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Biomedical subjects

Amy V Blue

Publications and source records attributed to Amy V Blue.

13 recordsLinked to original sources

Medical school application interview score has limited predictive validity for performance on a fourth year clinical practice examination.

BACKGROUND AND PURPOSE: : Data supporting the predictive validity of the medical school admission interview are mixed. This study tested the hypothesis that the admission interview is predictive of interpersonal interactions between medical students and standardized patients. METHOD: : We determined correlations between admission interview scores and performance on a senior-year Clinical Practice Examination piloting US National Board of Medical Examiners stations. We also completed regression analyses controlling for undergraduate academic performance, gender and ethnicity. Outcome measures included an Interpersonal Skills score and a separate Overall Checklist performance score, completed by standardized patients. RESULTS: : The applicant interview had limited but statistically significant correlation with the Interpersonal Skills (r = 0.15; p < 0.05) score. The applicant interview had a correlation of 0.13 with the Overall Checklist score (p = .056). In linear regression models, the applicant interview had limited but statistically significant correlations with the Interpersonal Skills score and the Overall Checklist score. CONCLUSION: : As practiced at this medical school, the admission interview has limited predictive validity for future interactions with standardized patients. More comprehensive assessment of interpersonal skills during the medical school selection process will be needed in order to better select matriculants with desirable interpersonal skills.

Clinical Competence↗

Performance outcomes associated with medical school community service.

BACKGROUND: Providing medical students with community service opportunities during medical school is believed to foster altruism. Little is known whether voluntary community service is associated with students' academic and clinical skill performance. This study examined the relationship between students' volunteer community service hours during medical school and their medical school academic performance, measures of clinical skills, and residency performance. METHOD: Subjects were 2001 and 2002 graduates of the institution. Performance measures were: United States Medical Licensing Examination (USMLE) Step 2 score, grade point average, fourth-year clinical skills examination scores, and two types of residency director assessments. Associations between performance measures and community service hour categories were analyzed using descriptive statistics, chi-square, and t-tests. RESULTS: Students in the highest service group (>/=18.5 hours) had significantly higher grade point averages, USMLE Step 2 scores, and scores on both residency director assessment when compared to students with no community service hours. CONCLUSIONS: Community service involvement in medical school appears associated with medical school academic and residency performances.

Community Health Services↗

How well are practice management curricula preparing family medicine residents?

BACKGROUND: While emphasis has been placed on practice management curricula in residency, studies indicate that residents are not adequately prepared. To assess the effectiveness of current practice management skills training in residency, we examined the confidence levels of family medicine residents and recent graduates in practice management skills. METHODS: A survey was sent to family medicine residency programs within South Carolina. Participants ranked their confidence level in 13 practice management skills on a 5-point Likert scale. Analysis of covariance compared confidence levels in their skills while controlling for program, gender, and age. Residency directors of these programs were also surveyed about the content of their practice management programs. RESULTS: Residents and graduates rated their confidence in all areas moderately high. Graduates rated themselves significantly more confident than residents did in seven practice management skills. CONCLUSIONS: Family medicine practice management curricula appear to be effective in establishing confidence regarding practice management skills in residents and recent graduates.

Adult↗

The relationship between the National Board of Medical Examiners' prototype of the Step 2 clinical skills exam and interns' performance.

PURPOSE: To examine the relationship between graduates' performances on a prototype of the National Board of Medical Examiners' Step 2 CS and other undergraduate measures with their residency directors' ratings of their performances as interns. METHOD: Data were collected for the 2001 and 2002 graduates from the study institution. Checklist and interpersonal scores from the prototype Step 2 CS, along with United States Medical Licensing Examination (USMLE) Step 1 and 2 scores and undergraduate grade-point average (GPA), were correlated with residency directors' ratings (average score for six competencies, quartile ranking, and isolated interpersonal communication competency score). Stepwise linear regression was used to identify the best outcome predictors. RESULTS: Quartile ranking was more highly correlated with GPA than Step 2 CS prototype interpersonal score, USMLE Step 2 score, USMLE Step 1 score, and Step 2 CS prototype checklist score. The average score on the residency director's survey was more highly correlated with GPA than USMLE Step 2 score, USMLE Step 1 score, Step 2 CS prototype interpersonal score, and Step 2 CS prototype checklist score. The best predictors for both quartile ranking and average competency score were GPA and Step 2 CS prototype interpersonal score (R(2) = 0.26 and 0.28). CONCLUSION: Both scores from the Step 2 CS prototype significantly correlated with the interns' quartile ranking and average competency score. Only GPA and Step 2 CS prototype interpersonal score accounted for most of the variance of performance in the regression model.

Clinical Competence↗

How does pre-admission community service compare with community service during medical school?

BACKGROUND: Little research has examined the link between premedical community service and subsequent community service undertaken in medical school. PURPOSE: This study examined the relationship between applicants' community service history with reported community service experiences during medical school. METHODS: Admission files were retrospectively reviewed and community service hours during medical school were totaled for 2003 graduates at the study institution. Data were analyzed using descriptive statistics, chi-square tests, and logistic regressions. RESULTS: Applicants who were women, had volunteered with multiple types of organizations, and volunteered more than 2 years were all significantly more likely, chi2 p < .05, to have provided greater community service hours during medical school than others. CONCLUSIONS: Aspects of applicants' community service histories, particularly the number of different types of organizations served and length of service, appear related to their subsequent community service involvement in medical school. Admissions committees may wish to provide additional consideration to such applicants.

