Factors Associated with Anesthesiology Grade Assignments in 5th year Medical Students P Toomtong, B Sirivanasandha, S Lapmahapaisan, P Waitayawinyu, P Vichitvejpaisal, J Lertakyamanee. Department of Anesthesiology, Faculty of Medicine Siriraj Hospital Mahidol University, Bangkok, Thailand Research Question Which parts of the scores for 5th year medical students did make an effect of grade in Anesthesiology? The rotation is so short, they have to integrate their knowledge in basic sciences with clinical practice, have to participate in case-study, oral presentation of their patient, involvement in bedside teaching in the operating theatres for discussion, hand skills (mask ventilation and endotracheal intubation) and work as a team member, and the examinations in MCQs and Essay. The sooner or The later medical students have any effects on grading the checklist? The MCQs has been recycled three times a year, does it have an impact on the students’ grade? A trigger point: a D+ grade was given to one medical student last academic year. Summary of work The overall scores, all categories of the score, from bedside teaching, hand-on skills, reports, examinations (MCQs & essays), period of rotation, and set of MCQ papers were analysed with factor analysis. The scores from 470 medical students from academic year 2010 and 2011 were reviewed and entered to principle component factor analysis. Rotated factors were further analysed with linear regression analysis and final grade results were applied as an independent outcome. Table 1. Total variance explained with Principle component factor analysis Component Initial Eigenvalues Extraction Sums of Squared Loadings Rotation Sums of Squared Loadings Total % of Variance Cumulative % 1 2.375 14.847 1.676 10.474 2 1.648 10.298 25.145 1.568 9.802 20.276 3 1.451 9.069 34.214 1.551 9.696 29.971 4 1.297 8.106 42.321 1.537 9.604 39.575 5 1.173 7.330 49.651 1.321 8.253 47.828 6 1.107 6.922 56.573 1.249 7.804 55.632 7 1.026 6.409 62.982 1.176 7.350 8 .841 5.257 68.239 9 .779 4.870 73.109 10 .761 4.756 77.864 11 .742 4.636 82.500 12 .718 4.489 86.989 13 .604 3.778 90.767 14 .578 3.611 94.378 15 .486 3.037 97.415 16 .414 2.585 100.000 Table 2. Rotated factor component and factor loading Factor Score Factor loading 1. Self Bedside teaching 1 Report presentation Case Study participation 0.776 0.479 0.605 2. Decision Preoperative investigation Choice of anaesthesia Pain control 0.541 0.725 0.752 3. Situation Airway essay Crisis management MCQ examination 0.726 0.627 0.595 4. Skill Airway management Skill and Affective 0.819 0.736 5. Time of year Period rotation Bedside teaching 2 0.863 0.575 6. Preparation Preoperative Lists of MCQs paper 0.586 0.687 7. Problem Medical problems 0.876 Table 3. Final regression Descriptive Statistics Model Unstandardized coefficients Standardized coefficients t Sig. 95% Confidence interval for B Collinearity Statistics B Std.error Beta Lower bound Upper bound Tolerance VIF (Constant) -3.209 0.227 -14.150 < 0.01 -3.654 -2.763 Self 0.138 0.010 0.382 14.208 0.119 0.157 0.840 1.191 Decision 0.024 0.006 0.093 3.671 0.011 0.037 0.945 1.058 Situation 0.036 0.002 0.481 18.596 0.032 0.039 0.906 1.104 Skill 0.060 0.005 0.351 13.160 0.051 0.068 0.850 1.177 Time of year 0.023 0.873 0.383 -0.002 0.901 1.109 Preparation -0.009 -0.036 -1.438 0.151 -0.022 0.003 0.968 1.033 Problem 0.027 0.129 5.191 0.017 0.986 1.015 Results & Discussion The grade assignment comes from nearly all medical student works assigned by the department, they need active participation in bedside teaching and problem-oriented case study, have practise an oral report presentation. They need to learn an appropriate way to handle an unforeseen problem, choose necessary preoperative investigations, give a reason for a better choice of anaesthesia and plan for patient’s postoperative pain control. They must have a plan for an airway challenge and must be competent to manage respiratory or haemodynamics crisis. The clinical skills are also important as well as decision making skills.They need to integrate their basic science knowledge and their clinical medicine knowledge to have a bigger and wider picture of perioperative care of their surgical patients, not only focus on their airway management practise. The period of anaesthesia rotation earlier or later does not have an important effect on their grade earned. Take home message It is an individual medical student responsibility to earn a successful grade in the subject of Anesthesiology. Active Participation in both hand-on skills and bedside teaching Decision making process has to be encouraged in medical students, they should have made a plan for their surgical patients and gain more experience in this area. Vigilance is very important in anaesthesia practise, however, it is an essential part in crisis management, we wish to find a way to instill this idea to our medical students. 1. Bacon DR: Iconography in anesthesiology. The importance of society seals in the 1920s and 30s. Anesthesiology 1996; 85: 414-9