Biomedical subjects

Clarence Kreiter

Publications and source records attributed to Clarence Kreiter.

8 recordsLinked to original sources

PubMed2004

Medical students' use of information resources: is the digital age dawning?

PURPOSE: One of the many challenges clinicians face is applying growing medical knowledge to specific patients; however, there is an information gap between information needs and delivery. Digital information resources could potentially bridge this gap. Because most medical students are exposed to personal computers throughout their education, this study postulated that students may be more comfortable using computer-based information resources within clinical interactions. METHOD: In 2001, the authors monitored second-year medical students' use of a unique digital textbook, UpToDate, as they transitioned from preclinical to clinical years at the University of Iowa Roy J. and Lucille A. Carver College of Medicine. In 2002, at the end of their third year, students were surveyed about their preferred clinical information resources. RESULTS: Medical students rapidly adopted UpToDate as a clinical resource during their clinical clerkship as evidenced by a rapid growth in the electronic textbook's use. One hundred sixteen of a possible 154 students (75%) responded to the survey. More than 85% of respondents identified electronic sources as their primary resource (UpToDate 53%, MDConsult 33%; p <.001 when compared to paper resources). They also reported using the information resources on a daily basis and requiring less than 15 minutes to answer most of their clinical questions. CONCLUSIONS: This study clearly demonstrates that medical students embrace and use electronic information resources much more than has been reported among practicing clinicians. The current generation of students may be the leaders in a medical culture shift from paper to electronic resources.

Attitude of Health Personnel↗

PubMed2004

Computer-based testing: initial report of extensive use in a medical school curriculum.

BACKGROUND: Computer-based digital technology offers many opportunities in medical education. One type of digital technology, computer-based testing (CBT), has potentially wide application in undergraduate, graduate, and continuing medical education. DESCRIPTION: This articles describes the development of CBT in an undergraduate medical curriculum. EVALUATION: An early step in evaluating CBT is to be sure that the exam format is measuring the examinees' knowledge and not their comfort level or confidence with the technology. It is, therefore, important that the CBT reproduce or accommodate traditional test-taking behavior. CBT also provides for a number of enhancements not easily achieved with traditional paper-and-pencil exams. These include easier control and editing of exam items, better incorporation of testing into the learning environment using specific feedback, and enhancing the questions by incorporating multimedia. CBT does present some unique challenges in testing security, and this article discusses the approach to the security issues. In addition, before initiating CBT into a medical curriculum, the institution must understand the technical and infrastructure requirements for CBT. CONCLUSIONS: By providing a 5-year experience with CBT in the medical curriculum, this article hopes to facilitate discussions among medical educators in its appropriate application and evaluation.

Clinical Competence↗

PubMed2003

Pelvic floor nerve conduction studies: establishing clinically relevant normative data.

OBJECTIVE: The purpose of this study was to establish data for normative distributions for pudendal and perineal nerve compound muscle action potential data in healthy women across a wide age range and varied history of vaginal deliveries. STUDY DESIGN: We studied 42 continent women, aged 20 to 67 years, including 29% nulliparous women with a disposable St. Mark's electrode to stimulate the pudendal nerve at the ischial spine by a transvaginal approach. The pudendal terminal motor latency and amplitude were detected with the use of surface patch electrodes overlying the external anal sphincter; the perineal responses were measured with the use of a surface ring electrode at the proximal urethra. RESULTS: None of the data were distributed normally and required the use of negative inverse and cube root transformations to create a normal distribution. Clinical correlations were found with advancing age and vaginal delivery. CONCLUSION: The collection of these data allows for the definition of normal limits and begins the study of clinically important variables on test results and clinical outcomes.

Action Potentials↗

PubMed2002

Innovative testing method for an integrated radiology-histology curriculum.

A module of radiology instruction was incorporated into an existing histology course for first-year medical students (n = 177). An innovative testing methodology for assessing the instructional effectiveness of the integrated radiology-histology module was developed and tested. Test items were designed to measure the students' ability to integrate the two disciplines successfully. Radiologic and histologic images were displayed at each of seven stations, to which the content of the images either were or were not related. The seven stations were incorporated into three traditional histology laboratory examinations. For purposes of data analysis, each test was divided into three components, including histology alone, histology in combination, and radiology in combination. Testing lengths were equated using the Spearman-Brown statistical adjustment. Analysis of the test results showed the reliability coefficients to be comparable to the traditional testing methods used previously in the course. Correct responses were similar in all three sections, ranging between 85 to 97%. This methodology thus appears to be an effective means of testing an integrated curriculum.

