Online Learning cum Evaluation Test Exercise – Medical Sharps Wastes Management – An Initial Report on What, How, and Cost-effectiveness

Online Learning cum Evaluation Test Exercise – Medical Sharps Wastes Management – An Initial Report on What, How, and Cost-effectiveness

Posted on August 24, 2012

Online Learning cum Evaluation Test Exercise

Medical Sharps Wastes Management

An Initial Report on What, How, and Cost-effectiveness


(I still have to include a feedback-survey from participants. – ROJ)

Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg

August 24, 2012

On July 23, 2012, I facilitated a seminar on medical sharps wastes management to 35 participants 0f Manila Doctors Hospital (MDH).

On that day, I tried out my online learning cum evaluation test exercise (OLETE) on medical sharps waste management.

The OLETE consisted of my making an online test through a freeware in the NET.  In this case, I used the QuizStar (  I made 2 sets of tests. One was on knowledge and attitude.  The other was on practice.  I made objective type of questions (true or false and multiple choices) to facilitate instant correction and analysis by the software.  I had 55 questions on the knowledge and attitude and 15 on the practice.

Here were my instructions on how to take the OLETE.

Get into the Internet.


Under Student Login Page, click “Students, get started”

Click “Sign-up”

Place your first name; last name – middle name; username; passwords.

Then, click “register.”

Then login your username and password.

Then click “Search”

In the box, under quiz title, enter the following:

– Assessment of Practices in MDH Sharps Safety & Waste Management Program – Managers – 12jul19

– Knowledge and Attitude on MDH Sharps Safety & Waste Management Program for Managers – 12jul19

Click “exact match” then “register.”

Then, “go to test” then “take.”

Then, take your test.

Before the seminar on July 23, 2012, I asked the participants to bring a laptop.  I also asked Information Technology of MDH to ensure accessibility of WIFI in the conference room.

Out of the 35 participants who attended, 34 took the KA test and 32 took the Practice test.  Those who were not able to take the OLETE did not bring a laptop as instructed; were still computer illiterate; and had technical difficulties with their laptops.

After the July 23, 2012 session, I gave instructions for the 34 participants who took the test to continue taking the online test within 2 weeks until they get a perfect score based on the recommended answers.  Follow-ups and reminders were done with the help of the staff of Quality Management Office, specifically, Francis Arcilla and Abigail Geralde.   Technical computer assistance was provided by the Mr. Arcilla and Ms. Geralde.  Mr. Roberto Alvaro, Jr. of the MDH-Pfizer Library also provided technical computer assistance when participants used the computers in the library.

Below shows the results as of August 17, 2012, the deadline set for the participants to get a perfect score based on recommended answers.  The deadline was extended to 4 weeks.

Knowledge – Attitude Part of OLETE

Out of 34 participants who took the OLETE – KA, 25 already got the perfect scores.  Those who have not gotten a perfect score numbered 9.  (They will be reminded to take again.)

Above shows the average attempts made, which is 2 out of 10 attempts allowed.  The lowest score is 42 or 76%.

There were 9 who have not reached yet the perfect score (55).  Once a participant reached a 100% score, he could opt not to repeat taking the test.  In this initial offering, there were those who already reached 100% and when they took the tests, their score went down to below 100%.  This is not taken against them.  Main reasons why they retook the tests were they wanted to test the technical functionality of the software and they just did it just for fun.

In this software, there is another useful information for the facilitator.  This is the question analysis.  This will help me, the facilitator, review the test questions especially in correcting any ambiguity that may be present.

Above shows how I designed the OLETE on Crisis Communication Management for MDH Staff.

– Ten (10) attempts were given to give allowance for technical online hitches. In the future, I will reduce the number to 5 attempts.

– Correct answers were given right after the test.

– Time allotted for the test was 60 minutes for the 55 objective questions (all were able to finish the test within this allotted time).

I gave the following instructions at the start of the OLETE last July 23, 2012:

Quiz Instructions


1. There are two (2) sections in this test, namely, Knowledge and Attitude.

2. You must indicate your name and position in the hospital. (You will be advised where to place these data.)

3. Please answer all questions.

4. There is only one answer per question.

5. The ultimate target is to get a 100% score.

6. You will be given 5 attempts to get a perfect score within 2 weeks. Don’t worry if you do not get 100% perfect score in the first attempt.

