Articles

High-quality collaborative discourse is essential for deep learning in Problem-Based Learning (PBL). However, novice facilitators frequently struggle with topic drift, which occurs when discussions deviate from core learning objectives. Grounded in Cognitive Load Theory and instructional scaffolding, this paper analyzes the cognitive mechanisms behind topic drift in PBL. It identifies three typical deviation patterns: "Premature Resolution" (bypassing mechanistic deduction), "Detail Fixation" (over-engagement with peripheral details), and "Social Avoidance" (stemming from dysfunctional group dynamics). To address these patterns, this paper presents a literature-based facilitation guide offering specific intervention strategies and discursive prompts. These include mechanistic backtracking, metacognitive monitoring, and cognitive visualization. The study argues that effective pedagogical intervention relies on the strategic timing of facilitation rather than the immediate correction of factual errors. Ultimately, built on a foundation of relational trust, this process requires educators to shift their role from "epistemic authorities" to "cognitive coaches."

<b>Background:</b> Tobacco endgame, defined as elimination of commercial tobacco sales The U.S. tobacco control landscape is a complex, adaptive system shaped by diverse stakeholders, evolving products and regulations, shifting social norms, and the strategic countermeasures of a powerful industry. Managing such complexity requires more than isolated interventions—it demands a coordinated, enterprise-wide approach that accounts for dynamic interactions, feedback loops, and emergent risks. <b>Objective:</b> Drawing on complex systems thinking, Zachman enterprise architecture model, and public health best practices, we conceptualize tobacco control as an evolving enterprise progressing through six interconnected phases: (1) Conception &#x26; Initiation, (2) Policy &#x26; System Design, (3) Implementation &#x26; Operation, (4) Evaluation &#x26; Adaptation, (5) Consolidation &#x26; Endgame Transition, and (6) Sustainment or Sunset. Each phase incorporates governance structures, performance benchmarks, and transition criteria designed to manage interdependence and reduce systemic vulnerabilities. <b>Results:</b> The lifecycle framing emphasizes how tobacco control in the U.S. can evolve as a complex, adaptive enterprise—integrating public health objectives with legal, operational, and cultural change processes. This model supports strategic sequencing, cross-sector alignment, and risk mitigation against emergent industry tactics, enabling a resilient and measurable pathway to the endgame. <b>Conclusions:</b> Seeing tobacco control as a complex enterprise that operates under a lifecycle model may offer a roadmap for achieving and sustaining the tobacco endgame. Using this approach may enhance policy coherence, resource efficiency, and adaptability, ensuring tobacco endgame is achieved.

This research is a collaboration involving a university team, a partnering corporation, and a hemodialysis clinic, which is a cross-disciplinary research initiative in the field of Artificial Intelligence of Things (AIoT) within the medical informatics domain. The research has two objectives: (1) The development of an <i>Internet of Things (IoT)</i><i>-based</i><i> Information System</i> customized for the hemodialysis machines at the clinic, including transmission bridges, clinical personnel dedicated web/app, and a backend server. The system has been deployed at the clinic and is now officially operational; (2) The research also utilized de-identified, anonymous data (collected by the officially operational system) to train, evaluate, and compare <i>Deep Learning-based Intradialytic Blood Pressure</i><i> (BP)</i><i>/Pulse </i><i>Rate (PR) </i><i>Predictive Models</i>, with subsequent suggestions provided. Both objectives were executed under the supervision of the Institutional Review Board (IRB) at Mackay Memorial Hospital in Taiwan. The system completed for objective one has introduced three significant services to the clinic, including automated hemodialysis data collection, digitized data storage, and an information-rich human-machine interface as well as graphical data displays, which replaces traditional paper-based clinical administrative operations, thereby enhancing healthcare efficiency. The graphical data presented through web and app interfaces aids in real-time, intuitive comprehension of the patients’ conditions during hemodialysis. Moreover, the data stored in the backend database is available for physicians to conduct relevant analyses, unearth insights into medical practices, and provide precise medical care for individual patients. The training and evaluation of the predictive models for objective two, along with related comparisons, analyses, and recommendations, suggest that in situations with limited computational resources and data, an Artificial Neural Network (ANN) model with six hidden layers, SELU activation function, and a focus on artery-related features can be employed for hourly intradialytic BP/PR prediction tasks. It is believed that this contributes to the collaborating clinic and relevant research communities.

