Authors:Naif Sannan et al. Abstract: Purpose. Online education was an inevitable approach during the COVID-19 lockdown period. We aimed to determine the effect of online learning on assessment results in courses containing practical learning objectives delivered during the pandemic. Method. A retrospective analysis was performed on the assessment scores in courses conducted during the lockdown and on-campus years. Accumulative and objective structured practical examination scores were used as outcome measures for academic performance. Courses were categorized into pure practical, theory + practical, and pure theory. Results. This study showed that online education increased student scores as evidenced by a higher P-value in theoretical ( PubDate: Tue, 17 Jan 2023 06:42:19 PST
Authors:Crystal Deas et al. Abstract: Purpose: Academic stress is a well-known component of life as a healthcare professional student, with the COVID-19 pandemic ushering in additional challenges. This study investigated trends in perceived stress, in relation to demographic and lifestyle choice variables among pharmacy students, during the initial months of the COVID-19 pandemic, at a U.S. school of pharmacy. Methods: A cross-sectional, descriptive study was conducted at Samford University’s McWhorter School of Pharmacy utilizing a web-based questionnaire that was distributed to all enrolled second-, third-, and fourth-year Doctor of Pharmacy students. The survey instrument contained 22 items and was arranged into three sections to characterize demographic information, lifestyle choices, and perceived stress – using the validated 10-item Perceived Stress Scale (PSS-10). Results were analyzed using SPSS. Results: A total of 332 students were invited to participate in the study. One-hundred fifty-seven responses were received (47.2% response rate). The median (IQR) Perceived Stress Scale (PSS-10) score of students was 22 (4.0), suggestive of a moderate level of perceived stress. There were no respondents with a PSS-10 score of 0-13, which would indicate low perceived stress. Thirteen (8.2%) students reported a PSS-10 score of ≥27, which is suggestive of a high level of perceived stress. Most students reported positive lifestyle choices (e.g., 75.2% reported sleeping 6-8 hours per night and 60.5% exercised 6-8 hours per week). In the analysis of mean rank PSS-10 score by demographic and lifestyle variables, a statistically significant difference was noted only by gender (p= .009), with the female gender reporting a higher mean rank PSS-10 score. Discussion: Despite engagement in positive lifestyle choices (i.e., routine exercise, adequate sleep, and social engagement), trends in perceived stress did not differ significantly from those respondents who reported more unhealthy behaviors (i.e., no exercise, insufficient hours of sleep, and social isolation). Timely study of factors that can positively influence student wellbeing are warranted. PubDate: Tue, 17 Jan 2023 06:42:14 PST
Authors:Keshrie Naidoo et al. Abstract: Purpose. To explore the effect of virtual mentoring on (1) the development of cross-cultural psychological capital among a group of mostly White health sciences faculty mentors and (2) the effect of perceived competence in mentoring for second-year peer mentors from minoritized backgrounds enrolled in health sciences programs. Method. This mixed-methods study leveraged an explanatory sequential design with quantitative (survey) data collected before qualitative data (focus group interviews). Four first-year physical therapy students and four first-year nursing students were each matched with a faculty mentor and a peer mentor from a minoritized background. Seven peer mentors and eight faculty mentors completed professional development and formed professional learning communities before guided e-mentoring interactions with mentees over six months. Eighteen faculty formed a comparison group. Results. Perceived competence in mentoring increased among peer mentors who tended to emotion as first-year mentees were isolated and frustrated during the pandemic and racial uprising in the country. Peer mentors also took responsibility for discussing race in the classroom if not addressed by faculty. Faculty mentors developed increased cross-cultural psychological capital compared to the comparison group and gained the confidence to engage in racial dialog in the classroom. Discussion A six-month e-mentoring program resulted in an increase in peer mentor self-efficacy as well as increased cross-cultural psychological capital among health sciences faculty mentors. Faculty described that the skills learned through cross-cultural mentoring could translate to other aspects of their professional role, including engaging in dialog about race in the classroom. Peer mentors described that when faculty shied away from talking about racial incidents, the burden fell on them, which was taxing. While faculty mentors felt that e-mentoring was effective, peer mentors still valued in-person contact with faculty outside the classroom, promoting belonging in higher education. PubDate: Tue, 17 Jan 2023 06:42:09 PST