7. After you have attained 100% score, you will be issued a certificate of proficiency. This certificate is valid for 3 years only. A re-certification is needed after 3 years.

Important Information:

1. There will be a “random testing” among those who have attained 100% score within the three year validity period of the certificate of proficiency. “Random testing” means administering the test (not necessarily the complete original test) on a randomly taken sample of those who have attained a certificate of proficiency. This random testing will be for administrative use only and will not affect the certificates previously issued.

2.The KA will be accompanied by annual audits of practices of staff on sharps safety and waste management.

3.There will be monitoring of incidence of medical sharps waste injuries in the hospital.


Practice Part of OLETE

Out  of 34 participants who took the OLETE – P, 30 already got the perfect scores.  Those who have not gotten a perfect score numbered 2.  Two have not taken this test yet. (They will be reminded to take again.)

Above shows the average attempts made, which is 1 out of 10 attempts allowed.  The lowest score is 10 or 67%.

My Personal Reflections and Recommendations:

Over the years, I have been trying to find an efficient way of education for all staff of MDH.  In the balanced scorecard of MDH, for the past three or four years or even earlier, we have been batting for a 100% attendance or participation in learning sessions in topics like disaster preparedness, quality management, basic life support, infection control, etc.  We have difficulty achieving our targets.  If we did, the strategies are not sustainable.  Besides, there had been no measurement on how much the participants have learned.

I vividly remember that it was in July 27, 2011 that I started to have a more concrete conceptualization of this OLETE strategy.  I was attending the DOH celebration of Disaster Consciousness Month in the Heritage Hotel with a launching of the Department of Health Health Emergency Management Staff’s publication and website.  It was also on this day that HEMS announced the publication of Beyond Data which contained a write-up of MDH Disaster Preparedness Program.  While listening, I was on my seat scribbling an OLETE strategy.   (I will try to locate my notes on this in the near future.)

One year after, July 23, 2012, I concretized my OLETE through a seminar on Crisis Communication Management for MDH Staff in the morning then in the afternoon, OLETE on the seminar on Medical Sharps Wastes Management.

I personally think the OLETE offers an efficient educational strategy in organizations and hospitals like MDH in which one can be confident, if not assured, of learning of all staff with minimal cost and loss of time from services.  As deduced from the “Quiz Instructions” above, participants will learn more in terms of knowledge at least compared attending face-to-face lectures.  There is active learning just by answering the questions. Simultaneously, there is evaluation of baseline knowledge and subsequent ones.  This is reason why I dub the exercise as “Online Learning cum Evaluation Test Exercise” or “OLETE.”

Consider a face-to-face lecture session.  Unless the facilitator gives out a pretest and a posttest, it will be difficult for him to measure how much the participants learned.  Second, hardly does  the facilitator expect all the participants to achieve a perfect score in the posttest, if there is one conducted.  After the lecture, the facilitator does not know what will happen to the items which were not answered correctly.  Were they corrected or not?

In OLETE, the target is a perfect score based on the recommended answers, no matter how many times the participants take the test within a prescribed period of time (from the experience, 2 weeks will be reasonable and practical.)  The testing can be continued after a face-to-face session if there is one. Note: in the future, with the presence of an accompanying website, with online education, most of the time one can do away with a face-to-face learning session or this will only be done on per need basis. .

In OLETE, there is measurement and documentation of learning that took place.  This is hardly seen in the current set-up.  The OLETE will be efficient in covering all the staff of an organization.  In MDH, there is about 1000 staff.  The OLETE will be very cost-effective for these 1000 staff.

Lastly, a re-certification can easily be done after a certain period of time.  The OLETE can be used in the re-certification.

I recommend MDH and other hospitals to adopt my OLETE.  By the way, the software, QuizStar is free.

Other action plans and recommendations:

  • I will recommend to MDH Administration the adoption of my OLETE.
  • I will request all the 9 participants in the first offering who have not yet reached a perfect score to take the test again.
  • I will issue certificates of proficiency for those who already achieved a perfect score.
  • I will fix the glitches in the technical aspect of online hosting of the tests and online registration for the test.
  • I will do a feedback-survey among the 34 participants who took the test.

Questions? Email:

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