a stink with heads of departments? Vice-chancellor? Or will this work against me?
I'm not surprised you feel this way.
Seriously, I'm starting to really ****ing hate people.
Idiots everywhere.
The lesson to take from it is that everyone, no matter what their position, makes mistakes. That lesson will serve you well in healthcare.
The second lesson to learn is that clubbing people over the head with their mistakes is not going to encourage them to admit their mistakes. Another lesson that will serve you well in healthcare.
If she was actually a nurse or doctor though, this would amount to misconduct. As she's a lecturer who's employed for research and has to teach to fulfill her requirements, she'll get away with being a lazy asshole.
You seem to have a somewhat unrealistic view of how healthcare actually works, and when you get out of university and into the real world, I suspect you will be even more outraged.
Tee Hee.
[s]
The appeals process is really slow and utterly ridiculous as well, so has anyone else got any advice as to what else I can do?
NO
Its like moaning about your boss it is very tempting and they are often wrong but ultimately it is futile.[/s]
EDIT:
If she was actually a nurse or doctor though, this would amount to misconduct.
She really needs to hear this from someone who has yet to gain a medical qualification,probably needs some swear words in it as well.
PS film it so you can show the uni how right you were
She was probably a very good nurse or doctor before going into academia - probably wouldnt have got the research job without being so.
Today one of my lecturers issued an in class MCQ examinations, you get four choices of answers.Out of 26 questions.
[s]1 of her answers was totally wrong.
1 of her questions was so badly worded it didn't make sense.
3 questions were effectively trick questions who's choice of answers were open to interpretation - eg "What's the most important aspect of evidence based medicine..... data or patient care" Errrr data because you can't give patients good care without good evidence. That's the whole point of EBM. Her answer was patient care, apparently I'm on a nursing course not a Med Stats course.
1 question had two answers that were exactly the same.[/s]
I didn't understand 6 of them
Do you have a class or course representative?
I was one for my final year in uni. They usually have the ear of a person that can help. It also is a formal route which you can fall back on if needs be down the line.
Take this one all the way to the VC lad. Sub-par multiple choice test - heads will roll.
You seem to have a somewhat unrealistic view of how healthcare actually works, and when you get out of university and into the real world, I suspect you will be even more outraged.Tee Hee.
It's also the fact that I'm directly paying for a service out of my own choice....I'm a customer here. But hey whatever.... you guys would be annoyed if you had paid for a bike and it came with a giant dent in it.
didn't understand 6 of them
I can tell you that was definitely not the case. The lecturers English, is errrr not exactly very good.
Know your place!
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bwaarp - MemberIt's also the fact that I'm directly paying for a service out of my own choice....[b]I'm a customer here[/b]. But hey whatever.... you guys would be annoyed if you had paid for a bike and it came with a giant dent in it.
Customer? If you are customer then go elsewhere with your money. Customers are always lied to so do you want to be treated as customer?
Yes, if I were buying for a bike I would go elsewhere ... plenty of choices.
I can tell you that was definitely not the case. The lecturers English, is errrr not exactly very good.
Yes, but the top brain surgeon in the world, if I am not mistaken, is a non native English speaker. Are you attending English literature lecture or something else? The latter only English needs to communicate.
The whole point of evidence based medicine is to improve patient care. What's the point in gathering data if you dont use it to improve patient care?
[i]I'm a customer here[/i]
...and the customer is always right... 🙄
The whole point of evidence based medicine is to improve patient care. What's the point in gathering data if you dont use it to improve patient care?
The question wasn't why is evidence based medicine important. It was, whats the most important aspect of evidence based medicine?
Now you can give your patient all of the best fluffy wuffy wuv holistic healthcare in the world but it won't be evidence based if it doesn't have good data to support it. This was a question designed with no other intention than to catch people out.
whats the most important aspect of evidence based medicine?
And patient care is still the answer.
Question is probably designed to see if you focus on the patient or the science.
Question is probably designed to see if you focus on the patient or the science.
You can't give patients the best choice or possible care without knowing what actually does offer them that in the first place.
