The details of these assignments are as follows.

All Assignments are online and must be submitted online through ”Learn”, the online course management system. Please do not submit any assignment over email, or do not provide us with hard copies or printouts. We do not need them, we do not encourage you to do so. For the third assignment in particular, you do not need to hand in a printed hard copy of your assignment. Also, please follow the templates provided. For the Third Assignment, also use only PDFs, do not submit Word documents.

Supporting Literature

For Assignments II and III, you are encouraged to utilize a wide range of up-to-date literature within their assignments. You should use peer reviewed scholarly articles referenced correctly in APA style wherever possible (rather than citing websites). In the course, we do not recommend or prescribe any evidence based textbook, and we shall provide you with a list of readings that you will need to read.

Assessment 1: Mid-Term Test

This is an online multiple choice quiz in Learn. We shall administer the test online with 35 multiple choice questions that you are expected to complete in one hour. The examination will be open from 9 AM - 5 PM, 7th April, 2017. This test is worth 35% of your total grade.

You can take the examination in any of the following places:

Computer Laboratory at the University of Canterbury
Home
Any UC Library
Any other place where you can access the Internet and use a PC/Laptop/Tablet Device, including in the designated classroom

This examination is worth 35% of the total grade and will have 35 questions. Each question is worth one mark. We will cover all topics taught in the first term (see the list of lectures). The test will have 35 questions. Each question will have a ”stem” and five options. The stem means it is either a statement or a question. Next to the stem we shall post five answer options. Only one out of five options is the correct answer. If you choose the correct answer, you will get the full mark, which is one. If you do not choose the correct answer, you will score zero for that question. We shall add up the correct answers and the total will be out of 35; your mark for the test. Answering all questions is compulsory.

The duration of the test from start to finish will be 60 minutes (one hour). You will have to finish the test within this time. After 60 minutes, the test will cut off and post the number of entries that you made for marking. In order to take the test, you must access a site and a computer that is connected to the Internet and use a web browser so that you can view and take the test on Learn. If you face technical problems such as power outage or Internet outage during your attempt, or if you face any other unforeseen circumstance after you begin the test, you must inform us so that we can take steps to address the problem. You can contact Arindam Basu by voice or text at 0226290356 or you can email him at arindam.basu@canterbury.ac.nz

Sample Question:

Which organ is indicated by the term ”cardiac”?

A- Lung
B-Liver
C-Kidney
D-Heart
E-Brain

The correct answer for this question is ”D” (Heart). If you select ”D”, you will score 1. If you select any other choice that is A, B, C, or E, you will get a score of 0. Only one correct answer is possible.

Please note that you will only have one chance to appear for this examination. We will not provide a remedy test if you fail to appear for it. If you fail to appear for this test on time, or do not ”begin the test”, then you will score a 0 for this assessment. If you begin the test but face technical difficulties (for example power or Internet outage, health related difficulty, or another unforeseen problem after you have started taking the test), please inform us either by calling over phone, or texting or other means (we will know from the examination logs whether you started your attempt or not). We will consider your situation. If you are ill or otherwise you think you have a valid reason for which you cannot take the test, please apply for special considerations. For more information on this, please see http://www.canterbury.ac.nz/exams/special-consideration.shtml

Assessment II: Forum Posts

The second assessment is based on forum posts. This assessment tests how well you can relate your everyday experiences and interactions with what you have learned in the class. For this we shall use the forum feature on Learn. Each discussion topic that you will write is based on a ”theme” described below.

In this assessment, you will participate in an online group discussion/debate in two parts.

Between 20th March and 7th April, 2017. You will discuss the following:

“What does Evidence-Based Practice Mean for Me?”

Between 15th of May and 2nd June you will discuss:

’Evidence-based & Person-Centred Care are at Odds with Each Other’

You should be able to write your own position and answer the questions with appropriate references. You must also be ready to engage in online discussions with your classmates. You must produce "evidence" for all facts you state by citing a paper published in a peer-reviewed journal or a book, rather than a website (for example an article published in Online Stuff or another newspaper without critically examining it). As this is a forum post or online contribution of ideas, we do not expect any specific format to write your citations, but the convention of the University of Canterbury is to use APA 6th version. For these forum posts, there is no word limit, although you should try to be brief.