Unfortunately, it is not disaster recovery, high availability, or cloud technologies that are inherently difficult to understand, but rather the action of implementing them for software applications that is difficult. The unique method of implementation for a microservices architecture is explored. Regulatory compliance doesn’t stop just because an effective disaster recovery requirement is tough to satisfy for infrastructure unique to sleek microservices. The high-availability location transparency bliss offered by a cloud solution is appealing to a security engineering department. However, the headache starts when the technology presents a handful of undesirable surprises that leak RESTful microservices to the outside world. These are the challenges that post-SOA cloud-resident robustly scalable applications will need to address and overcome. The goal is to explore several popular methods of accomplishing these tough objectives so that engineers can further research the most practical solution. An innovative implementation that leverages Service Bus relays as an elegant disaster recovery solution while enforcing a strict subnet where RESTful microservices solely live will be discussed. The curiosity lies in the atypical experimentation beyond basic gateways and the facility of using such simplicity while still answering day-to-day software development infrastructure challenges for applications we build. Resilient full-service web proxy service crashes and delivery latency switches by harnessing the microservices pod health will also be discussed [1].

The study aimed to examine the availability of protective clothing and its usage among workers at the University of Cape Coast in the central region of Ghana. It used the Accident-Proneness Theory and the Theory of Reasoned Action to achieve the study's objectives. The study adopted the positivist research paradigm. The study used a descriptive design with mixed methods. The study population comprised all workers and supervisors whose work demands the use of protective clothing at the University of Cape Coast. The study used multistage sampling techniques (stratified, purposive, proportional and Systematic random sampling techniques) to select one hundred and ninety-six departmental workers and five (5) supervisors in the University. The main instruments for data collection were a Semi-structured questionnaire and an unstructured interview guide. Mean and standard deviation, frequency count, and percentages were used to analyse the quantitative data. The qualitative data was analysed through the development of data categories and themes. The study concluded that “not all the protective clothing for the various departments were available. The University ensured that workers used what was in stock at the department. The protective clothing supplied to the various departments was insufficient, so their continuous use of the existing ones got them defaced, bringing about shortages. The study also revealed that workers used protective clothing most often, but not all used it because safety laws were relaxed. The study recommended that the University ensure a regular and adequate supply of PPC, insist on its usage, and enforce the use of PPC by all workers whose work demands it.

<b>Background: </b>Electrical injuries are underreported in literature, but they can affect the peripheral and central nervous system causing permanent disability. <b>Aims and objectives: </b>This case report aims to highlight cervical spinal cord injury secondary to electrocution, a rare cause of spinal cord injury. <b>Case report:</b> We report the case of a 54-year-old housewife who presented with transient loss of consciousness and right sided hemiparesis following electrocution, while at home. <b>Results: </b>The patient met clinical critera for partial Brown- Sequard syndrome, which to our knowledge, has not been previously reported. She showed significant improvement over a month and is currently under monitoring. <b>Conclusions:</b> Electrical injury is a rare cause of normal MRI myelopathy and the potential for immediate, delayed, and long- term neurological disability.

The role and contribution of women in modern organisations have been phenomenal. However, societal norms and other patriarchal values continue to stifle the progress of women leaders. The study's overall purpose was to examine the leadership styles of female leaders in managing senior high schools in the Central Region of Ghana. The study adopted non-numerical data and used a purely qualitative research approach. A phenomenological design supported the study framework, and the required data was collected through interviews. The target population for the study were female headmistresses and assistant headmistresses in the various Senior High Schools in the Metropolis. The study involved all six female headmistresses and eight assistant headmistresses in the Metropolis. The participants were sampled using the census to meet the study objectives. The data were analysed thematically. The study revealed that married couples use the participatory leadership style, but those who are single use the assertive style. The study also concluded that women leaders who are single and are farther from 60 years old are more likely to have problems in the discharge of their duties as leaders since men, per societal influence, will always try to resist the control of women leaders. The Ghana education service should package special incentives for women who aspire to achieve the utmost leadership role of becoming heads of senior high schools. It will motivate the young women generation. It is also recommended that women in leadership positions in the Ghana Education Service are advised to learn by updating their skills and competencies to grow in confidence and share ideas with colleagues in the same field to adopt and adapt leadership styles that have worked in other institutions to handle institutional challenges.

