Objective. To investigate students' metacognitive skills to distinguish what they know from what they do not know, to assess students' prediction of performance on a summative examination, and to compare student-identified incorrect questions with actual examination performance in order to improve exam quality. Methods. Students completed a test-taking questionnaire identifying items perceived to be incorrect and rating their test-taking ability. Results. Higher performing students evidenced better metacognitive skills by more accurately identifying incorrect items on the exam. Most students (86%) underpredicted their performance on the summative examination (actual573.6 6 7.1 versus predicted563.7 6 10.5, p,0.05). Student responses helped refine items and resulted in examination changes. Conclusion. Metacognition is important to the development of life-long learning in pharmacy students. Students able to monitor what they know and what they do not know can improve their performance.

To determine the reproducibility of the first phase insulin response to intravenous glucose, ten normal subjects underwent two intravenous glucose tolerance tests separated by at least two weeks. Intravenous dextrose (0.3 g/kg) was administered over 2 min by continuous infusion and arterialised-venous samples were taken from a retrogradely cannulated hand vein in the opposite arm. Within subjects, median coefficient of variation for the 3 min insulin was 4.0% (range 1.2-24.3%) and median coefficient of variation for the 0-10 min area was 6.7% (range 1.7-18.8%). These coefficients of variation are close to those of the assay itself (less than 10%). Despite this, between subject responses varied by greater than sixfold. In conclusion, contrary to previous reports the intravenous glucose tolerance test is highly reproducible. This makes it a very valuable tool for further studies of the pathogenesis of diabetes.

These provincial benchmarking data provide direction for maintaining and expanding community pharmacist-provided influenza immunization.