Online teaching and learning is not a new phenomenon. For the last many years, it has been used but mainly as a part of face to face teaching. Assessment is an essential part of teaching and learning, as it establishes the achievement of course learning outcomes. Computer-based assessment, mainly summative is in place for a long time now, however, online formative and summative assessments have been less practiced. This is because of the issues of validity, reliability and dishonesty. During the COVID 19 pandemic, the educational environment has taken a paradigm shift in many medical schools, both nationally and internationally. This situation demands a method of assessment that is safe, valid, reliable, acceptable, feasible and fair. This paper describes the different formats of online assessment and their application in formative and summative assessments during and after the COVID 19 pandemic. doi: https://doi.org/10.12669/pjms.36.COVID19-S4.2795 How to cite this:Khan RA, Jawaid M. Technology Enhanced Assessment (TEA) in COVID 19 Pandemic. Pak J Med Sci. 2020;36(COVID19-S4):---------.  doi: https://doi.org/10.12669/pjms.36.COVID19-S4.2795 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Thirty-eight patients with mammary gland tuberculosis were evaluated over a 5-year period presenting to the surgical unit of our institution. Unilateral involvement of the breast in a woman presenting at an average age of 29 years was the commonest observation. A lump in the breast with or without discharging sinuses was the most common clinical presentation. Ten (26%) of these patients had breast pain with or without increased breast nodularity. Axillary lymph nodal involvement was evident in 14 (36%) of our patients. Only five patients had associated pulmonary tuberculosis, the rest having an isolated involvement of the breast. Fine-needle aspiration cytology was the most reliable diagnostic modality. Medical therapy with antitubercular drugs ranging from 6 to 9 months was the mainstay of treatment. Surgical intervention was reserved for selected refractory cases.

Objective:To determine the causes of medical errors, the emotional and behavioral response of pediatric medicine residents to their medical errors and to determine their behavior change affecting their future training.Methods:One hundred thirty postgraduate residents were included in the study. Residents were asked to complete questionnaire about their errors and responses to their errors in three domains: emotional response, learning behavior and disclosure of the error. The names of the participants were kept confidential. Data was analyzed using SPSS version 20.Results:A total of 130 residents were included. Majority 128(98.5%) of these described some form of error. Serious errors that occurred were 24(19%), 63(48%) minor, 24(19%) near misses,2(2%) never encountered an error and 17(12%) did not mention type of error but mentioned causes and consequences. Only 73(57%) residents disclosed medical errors to their senior physician but disclosure to patient’s family was negligible 15(11%). Fatigue due to long duty hours 85(65%), inadequate experience 66(52%), inadequate supervision 58(48%) and complex case 58(45%) were common causes of medical errors. Negative emotions were common and were significantly associated with lack of knowledge (p=0.001), missing warning signs (p=<0.001), not seeking advice (p=0.003) and procedural complications (p=0.001). Medical errors had significant impact on resident’s behavior; 119(93%) residents became more careful, increased advice seeking from seniors 109(86%) and 109(86%) started paying more attention to details. Intrinsic causes of errors were significantly associated with increased information seeking behavior and vigilance (p=0.003) and (p=0.01) respectively.Conclusion:Medical errors committed by residents have inadequate disclosure to senior physicians and result in negative emotions but there was positive change in their behavior, which resulted in improvement in their future training and patient care.

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Objective:To measure the level of awareness of patient safety among undergraduate medical students in Pakistani Medical School and to find the difference with respect to gender and prior experience with medical error.Methods:This cross-sectional study was conducted at the University of Lahore (UOL), Pakistan from January to March 2017, and comprised final year medical students. Data was collected using a questionnaire ‘APSQ- III’ on 7 point Likert scale. Eight questions were reverse coded. Survey was anonymous. SPSS package 20 was used for statistical analysis.Results:Questionnaire was filled by 122 students, with 81% response rate. The best score 6.17 was given for the ‘team functioning’, followed by 6.04 for ‘long working hours as a cause of medical error’. The domains regarding involvement of patient, confidence to report medical errors and role of training and learning on patient safety scored high in the agreed range of >5. Reverse coded questions about ‘professional incompetence as an error cause’ and ‘disclosure of errors’ showed negative perception. No significant differences of perceptions were found with respect to gender and prior experience with medical error (p= >0.05).Conclusion:Undergraduate medical students at UOL had a positive attitude towards patient safety. However, there were misconceptions about causes of medical errors and error disclosure among students and patient safety education needs to be incorporated in medical curriculum of Pakistan.