Browsing by Author "Seneviratne, R."

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Admission to medical schools in Sri Lanka: predictive validity of selection criteria
(Sri Lanka Medical Association, 2006) de Silva, N.R.; Pathmeswaran, A.; de Silva, N.; Edirisinghe, J.S.; Kumarasiri, P.V.R.; Parameswaran, S.V.; Seneviratne, R.; Warnasuriya, N.; de Silva, H.J.
OBJECTIVE: To assess the extent to which current selection criteria predict success in Sri Lanka's medical schools. METHODS: The study sample consisted of all students selected to all six medical schools in two consecutive entry cohorts. The aggregate marks of these students at the General Certificate of Education (GCE) Advanced Level examination, the district of entry, admission category, candidate type (school/private) and gender, were identified as entry point variables. Success in medical school was measured in four ways: the ability to pass the first summative examination and the final examination at the first attempt, and obtaining honours in either examination. Multivariate analysis using logistic regression was used to assess the extent to which these entry point factors predict variability in outcome measures.RESULTS: Aggregate scores among the 1740 students in the study sample ranged from 212 to 356, with a median of 285. The male:female ratio was 1.4:1. Private candidates (taking the examination for the third time) accounted for 22% of students. Being a school candidate, female and having a higher aggregate score, were the only independent predictors of success for all four outcome measures. The aggregate score alone accounted for only 1-7% of the variation in performance in medical school. CONCLUSIONS: Marks obtained at the A Level examination (the only academic criterion currently used for selection of medical students in SriLanka) is a poor predictor of success in medical school.
Energy expenditure and pregnancy outcome
(Sri Lanka College of Obstetricians and Gynaecologists, 2005) Abeysena, C.; Jayawardana, P.; Seneviratne, R.
OBJECTIVE: To determine the effect of energy expenditure on pregnancy outcome. Methodology: A prospective cohort study was carried out at Ragama and Ja-ela MOH areas. Eight hundred and seventy five pregnant mothers were recruited at 16 weeks of gestation (POA). Daily energy expenditure was assessed based on the activities indicated by the pregnant mothers in the Activity Record1 on two occasions during 20 (371 subjects) and 32weeks of POA (271 subjects) at home by housewives and both at home and at work by working mothers. On each occasion activities related to 3 different days were recorded. Average energy expenditure was calculated and >2550 kcal/day was considered as the cut off. Information on potential confounding factors was gathered on average at 12th, 28s11 and 36 POA. Pregnancy outcome was assessed in terms of maternal complications (MC) such as pre-eclampsia, ante-partum haemorrhage and gestational diabetes, pre-term birth , low birth weight (LEW), small for gestational age <10dl (SGA<1O) and <5th (SGA<5) centiles. Logistic regression analysis was applied and the results are expressed as odds ratios (OR) and 95% confidence intervals (95%CI). Results: Univarite analysis revealed that >2550 kcal/day energy expenditure during 20 weeks of POA was significantly associated with subsequent development of MC (OR6.86, 95% CP=2.38-19.76) and with MC (OR=1 1.03, 95%CFI.36-89.24), LBW (OR=O.05, 95% CI-O.006-0.36) and SGA<5 (OR=O.29, 95% CIO.10-0.87) during 32" xveek of POA. On multivariate analysis subsequent development of MC (OR=6.305 95% CI 21.94} and SGA<5 (OR=0.29, 95% CI = 0.09-O.96), remained significantly associated with high energy expenditure during 20 ' week of POA and 32"d week of POA respectively. CONCLUSION: High energy expenditure was a risk factor for maternal complications and a protective factor against the birth of a small for gestational age infant.
Limitations of current measures used for selection of students to medical schools in Sri Lanka
(Sri Lanka Medical Association, 2005) Pathmeswaran, A.; de Silva, N.R.; de Silva, N.; Edirisinghe, S.; Parameswaran, S.C.; Seneviratne, R.; Warnasuriya, N.; de Silva, H.J.
INTRODUCTION: Policy regarding selection of students for admission to medical school in Sri Lanka is considered unsatisfactory by many. This study was carried out across all six medical schools in the country, to assess the extent to which selected factors at point of entry predict success in medical School. METHODS: The study sample consisted of all students selected by the University Grants Commission to study medicine in two consecutive entry cohorts. The 'A' level aggregate marks of these students, the district of entry, gender and candidate type (school/private) we're identified as entry point variables. Success in medical school was measured in four ways: the ability to pass the first Summative examination and the final examination at the first attempt, and the ability to obtain a class in either. Multiple logistic regression was used to assess the extent to which these entry point factors Could predict variability in outcome measures. RESULTS: The mean 'A' level aggregate among the 1740 students in the study sample was 282 (range: 212-356). The male: female ratios were 1.5 and 1.3 respectively in the two cohorts. 22% of students were private candidates, who were probably attempting the 'A' levels for the third time. Having a high A'level aggregate, being female, and being a school candidate were all independent predictors of success in all outcome measures. However, the aggregate score alone and candidate type each accounted for only 1-7% of the variation in performance in medical school. CONCLUSION: The only measure of academic performance used for selection of medical students is a weak predictor of success in our medical schools.