Evidence based medicine is important in improving patient care. "Aspect" implies what is important in achieving this goal (good patient care is the goal not the underlying important processes).
OK - why are you gathering data?
As I said, that's the goal....the endpoint. Not what is relevant in achieving that outcome using EBM methodology.
It was a semantics question that had no place in the exam.
Not to mention there were then more mistakes in the exam, that were quite clearly mistakes not semantics.
[i]You can't give patients the best choice or possible care without knowing what actually does offer them that in the first place.[/i]
Oh you really are in for a surprise...
Go look up the history of Xigris for a start, and consider that this this was used across the world, at about £5000 a go for a number of years...
It's stuff like this that led to the Staffordshire scandal. 😐
The lecturers English, is errrr not exactly very good.
The lecturer's English is, errr, not exactly very good.
Next you'll be telling me that we shouldn't use techniques for which there is very little evidence after the evidence based techniques have failed.
To go off on a wee tangent. I work in physio - most of the conditions people go to a physio clinic for have strengthening exercises as the technique with the most evidence. But in my experience friction massage and ultrasound is more effective than strengthening - this goes for most of my physio colleagues too. Do we forget about non-evidence based techniques or do we concentrate on techniques that improve the patient's condition?
Drotrecogin alfa was a failure in decent data!
Next you'll be telling me that we shouldn't use techniques for which there is very little evidence after the evidence based techniques have failed.
Yup, that would be correct. If data can't support it, it shouldn't be used - especially if there are significant sides.
To go off on a wee tangent. I work in physio
Oh god. You weren't the Chiro were you?
Paying for education = customer ... 😆
It's stuff like this that led to the Staffordshire scandal.
Data helped uncover the staffordshite scandal.
EBM is a methodological technique, that is all. It's not some fluffy human concept like "care".
I care about patients but me caring doesn't make my EBM techniques any better. Good data does.
Yup, that would be correct. If data can't support it, it shouldn't be used - especially if there are significant sides.
How do you gather data from which to build new evidence without giving patients care?
Data helped uncover the staffordshite scandal.
Maybe if staff hadn't been preoccupied with gathering data they would have had more time to spend on caring for patients.
[i]Drotrecogin alfa was a failure in decent data![/i]
Nope.
The data was excellent, the problem was that the data was inconvenient, and therefore ignored. The world isn't black and white, data isn't simply numbers on a page, healthcare isn't simple and getting grumpy about a test solves nowt.
The world is much more complex...
Treat this as a positive thing. Feeling ignored and maddened with rage will help you develop empathy with what your future clientele are experiencing.
No, the pharma company had good data. Everyone else (Cochrane) realized they didn't, hence why meta-analysis is becoming ever more important in EBM.
That was a failure in EBM....specifically to much credibility being given to RCT's.
[i]No, the pharma company had good data. Everyone else (Cochrane) realized they didn't, hence why meta-analysis is becoming ever more important in EBM. [/i]
But the company used various techniques to sell their product, which ignored the data. I've still got Lilly pens in my locker from the big marketing push...
You will learn that data is much less important than money...
That didn't effect anything to do with EBM did it....EBM is not a physical thing that can be touched. It was a failure in basic human compassion and care.
But the company used various techniques to sell their product, which ignored the data. I've still got Lilly pens in my locker from the big marketing push...You will learn that data is much less important than money...
Lying about/misrepresenting something is a failure in care yes, but it was also a failure in EBM.
RCT's cannot be trusted by themselves, they need rigorous meta-analysis to cut through the bias.....as I said, failure in EBM.
[i]they need rigorous meta-analysis to cut through the bias[/i]
Unfortunately, this seems to occur [i]after[/i] the sale of such things...
No comments on the video?
Unfortunately, this seems to occur after the sale of such things...
Hence why data analysis needs to be improved, not (in this case) patient care.
More rigorous trialing of drugs with data collected from multiple independent labs and a subsequent meta-analysis of this data could have prevented this.
No comments on the video?
Nope, didn't data analysis help to spot the problems at Staffs?
Didnt excessive data gathering cause part of the problem at Staffs?