Authors:Evan V. Papa et al. Abstract: Purpose: The embrace of technology-mediated learning environments for physical therapist education has perpetuated a natural shift toward blended online and hybrid learning environments. Yet understanding how students in graduate level physical therapy programs perceive distance learning remains unexamined. The purpose of this study was to examine students’ perspectives of a distance learning (DL) course delivered via synchronous videoconferencing within a traditional campus-based doctor of physical therapy (DPT) program. Method: A convenience sample of 150 first year DPT students was collected. All students were present on-campus in Pocatello, and Meridian, Idaho. The instructor was located on-campus in Meridian. Student perceptions were examined using a survey given on the first, and last days of a clinical kinesiology course. The survey consisted of favorable and unfavorable questions regarding the use of DL each rated on a five-point Likert scale. Descriptive statistics and tests of two proportions with z-scores were used to analyze survey results. Results: Most students preferred traditional in-person learning environments (74.5%). Students reported difficulty contributing to in-class discussions, with the percentage increasing from baseline compared to the end of the course (∆10.1% z= -2.14, p=0.03). Many students (57.8%) disagreed with the idea that DL negatively impacts grades. Discussion: Contemplation of the pre and post changes of students’ responses to the survey seem to indicate: 1) students can adapt to DL, even when not preferred, and most do not believe it negatively impacts their grade 2) students do not consider the technology a barrier to their learning and some learned to enjoy it 3) learning strategies must adjust when the instructor and students are physically distant. Further research is warranted to better understand the skills necessary to effectively engage students in synchronous videoconference formats. PubDate: Tue, 17 Jan 2023 06:42:04 PST
Authors:Michael R. Jiroutek et al. Abstract: Purpose: The purpose of this study was to compare statistical knowledge of faculty who teach statistics (versus those who do not) in accredited health science schools (dentistry, medicine, nursing, pharmacy and public health). Methods: A stratified probability sample of accredited schools was selected, and all faculty at each selected school were invited to participate in an online survey assessment of fundamental statistical topics. Results: A total of 708 faculty from 102 schools participated. The overall response rate was 6.5%. Seventeen percent of faculty who reported teaching statistics had taken two or less statistics/biostatistics courses. Among the faculty who reported teaching statistics, the average score on the eight-question, multiple-choice assessment was 84.7%, with 37.2% unable to score higher than a ‘C’ grade. Among faculty not teaching statistics, the average assessment score was 62.1%, with 77.7% unable to score higher than a ‘C’ grade. Discussion: Statistical knowledge is critical for researchers/scientists to function knowledgeably and ethically in the current evidence-based Information Age. These study results reveal limited statistical training of health educators and concerns regarding the knowledge of those same health educators responsible for instructing the next generation of health science professionals. Recommendations for addressing these issues are provided. PubDate: Tue, 17 Jan 2023 06:41:59 PST
Authors:Virginie Servant-Miklos et al. Abstract: The world is already facing the consequences of climate change and biodiversity collapse, yet current trends suggest a far more difficult future in which the existence of human civilization is at stake. This commentary addresses the PBL community's lukewarm engagement with sustainability questions with a friendly warning. Unless PBL practitioners and scholars take the full measure of the emergency and change in proportion to the threat, PBL risks becoming irrelevant. Several avenues for changing PBL in a more sustainable direction are suggested, but this commentary is an invitation for all PBL scholars and educators to come together and bring forward ideas to effect change. PubDate: Tue, 17 Jan 2023 06:41:54 PST
Authors:Ramy Ameen Fodah et al. Abstract: Purpose. Assessment drives learning, and one assessment tool cannot measure all students learning competencies. Thus, multiple methods of assessment were developed to address this matter. This study aimed to measure whether in-classroom theoretical knowledge impacts students’ mastery of practical clinical skills and whether a strong association between the two parameters exists.Methods. A retrospective, correlational study design was conducted to examine the correlation between the theoretical knowledge (assessed by final written MCQs examination) and students’ practical clinical skills (assessed by OSCE and/or OSPE). Two batches of male and female students (a total of 478) were included in the study from the nine programs offered at College of Applied Medical Sciences (CAMS) at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS).Results. Interestingly, moderate to strong correlations were observed between the theoretical and practical skills assessments across the nine programs. However, there were no consistent differences in the correlations when the subjects were stratified by gender nor by third- and fourth-year courses. The study also came across a couple of interesting findings in which both male and female students performed better in practical skills than theoretical knowledge assessment. Moreover, female students’ performance exceeded the male counterpart in both assessments across the different programs.Discussion. All students performed better at the practical skills than theoretical knowledge assessment, and female students surpassed male students in both practical and theoretical assessments in five programs. There is a need to perform an in-depth analysis about the assessment methods utilized for practical assessments (OSPE and OSCE) among different programs/courses offered at CAMS to verify that the significant correlations obtained between the theoretical knowledge and practical assessments were not due to the similarities of construct/content of the assessment methods. PubDate: Tue, 17 Jan 2023 06:41:49 PST