Adult↗

Student observations and ratings of preceptor's interactions with patients: the hidden curriculum.

BACKGROUND: Professional values and behavior are conveyed to students through both formal and informal curricular activities. PURPOSE: This study examined 1st-year students' observations of community-based physicians' behaviors during a community-based clinical experience. METHODS: First-year students completed a 14-item instrument regarding their community-based physicians' behavior with patients. Responses were on a 5-point scale (1 = never, 5 = all of the time). Descriptive statistics were computed. RESULTS: 119 students completed the instrument (87% response rate). Students rated aspects of physicians' demeanor with patients highest (mean ranges 4.7-4.57). The lowest rated item was the physician's view of his or her professional role (M = 3.39), eliciting patients' ideas about illness and treatment (M = 3.55), and modeling interviewing techniques learned in class (M = 3.71). CONCLUSIONS: Community-based physicians reinforce many professional values associated with positive role-modeling aspects of the physician-patient interaction.

Curriculum↗

Medical students' perceptions of rural practice following a rural clerkship.

BACKGROUND AND OBJECTIVES: Evidence suggests that rural experiences can positively influence students' preferences for rural practice. This study examined changes in students' perceptions toward rural primary care following a required rural clerkship. METHODS: Third-year students completed pre- and post-clerkship questionnaire items assessing their beliefs about primary care physicians who practice in rural communities in comparison with their urban/suburban counterparts. A factor analysis was performed, and pre- and post-clerkship scale means were calculated to determine differences. RESULTS: A total of 428 (88%) students completed these questionnaires. There was a significant increase in students' perceptions of rural primary care physicians' primary care service features and medical expertise. Students perceived the physicians' work demands more positively, and there was no change in students' perceptions of the physicians' income potential. CONCLUSIONS: Results suggest that the rural primary care clerkship positively influenced students' perceptions toward rural primary care.

Attitude↗

The role of medical students in curriculum committees.

BACKGROUND: Medical students often play a role in local curricular issues by assessing the curriculum and bringing consumers' perspectives to curricular committees. PURPOSE: To identify the formal roles that medical students play on curriculum committees. METHODS: Mail survey to associate deans of medical education at all U.S. medical schools (N = 144). RESULTS: A total of 109 surveys were returned (response rate = 75.7%). Students had formal roles on the curricular committees at 100% of the respondent institutions. The majority of medical schools allow peers to elect their representatives to the committee (53.2%). Students have a right to vote on curricular changes at 86% of the respondent institutions. The vast majority of respondents (97.2%) felt that medical students were important in initiating curricular change. CONCLUSIONS: Medical students play an active role on curriculum committees at U.S. medical schools. Further research is needed to fully elucidate these specific roles.

Chi-Square Distribution↗

Assessing students' communication and interpersonal skills across evaluation settings.

BACKGROUND AND OBJECTIVES: Medical students' interpersonal and communication skills are a fundamental dimension of their clinical competence and will be measured on the anticipated US Medical Licensure Examination (USMLE) standardized patient (SP) exam. We compared students' performance on measures of SP satisfaction on a third-year family medicine Objective Structured Clinical Examination (OSCE) with measures of SP satisfaction on a fourth-year Clinical Practice Examination (CPX). METHODS: A total of 127 students completed both the clerkship OSCE and a CPX. The CPX was a pilot of the National Board of Medical Examiners Standardized Patient Exam. To assess students' interpersonal skills, both exams used modified versions of the American Board of Internal Medicine Patient Satisfaction Questionnaire. Students' scores were standardized, and correlations were calculated. A logistic regression model examined the ability of the OSCE to predict poor performance on the CPX. RESULTS: The correlation between the OSCE and CPX patient satisfaction scores was.08. There was no significant predictive ability of the OSCE for poor performance on the CPX. CONCLUSIONS: Our study calls into question the ability of a routine end-of-clerkship OSCE to identify students' interpersonal skills abilities on fourth-year clinical performance exams and potentially that component of the anticipated USMLE SP exam.

Adult↗

Predictive validity of the Medical College Admissions Test Writing Sample for the United States medical licensing examination steps 1 and 2.

Despite the amount of published research on the predictive validity of the Medical College Admissions Test (MCAT) taken as a whole, few published reports separate the individual predictive validity of the Writing Sample. The purpose of this study is to provide data on the predictive validity of the Writing Sample for the national licensing exam used in the United States. Subjects consisted of 1992-1995 matriculants from a publicly owned medical school in the Southeastern United States. Independent variables were undergraduate grade point average, and four section scores on a required admissions test (Biological Sciences, Physical Sciences, Verbal Reasoning, and Writing Sample). The dependent variables were Steps 1 and 2 on the three step licensing examination. Steps 1 and 2 of the examination are taken during medical school. Multiple regression models calculated additional variance accounted for by the addition of the Writing Sample to a model containing grade point average and the other admissions test section scores. In multivariate analyses, when grade point average and all admissions test scores were considered as predictors of licensing exam scores, the Writing Sample variable did not add to the ability to predicting the Step 1 or Step 2 scores. The results of this study suggest that the Writing Sample has limited predictive validity for assessing success on a national licensing exam. However, as others suggest, the value of the Writing Sample and other surrogates of communication probably lie in predicting performance in the clinical years of medical school and beyond. Additional work should include evaluating the predictive validity of the Writing Sample and other pre-medical school measures of communication with widely acceptable measures of performance in clinical settings, including physician-patient communication.

Adult↗