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Biomedical subjects

A J Scherpbier

Publications and source records attributed to A J Scherpbier.

16 recordsLinked to original sources
PubMed2001

Students' perceptions of time spent during clinical rotations.

Some rotations during clinical education are characterized by a high number of hours spent per week in the hospital because students panicipate in a hospital on-call system, i.e. hours beyond usual working hours, e.g. at night. However, students complain about spending too many hours in the hospital on non-instructive activities. This study was undertaken to investigate differences among rotations in time spent in hospital, in on-call hours, in self-study and in non-instructive activities and to investigate the relationship between time spent on the various activities and the overall effectiveness as perceived by students. A questionnaire was administered to students at the end of various clinical rotations. Rotations differ considerably in time spent in hospital, on call (i.e. beyond usual working hours), on self-study and on non-instructive activities. In some rotations students report spending on average 18-20% of their time in the hospital on non-instructive activities. Furthermore, the numbers of hours spent in hospital do not correlate with the overall effectiveness as perceived by students, unless the numbers of hours spent in non-instructive activities are taken into account. The effectiveness of a rotation does not automatically improve if students spend more hours in hospital. The number of hours spent on non-instructive activities should be reduced in some rotations and should be kept as low as possible. Further research is needed to find out which activities are perceived as non-instructive.

Journal Article↗
PubMed2001

Relationship of tutors' group-dynamics skills to their performance ratings in problem-based learning.

PURPOSE: A tutor's performance is often investigated as a stable teacher characteristic, isolated from the context in which the tutor functions. This study investigated the influence of a tutor's group-dynamics skills in differently functioning tutorial groups on performance ratings. METHOD: Students' ratings of tutors' performances collected from 75 tutorial groups at one school over four different academic years were compared with the independent variables, groups' cohesion scores and sponging scores (the degree to which some students let others do the work), and the intervening variable, tutors' group-dynamics skills. RESULTS: Tutors with strong group-dynamics skills were assigned mean tutor's-performance scores of 7.4 (SD = 0.8) and 8.2 (SD = 0.5), respectively, by groups scoring low and high on cohesion. Tutors with low group-dynamics skills were rated 7.0 (SD = 1.1) and 7.4 (SD = 1.1) by the same groups. The same pattern held for sponging scores. Tutors who had strong group-dynamics skills received mean tutor's-performance scores of 8.1 (SD = 0.6) and 7.4 (SD = 0.8), respectively, from groups with low and high sponging scores. Tutors with weak group-dynamics skills were scored 7.6 (SD = 1.0) and 6.9 (SD = 1.1) by the same groups. CONCLUSIONS: Tutors possessing group-dynamics skills were rated higher by students than were tutors who lacked these skills, irrespective of the quality of a tutorial group's performance. A tutor who evaluates tutorial-group function on a regular basis and makes appointments with students based on these evaluations is seen as performing better than a tutor who does not.

Analysis of Variance↗
PubMed2000

Effect of a short skills training course on competence and performance in general practice.

OBJECTIVES: Evaluation of the efficacy of a short course of technical clinical skills to change performance in general practice. DESIGN: Subjects were self-selected general practitioners (n=59) who were unaware of the study design. They were assigned to the intervention group (n=31) or control group (n=28) according to their preference for course date. The course covered four different technical clinical skills (shoulder injection technique, PAP-smear, laboratory examination of vaginal discharge, ophthalmoscopic control in diabetes mellitus). Main outcome measures used were pre- and post-training scores on a knowledge test of skills (60 multiple choice items), and pre- and post-training performance of procedures in practice using a log-diary covering 20 days. SETTING: University of Maastricht, The Netherlands. SUBJECTS: Self-selected general practitioners. RESULTS: Competence, as measured by the knowledge test of skills, improved significantly as a result of the training and skills test scores were satisfactory after training. A significant effect on performance in practice was found for PAP-smear and shoulder injection technique, whereas no effect could be demonstrated for examination of vaginal discharge and ophthalmoscopic control in diabetes mellitus. CONCLUSIONS: A good degree of competence is a necessary but not always sufficient condition for a physician to change his performance in practice. While some skills training seems adequate to bring about desired changes, for other skills more complex interventions are probably needed.

Education, Medical, Undergraduate↗
PubMed2000

The effect on reliability of adding a separate written assessment component to an objective structured clinical examination.

