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Biomedical subjects

Claudio Violato

Publications and source records attributed to Claudio Violato.

13 recordsLinked to original sources
PubMed2006

A multi source feedback program for anesthesiologists.

PURPOSE: To assess the feasibility, validity, and reliability of a multi source feedback program for anesthesiologists. METHODS: Surveys with 11, 19, 29 and 29 items were developed for patients, coworkers, medical colleagues and self, respectively, using five-point scales with an 'unable to assess' category. The items addressed communication skills, professionalism, collegiality, continuing professional development and collaboration. Each anesthesiologist was assessed by eight medical colleagues, eight coworkers, and 30 patients. Feasibility was assessed by response rates for each instrument. Validity was assessed by rating profiles, the percentage of participants unable to assess the physician for each item, and exploratory factor analyses to determine which items grouped together into scales. Cronbach's alpha and generalizability coefficient analyses assessed reliability. RESULTS: One hundred and eighty-six physicians participated. The mean number and percentage return rate of respondents per physician was 17.7 (56.2%) for patients, 7.8 (95.1%) for coworkers, and 7.8 (94.6%) for medical colleagues. The mean ratings ranged from four to five for each item on each scale. There were relatively few items with high percentages of 'unable to assess'. The factor analyses revealed a two-factor solution for the patient, a two-factor solution for the coworker and a three-factor solution for the medical colleague survey, accounting for at least 70% of the variance. All instruments had a high internal consistency reliability (Cronbach's alpha > 0.95). The generalizability coefficients were 0.65 for patients, 0.56 for coworkers and 0.69 for peers. CONCLUSION: It is feasible to develop multi source feedback instruments for anesthesiologists that are valid and reliable.

Anesthesiology↗
PubMed2006

Self and peer assessment of pediatricians, psychiatrists and medicine specialists: implications for self-directed learning.

Self-regulation in medicine depends on accurate self-assessment. The purpose of the present study was to examine the discrepancy between self and peer assessments for a group of specialist physicians from internal medicine (IM), pediatrics, and psychiatry clinical domains (i.e., patient management, clinical assessment, professional development, and communication). Data from 304 psychiatrists, pediatricians and internal medicine specialists were used. Each physician had data from an identical self and 8 peer (38 item/4 clinical domains assessment). A total of 2306 peer assessments were available. Physicians were classified into quartiles based on mean assessment peer data and compared with self-assessment data. The analyses showed that self and peer assessment profiles were consistent across specialties and domains. Physicians assessed in the lowest and highest quartiles (i.e., <25th and >75th) by colleagues tended to rate themselves 30-40 percentile ranks higher and lower than peers, respectively. This study suggests that practicing physicians are inaccurate in assessing their own performance. These data suggest that systems to provide practicing physicians with regular and routine feedback may be appropriate if we are to ensure physicians are able to accurately assess themselves in a profession in which self-regulation is predicated upon the assumption that physicians know their capabilities and limitations.

Clinical Competence↗
PubMed2006

Medical students' clinical reasoning skills as a function of basic science achievement and clinical competency measures: a structural equation model.

BACKGROUND: The purpose of this study was to investigate the fit of a hypothesized model of medical students' diagnostic or clinical reasoning skills based on their aptitude for medical school, basic science achievement, and clinical competency measures. METHOD: A total of 589 medical students who received their MD from 1994 to 2002 participated in this study. Confirmatory factor analysis was used to evaluate the fit of theoretical models of clinical reasoning using measures of basic science and clinical knowledge. RESULTS: The results provided support for a three-factor model of medical student performance (Bentler's Comparative Fit Index = .905, standardized root mean squared residual = .054, root mean squared error of approximation = .105). The clinical reasoning skills of medical students were influenced by an independent relationship between latent variables of basic science achievement and clinical competency. CONCLUSION: The findings support a theoretical model of diagnostic or clinical reasoning that treats the basic science and clinical knowledge of medical students as distinct domains.

Aptitude Tests↗
PubMed2006

Assessment of pediatricians by a regulatory authority.

OBJECTIVE: To determine whether it is possible to develop feasible, valid, and reliable multisource feedback data for pediatricians. METHODS: Surveys with 40, 22, 38, and 37 items were developed for assessment of pediatricians by patients, co-workers, medical colleagues, and themselves, respectively, using 5-point scales with an "unable to assess" category. Items addressed key competencies related to communication skills, professionalism, collegiality, continuing professional development, and collaboration. Each pediatrician was assessed by 25 patients, 8 medical colleagues, and 8 co-workers. Feasibility was assessed with response rates for each instrument. Validity was assessed with rating profiles, the percentage of participants unable to assess the physician for each item, and exploratory factor analyses to determine which items grouped together into scales. Cronbach's alpha and generalizability coefficient analyses assessed reliability. RESULTS: One hundred pediatricians participated. The mean number of respondents per physician was 23.4 (93.6%) for patients, 7.6 (94.8%) for co-workers, and 7.6 (95.5%) for medical colleagues. The mean ratings ranged from 4 to 5 for each item on each scale. Few items had high percentages of "unable to assess" responses. The factor analyses revealed a 4-factor solution for the patient survey, a 3-factor solution for the co-worker survey, and a 4-factor solution for the medical colleague survey, accounting for at least 64% of the variance. All instruments had high internal consistency. The generalizability coefficients were .85 for patients, .87 for co-workers, and .78 for medical colleagues. CONCLUSION: Surveys can be developed to provide feedback data on key competencies.

