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Charlotte Rees

Publications and source records attributed to Charlotte Rees.

At least 19 recordsLinked to original sources
PubMed2005

Multischool, international survey of medical students' attitudes toward "holism".

PURPOSE: Core and optional courses of study in complementary and alternative medicine (CAM) are being incorporated into medical curricula. The authors carried out this study to validate a tool to examine students' attitudes toward holism and CAM and explore the relationships between their attitudes and other demographic and education-related characteristics in a large, multischool, international sample of medical students. METHOD: In 2003 the authors used a modified version of the Integrated Medicine Attitude Questionnaire (IMAQ) to survey students at a total of six medical schools in the United Kingdom, New Zealand, Canada, the United States, and Hong Kong, China. A three-factor model was tested using confirmatory factor analysis, and the internal consistency of the factors were identified using Cronbach's alpha coefficients. A multiple-indicator multiple-cause (MIMIC) analysis was carried out to determine the relationship between IMAQ factors and student characteristics. RESULTS: The authors validated a three-factor model for the IMAQ: (1) attitudes toward holism, (2) attitudes toward the effectiveness of CAM, and (3) attitudes toward introspection and the doctor-patient relationship. Cronbach's alpha coefficients ranged from .41 to .71. The MIMIC model indicated that various background variables were associated with IMAQ factors (gender, race/ethnicity, and school), depending on whether students had previously visited a CAM practitioner and whether students were willing to undertake a special study module in CAM. CONCLUSIONS: Further development work on the IMAQ is required and qualitative research to verify and examine the reasons behind the relationships found in this study between students' attitudes to holism and their demographic and education-related characteristics.

Adolescent↗
PubMed2005

Students' and assessors' attitudes towards students' self-assessment of their personal and professional behaviours.

INTRODUCTION: Previous research has demonstrated self-assessment inaccuracy in medical students. This study aims to examine students' and assessors' attitudes towards students' self-assessment of personal and professional behaviours. METHODS: Twenty-eight [corrected] participants (16 [corrected] Year 1 medical students and 12 personal and professional development assessors) participated in 4 semistructured focus group discussions in April and May 2003. All discussions were audio-taped and transcribed verbatim and the transcripts were theme analysed independently by 2 analysts. RESULTS: Assessors and students perceived accurate self-assessment to be difficult for students and feedback was deemed to be crucial in helping students develop accurate self-assessment of their personal and professional behaviours. Assessors thought that some students had unrealistically high expectations of their own performance and this was thought to be due to various factors, such as previous academic success and gender. Assessors felt that students with high expectations of their own performance exhibited difficult behaviours if they failed to achieve their expectations. Students suggested that the school and the assessors had too high a level of expectation of their personal and professional behaviours, leading them to underestimate students' performance. DISCUSSION: These difficulties surrounding self-assessment accuracy support the findings reported in previous literature and suggest that medical educators should encourage students to self-assess their own performance wherever possible. These results need to be triangulated with other sources of data such as expert panels or quantitative data.

Adolescent↗
PubMed2005

The acceptability of 360-degree judgements as a method of assessing undergraduate medical students' personal and professional behaviours.

INTRODUCTION: Medical students' personal and professional behaviours have been assessed poorly in medical schools. No research exists exploring the acceptability of 360-degree judgements as a method of assessing such behaviours. This study aims to explore students' and assessors' views and experiences of 360-degree judgements. METHODS: Sixteen [corrected] students and 12 assessors participated in 4 focus group discussions in spring 2003. Discussions were audio-taped and transcribed verbatim and the transcripts were theme analysed independently by 2 analysts. RESULTS: Although 360-degree judgements were felt to drive students' behaviour positively, they were also thought to influence learning and behaviour adversely. Various factors were thought to influence assessors' abilities to make good quality judgements, such as situational factors like the length of time spent with students, characteristics relating to the assessment criteria and characteristics of the assessor, such as apathy. DISCUSSION: Additional research using qualitative and quantitative methods is needed to explore these issues further.

Adolescent↗
PubMed2004

Medical students' views and experiences of methods of teaching and learning communication skills.

This study aims to explore undergraduate medical students' views and experiences of methods of teaching and learning communication skills. Five focus groups were conducted with 32 students, with representatives from each of the 5 years of the medical degree, at the University of Nottingham, UK. The audiotapes were transcribed in full and the transcripts were theme analysed independently by two analysts. Two themes relating to methods of teaching and learning communication skills emerged from the analysis. Students had mixed views about instructional methods of teaching and learning communication skills such as lectures. Students seemed to prefer experiential methods of learning communication skills such as role-playing with simulated patients and communicating with real patients in a clinical context. These findings have a number of educational and research implications and these are discussed in this paper.

Adult↗
PubMed2004

Undergraduate medical students' views about a reflective portfolio assessment of their communication skills learning.

