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Biomedical subjects

Arthur Rifkin

Publications and source records attributed to Arthur Rifkin.

10 recordsLinked to original sources
PubMed2005

Correlation between housestaff performance on the United States Medical Licensing Examination and standardized patient encounters.

BACKGROUND: There is interest in the use of "standardized patients" to assist in evaluating medical trainees' clinical skills, which may be difficult to evaluate with written exams alone. Previous studies of the validity of observed structured clinical exams have found low correlation with various written exams as well as with faculty evaluations. Since the United States Medical Licensing Examination (USMLE) results are often used by training programs in the selection of applicants, we assessed the correlation between performance on an observed structured clinical exam and the USMLE, steps 1 and 2, for internal medicine housestaff. METHODS: We collected scores on the USMLE, steps 1 and 2, and the overall score from a required standardized patient encounter for all PGY-1 trainees, in a single urban teaching hospital. Pearson coefficients were used to compare the USMLE and observed structured clinical exam performance. RESULTS: The two steps of the USMLE correlated with each other to a large extent (r=0.65, df=30, p=0.0001). However, both steps of the USMLE correlated poorly with the observed structured clinical exam (step 1 r=0.2, df=32, p=0.27; step 2 r=0.09, df=30, p=0.61). CONCLUSIONS: The low correlation between the USMLE and performance on a structured clinical exam suggests that either the written exam is a poor predictor of actual clinical performance, the small window of clinical skills measured by the structured clinical exam is inadequate, or the two methods evaluate different skill sets entirely. Our findings are consistent with previous work finding low correlations between structured clinical exams and accepted common means of evaluation, such as faculty evaluations, other written exams and program director assessments. The medical education community needs to develop an objective, valid method of measuring important, yet subjective, skill-sets such as interpersonal communication, empathy and efficient data collection.

Clinical Competence↗
PubMed2004

The efficacy of ECT in adults with mental retardation experiencing psychiatric disorders.

There is a paucity of empirical data establishing the efficacy of electroconvulsive therapy (ECT) in patients with mental retardation and psychiatric disorders. This study examines the efficacy of ECT on specific symptoms and between psychiatric diagnoses in patients with mental retardation who are psychiatrically ill. A chart review was performed on 20 inpatients who had received ECT on a dedicated Mental Retardation-Dual Diagnosis Unit and were divided into 3 categories: mood disorders (n = 12), psychotic disorders (n = 6), and intermittent explosive disorder (n = 2). Ratings were performed 1 week before ECT treatment and 1-week after its termination using the Aberrant Behavior Checklist and the Clinical Global Impressions Severity Scale. A repeated-measures analysis of variance comparing Aberrant Behavior Checklist scale scores revealed a significant time-by-treatment interaction (F = 75.43, df = 1,9, P = 0.000, 2 t). The mood disorder and psychotic disorder groups had significantly lower irritability and hyperactivity scores after treatment compared with the intermittent explosive disorder group. The Clinical Global Impressions Severity Scale rating scores showed significant improvement in the mood disorders group (67%), in contrast to the intermittent explosive disorder group (0%). Our data suggests the utility of ECT for patients with mental retardation who also have treatment-resistant mood disorders and psychotic disorders, particularly with symptoms of hyperactivity and irritability. The data are sufficiently encouraging to justify prospective research of this question.

Adult↗
PubMed2004

General psychiatry residents' perceptions of specialized training in the field of mental retardation.

This study examined the perceptions of general psychiatry residents about the utility of specialized training that they received on an inpatient unit for patients with mental retardation and co-occurring psychiatric disorders. An anonymous questionnaire was sent to 58 former and current residents, and 43 questionnaires were returned. Views about the educational components of the training program were rated by Likert scale. A total of 98 percent of respondents strongly agreed or agreed that training was useful. Most respondents (56 percent) rated the training as sufficient preparation to treat patients with mental retardation; 84 percent reported that the training should be required during psychiatric residencies. Psychiatry residents were very satisfied with their specialized educational experience and found it to be a valuable component of their training.

Attitude of Health Personnel↗