This study aimed to evaluate the Social Studies Curriculum for Senior High Schools in Ghana to determine whether the subject has attained its goal(s) or not, using Stake’s Countenance Evaluation Model. The study took place in the Asante Akim North District. The population for study were all Social Studies teachers and students in the district. The multi-stage sampling technique was adopted for the study and the sample size was 120, made up of 100 students and 20 teachers. The concurrent mixed method approach was adopted. The main instruments used for collecting data were questionnaires, interviews (focus group and unstructured interview), observation and documentary analysis. Quantitative data were tabulated, organised, analysed and interpreted to draw sound conclusions and generalisations. The data were presented in the form of tables and percentages. Words were used to interpret the tables and percentages for easy understanding. The qualitative data responses were described and explained in the form of themes. Sometimes responses were quoted verbatim to authenticate claims made. The study looked at the congruence between what was intended to occur and what was observed before and during the implementation of the curriculum in the Asante Akim North District. On the transactions, it was revealed that teachers in the district communicate the problem the topic seeks to address and the specific objectives to the learners during instruction. Also, teachers varied their teaching methods, techniques and strategies. However, teachers failed to take students out on field trips. Also, they failed to use video documentaries to deliver their lessons inhibiting students’ creativity as they are denied the opportunity to explore and get first-hand information to build up knowledge and develop the needed attitudes and values. From the findings, it is therefore recommended that the National Council for Curriculum and Assessment should increase the time allotted to the teaching of Social Studies at the SHS level from 3-periods of 40 minutes a week to 5-periods of 40 minutes a week to give teachers and learners ample time to discuss, debate, digest and solve problems during instructional hours to enable the goal of the subject attained.

The current financial services sector is realising considerable changes in its operations due to development in technology and embracing of digital platforms. This evolution is changing the established concepts of business, consumers and channels of delivery of services. Financial services firms are changing the way they work through digital transformation due to developments in technology, changes in customer needs, and an increase in emphasis on sustainability. Understanding the opportunities, risks, and new trends in digital transformation is the focus of this paper. Opportunities include efficient real-time decision-making processes, increased transparency and better process controls, which are balanced by the threats of change management, dubious organization-technology fit, and high implementation costs. The study also examines recent advancements, including the application of machine learning and artificial intelligence, developments in mobile and online banking, integration of blockchain, and increasing focus on security and personalised banking. A literature review yields some findings from different studies on rural financial services, the evolution of the blockchain, drivers of digital transformation, cloud-based learning approaches, and emerging sustainability practices. All of these results suggest that more strategic planning, analytics, and more focus on ensuring that organisational objectives are met with transformations should be pursued. Hence, this research findings add to the existing literature in determining how innovative and digital technologies are likely to transform the financial services sector and advance sustainability.

Machine learning operations (MLOps) comprises the practices, methods, and tooling that facilitate the deployment of reliable ML models in production environments. While many aspects of cloud data platforms are designed to enable reliability, only some managed ML services support the MLOps goals of continuous integration, continuous delivery, data lineage tracking, associated reproducibility, governance, and security. Furthermore, reliability encompasses not only the fulfillment of service-level objectives, but also systematic monitoring, alerting, and incident response automation. Architectural patterns are proposed to enable reliable deployment in cloud data platforms, focusing on the implementation of continuous integration and testing pipelines for ML models and the formulation of continuous delivery and rollout strategies. Continuous integration pipelines reduce the risk of regressions and ensure sufficient model performance at the time of deployment, while continuous delivery pipelines enable rapid updates to production models within acceptable risk profiles. The landscape of publicly available MLOps frameworks, tools, and services is also examined, emphasizing the pros and cons of established and rising solutions in containerization, orchestration, model serving, and inference. Containerization and orchestration contributes to the building of reliable deployment pipelines in cloud data platforms, whether general-purpose tools (e.g. Docker and Kubernetes) or solutions tailored for ML workloads. Containerized serving frameworks designed for high-throughput, low-latency inference can benefit a wide range of business applications, while auto-scaling and model versioning capabilities enhance the ease of use of cloud-native ML services.