INTRODUCTION: To date, no studies have examined preclinical medical students' views about portfolios. Since portfolios are becoming increasingly valued in medical education, this study explores second-year medical students' views about a reflective portfolio assessment of their communication skills. METHODS: 178 second-year medical students at the University of Nottingham completed the 18-item reflective portfolio questionnaire (RPQ) (alpha = 0.716) and a personal details questionnaire three days before submitting their portfolio assessment for communication skills. Data were analysed using univariate and multivariate statistics on SPSS Version 10.0. RESULTS: Total scores on the RPQ ranged from 40 to 75 (mean 58.28, SD 7.08). Significant relationships existed between RPQ total scores and students' ratings of their reflection skills (rs = 0.322, P < 0.001), RPQ total scores and students' confidence building another portfolio (T = 4.381, d.f. = 176, P < 0.001), and RPQ total scores and students' marks for their reflective portfolio assessment (rs = 0.167, P = 0.029). Students with more positive views about reflective portfolios were more likely to rate their reflection skills as good, receive better marks for their portfolio assessment, and be more confident building another portfolio. DISCUSSION: This study begins to highlight preclinical medical students' views about reflective portfolios. However, further research is required using qualitative studies to explore students' views in depth. Medical educators should be encouraged to consider introducing portfolios as a method of formative and summative assessment earlier in the medical curriculum.

Adolescent↗
PubMed2003

Development of a reliable and valid questionnaire to test the prostate cancer knowledge of men with the disease.

Several prostate cancer knowledge questionnaires exist but none have demonstrated both reliability and validity when used by men with the disease. This study aims to develop a reliable and valid knowledge questionnaire for men with prostate cancer. After developing a 40-item Prostate Cancer Knowledge Questionnaire (PCKQ-40) in phase I, it was piloted in phase II with 391 medical students. This resulted in the reduction of the tool by removing items of poor discriminatory value. A balance between true and false items and content domains was also maintained in the reduced scale. The PCKQ-12 had a moderate internal consistency. Phase III of the study assessed the reliability and construct validity of the tool by measuring the prostate cancer knowledge levels of men with prostate cancer (n=28), men with other cancers (n=10) and men without cancer (n=84). Men with prostate cancer achieved significantly higher PCKQ-12 scores compared with men without cancer, supporting the construct validity of the tool. The tool's reliability was also confirmed with a moderate internal consistency. This study provides some evidence for the reliability and validity of the PCKQ-12 and supports its use with men with prostate cancer in further research.

Adolescent↗
PubMed2003

A phase I trial of ZD9331, a water-soluble, nonpolyglutamatable, thymidylate synthase inhibitor.

PURPOSE: ZD9331 is a novel, direct-acting antifolate cytotoxic that does not require polyglutamation for activity, and is a specific thymidylate synthase inhibitor. This Phase I trial aimed to determine the maximum tolerated dose of ZD9331, given as a 30-min i.v. infusion on days 1 and 8 of a 21-day cycle. Pharmacokinetic parameters and tumor response were also assessed. EXPERIMENTAL DESIGN: A total of 71 patients, with a range of solid malignancies and refractory to standard therapies (44% had received > or =3 prior chemotherapy regimens), were treated. The most common malignancies were colorectal cancer (35% of patients) and ovarian cancer (31%). ZD9331 was escalated from 4.8 mg/m(2)/day. RESULTS: Dose-limiting toxicity occurred at 162.5 mg/m(2) ZD9331, with grade 4 thrombocytopenia, grade 4 neutropenia lasting > or =7 days, and grade 3 nonhematologic toxicity. Plasma clearance of ZD9331 was slow and dose-dependent; however, ZD9331 pharmacokinetics were nonlinear. Pharmacodynamics of ZD9331 were determined by measurement of plasma deoxyuridine, which increased at all of the dose levels; dose-related increases in plasma deoxyuridine were significant (P = 0.003) on day 5. Stable disease was observed in 37% of patients; 23% of ovarian cancer patients had a > or =50% reduction in CA125 levels. CONCLUSIONS: The maximum tolerated dose of this schedule was 130 mg/m(2). The toxicity profile at this dose was acceptable, with 7 of 28 patients treated developing grade 3/4 neutropenia and thrombocytopenia, 2 grade 4 diarrhea, and 2 grade 3/4 rash. This schedule was convenient and demonstrated activity in extensively pretreated patients; therefore, this is the recommended dose for study in Phase II trials.

Adult↗
PubMed2003

Phase I trial of ZD9331, a nonpolyglutamatable thymidylate synthase inhibitor, given as a 5-day continuous infusion to patients with refractory solid malignancies.