We will grade your submission based on the quality of your written responses. For each of the two questions, you must write a minimum of one post and a maximum of three posts per question. This means to each question, you must write a minimum of one post and a maximum number of three posts between the times indicated. You will not be able to write any post on the topic after the date and time expire, so be mindful of the time constraints.

In responding to these questions, remember that there is no right or wrong answer. Take it like a debate and you can take any position. For example, in response to the second question, you can argue that Evidence and Person-Centred Care are opposite of each other and the two are incompatible as Evidence is about populations and groups of people and we cannot draw conclusions pertaining to one person. Or, you can also argue that as paying attention to a patient's individual circumstances and shared decision making is an integral element of Evidence-based health, Evidence based health and personalised medicine are really complementary to each other, and not at odds with each other at all. Then cite appropriate responses to justify your position. Not only this, you can also state that this question may not be relevant at all, as evidence appraisal must be included within personalised care. You can argue in the context of New Zealand health care, but do not be confined to NZ alone. Think of a global context and indeed we encourage you to think of examples from other countries.

So to summarise, here are the rules of participating in this debate/discussion:

You must post a minimum of one post and can post a maximum of three posts for each question. Response to one of your class mates will be considered as a post.
We will not allow more than three posts. We will allow only the first three posts from you in chronological order to mark, and will remove the subsequent posts on the same topic.
You must write your responses to both questions. If you participate in only one debate and not in the other, you will be marked on 50% of the assignment. If you do not participate in any debate at all, you will get no mark at all.
You must write between the dates posted. The forum software will not allow you to post any comment outside of the dates and time posted, and we cannot accommodate any request to allow you post outside of these dates.
Your response must be backed up by evidence and arguments. Evidence here means that you should cite a research paper published in a peer-reviewed journal or a book. You can cite and hyperlink newspaper articles and blogs, but these will not be counted as evidence for the purpose of this assignment.
We encourage you to interact with other students, and respond to other students’ arguments and debate their points.
When you interact with your classmates, you must be polite, civil, and must not "attack" or harsh with comments.

Note:

If you answer only one question (even if you submit 3 posts) you can only get a maximum of 50% (because you have only answered one question, so only completed half of the assignment). If they answer both questions they can get up to 100%

In marking your posts, we will mark on the basis of the following the three points for each post are:

Have you answered the forum question?
Have you made a clear argument?
Have you provided strong evidence to support this argument?

Strong evidence base means citing evidence from peer-reviewed journals or books (rather than websites or news articles). See the course outline.

Assessment III: Evidence Appraisal

This component of the evaluation will test your ability to apply everything you learned in the course. You will use this knowledge to solve or address a well-defined clinical or public health type of question. This component of the course will account for 45% of the overall grade. We will mark this assessment out of a total of 45 marks. You will only need to submit this assignment on Learn. If you fail to submit this assignment on time on Learn, you will need to ask for permission for extension ahead of time. The late penalty will be as follows. A 5% deduction in the mark will be done for every day late, so if one day late the mark is actual mark*0.95, 2 days late actual mark*0.90 and so on. If you think you have a valid reason for not being able to submit this assessment, you can ask for special considerations. Please see the relevant website for how to apply for special considerations.

What You Will Have to Do:

Please follow the steps described below to guide “your clients” to arrive at evidence based decisions.