The study is a follow-up of the study "Coronavirus in pregnant patients and their clinical outcomes – results of a case-control study" conducted by R.Kadriu et al (2023) in which,in addition to the pregnant patients whose outcome is now being investigated,a control group of patients who were not pregnant,conducted with pregnant patients and a control group that were non-pregnant patients.This study was conducted 6 months after the discharge of the patients and their newborns,and highlights the impact of COVID-19 on their health as well as the health of the newborns. The aim of the study is to follow up the patients after 6 months of their hospitalization as COVID-19 patients and after their delivery.In the COVID study, none of the health indicators showed statistically significant differences between the population before and after hospitalization.Patient data were collected at the case level summarized in their respective groups.For secondary objectives, several comparative analyzes were performed regarding comorbidity-related parameters and available risk factors.A significance level (α) of 0.05 was used for statistical significance. While these results may be reassuring regarding the stability of health status, one should be aware of the limitations of the study, including sample size and specific population characteristics.

The government of Mexico City carried out the introduction of palm trees in the 50s to increase the visual appearance of the main avenues. As a result of introduction of these exotic species, phytosanitary problems appeared. Currently there is scarce information on how to evaluate the health of these majestic monocots, in this sense, it is necessary to implement assessment scales to determine the health condition of the most frequently found species to advance on their care and management. The present study had the following objectives: 1) To determine the current state of health of palm trees by means of a scale of visual evaluation of the crown; 2) To know the diversity and structural characteristics of palm trees and 3) To determine the influence of composite variables on the ecosystem services such as the amount of shade provided. Health of palm trees were evaluated two times (dry and rainy seasons in 2022) on 35 transects of 200 m length. An imaginary circle divided into twelfths was overlapped on palm tree “crowns”, and through it, two absolute variables, Live Crown Ratio (LCR) and Crown Quality (CQ) were evaluated. Composite variables were also calculated. The 12/12 health scale adapted in the present study was useful. Four health categories were obtained for the Live crown ratio (LCR): 7.62% of the palm trees were in critical condition, 7.80% were in intermediate condition, 80.36% were in normal condition, and 4.20% were in excellent condition. Meanwhile, for crown quality (CQ), the percentages were 13.50%, 20.00%, 56.96% and 0.43%, respectively. The total height and “crown” diameter showed a positive correlation with the volume composite variables. The shadow area projected as an important ecosystem service increased as the health of the palm trees improved. This is the first study on palm trees health assessment in Mexico City.

The study was conducted to assess the antibacterial activity of <i>Phyllanthus</i><i> </i><i>amarus</i><i> (</i>Schum and Thonn) extract against <i>Salmonella </i><i>typhi</i> causative agent of typhoid fever at the laboratories of the Departments of Chemistry and Theoretical and Applied Biology of the College of Science, Kwame Nkrumah University of Science and Technology, Kumasi. The objectives were to determine the highest yield of crude extract of <i>P. </i><i>amarus</i><i> </i>using different proportions of water to ethanol and to determine the sensitivity of <i>Salmonella </i><i>typhi</i> to these. Three different extraction procedures were carried out. In the first procedure, seven extraction setups each containing different proportions of the two extract (water and ethanol) were used with 10g of the plant sample. In the second procedure, eight setups were used for the two solvents. Ten grams of both fresh and dry plant sample were extracted in two different 200ml of water and in another two different 200ml of water; 20g of both fresh and dry plant sample were again extracted. The same procedure was repeated using ethanol as the solvent. In the third procedure, 10g each of fresh plant sample were boiled in 100ml and 200ml of water for 30 minutes. A sensitivity test to determine the zones of inhibition for the various plant extracts was done on <i>Salmonella </i><i>typhi</i> isolated from human. Results from the crude yield of <i>P. </i><i>amarus</i> using water only had the highest crude yield of 2.57g, followed by ethanol only which was 2.52g. The sensitivity studies conducted on the fresh <i>P. </i><i>amarus</i><i> </i>indicated that aqueous extract of <i>P. </i><i>amarus</i><i> </i>inhibited <i>S. </i><i>typhi</i> to a zone of 5.00mm in 10g/200ml and 7.17mm in 20g/200ml. Ethanol extract also recorded an inhibition zone of 2.67mm and 5.33mm in 10g/200ml and 20g/200ml respectively. Again, sensitivity studies using dry <i>P. </i><i>amarus</i><i> </i>samples showed that the aqueous extracts recorded a zone of inhibition of 7.33mm in 10g/200ml and 13.50mm in 20g/200ml. Also ethanol extracts also recorded an inhibition zone of 6.83mm in 10g/200ml and 10.50mm in 20g/200ml. Significant differences were observed among the extracts and the control in both 10g/200ml and 20g/200ml concentrations (P<0.05). Aqueous and ethanol extracts of <i>P. </i><i>amarus</i><i> </i>proved inhibitory to <i>S. </i><i>typhi</i>.