PURPOSE: This dose-escalating study investigated the toxicity, pharmacokinetics, and efficacy of the novel direct-acting antifolate ZD9331, given as a 5-day i.v. infusion every 3 weeks. EXPERIMENTAL DESIGN: Forty-five patients with refractory solid malignancies received ZD9331, which was escalated from 0.125 mg/m(2)/day. RESULTS: Dose-limiting grade 4 thrombocytopenia occurred in 3 of 6 patients treated at 8 mg/m(2)/day; other drug-related toxicities, across dose levels, included skin and gastrointestinal toxicity, lethargy, and asymptomatic, reversible, elevated transaminases. The maximum plasma concentration and area under the curve increased with dose. Clearance was dose-dependent and predominantly renal. At doses >/=2.4 mg/m(2)/day, plasma 2'-deoxyuridine levels were elevated consistently indicating inhibition of thymidylate synthase. Two patients had a partial response (breast, 1 patient; ovarian, 1 patient), and 10 patients had stable disease. CONCLUSION: The maximum tolerated dose was defined as 6 mg/m(2)/day, and the toxicity profile for this regimen was considered acceptable and manageable. Administration of ZD9331 lead to elevation of 2'-deoxyuridine levels, signifying thymidylate synthase inhibition, and evidence of antitumor activity was observed.

Adult↗
PubMed2002

The development of a scale to measure medical students' attitudes towards communication skills learning: the Communication Skills Attitude Scale (CSAS).

INTRODUCTION: There is little research identifying medical students' attitudes towards communication skills learning. This pilot study outlines the development of a new scale to measure attitudes towards communication skills learning. METHODS: First- and second-year medical students (n = 490) completed the 26-item Communication Skills Attitude Scale (CSAS) and 39 students completed the CSAS on a second occasion. Factor analysis was conducted to determine the factors underpinning the scale. The internal consistency of the subscales was determined using alpha coefficients. The test-retest reliability of the individual scale items were determined using weighted kappa coefficients and the test-retest reliability of the subscales were established using intraclass correlation coefficients. RESULTS: Maximum likelihood extraction with direct oblimin rotation resulted in a 2-factor scale with 13 items on each subscale. Factor I represented positive attitudes towards communication skills learning and factor II represented negative attitudes. Subscale I had an internal consistency of alpha=0.873 and an intraclass correlation of 0.646 (P < 0.001). Subscale II had an internal consistency of alpha=0.805 and an intraclass correlation of 0.771 (P < 0.001). The majority of items on the positive (n=9, 69.2%) and the negative attitude subscales (n=8, 61.5%) possessed moderate test-retest reliability. DISCUSSION: The development of a new and reliable scale to identify medical students' attitudes towards communication skills learning will enable researchers to explore the relationships between medical students' attitudes and their demographic and education-related characteristics. Further work is needed to validate this scale among a broader population of medical students.

Adolescent↗
PubMed2002

Communication skills assessment: the perceptions of medical students at the University of Nottingham.

INTRODUCTION: Despite the wealth of literature surrounding communication curricula within medical education, there is a lack of in-depth research into medical students' perceptions of communication skills assessment. This study aims to address this gap in the research literature. METHODS: Five focus group discussions were conducted with 32 students, with representatives from each of the 5 years of the medical degree course at Nottingham University. Audiotapes of the discussions were transcribed in full and the transcripts were theme analysed independently by 2 analysts. RESULTS: Two assessment-related themes emerged from the analysis: namely, students' perceptions of formative assessment and students' perceptions of summative assessment. While students seemed to value formative methods of assessing their communication skills, they did not appear to value summative methods like objective structured clinical examinations (OSCEs). Students had mixed views about who should assess their oral communication skills. Some students preferred self-assessment while others preferred peer assessment. Although students appeared to value medical educators assessing their communication skills, other students preferred feedback from patients. Although summative methods like OSCEs were criticized widely, students suggested that examinations were essential to motivate students' learning of communication skills. DISCUSSION: This study begins to illustrate medical students' perceptions of communication skills assessment. However, further research using large-scale surveys is required to validate these findings. Medical educators should provide students with feedback on their communication skills wherever possible. This feedback should ideally come from a combination of different assessors. Over-assessment in other subject areas should be minimized to prevent students being discouraged from learning communication skills.

Adult↗
PubMed2002

The relationship between medical students' attitudes towards communication skills learning and their demographic and education-related characteristics.

INTRODUCTION: The General Medical Council (GMC) has stressed the importance of medical students' attitudes towards learning. However, few studies have explored medical students' attitudes towards communication skills learning. This study explores the relationship between the attitudes of medical students at two different schools and their demographic and education-related characteristics. METHODS: A total of 490 medical students from the Universities of Nottingham (Years 1 and 2) and Leicester (Year 1) completed the 26-item Communication Skills Attitude Scale (CSAS) and a personal details questionnaire satisfactorily. The relationships between students' attitudes and their demographic and education-related characteristics were analysed separately for Nottingham and Leicester students using both univariate and multivariate statistics. RESULTS: The attitudes of Nottingham and Leicester medical students towards communication skills learning were significantly associated with a number of demographic and education-related characteristics. Both Nottingham and Leicester students with more positive attitudes towards communication skills learning tended to be female, tended to think their communication skills needed improving and tended not to have parents who were doctors. Both Nottingham and Leicester students with more negative attitudes towards communication skills learning tended to think their communication skills did not need improving. DISCUSSION: The results indicate that medical students' attitudes towards communication skills learning are associated with their demographic and education-related characteristics. These findings have a number of implications for educational practice and further research and these are discussed in this paper.

Adult↗