Biomedical subjects

André De Champlain

Publications and source records attributed to André De Champlain.

4 recordsLinked to original sources

PubMed2006

Assessing the underlying structure of the United States Medical Licensing Examination Step 2 test of clinical skills using confirmatory factor analysis.

BACKGROUND: The purpose of the present study was to assess the fit of three factor analytic (FA) models with a representative set of United States Medical Licensing Examination (USMLE) Step 2 Clinical Skills (CS) cases and examinees based on substantive considerations. METHOD: Checklist, patient note, communication and interpersonal skills, as well as spoken English proficiency data were collected from 387 examinees on a set of four USMLE Step 2 CS cases. The fit of skills-based, case-based, and hybrid models was assessed. RESULTS: Findings show that a skills-based model best accounted for performance on the set of four CS cases. CONCLUSION: Results of this study provide evidence to support the structural aspect of validity. The proficiency set used by examinees when performing on the Step 2 CS cases is consistent with the scoring rubric employed and the blueprint used in form assembly. These findings will be discussed in light of past research in this area.

Clinical Competence↗

PubMed2006

Modeling longitudinal performances on the United States Medical Licensing Examination and the impact of sociodemographic covariates: an application of survival data analysis.

BACKGROUND: This study models time to passing United States Medical Licensing Examination (USMLE) for the computer-based testing (CBT) start-up cohort using the Cox Proportional Hazards Model. METHOD: The number of days it took to pass Step 3 was treated as the dependent variable in the model. Covariates were: (1) gender; (2) native language (English or other); (3) medical school location (United States or other); and (4) citizenship (United States or other). RESULTS: Examinees were .59 times as likely to pass USMLE if they were trained abroad. Additionally, examinees who reported having English as their primary language and U.S. citizenship were more likely to ultimately pass USMLE. Finally, though gender was also associated with passing USMLE, its practical significance was very small. CONCLUSION: Cox regression provides a useful tool for modeling performances in a continuous delivery model. Findings suggest that passing the USMLE sequence tends to be associated with native English-speaking USMGs who also hold U.S. citizenship.

Female↗

PubMed2004

Assessment of patient management skills and clinical skills of practising doctors using computer-based case simulations and standardised patients.

CONTEXT: Standardised assessments of practising doctors are receiving growing support, but theoretical and logistical issues pose serious obstacles. OBJECTIVES: To obtain reference performance levels from experienced doctors on computer-based case simulation (CCS) and standardised patient-based (SP) methods, and to evaluate the utility of these methods in diagnostic assessment. SETTING AND PARTICIPANTS: The study was carried out at a military tertiary care facility and involved 54 residents and credentialed staff from the emergency medicine, general surgery and internal medicine departments. MAIN OUTCOME MEASURES: Doctors completed 8 CCS and 8 SP cases targeted at doctors entering the profession. Standardised patient performances were compared to archived Year 4 medical student data. RESULTS: While staff doctors and residents performed well on both CCS and SP cases, a wide range of scores was exhibited on all cases. There were no significant differences between the scores of participants from differing specialties or of varying experience. Among participants who completed both CCS and SP testing (n = 44), a moderate positive correlation between CCS and SP checklist scores was observed. There was a negative correlation between doctor experience and SP checklist scores. Whereas the time students spent with SPs varied little with clinical task, doctors appeared to spend more time on communication/counselling cases than on cases involving acute/chronic medical problems. CONCLUSION: Computer-based case simulations and standardised patient-based assessments may be useful as part of a multimodal programme to evaluate practising doctors. Additional study is needed on SP standard setting and scoring methods. Establishing empirical likelihoods for a range of performances on assessments of this character should receive priority.

Adult↗

PubMed1998

Maintaining Content Validity in Computerized Adaptive Testing.

A major advantage of using computerized adaptive testing (CAT) is improved measurement efficiency; better score reliability or mastery decisions can result from targeting item selections to the abilities of examinees. However, this type of engineering solution can result in differential content for different examinees at various levels of ability. This paper empirically demonstrates some of the trade-offs which can occur when content balancing is imposed in CAT forms or conversely, when it is ignored. That is, the content validity of a CAT form can actually change across a score scale when content balancing is ignored. On the other hand, efficiency and score precision can be severely reduced by over specifying content restrictions in a CAT form. The results from two simulation studies are presented as a means of highlighting some of the trade-offs that could occur between content and statistical considerations in CAT form assembly.

Journal Article↗