This research is conducted with main aim of assessing the economic consequences of Covid-19 pandemic in Western Ethiopia. Primary data is collected through questionnaire and interview from 320 respondents living in three zones of Western Ethiopia. The study areas (zones) are selected purposively from Oromia region; however, the respondents are sampled by employing random sampling technique. The respondents were stratified as community members, daily laborer, business owners, government sector and NGOs employees. Exploratory research design was adopted to achieve the research objectives. Simple descriptive statistics and ordinary least square regression model are used to analyze and interpret the collected data. The study results disclose that majority of community have good awareness about the pandemic and social interaction is reduced due to social distancing. Majority of respondents realize the negative impact of Covid-19 on their economy; reduction of office services; and reduced access to market; and absence of strong support from the government. The great severity of Covid-19 impacts is failed on daily laborers. The regression result shows that sales, experience in business, education level in years, employment status of the respondent, number of workers in the business and work hours per week are positively and significantly influencing daily income of business owner before and after the pandemic outbreak. It is advised the stakeholders to give frequent follow-up and support particularly for daily laborers and small business holders to reduce the future socio-economic impacts of Covid-19 pandemic.

The purpose of the study was to examine the objectives and contents of Social Studies and its related challenges facing the Colleges of Education in Ghana The study adopted a quantitative research approach. The population comprises tutors and students of Social Studies in the three (3) Colleges of Education in the Central Region of Ghana. The purposive sampling technique was used to select the three Colleges of Education and twenty (20) Social Studies tutors. Krejcie and Morgan’s table was used to determine sample size two and forty-eight (248) students out of seven hundred (700) students. The main instrument for data collection was a questionnaire. The quantitative data entry and analysis were done using IBM SPSS Statistics software, version 22. Frequencies and percentages were used as statistical tools to analyse responses to all the research questions. The study revealed that students in the Colleges of Education of Ghana had had an understanding of the Social Studies programme in terms of objectives, content, and scope as well as the integrated nature of the subject and its usefulness in the resolution of social problems. . The study also indicated teachers who may not be well versed in specific topics in the subject and may either skip it or teach it anyhow. It is recommended that regular workshops and conferences be organised for Social Studies teachers of the Colleges of Education in order to update their knowledge on some topics especially current issues on the subject. It is also recommended that Social Studies teachers should be encouraged to engage the services of resource persons to support them teach unfamiliar or challenging topics to avoid polluting the pre-service teachers.

The purpose of the study was to assess teachers’ knowledge in integrating affective domain in teaching and learning of Social Studies lessons in the junior high schools in Aowin Municipality. A quantitative approach and survey research design used the study. The study population constituted Social Studies teachers in the 40 Junior High Schools in the Aowin Municipality of the Western North Region of Ghana. Simple random and convenient sampling techniques were used to sample the respondents of the study. The sampling technique was to ensure the representativeness of the sample. The study used structured questionnaires to collect the data. Descriptive statistics in the form of percentages was used in this study. SPSS was used to analyse the data. The study concluded that the Social Studies teachers have some level of knowledge of the principles of developing affective test items. The study also indicated that Social Studies teachers in the study area can define affective objectives in behavioural terms and have some level of knowledge of the principles of developing affective test items, they do not teach the affective domain. It is recommended that, Coordinators for junior high schools and the headmasters (academic) should ensure that affective objectives are inculcated in the general lesson objectives of Social Studies teachers. Intensive in-service training should be ran for Social Studies teachers to equip them on the formulation of affective objectives. It is also recommended that in service training should be organised by the education directorate in the municipality to train teachers in the teaching of lessons involving the affective domain. The headmasters, as well as the coordinators for junior high schools, should monitor whether teacher’s qualification reflect in the teaching of the social studies lessons that involve the affective domain.