Authors:Alberto Au et al. Abstract: Purpose: We have previously reported that a one-day educational programme could help strengthen Australian senior secondary school students’ decision to pursue a health-related career. Given that graduate-entry pathway, following a life-science related undergraduate degree, is becoming the common entry pathway to healthcare degree in Australia, the need for an educational programme specifically designed for life-science related undergraduates interested in pursuing a career in healthcare is crucial. To address this gap, MED-E-SIM (Graduate Entry) pilot programme was designed and implemented.Method: MED-E-SIM (Graduate Entry) is a one-day educational programme aimed at inspiring Australian life-science related undergraduates in pursuing healthcare professions through immersive and simulated learning. To evaluate the impact of MED-E-SIM (Graduate Entry), 55 life-science related undergraduates who participated in the programme were invited to complete the post programme evaluation survey. Participants were also interviewed shortly after the completion of their life-science related undergraduate degree to confirm their healthcare career pursuit status.Results: We observed significant increases in students’ certainty in pursuing healthcare career (P < 0.001) immediately after the completion of MED-E-SIM (Graduate Entry) programme. Follow-up interview data showed 55.10% of respondents reported to have succeeded in enrolling into a medicine or healthcare related entry-to-practice degree after the completion of their life-science related undergraduate degree. Out of those not enrolled into a subsequent entry-to-practice healthcare degree, 38.78% expressed to be still considering or pursuing a future career in healthcare.Discussion: MED-E-SIM (Graduate Entry) programme can be used as a feasible strategy to increase life-science related undergraduates’ pursuit in healthcare careers and ultimately help alleviate the alarming worldwide shortage of healthcare workers faced within the next decade. PubDate: Sun, 13 Nov 2022 23:25:22 PST
Authors:Abishek Jayapal Rajeshwari et al. Abstract: Purpose: Academic dishonesty is not only a serious threat to academic integrity but also to the late professional life of a health science professional. Lack of professionalism leads to decreased treatment outcomes thereby leading detoriation of reputation.Objective: To find out the prevailing academic dishonest behavior among health science students in Chennai.Methodology: A cross sectional study was conducted among 200 health science students of both the genders in Chennai and their level of academic dishonesty was assessed using a self-administered questionnaire.Results: The study results were analyzed in general and the dishonesty behavior was compared between both men and women using independent sample t test. Men tend to be highly deviant in academic behavior than women students (p=0.000).Conclusion: Students of health care profession are highly involved in the academic dishonest behavior despite the student ethics and academic integrity. PubDate: Sun, 13 Nov 2022 23:25:17 PST
Authors:Matthew Kelly et al. Abstract: Purpose. Interprofessional collaboration is an important aspect of health practice. Individuals with communication and/or swallowing impairments are often managed by interdisciplinary teams including speech-language pathologists (SLPs), and other healthcare professionals. Literature reports that other allied health professionals may not be confident working with this caseload and little evidence exists that explores undergraduate allied health students’ confidence, knowledge, and experience working with this caseload, and as part of an interdisciplinary team. Such knowledge is essential in order to inform curriculum and to improve overall professional practice and patient outcomes. This research aimed to investigate: (1) the knowledge and confidence of non-SLP undergraduate allied health students who have worked with individuals with communication and swallowing disorders; and (2) how often these students have worked with a SLP on placement. Method. 131 undergraduate allied health students from physiotherapy, occupational therapy, social work, and nutrition and dietetics completed a survey to evaluate their confidence, knowledge, and experience when working with this caseload, and as part of an interprofessional team with SLPs. Results. Participants had equal levels of confidence across disciplines and were more confident working with people with communication impairments compared to swallowing impairments. Student participants from all professions stated they would like more education regarding working with this caseload.Discussion. Findings revealed a want for further education regarding communication and swallowing impairments. There was an overall lack of experience working with SLPs, indicating a potential lack of interprofessional education in allied health students’ tertiary education. PubDate: Sun, 13 Nov 2022 23:25:12 PST