[i]More rigorous trialing of drugs with data collected from multiple independent labs and a subsequent meta-analysis of this data could have prevented this.[/i]
Indeed.
However, someone has to [b]pay[/b] for this...
The lecturer's English is, errr, not [s]exactly[/s] very good
😀
Just perhaps if those failed managers at stafford failed hospital had spent more time on patient contact instead of tick box questionaires, then people wouldnt have died or suffered all for the sake of a score on a piece of paper.
Not a massively useful contribution I'm afraid, but I've been at Evidence Live this week.
Big emphasis on patient care being considered as part of EBM.
Pesky double post.
Hey,
ignoring all the stuff going off at a tangent, if you feel that there was a serious problem with the exam, and it's something that is actually counting towards your mark, then yes, you obviously should at least seek further clarification of the reasoning behind the particular answers in case you didn't fully understand them, and complain if you still think that there was a problem with the test. If you complain now, it at least gives the lecturer an opportunity to make any future assessments better.
Who you should moan to depends on your university. Probably talk first to your personal tutor as a default contact person, if not them (probably not), then it'll be their job to tell you who is the right person.
What Joe says.
Both my kids have had issues with lecturers/tutors.
Daughters class was being given a lecture about poor performance and quality of their report writing and none of them were worthy of being on a degree course (teaching)and that most of them would fail. The lecturer was unaware that my daughter already had an MA in another subject. She put her hand up to gain the lecturers attention and advised her that she already had a degree and that she, the lecturer, would not have been employed at her previous uni given the way she used PowerPoint as a way of delivering lectures!
At this point the lecturer switched off the laptop and asked for any student who had issues with her delivery to meet in her office. She got her wish!
Daughter gained an "outstanding" report on her first Ofsted inspection last month.
That is only one of many tales of woe suffered by my daughter during her time at uni. 🙄
Personal Tutor and then you should have a specific assessment and appeals procedure.
Any decent institution should have any form of somethingive assessed examination verified by an examining board and possibly an external examiner prior to it having been used. This makes room for appeal very difficult as essentially the examination has been peer reviewed and agreed.
Of course I can't comment on all institutions...
Trekster - MemberThe lecturer was unaware that my daughter already had an MA in another subject. She put her hand up to gain the lecturers attention and advised her that she already had a degree and that she, the lecturer, would not have been employed at her previous uni given the way she used PowerPoint as a way of delivering lectures!
Whhhhhaatttt! They used PowerPoint? Lame. Lightweight!
When I was at the Uni the lecturers just stood there and lecture for 55 mins ... that's it. I/we listened and took notes.
No, technological nonsense or handouts. You get the handouts of references in the seminar or tutorial. You find information yourself from the library. End off.
Also all lecturers are supposed to be different and that's the interesting part of being at the Uni or at least part of the fun at Uni. How can you compare lecturers?
Is using PowerPoint the reason for complain? In fact is using PowerPoint the ground for complain? I mean lecturers are NOT entertainers so the delivery of a lecture is entirely of individual concern or style ... or is there a new benchmark on how to speak nowadays? 🙄
I had a Yank lecturer who was a chain smoker ohhh bless him (should have asked him to speak in English ...), a Russian who we thought was a spy, a Yorkshire guy (yes, should have asked him to speak proper English too), a very nice polite English gentleman, a lecturer who only spoke in Economy ... he was from different planet, then some other weirdos but we just get on with learning ... yes, we learned as we do not expect to be taught. Teaching is for secondary school. We were coool dudes at Uni ... we did not complain but get on with it.
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http://adc.bmj.com/content/90/8/837.full
WHY EVIDENCE BASED MEDICINE?
The most important reason for practising EBM is to improve quality of care through the identification and promotion of practices that work, and the elimination of those that are ineffective or harmful.4 EBM promotes critical thinking. It demands that the effectiveness of clinical interventions, the accuracy and precision of diagnostic tests, and the power of prognostic markers should be scrutinised and their usefulness proven. It requires clinicians to be open minded and look for and try new methods that are scientifically proven to be effective and to discard methods shown to be ineffective or harmful.