The purpose of the study was to examine Social Studies teachers’ knowledge in the implementation of Social Studies lessons in formative assessment practices in Asante Akim North Municipality in the Ashanti Region of Ghana. The study employed both descriptive and interpretative techniques. The population for the study consisted of all Social Studies teachers and students in the Senior High Schools in the Asante Akim North Municipality of the Ashanti Region. Purposive, convenient and simple random sampling techniques were used to select the schools, teachers and students for the study in all, seventeen (17) Social Studies teachers and fifty (50) students were selected from six (6) Senior High Schools. The main instrument for data collection observation, interview and focus group discussion. The study revealed that not lessons presented were in line with the general objective of the subject (Social Studies). This affected the students understanding of concepts in the subject in helping them to right wrong their decision making. The study also indicates that teaching and learning Social Studies should not be one-man affair, with the teacher doing all the talking and the students doing all the listening. It is recommended that Ghana Education Service should organise workshops and in-service training for Social Studies teachers at the Senior High School level on how to present and evaluate social Studies lessons in order to realise the goals and objectives envisaged for national development. It is also recommended that teachers who have the exposure of the subject and are equally qualified to teach it at the Senior High Schools but are found teaching at the basic level, should be allowed by the Ghana Education Service to teach the subjects at the Senior High School level. The Government of Ghana should make it a laid down policy for the recruitment of qualified Social Studies teachers to teach at the Senior High School (SHS) level for effective assessment in the classroom.

The purpose of this study was to examine the effects of Subject Conception and Efficacy Beliefs on the Teaching Effectiveness of Social Studies teachers. The study focused on how teachers’ conception of Social Studies affect their sense of efficacy and ultimately their teaching effectiveness. The study adopted a non-experimental descriptive design to achieve its objective. The population for the study comprised of fifty-two (52) JHS Social Studies teachers. In this study the accessible population was the same as the target population. All the fifty-two (52) teachers teaching Social Studies in the Tano South district were used for the study. Purposive sampling technique was used to sample the respondents for the study. The data for the study was collected using the observation guide, questionnaire and teacher sense of efficacy scale adapted from Tschannen-Moran and Hoy, (2001). Mean, percentages, ranges and correlation were used to analyse the data using SPSS. The findings of the study showed that majority of the Social Studies teachers conceived the subject as citizenship education. Teachers’ also rated their sense of efficacy very high. However, the study revealed that most of the Social Studies teachers teaching effectiveness was low. The low teaching effectiveness would affect the realisation of the objectives of Social Studies. Also, there exist low correlation between teacher efficacy and teaching effectiveness as well as subject conception and teaching effectiveness. The correlation between teacher efficacy and effectiveness was weak and as such it is recommended that there should be a concerted effort to update and upgrade teachers’ knowledge with strong pedagogical skills and better understanding of the task of the Social Studies teacher through workshops and short courses.

The concept of the green economy is one of the global strategies to face contemporary societies' economic and environmental crises. Methodologically, the conceptualization, objectives, implementation, and criticism of various sectors of society to this new economic paradigm are addressed. It was found that authors and civil organizations have great expectations in the face of the challenges and challenges of this global strategy that has within its objectives sustainability, the eradication of poverty, and the inclusion of vulnerable social sectors. It is concluded that the green economy can contribute to maintaining a healthy environment and the proper use of ecosystem services, both for the present generation and for future generations.

<b>Background and aim:</b> Developing clinical skills and its assessment is one of the most important components in nursing education which prepares the student for the reality of practice. Objective structured clinical examination (OSCE) is extensively used and widely accepted by nurse educators across the globe to assess the competency skills of nursing students. The present study aimed at identifying the attitude and perceptions of faculty, and exploring their feedback and experience in conducting OSCE as an assessment tool. <b>Methods:</b> A triangulation research approach was used with convenience sampling. Data collection was carried out using questionnaires and semi-structured interviews. Participants were ten faculty members who were involved in conducting OSCE for students. <b>Results and conclusion</b>: Most of the faculty felt that OSCE reflected the skills of delivery of safe patient care, and the structure reflected mastery of knowledge and skills, which are related to course objectives. OSCE was regarded by the faculty as a consistent, reliable, valid, and objective measure to assess students’ performance and to improve students’ confidence in clinical skills. Concerns were raised about a high level of stress in students, the time required for the proper performance of tasks, OSCE scenarios lacking real-life situations in assessment, and the need for repeated practice and intensive mock training sessions. The applicability of OSCE in terms of limitations in human and material resources with a large number of students would necessitate rethinking in developing other assessment strategies to improve the overall process.