PURPOSE: To determine the effect on test reliability when a separate written assessment component is added to an objective structured clinical examination (OSCE). METHOD: Volunteers (n=38) from Maastricht Medical School were recruited to take a skills-related knowledge test in addition to their regular end-of-year OSCE. The OSCE scores of these volunteers did not differ from those of the other students of their class. Multivariate generalizability theory was used to investigate the combined reliability of the two test formats as well as their respective contributions to overall reliability. RESULTS: Combining the two formats has an added value. The loss of reliability due to the use of fewer stations in the OSCE can be fully compensated by lengthening the written test component. CONCLUSION: From the perspective of test reliability, it is possible to economize on the resources needed for performance-based assessment by adding a separate written test component.

Adult↗
PubMed1999

Reliability and credibility of an angoff standard setting procedure in progress testing using recent graduates as judges.

INTRODUCTION: Progress testing is an assessment method that samples the complete domain of knowledge that is considered pertinent to undergraduate medical education. Because of the comprehensive nature of this test, it is very difficult to set a passing score. We obtained a progress test standard using an Angoff procedure with recent graduates as judges. This paper reports on the reliability and credibility of this approach. METHODS: The Angoff procedure was applied to a sample of 146 progress test items. The items were judged by a panel of eight recently graduated students. Generalizability theory was used to investigate the reliability as a function of the number of items and judges. Credibility was judged by comparing the pass/fail rates resulting from the standard arrived at by the Angoff procedure with those obtained using a relative and a fixed standard. RESULTS: The results indicate that an acceptable error score can be achieved, yielding a precision within one percentage on the scoring scale, by using 10 judges on a full-length progress test (i.e. 250 items). The pass/fail rates associated with the Angoff standard came closest to those of the relative standard, which takes variations in test difficulty into account. A high correlation was found between item-Angoff estimates and the item P-values. CONCLUSION: The results of this study suggest that the Angoff procedure, using recently graduated students as judges, is an appropriate standard setting method for a progress test.

Education, Medical, Undergraduate↗
PubMed1996

Performance-based assessment in continuing medical education for general practitioners: construct validity.

The use of performance-based assessment has been extended to postgraduate education and practising doctors, despite criticism of validity. While differences in expertise at this level are easily reflected in scores on a written test, these differences are relatively small on performance-based tests. However, scores on written tests and performance-based tests of clinical competence generally show moderate correlations. A study was designed to evaluate construct validity of a performance-based test for technical clinical skills in continuing medical education for general practitioners, and to explore the correlation between performance and knowledge of specific skills. A 1-day skills training was given to 71 general practitioners, covering four different technical clinical skills. The effect of the training on performance was measured with a performance-based test using a randomized controlled trial design, while the effect on knowledge was measured with a written test administered 1 month before and directly after the training. A training effect could be shown by the performance-based test for all four clinical skills. The written test also demonstrated a training effect for all but one skill. However, correlations between scores on the written test and on the performance-based test were low for all skills. It is concluded that construct validity of a performance-based test for technical clinical skills of general practitioners was demonstrated, while the knowledge test score was shown to be a poor predictor of competence for specific technical skills.

Adult↗
PubMed1991

The way we train the clinical eye through slides.

Inspection is an important clinical skill. It is remarkable that in basic medical education this skill is not specially trained. To remedy this, we have developed a method of instruction at Groningen University Hospital to train inspection. We give an outline of the method and provide examples of dialogue.

Clinical Competence↗
PubMed1985

Synovial chondromatosis of the temporo-mandibular joint. Report of three cases and a review of the literature.

Synovial chondromatosis of the temporo-mandibular joint is a rare affection, characterized by the formation of cartilage particles in the synovial membrane. These particles can break through and enter the joint compartments. The diagnosis must be considered for patients who complain of slowly progressive swelling, pain, and crepitus in the region of the temporo-mandibular joint. When the changes are not visible on plain X-rays due to absence of ossification, important diagnostic information can be obtained by a technetium 99m (99m Tc) bone scan and a computerized tomography (CT) sialogram. The diagnosis can be established only by histopathologic examination of surgically removed particles or resected synovial membrane. Discussed are 25 cases of histopathologically verified chondromatosis of the temporo-mandibular joint reported in the literature, as well as 3 new cases seen and treated at the University Hospital Groningen since 1970. A good clinical result can be obtained by removal of all particles and synovectomy. Condylectomy is seldom required.

Adolescent↗
PubMedDate not supplied

Changing patterns in graduate surgical education in The Netherlands.

An overview is presented of the organization, outline, and contents of graduate surgical training programs in The Netherlands. Adaptations of these programs to changes in demands in surgical practice and health care delivery systems are discussed. Special emphasis is given to the relation of surgery and the surgical specialties, additional training, theoretic training, and manpower planning. The principal questions regarding the optimal way to respond to changing concepts in the field of surgery are presented and discussed in the context of the situation in The Netherlands, but they seem to be similar in the surgical communities of many countries.

Delivery of Health Care↗