Step One: Study the list of problems posted below and select only one problem. Study each problem and decide your response. Based on your understanding of the problem posed, construct a key question that you will work on. This is your first step.
Step Two: Convert that question into a PICO format (you will learn what PICO format means in the course)
Step Three: Use the PICO formatted question to search pre-appraised and non-pre-appraised databases. You will learn more about these in the searching literature section of the course. Remember to write down your search terms, the databases searched, and the results you obtained.
Step Four: Target to retrieve evidence summaries & systematic reviews or meta analyses first. If these help you to answer your query, that should be sufficient for you to go to the next step. If you do not find that evidence summaries &/or systematic reviews and meta analyses are enough for you to answer your question, search for primary studies. Limit your search for Randomized controlled trials or Cohort and Case Control studies only. Obtain full texts of the summaries, reviews and primary, studies.
Step Five: Use the http://gradepro.org – the Online Gradepro Tool to construct evidence summaries based on your findings and grade the level of evidence. Remember that in Evidence Based Health, there is no such thing as “absence of evidence”, or “lack of evidence”, you may have low confidence in the evidence presented or high confidence in the evidence presented. Use the Gradepro tool to appraise the levels of evidence in the literature you have retrieved and at the end of Step Five, you should be able to write whether the cumulative evidence on the problem you have decided to work makes you confident enough for an answer or not.
Step Six: Now put all of that information together and write a text of no more than 2500 words (the word count excludes words in the title, words in the tables and figures, words in captions, and words in references). So, the phrase “word count” here indicates all words that you will write in the body text and section headers. You should not exceed 2500 words in your text. The purpose of this text will be to respond to the request and answer the question posed. Your text will contain information on the background of the problem and your understanding of it, the process of putting together the evidence that you have followed (see steps one through five above), and your interpretation of the findings. This text must be accompanied by proper attributions and citations and references. You can include as many tables and figures as you like. Please use the template provided in the assignment page. You can also use the Overleaf template and export from Overleaf to a PDF document.
Submit through the Learn submission system as a PDF document. If you use Word, convert it to PDF, and submit.

List of Problems

An International NGO has provided funds to your local community to establish “programmes” aimed at cognitive development of children. One of the ideas that the NGO has indicated is to promote breast feeding among mothers, based on the perception that infants who are breast fed, compared with infants who are formula fed, show signs of better cognitive development in primary school. The NGO would consider performance of the children in primary school as their critical outcome. The community members have approached asking you if you can you provide an evidence appraisal whether breast feeding of infants lead to better cognitive performance?
Patrick is a nine-month old infant and is diagnosed with profound hearing loss. The specialists have advised that he should undergo cochlear implant (CI) surgery right away. This, along with speech therapy is indicated to restore Patrick’s hearing and development. CI is an expensive procedure and technically demanding with implications of lifelong care of the recipient. Patrick’s parents cannot afford the cost of surgery, and the community is raising funds to pay for the surgery. The community members have also read somewhere that CI, if done between 12-24 months is as effective for hearing and development/learning of children as if it were done at 12 months or less than 12 months of age. The community members feel that if the surgery can be deferred till 12-24 months of age, it may make it easy for them to pay for the costs. For Patrick’s parents, their child’s hearing restoration and cognitive development is critical to decide whether they should go for surgery. Can you provide an evidence based appraisal of how effective is CI for infants, done at 12 months versus at older age, with respect to restoration of hearing and further learning?
Josh is a 20-year old builder and is a regular smoker. He smokes a pack a day and lately he complained of craving for smoking when he wakes up in the morning. He was advised to use Nicotine Replacement Therapy and his treatment would be subsidized. Despite this, he does not want to use NRT because he thinks NRT causes heart disease and increased risk of death from heart disease. He needs evidence based information about whether NRT really works for smoking cessation and that whether the risks will outweigh his benefits. He is concerned about giving up smoking but also does not want to suffer from heart disease. Can you advise him on the evidence of the relative benefits, and harm of nicotine replacement therapy for smoking cessation?
Mr Pratt is a Principal of a primary school (students aged 5-11 years) in your community and he is dismayed that over half of his students in the school are obese. He wants to apply for funds to start school based interventions that will lead to less overweight and obese children in his school. The funding board is not convinced that school based interventions lead to a reduction in obesity among schoolchildren or justify the expenses. Can you provide an evidence base examining the role of school based interventions as primary school level that may lead to fewer obese children?
Peter is a 45 year old builder and suffers from Asthma. He recently read about the Buteyko method or breathing exercises and would like to find out about its effectiveness for patients like him. What can you advise him on the effectiveness of breathing exercise for patients with asthma?

Due date: 2nd June, Friday, 5 PM . Submit Online through Learn course website ONLY as a single PDF document. You are only allowed to submit one file.

Templates and Overleaf

You are required to use the templates to write your third assignment. The templates are available for Word and on Overleaf. Review the Assessment page on Learn for more information.