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Biomedical subjects

A M M Muijtjens

Publications and source records attributed to A M M Muijtjens.

6 recordsLinked to original sources

Evaluation of a course on patient records.

OBJECTIVES: To determine whether self-directed learning about (electronic) patient records during a PBL (problem-based learning) block, dealing with the content of disciplines concerned with the diagnosis and therapy of diseases of the abdomen, increased the knowledge of the students with respect to the patient records. METHODS: At the beginning and at the end of the ten-week block the same questionnaire was offered to the students (180). Cohen's d for effect size was used to determine the increase in knowledge. RESULTS: For those students that answered the questionnaire twice (53), a Cohen's d of 0.94 was obtained. CONCLUSIONS: The knowledge of the students concerning the advantages and limitations of (electronic) patient records increased significantly. The corresponding effect size was large.

Abdomen↗

Is an Angoff standard an indication of minimal competence of examinees or of judges?

BACKGROUND: To establish credible, defensible and acceptable passing scores for written tests is a challenge for health profession educators. Angoff procedures are often used to establish pass/fail decisions for written and performance tests. In an Angoff procedure judges' expertise and professional skills are assumed to influence their ratings of the items during standard-setting. The purpose of this study was to investigate the impact of judges' item-related knowledge on their judgement of the difficulty of items, and second, to determine the stability of differences between judges. METHOD: Thirteen judges were presented with two sets of 60 items on different occasions. They were asked to not only judge the difficulty of the items but also to answer them, without the benefit of the answer key. For each of the 120 items an Angoff estimate and an item score were obtained. The relationship between the Angoff estimate and the item score was examined by applying a regression analysis to the 60 items (Angoff estimate, score) for each judge at each occasion. RESULTS AND CONCLUSIONS: This study shows that in standard-setting the individual judgement of the individual item is not only a reflection of the difficulty of the item but also of the inherent stringency of the judge and his/her subject-related knowledge. Considerable variation between judges in their stringency was found, and Angoff estimates were significantly affected by a judge knowing or not knowing the answer to the item. These findings stress the importance of a careful selection process of the Angoff judges when making pass/fail decisions in health professions education. They imply that judges should be selected who are not only capable of conceptualising the 'minimally competent student', but who would also be capable of answering all the items.

Clinical Competence↗

Comparison of text and video cases in a postgraduate problem-based learning format.

OBJECTIVE: To investigate whether adding a brief video case instead of an equivalent written text improves the cognitive and metacognitive processes (data exploration, theory building, theory evaluation and metareasoning) of residents in problem-based learning. SUBJECTS: Paediatric residents. SETTING: Department of Paediatrics, Arhus University Hospital, Skejby, Denmark. METHODS: Eleven residents were each assigned to 1 of 2 groups. Both groups analysed an identical vignette of a patient case. Immediately after this, 1 group watched a 2.5-minute video recording and the other group read a description of the same video recording. The groups then reanalysed the case. Thinking processes were tapped by recording and analysing the verbal group interaction. The frequencies of clause categories were calculated and compared using chi-square tests. RESULTS: The verbal interaction showed statistically significant improvements in data exploration, theory building and theory evaluation after the video case. CONCLUSIONS: The greater improvement in clause frequency after the video case compared with the equivalent text suggests an improvement in data exploration, theory building and theory evaluation. The use of patient video recordings may be a valuable supplement to postgraduate paediatric training, particularly pertaining to movement disorders.

Denmark↗

Cross institutional collaboration in assessment: a case on progress testing.

The practice of assessment is governed by an interesting paradox. On the one hand good assessment requires substantial resources which may exceed the capacity of a single institution and we have reason to doubt the quality of our in-house examinations. On the other hand, our parsimonity with regard to our resources makes us reluctant to pool efforts and share our test material. This paper reports on an initiative to share test material across different medical schools. Three medical schools in The Netherlands have successfully set up a partnership for a specific testing method: progress testing. At present, these three schools collaboratively produce high-quality test items. The jointly produced progress tests are administered concurrently by these three schools and one other school, which buys the test. The steps taken in establishing this partnership are described and results are presented to illustrate the unique sort of information that is obtained by cross-institutional assessment. In addition, plans to improve test content and procedure and to expand the partnership are outlined. Eventually, the collaboration may even extend to other test formats. This article is intended to give evidence of the feasibility and exciting potential of between school collaboration in test development and test administration. Our experiences have demonstrated that such collaboration has excellent potential to combine economic benefit with educational advantages, which exceed what is achievable by individual schools.

Cooperative Behavior↗

Setting a standard for performance assessment of doctor-patient communication in general practice.

CONTEXT: Continuing professional development (CPD) of general practitioners. OBJECTIVE: Criterion-referenced standards for assessing performance in the real practice of general practitioners (GPs) should be available to identify learning needs or poor performers for CPD. The applicability of common standard setting procedures in authentic assessment has not been investigated. METHODS: To set a standard for assessment of GP-patient communication with video observation of daily practice, we investigated 2 well known examples of 2 different standard setting approaches. An Angoff procedure was applied to 8 written cases. A borderline regression method was applied to videotaped consultations of 88 GPs. The procedures and outcomes were evaluated by the applicability of the procedure, the reliability of the standards and the credibility as perceived by the stakeholders, namely, the GPs. RESULTS: Both methods are applicable and reliable; the obtained standards are credible according to the GPs. CONCLUSIONS: Both modified methods can be used to set a standard for assessment in daily practice. The context in which the standard will be used - i.e. the specific purpose of the standard, the moment the standard must be available or if specific feedback must be given - is important because methods differ in practical aspects.

Clinical Competence↗

Panel expertise for an Angoff standard setting procedure in progress testing: item writers compared to recently graduated students.

INTRODUCTION: An earlier study showed that an Angoff procedure with > or = 10 recently graduated students as judges can be used to estimate the passing score of a progress test. As the acceptability and feasibility of this approach are questionable, we conducted an Angoff procedure with test item writers as judges. This paper reports on the reliability and credibility of this procedure and compares the standards set by the two different panels. METHODS: Fourteen item writers judged 146 test items. Recently graduated students had assessed these items in a previous study. Generalizability was investigated as a function of the number of items and judges. Credibility was judged by comparing the pass/fail rates associated with the Angoff standard, a relative standard and a fixed standard. The Angoff standards obtained by item writers and graduates were compared. RESULTS: The variance associated with consistent variability of item writers across items was 1.5% and for graduate students it was 0.4%. An acceptable error score required 39 judges. Item-Angoff estimates of the two panels and item P-values correlated highly. Failure rates of 57%, 55% and 7% were associated with the item writers' standard, the fixed standard and the graduates' standard, respectively. CONCLUSION: The graduates' and the item writers' standards differed substantially, as did the associated failure rates. A panel of 39 item writers is not feasible. The item writers' passing score appears to be less credible. The credibility of the graduates' standard needs further evaluation. The acceptability and feasibility of a panel consisting of both students and item writers may be worth investigating.

Curriculum↗