necessary to develop good assessment tools to evaluate the competence of our students. Our medical education department, therefore, changed its face to face workshops on 'how to create multiple choice questions (MCQs)' into online ones. It was the first time our medical education department had created questions online. | WHAT WA S TRIED?Cognitive apprenticeship concepts were adopted when designing and implementing the training workshop. We started with full instructions on how to use Zoom™ cloud (Zoom Video Communications Inc., San Jose, CA, USA) through video and a technical training session offered before the workshop. Video-recording of a lecture explained the guidelines adopted by the assessment unit regarding the MCQ design. A document including frequently asked questions regarding the design of MCQs was also disseminated 2 days before the synchronous meeting. During the meeting, we started by 'modelling' with a short presentation on how to write a high-quality MCQ. Then, 'coaching' and 'scaffolding' was achieved by dividing participants into groups based on their specialty, with each group having an online coach (facilitator). Using breakout rooms in Zoom cloud, each group worked together and received tips from their coach for correcting poorly constructed MCQs. One coach was assigned to each group of 3-4 trainees. 'Reflection' was then performed individually and asynchronously by sending the trainee an email containing a file of MCQs' designed by them previously' with a request to critique and reflect on their quality. Upon returning the file the trainee received feedback. Additionally, 'articulation' was performed by asking learners to write down step-by-step instructions on how to modify their previously constructed MCQs, leading to a second round of feedback. Finally, learners engaged in 'exploration' as they were asked to create new MCQs and send them via email for further feedback.The quality of the newly designed questions was judged against a checklist for assessing the quality of MCQs adopted, revealing newly designed MCQs that were higher in quality than those submitted pre-workshop. | WHAT LE SSON S WERE LE ARNED?1. Proper design of hands-on activities can change faculty staff minds. Offering multiple and different opportunities for hands-on ac-tivities to the trainee with constructive feedback can improve the outcomes of faculty development activities.3. It is important to provide appropriate scaffolding to faculty staff when they perform assigned activities to support their learning. 4. Providing additional experience to practice (and check ability to transfer newly acquired knowledge and skills) is valuable. 5. Unexpectedly, when we were able to achieve what had been done in previous face to face training sessions, trainees reported less interference and better participation was achieved by conducting the workshop online. O RCI DAyat Nabil Eltayar https://orcid.org/0000-0001-7177-1126

Background: Mental and psychological health of adolescents in general and prospective medical students in particular is a priority area to investigate as it affects wellbeing of the future doctors. Objectives: The current research was conducted to screen first year medical students accepted for enrollment at Alexandria Faculty of Medicine to identify those with a high probability of having psychological distress before the start of academic courses as well as explore the sources of stress among them. Methods.A cross sectional survey of 779 high school graduates accepted for admission to Alexandria Faculty of medicine was conducted. Participants were approached on the days of obligatory pre-enrollment medical examination. The translated Arabic version of DASS 21 questionnaire was used to screen students for three negative emotional symptoms namely depression, anxiety and stress. Inquiry about age, sex, residency and type of high school was added. Results: More than a tenth of studied medical students (12.6%) suffered from severe or profound stress and 29.1% of them had mild to moderate stress. Moreover, one fifth (20%) of studied students were severely anxious and less than one third (29.3%) had mild to moderate anxiety. Severe and profound depression was diagnosed among 14.3% of students whereas, 18.7% them were moderately depressed. No association was found between any of studied negative emotional symptoms and the students' educational background or their residency. Conclusion: Nearly half of the prospective medical students might have some sort of psychological distress before starting their study in the Faculty of Medicine. They should be investigated to verify diagnosis and start intervention to minimize its adverse effects on academic performance and advancement at the faculty. Stress management courses should be considered for all medical students.

Background A workplace-based assessment (WBA) is used to assess learners’ competencies in their workplaces. Many workplace assessment tools are available and validated to assess various constructs. The implementation of workplace-based assessment requires proper training of the staff. Objective This study aimed to explore the impact of staff training on WBA practices and evaluate the inter-rater reliability of these practices while using entrustment scales, performance descriptors, and personal judgment. Design A quasi-experimental study, in which the staff members of the orthopedic department were invited to participate in a training program on the use of entrustment scales and assessment descriptors within the WBA tools. As a response to the training, subjective judgment was replaced by entrustment scales and performance descriptors in a trauma course offered by the orthopedic department. The inter-rater reliability of the WBA was evaluated using various rating scales. Results The entrustment scales had higher inter-rater reliability of the assessment tools than performance descriptors and the personal judgment. Conclusion The inter-rater reliability was highest when using entrustment scales for WBAs, which could indicate that the entrustment scales achieve good psychometric properties as regards consistency among different raters. Thus, they decrease the confounding effect of differences in assessors. They may also give a clearer image of the actual academic level of the learners.

Background The concepts of online and blended education came into the limelight in the 19th century. Over time, the concepts expanded and reached a peak in 2021 in response to the COVID-19 lockdown. One of the challenges is the monitoring of the performance of distant learners. In face-to-face courses, an instructor can easily identify struggling learners during the regular meetings. Aim of the Study This study explored variables that can predict the academic achievement of learners early in online learning environments. Although there was no consensus, the factors were still hypothesized as predictors for academic achievement. Methods A quasi-experimental study was conducted to test the hypothesis. Thirty-three graduate learners were enrolled in a blended trauma course. The learners’ age, their previous experiences in online education, pre-test scores, and the number of logs to the online platform were studied. These elements were considered as predictors of academic achievement in the online aspect of the course. Results The findings revealed that there was no statistically significant correlation between the age, the previous experience in online education, the pre-test scores, and the number of logs in the first two weeks. However, there was a statistically significant correlation between the number of logs into the online platform in the first three weeks of study and the learners’ academic achievement. Additionally, the number of logs in the first three weeks was a statistically significant predictor for academic achievement in online education. This early prediction can help instructors to identify and support struggling learners. Conclusion The records of the online activity of learners in the first three weeks of study can help in early prediction of their academic achievement. Age, previous online education, and pretest scores were not statistically significant predictors.

Clinical reasoning is an important aspect in learning medicine. Due to social distancing in COVID-19 pandemic, clinical training of residents in orthopedic department in Alexandria faculty of medicine (AFM) faced many restrictions. The experiential learning cycle of Kolb was adopted in serious gaming platform. “Mediactiv platform” was used to create a case to teach clinical reasoning for orthopedic residents. Our experience guarantees that Virtual patients and serious gaming platforms can be used to teach clinical reasoning, replacing face to face discussions. AFM is the first medical school in Egypt to use a virtual patient platform to teach clinical reasoning for graduates in orthopedics. Our experience was beneficial as mentioned by staff and trainers.