Authors:Catherine Evans et al. Abstract: Purpose. Master’s students complete a major project as a mandatory component of their programme and many conduct Quality Improvement (QI) projects. Publishing student work enables knowledge sharing and may be helpful for career progression, however there is limited literature on the publication potential of Master’s students’ work. This study aimed to investigate whether there is a difference in the study size, approach and quality of the reporting in student produced and equivalent published QI activities.Method. Ten student and ten published articles were identified for analysis. Each paper was quality appraised and data pertaining to the size and scope of the projects were extracted, including approach to data collection, number of quality cycles performed, number of sites studied, and study outcome. Descriptive and inferential statistical analysis was conducted to explore the comparative performance of the two bodies of work.Results. Compared to student work, published work was characterised by larger sample size (n=744 vs 171.6), longer duration of data collection (12.75 vs 4.83 months) , more prospective designs and more studies that involved introducing a new intervention than student work. No differences were identified between quality appraisal scores between the two bodies of work (p=.24), apart from in studies that included a new intervention, in which published work performed better than student work (81.80% vs 65.50% for achievement of quality appraisal domains). All published studies demonstrated positive findings, compared to just half of student work.Conclusion. Published and student QI work appear to differ in terms of scale and quality, however there are many encouraging factors for consideration for students wishing to disseminate their QI projects. Supporting the process of preparation for publication is an important learning experience. Practical approaches to improve the scope and quality of student projects are identified. PubDate: Sun, 13 Nov 2022 23:20:26 PST
Authors:Mohammed A. Islam et al. Abstract: Purpose: Pharmacists play a significant role in toxicology from research to clinical practice. Adequate toxicology content coverage is expected in the curricula of US PharmD programs. The purpose of this study is to evaluate the status of toxicology education in the professional PharmD programs in US schools and colleges of pharmacy.Method: The websites of 142 pharmacy programs were visited. Pages with PharmD curriculum, course catalog, student handbook were identified and retrieved. The toxicology course titles and catalog descriptions were compiled and uploaded into the qualitative data analysis software, NVivo® 12. A word cloud analysis of the toxicology course descriptions was conducted. Standard data coding strategies were employed for the thematic analysis of the course descriptions.Results: Toxicology content integrated with other biomedical sciences was found in 108 (78%) pharmacy programs. Standalone toxicology required courses and didactic elective courses were identified in 21 and 34 programs, respectively. The number of semester hours dedicated to the stand-alone toxicology courses varied from 1.0 to 4.0 (median=2.5, mode=3.0, mean=2.73). The thematic dimensions related to toxicology in the titles and the course descriptions included acute and chronic toxicity of drugs, drug overdoses, drug-adverse reactions, poisons, diverse types of toxicants, toxicological manifestations, detection of toxicants/clinical assessments, and prevention/ management of poisoning.Conclusion: Most of the pharmacy programs integrate toxicology within biomedical science courses while a smaller proportion offer standalone courses either as required or elective courses. Our study may be a useful guide for pharmacy schools/colleges to review toxicology content offerings. PubDate: Sun, 13 Nov 2022 23:20:21 PST
Authors:Amanda K. Burbage et al. Abstract: Purpose. The value of a diverse healthcare workforce and the need for all healthcare providers to be educated to provide culturally competent care is widely acknowledged. In part, educating diverse and culturally competent providers is a responsibility of higher education institutions. This study investigated health professions education (HPE) institution-level and program-level websites for evidence of diversity, equity, and inclusion (DEI) content to address the recruitment and the preparedness of future health profession educators using the diversity and inclusion engaged marketing (DIEM) framework. The study was guided by two research questions: What is the relationship between institution-level and HPE program-level website diversity content', and What evidence of diversity embeddedness exists on HPE program-level websites'Method. Systematic website review methods were used in this non-experimental study design to examine the relationship of graduate HPE program-level websites and institution-level websites for DEI embeddedness. Two data extractors independently and collaboratively extracted and recorded data from 43 institution-level and program-level websites, coding 15 DEI elements.Results. A