A computer-based test item-bank for cognitive assessment of medical students during a clinical medicine clerkship

The development and utilization of multiple-choice test items and the utilization of computer technology have significantly altered evaluation practices in medical schools. This paper describes the development and implementation of a computer-based multiple-choice test item-bank for use in a junior medicine clerkship. The computer program, ITEMBANK, is an interactive system that stores and edits test items and constructs and prints an original copy of each test. Tests can be produced almost immediately by the clerical staff and the total developmental costs have been minimal. The program has reduced the amount of teaching time required to develop tests, and has enhanced the learning of essential information by medical students and residents. Teaching staff and student response has been enthusiastic and positive. Statistically significant Pearson correlation coefficients have been obtained between student performance on these tests and clinical evaluation and NBME Part II scores. The program has made a valuable contribution to the improvement of evaluation procedures in the Internal Medicine clerkship.     

Breast-milk Jaundice

The syndrome of breast-milk jaundice, which often results in cessation of breastfeeding, maternal anxiety, and guilt, may be increasing. Research to date on pregnanediol, increased lipase, and free fatty acids as the causes of breast milk jaundice is reviewed. Variations in current treatment are presented and nursing measures supportive of parents and continued breastfeeding are provided.