Trekster - MemberThe lecturer was unaware that my daughter already had an MA in another subject. She put her hand up to gain the lecturers attention and advised her that she already had a degree and that she, the lecturer, would not have been employed at her previous uni given the way she used PowerPoint as a way of delivering lectures!
p/s: oh ya ... MA in another subject is by no means a good way to do a comparison. Not comparing apple with apple.
It's about being able to adapt to others' styles. So what happens in future employment when the employer does not meet her "standard"? Fire the employer? Or perhaps what the employer/job can do for them as oppose to what they can contribute to the employer/job. Doom!
Me mates are lecturers and part-time lecturers so I tend to hear them talking about it all the time ... yes, they just give them the marks they want and be entertainers, otherwise their job will be unbearable with their bosses breathing down their neck demanding high satisfaction ... from students demanding more spoons to be used.
The advice I gave to me mates was to get out of that profession while they could as there would be no satisfaction facing several hundred demand people. One complain and all their efforts in "teaching" would go down the drain ...
There will be a complaints process, but whether it's actually meaningful is another question- we poll well for quality of teaching but IMO our complaints process is designed to defuse (or diffuse) complaints not resolve them. Coming from a commercial environment to a university one the difference is pretty clear, but I think most of our academics still think it's too strong. Students paying their own fees is a shock to the system! But talking about customers isn't helpful, regardless of payment it's not a typical customer/provider relationship.
Not clear how the data can be more important than the patient care though, the former is worthless unless it's serving the latter. But it's a poor question- adequate for discussion, not for examination.
first world problem. **** off.
Well, I dealt with this by getting.
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Can barely feel my own fingers let alone type right now. That exam was worth a lot of marks. feeling as if I wasted a lot of money. There was no effort in ""teaching", all this lecturer wants to do.... like many others.... is to get on with their research. They don't care, waste of god damn money.....I could teach myself this shit my renting out books in a library but instead I have to pay assholes like this to make me jump through their half arsed or illogical hoops.
yep bwaarp-- thats so called higher education for you-- high cost yes-- learning by rote, total let down IME
As a healthcare analyst (unqualified, but with Real World experience) Rob can confirm that the answer is [b] ALWAYS [/b] patient care.
forgetting the off topic stuff....
Shouting doesn't work very well in the long run
Did anybody else have the same problems as you?
If they did get your points down and ask for a review with the lecturer
If not go see your personal tutor
As there is an appeals process enter it, it's a university it's not meant to be fast and efficient, you just have to jump the hoops.
Be prepared to MTFU and admit if you were wrong (it's sometimes called learning) it is possible you did not get the context of the questions (this may be due to the way they are written or not)
If it goes against you then get over it. Formalised learning is about ticking the boxes, if you wanted free thinking and all that you should have done an arts course.
Love that the patient care question went over your head!
Would you allow a patient to die to collect more data? Or stop collecting data to save the patient?
There's your answer.
There was no effort in ""teaching", all this lecturer wants to do.... like many others.... is to get on with their research
The irony being of course that Bwaaaaaaaaarp would like some more customer (patient) care, when the lecturer would rather be out gathering more data (evidence).
I've a question for the OP.
If a patient believes that a complimentary therapy taken alongside traditional treatment is doing them some good despite there being no evidence to back that up that claim, would you discourage them from continuing with the evidentially worthless treatment?
Raouligan - Member
Personal Tutor and then you should have a specific assessment and appeals procedure.Any decent institution should have any form of somethingive assessed examination verified by an examining board and possibly an external examiner prior to it having been used. This makes room for appeal very difficult as essentially the examination has been peer reviewed and agreed.
Of course I can't comment on all institutions...
This. Where i work, when an assessment is set it is checked by an internal moderator and then sent to an external examiner if it is second or third year. If there is an error which isn't picked up at this stage, but is found later and it was detrimental to student performance the students who took it will get a TEC (technical extenuating circumstances) and marks adjusted - in this case the questions deemed incorrect will be ignored in the calculation of the marks.