small but significant amount of variance in program-level website diversity content scores was explained by institution-level website diversity content scores (R2 = .093, p = .046). In addition, program-level websites did not present evidence of embedding diversity within the curriculum with only eight programs (19%) offering HPE students a course with keyword terms (“diversity,” “equity,” “DEI,” “health disparity,” “social justice,” or “cultural competence”) incorporated in the title or course description. Only one of the 43 programs (2%) offered a formal track, concentration, or certificate dedicated to diversity-related topics within the HPE context.Discussion. Findings demonstrate institution-level evidence of diversity commitment through textual statements, links to academic and financial resources, and use of gender and race diverse images. However, program-level websites infrequently displayed gender and race diverse images of faculty, students, and student life, nor offered textual evidence such as program-level diversity statements, or diversity curriculum embeddedness. The findings suggest DIEM strategies have not trickled down from the institution to the program-level. The program-level diversity website content gaps may be attributable to a lack of awareness or lack of technical capabilities, and although some issues may be easily resolved, others, such as diversifying faculty bodies or revising the curriculum, may require more sustainable change approaches beyond a surface-level website update. PubDate: Sun, 13 Nov 2022 23:20:16 PST
Authors:Jerome I. Rotgans et al. Abstract: The COVID-19 pandemic constituted a stress test for medical education, especially for assessment. Exams needed to be postponed or even cancelled. This was a problem because many schools rely on decision making with regard to student performance and their progress through the curriculum using only a few high-stake examinations. In this report we present how a medical school can make a relatively easy transition to multisource progress assessment, based on results on a large number of low-stake tests. Such tests are often integral parts of the curriculum, but hidden because they are not used for decision making. We will present how results of such low-stake tests can be combined and visualized to allow for more comprehensive (and potentially more reliable and valid) assessment decisions. PubDate: Sun, 13 Nov 2022 23:20:11 PST
Authors:Mohamed Elhassan Abdalla et al. Abstract: Purpose This study aims to explore the impact of community-based education on graduates’ work performance and career paths in later life. Methods A self-administered critical incident questionnaire was given to a group of graduates from a community-based medical school. The target population was the graduates of the Faculty of Medicine in the University of Gezira who graduated between the years 1984-2021. Participants responded using audio recording or in writing and reported on ‘critical incidents’ they had experienced. Data was analysed using thematic data analysis to develop codes, categories and themes from the critical incident techniques. Results Twenty-three critical incidents were reported from a total of 91 responses yielded from the recorded and written data. Most of the incidents take place in the Interdisciplinary Field Training, Research and Rural Development Programme, as well as in Rural Residency, Primary Health Care Centre Practice, and Family Medicine. From the reporting of the critical incidents, five themes were identified concerning the benefit of community-based education in learning at undergraduate level: leadership, care of patients, professionalism, personal development and belonging. Similarly, five themes demonstrating the impact of community-based education after graduation were also identified including improving patient care, improving health system practice, curriculum development, self-improvement skills, and family medicine practice. Discussion Community-based education was shown to have a positive impact on students learning at undergraduate and post graduate level. Community-based education is also associated with the development of essential skills required by medical doctors after graduation. Structured community-based education is needed to maximize these benefits. PubDate: Tue, 02 Aug 2022 05:45:24 PDT
Authors:Said Abbadi et al. Abstract: Purpose: To analyze and evaluate the perceptions and insights of undergraduate medical students at Suez University towards Online learning. Methods: A cross-sectional study was conducted at Faculty of Medicine, Suez University where an online questionnaire was distributed to undergraduate medical students in 1st, 2nd, and 3rd years. A self-administrated questionnaire was formulated based on a literature review. It was accessed online using Microsoft teams platform. Results: A total of 182 students’ responses were collected through the online questionnaire. The respondents' ages range from 18-20. The current study reveals the preferences of some medical students for online learning for many reasons as it provides them with the flexibility of space and time, the easy access of study materials, it saves time, effort and money needed by some students to travel to campus, and others. Some fruitful suggestions and recommendations were also pointed by those students to improve online learning in the future. Discussion: Covid-19 pandemic has not only impacted human life but also impacted educational system as well. It has created an unprecedented challenge on education. With principles of social distancing, campuses are closed and the higher educational institutions (HEI) around the world suspended face to face learning and it has moved online to ensure the continuity of teaching-learning process and human safety simultaneously. However, it requires successful implementation and taking into consideration the students’ suggestions. PubDate: Tue, 02 Aug 2022 05:45:19 PDT
