Objective. To incorporate Bloom's taxonomy into multiple-choice examination questions in a pharmacotherapeutics course and assess its effectiveness in detecting areas of improvement in learning. Design. Bloom's taxonomy was incorporated into examination questions through a multi-step process: Sample questions representing each learning domain within Bloom's taxonomy (knowledge, comprehension, application, analysis, synthesis, and evaluation) were introduced to students during lecture presentations and discussions. Quiz and examination containing questions categorized according to Bloom's taxonomy were administered to students. During review sessions following each quiz or examination, the categorization of each question was provided to students and feedback from students was gathered. Assessment. The effect of the 5 types of test questions on the correct response fraction and discrimination index was determined after combining synthesis and evaluation. Correct response fractions for knowledge, comprehension, and application questions were significantly higher than those for analysis and synthesis/evaluation questions (p,0.05). However, discrimination index for application and synthesis/ evaluation questions were significantly higher than those for knowledge and comprehension questions (p,0.05). In interviews with students who had requested learning assistance, the majority realized the importance of critical-thinking skills in the learning process. Conclusion. Well-designed multiple-choice questions incorporating different learning domains of Bloom's taxonomy may be a potential method of assessing critical-thinking skills in large classes of students.
Dental education has undergone significant curriculum reform in response to the 1995 Institute of Medicine report Dental Education at the Crossroads and the series of white papers from the American Dental Education Association Commission on Change and Innovation in Dental Education (ADEA CCI) first published in the Journal of Dental Education and subsequently collected in a volume titled Beyond the Crossroads: Change and Innovation in Dental Education. An important element of this reform has been the introduction into academic dentistry of active learning strategies such as problem–based and case–based learning. As an aide to broadening understanding of these approaches in order to support their expansion in dental education, this article reviews the major characteristics of each approach, situates each in adult learning theory, and discusses the advantages of case–based learning in the development of a multidisciplinary, integrated predoctoral dental curriculum.
The eyes of 64 patients known to have neurofibromatosis were examined. Lisch nodules were the commonest manifestation of the disease and were present in 95% of all patients (100% of those aged 16 years or older). Neurofibromatosis was first described by von Recklinghausen in 1882.' A wide range of complications of the disease are now recognised, and it has become apparent that there are several forms of neurofibromatosis. The one described by von Recklinghausen is by far the most common and is now referred to as von Recklinghausen or peripheral neurofibromatosis. The other forms include central neurofibromatosis, the major defining features of which are bilateral acoustic neuromas with few if any cutaneous manifestations, and segmental neurofibromatosis, where the features of the peripheral form are confined to one segment of the body.2 Von Recklinghausen neurofibromatosis (NF) is an autosomal dominant disorder with a high mutation rate and a prevalence of around 30/100 000 of the population.3 There is no laboratory test for NF and the diagnosis is made on the basis of the major defining features of the disease-cafe au lait spots and cutaneous neurofibromas. Cafe au lait spots are flat light brown patches which vary in size from a few millimetres to several centimetres. They begin to develop at or soon after birth and increase in number and size throughout childhood. Some patients with NF also develop axillary freckling, a clinical sign unique to the disease. Cutaneous neurofibromas begin to appear about the time of puberty and increase in number throughout life. Approximately 25% of patients with NF develop complications which include plexiform neurofibromas, malignancies (of which neurofibrosarcomas and embryonic childhood tumours are the most frequent), scoliosis, congenital bone defects, and tumours of the central nervous system.4 The complications of NF that may present to the ophthalmologist are optic gliomas, plexiform neurofibromas Correspondence to Mr D Jones.
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