What you need to do is raise it with the class rep/HoD/programme leader. This will then go forward to the exam board. It might seem slow, but it isn't until the end of the year that anything can be done - that is the way the regulations governing exams are written. Don't escalate it to the VC ffs - they'll just tell you to read the regulations about appeals. And if there are genuine mistakes, the lecturer will be feeling pretty bad about, despite what you claim - don't make it worse for them, mistakes happen.
bwaarp - Member
Can barely feel my own fingers let alone type right now. That exam was worth a lot of marks. feeling as if I wasted a lot of money. There was no effort in ""teaching", all this lecturer wants to do.... like many others.... is to get on with their research. They don't care, waste of god damn money.....I could teach myself this shit my renting out books in a library but instead I have to pay assholes like this to make me jump through their half arsed or illogical hoops.
You're at university, not school. You pay for the [u]opportunity[/u] to learn, not to be taught. Contact with academics is there to guide your learning and introduce you to the material. Then you have to go away and learn it.
If you're worried about value for money of one test, you've got your priorities wrong. In the wider scheme of things the marks you get for assessments aren't as important as what you learnt before them and when preparing for them.
Next you'll be telling me that we shouldn't use techniques for which there is very little evidence after the evidence based techniques have failed.
Yup, that would be correct. If data can't support it, it shouldn't be used - especially if there are significant sides.
To go off on a wee tangent. I work in physio
Oh god. You weren't the Chiro were you?
No. That would be me. And I agree with what glupton is talking about - data and evidence is obviously important in ebm but patient centered care is the end goal.
As much as I'm enjoying reading this, you do sound like you have some anger and superiority issues i.e. you are right, everyone else must be wrong/an idiot.
As much as I'm enjoying reading this, you do sound like you have some anger and superiority issues i.e. you are right, everyone else must be wrong/an idiot.
Seems to be a recurring trait on here, sadly.
And they say that university doesn't prepare people for the real world?
Having to deal with an incompetent, lazy, half-wit, inexplicably in a position of authority, and being paid a lot more than you? On a daily basis? While biting your lip to stem the verbal onslaught and explosion of impotent rage?
Sounds like perfect preparation to me 😀
As a healthcare analyst (unqualified, but with Real World experience) Rob can confirm that [b]the answer is ALWAYS patient care.[/b]
That's going to be a pretty easy exam to pass.
I could teach myself this shit my renting out books in a library but instead I have to pay assholes like this to make me jump through their half arsed or illogical hoops.
Welcome to university.
So tell me Bwaarp, are you studying to become a doctor? The clue is most likely in the topic but i know naff all about medicine. You seem to incredibly confident in your own view, to the point where everyone else is utterly wrong. In true STW form this is naturally based on a very narrow survey covering this thread, your views on 29ers and I seem to recall you appearing in a Hope brakes thread as well. Would you say this is a good personality trait for a doctor/medical professional?
the new Dr Who !
I'm guessing it's a big hangover that is being nursed there.....
I have some sympathy for bwaarp's view here - if the purpose of medicine is patient care, then evidence based medicine must be about the evidence
however, since he's not provided any evidence in terms of 5 of the 6 questions he was asked, we're left with nothing to go on
... and he's too grumpy 😥
I just skimmed the above...
But as someone that's set, marked and given feedback on assessments etc at a uni - don't just complain by email/to other people/get angry.
Speak/email the person and ask for a meeting to go over some of the feedback, say you don't understand 6 of the questions and would like to understand the correct answers better.
I always offered this as a first step when people had issues about something - no-one took me up on it, but I'd have been happy to go over answers and correct marking if I was wrong (it happens!).
Seriously, the person wants to teach, not do exam admin. Give them a chance to teach you, rather than deal with the admin of a complaint. They may realise there were mistakes (or you may realise you made a mistake).
Which brings me on to.... there's a chance you could be wrong! And by the very nature of being wrong, you wouldn't know it! Worse still, you'd be convinced you were right! The number of students insisting they had the right answers/deserved all the marks etc. when they were clearly wrong etc. amazed me. Some people just totally didn't get things/grasped the wrong end of the stick.