Authors:Gerard J.A. Baars et al. Abstract: Purpose. To investigate how well at an early stage, based on pre- and post-enrolment data, students could be identified who become successful and unsuccessful in the first year at the university.Method. Based on pre-and post-enrolment data, 24,976 students of the cohorts 2009-2015 were divided in subgroups. For each subgroup the percentage of successful, delayed, and unsuccessful students at the end of the first year was determined.Results. Based on only the pre-enrolment data, i.e. sex, ethnic background, and type and level of achievement during the final examinations of pre-university education, on the one hand subgroups of students with a 74-82% success rate and a 5-10% dropout rate could be identified. On the other hand, subgroups with only a ≤ 35% success rate and an almost 50% dropout rate. By adding post-enrolment data, i.e. the achievement of students at the first two exams in the university, subgroups with a ≥ 90% success rate and a ≤ 5% dropout rate could be identified, and subgroups with only a ≤ 10% success rate and a ≥ 70% dropout rate.Discussion. It is possible to identify successful and unsuccessful students at a very early stage. The challenge for the future is to investigate what appropriate interventions can be developed for (a) students who already before the start of their academic career or very early after the start at the university have a high chance of becoming unsuccessful and for (b) those who have a high chance of becoming successful PubDate: Tue, 02 Aug 2022 05:45:14 PDT
Authors:Jennifer A. Cleland et al. Abstract: Purpose. To date, we know little about the impact of responsive shifts from conventional to remote learning during the Covid-19 pandemic on student outcomes. If learning suffered, this may potentially have significant negative effects on students’ knowledge and skills acquisition hence eventually impacting the overall quality of our doctors and the care they provide. To address this gap in knowledge, we investigated the impact of switching from classroom team-based learning (cTBL) to online TBL (oTBL) on medical student performance in class tests and end-of-year examinations. Methods. Our participants were 137 second-year medical students who had cTBL experience prior to the shift to oTBL. We held the structure, activities and organisation of TBL constant. The only difference was that oTBL students engaged virtually while cTBL students met in person. We examined if there were differences between cTBL and oTBL in terms of individual (iRA) and team performance (tRA) in class and end-of-year exam scores. Our educational focus was the female reproductive system. We also examined the mean iRA and tRA scores for all modules. Analysis was via repeated-measures ANOVA. Results. There was a statistically significant difference between cTBL and oTBL groups’ iRA, tRA and specific exam items for female reproductive knowledge. Similarly, when we looked at year 2 teaching more generally, students scored significantly higher on the iRAs and exam items that were taught by means of oTBL compared to cTBL Discussion. During a time of educational disruption, shifting a highly structured instructional design from the classroom to online, while keeping all other factors constant, maintained learning outcomes. This reassurance of the effectiveness in respect of student learning opens the door for further research to explore the educational, social and interactional processes of both face-to-face and online TBL. PubDate: Tue, 02 Aug 2022 05:45:09 PDT
Authors:Mona Hmoud AlSheikh et al. Abstract: Purpose: This paper aims to describe the role of the Medical Education unit/department (MED) from a world-wide perspective, how it qualifies as a wicked issue, and provide tips on how to tame it. Methods: The authors reviewed the regional and international literature to obtain a framework of functions and then used brainstorming and focus group discussions to define the scope of functions of the MED. Telephone interviews with present or previous chairs of medical education departments in the Kingdom and the region helped define the challenges that are faced. Results: The functions of the MED were found to fall under 10 domains (Table 1) and 40 functions (Table 2). Challenges facing MED role include governance and organizational structure, financial support, manpower, intersection with the roles of other structural entities, and dual reporting of MED staff. Ten tips are described to deal with these challenges. Conclusion: The MED role is complex and faced with many challenges. It has changing and dynamic boundaries, and is entangled with other entities in the college or university. Ten tips are proposed to tackle these challenges and tame the wickedness of the MED role. PubDate: Tue, 02 Aug 2022 05:40:16 PDT
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