Anatomy↗

PubMed2002

Integrated approach to teaching and testing in histology with real and virtual imaging.

The University of Iowa College of Medicine histology teaching laboratory incorporates extensive Web- and computer-based teaching modalities, including the Virtual Microscope (VM), as emerging learning aids in histology and pathology laboratory instruction. We report here our experience in offering a multiple resource-based approach to laboratory instruction while retaining the opportunity and requirement of examining actual microscopic slide preparations with the microscope. Acceptance of this approach has been high among our students and faculty, and performance levels established over years of teaching histology by traditional means have been maintained.

Anatomy↗

PubMed2002

A statistical technique for the development of an alternate list when using constrained optimization to make admission decisions.

BACKGROUND: In an earlier study it was demonstrated that constrained optimization could be used to accurately translate admission goals. Constrained optimization differs from weighting equations in that it does not assign a rank ordering. Although constrained optimization is conceptually superior, some procedures within the admissions process require a rank ordering of applicants. PURPOSE: The purpose of this study is to describes and evaluate the use of two discriminant analysis procedures to obtain a rank order list by generating weights that model constrained optimization procedures. This study also evaluates the usefulness of an additional method that does not require a rank ordering. METHODS: Premium Solver selected a class from the 1998/99 applicant pool. A discriminant analysis was used to generate a discriminant function for modeling the dichotomous group classification selection variable. These weights were then applied and the discriminant function values calculated. The success of the procedure was evaluated by examining rank orders and the magnitude of the correlation and R-square statistic. RESULTS: Discriminant analysis accounted for 70% of the decision variance generated by the constrained optimization procedure. Using real data allowed an estimate of the number of students impacted by inconsistent outcomes. CONCLUSION: Discriminant analysis could be used to manage an alternate list, however it will be based on somewhat different criteria than the initial selection procedure. Each method evaluated has advantages and disadvantages and the selection of one method over another depends on what outcomes are most valued by the college.

Discriminant Analysis↗

PubMed2002

Teaching delivery of bad news using experiential sessions with standardized patients.

BACKGROUND: Delivering bad news is a difficult task that is important to address in medical education. PURPOSE: This study evaluated the impact of an experiential educational intervention using multiple standardized patient scenarios on medical students' comfort with delivering difficult news. METHODS: In small groups, 3rd-year medical students practiced communicating bad news within the context of five different patient scenarios. During 1999 and 2000, surveys were administered to 341 students before and 4 weeks and 1 year after the program. Students rated comfort level in discussing bad news, terminal illness, hospice, and dying with patients. RESULTS: A significant one standard deviation change was observed in students' self-reported comfort in communicating bad news after the educational program. The intervention was highly rated, especially the encounters with standardized patients and observation of others. CONCLUSIONS: Experiential education using multiple standardized patient scenarios is a successful model for increasing student comfort in responding to difficult clinical communication tasks.

Communication↗

PubMedDate not supplied

Using infant mannequins in objective standardized clinical examinations: are there unintended consequences?

OBJECTIVE: In objective standardized clinical examination (OSCE) of infants, real infants are generally not used. Instead, the standardized patient portrays a parent who answers a student's questions, and there is no physical examination. One way to assess physical examination skills in these encounters is to have students demonstrate the appropriate examination on a mannequin. But before using this approach, we wanted to assess whether having students examine mannequins affects their history-collecting or communication skills. METHODS: Third-year medical students were randomized to 2 versions of an infant OSCE case. During the encounter, controls were handed a printed listing of all physical examination (PE) findings. Students in the mannequin group were told relevant PE findings only after the students had examined a part of the mannequin. Student performances on the OSCE case and perceptions about the case were compared. RESULTS: Thirty-two students were in the control group, and 35 students examined mannequins. No differences were found in total case score (P = .78), or on history-gathering skills (P = .86) and communication skills subscales (P = .78). In addition, questionnaires completed by students after the encounter indicated that the infant mannequins did not affect student perceptions about the realism of the case (P = .91). CONCLUSIONS: Student performances at collecting the clinical history or communicating with the standardized patient were not adversely affected by inclusion of an infant mannequin. This suggests mannequins can be used to assess students' knowledge of the relevant case-specific PE without adverse effect.

Adult↗