I'd love to know how this somethingive assessment compared to any formative assessment and the feedback processes involved.
I think the problem here is that you were too clever for the test. That happens to me ALL THE TIME.
What you need to do is dumb down your IQ a few points by watching Hollyoaks for a week, or have a few drinks before class.
Ok, whilst I was nursing a massive hangover I asked myself if I was wrong on this. I tried, I really did but I can't see the other view point - someone gave an example earlier (i think) of a patient taking a drug/something that is making them feel better whilst there being no evidence to support it's use....as a way of making a point.
Let's try a scenario to counter this. Bare with my as I'm still worse for wear from last night.
A 26 year old female patient presents symptoms to physicians that are most likely psychogenic/anxiety related - the patient has decided to take a new natural medicine for whatever it is that is wrong with them. It seems to be working as their symptoms subside, the medics who are involved in the case do not discourage the patient to stop taking the natural remedy as they've decided the placebo effect has relieved her anxiety. Three weeks later the patient develops liver failure and dies, several years later after extensive studies have been performed on the plant extract it's realized that this plant can cause liver failure in patients taking combined oral contraceptives.
Now was this a failure of care, or a failure to find good data before recommending it's use?
It was a failure in EBM/data that lead to an unintentional failure in care, despite the best intentions of the medics they saw nothing wrong with the patient carrying on taking their herbal medicine - even though they knew very little about it's effects both positive and negative. Therefore they were unable to give the patient the best possible advice based on good data.
Care isn't a component of EBM....it's the other way round, EBM is a component of care. You can't make the best possible choice or inform a patient of their best choices without good evidence.
P.S This is almost a chicken and the egg scenario which I feel has no place in a multiple choice exam, it would have been better asked in an essay based exam.
Tell you what, use google scholar, look at what the peer reviewed papers say. If you see a difference of opinion then try to see if they can be reconciled. If not, then look at why there is this difference. Do they represent different world views?
Ow do people arrive at such different views?
Care isn't a component of EBM....it's the other way round, EBM is a component of care.
"What's the most important aspect of evidence based medicine..... data or patient care" Errrr data because you can't give patients good care without good evidence. That's the whole point of EBM. Her answer was patient care
So given that you've decided that EBM is a component of care, rather than the other way round, does that mean you are now in agreement with her?
/Edit scrap that question, just saw your postscript.
you failed the exam, didn't you?
P.S This is almost a chicken and the egg scenario which I feel has no place in a multiple choice exam, it would have been better asked in an essay based exam.
Well, f you don't know which of these came first then there really is no hope.
Worst kind of student. You were wrong, just admit it,it happens sometimes, just move on.
So given that you've decided that EBM is a component of care, rather than the other way round, does that mean you are now in agreement with her?
No because the question was "What's the most important aspect of EBM"...not "Why is EBM important".
Again as I said, I think it was utterly ridiculous that this question was asked in a multiple choice format.
Just to highlight why I thought the question was ridiculous....it turns out EBM doesn't work without any of the following three concepts being involved.
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So equal importance, which brings me back to my point....why the **** was this an MCQ?
3 questions were effectively trick questions who's choice of answers were open to interpretation - eg "What's the most important aspect of evidence based medicine..... data or patient care" Errrr data because you can't give patients good care without good evidence. That's the whole point of EBM. Her answer was patient care, apparently I'm on a nursing course not a Med Stats course.
Crikey. You don't know the answer? It's elementary! Of course it's patient care if you apply common sense. Everyone in UK knows that. It's so basic.
How can you apply all the bureaucratic answer of assuming the data being more important than patient care?
The question is so so simple you are [b]Not even able to prioritise the answer[/b]. Everyone knows patient care regardless of whether you got the data or not so long as they die happy with good patient care ... in the very unfortunate circumstances.
If you start to fluff around with data before patient care you miss the point completely as you are merely trying to cover yourself by blaming the data. Or you cannot apply common sense without available data for patient care, so when the computer says NOooooo ... you will run like headless chicken not knowing what to do.
Damn! You got that answer wrong? You failed! You don't even understand the basic. You failed! Damn!