Canada↗
PubMed2005

Does the medical college admission test predict clinical reasoning skills? A longitudinal study employing the Medical Council of Canada clinical reasoning examination.

BACKGROUND: To investigate the predictive validity of the Medical College Admission Test (MCAT) for clinical reasoning skills upon completion of medical school. METHOD: A total of 597 students (295 males, 49.4%; 302 females, 50.6%) participated from 1991 to 1999. Stepwise multiple regressions of the MCAT and premedical school GPA (independent variables) on the Part 1(declarative knowledge) and Part 2 (clinical reasoning) of the Medical Council of Canada Examinations (dependent variables) were employed. RESULTS: For Part 1, the multiple regression revealed that three predictors (verbal reasoning, biological sciences, GPA) accounted for 23.3% of the variance, and for Part 2, two predictors (verbal reasoning, GPA) accounted for 11.2%. CONCLUSION: There is both convergent and divergent evidence for the predictive validity of the MCAT for clinical reasoning.

Canada↗
PubMed2005

Impact of cognitive imaging and sex differences on the development of laparoscopic suturing skills.

BACKGROUND: The introduction of noninvasive laparoscopic surgery has raised concerns about appropriate teaching techniques for medical students considering surgery as a specialization. The principal aim of this study was to determine the effect, between the sexes, of cognitive imaging as a teaching method in the context of learning a surgical technique. METHODS: A randomized treatment-control sample of 42 medical student volunteers was used to test the effect of cognitive imaging on performance and on traditional instructional techniques to help medical students acquire suturing skills specific to laparoscopic surgery. RESULTS: Repeated-measures analysis of variance showed no significant effect for the use of cognitive imaging (F1,40 = 0.97, p > 0.05). Males tended to perform better than females in completing tasks that required the use of visual-spatial manipulation of the instruments within a simulated laparoscopic environment (F1,40 = 5.08, p < 0.05). CONCLUSIONS: These results, which are in concordance with other research findings, indicate that females generally have lower visual-spatial abilities than males. Enhanced performance for both sexes, however, increases rapidly with practice. Other than verbal one-on-one instruction, males on average rank instructional approaches that are applied and visual higher than do females.

Adult↗
PubMed2004

An examination of the appropriateness of using a common peer assessment instrument to assess physician skills across specialties.

PROBLEM STATEMENT: To determine whether a common peer assessment instrument can assess competencies across internal medicine, pediatrics, and psychiatry specialties. METHOD: A common 36 item peer survey assessed psychiatry (n = 101), pediatrics (n = 100), and internal medicine (n = 103) specialists. Cronbach's alpha and generalizability analysis were used to assess reliability and factor analysis to address validity. RESULTS: A total of 2,306 (94.8% response rate) surveys were analyzed. The Cronbach's alpha coefficient was.98. The generalizabililty coefficient (mean of 7.6 raters) produced an Ep(2) =.83. Four factors emerged with a similar pattern of relative importance for pediatricians and internal medicine specialists whose first factor was patient management. Communication was the first factor for psychiatrists. CONCLUSIONS: Reliability and generalizability coefficient data suggest that using the instrument across specialties is appropriate, and differences in factors confirm the instrument's ability to discriminate for specialty differences providing evidence of validity.

Clinical Competence↗
PubMed2004

A model of childhood perceived peer harassment: analyses of the Canadian National Longitudinal Survey of Children and Youth Data.

The authors developed a model of childhood perceived peer harassment, using several personality, peer, and familial characteristics of victims, and tested it with children 10 to 11 years old (N = 3,434) drawn from the Canadian National Survey of Children and Youth, which is a stratified random sample of 22,831 households in Canada. A 3-step analytic procedure with 3 separate subsamples of the children was used to explore psychosocial correlates of peer harassment. Results from the latent variable path analysis (comparative fit index = .90) showed that victims are likely to feel anxious and disliked by their peers. Their parents reported using high levels of control and low levels of warmth with their children and reported high levels of depression and marital conflict themselves. These results are discussed from a social-cognitive perspective.

Adolescent↗
PubMed2004

A meta-analysis of the published research on the affective, cognitive, and behavioral effects of corporal punishment.

The present study is a meta-analysis of the published research on the effects of corporal punishment on affective, cognitive, and behavioral outcomes. The authors included 70 studies published between 1961 and 2000 and involving 47,751 people. Most of the studies were published between 1990 and 2000 (i.e., 53 or 68%) and were conducted in the United States (65 or 83.3%). Each of the dependent variables was coded, and effect sizes (ds) were computed. Average unweighted and weighted ds for each of the outcome variables were .35 and .20 for affective outcomes, .33 and .06 for cognitive outcomes, and .25 and .21 for behavioral outcomes, respectively. The analyses suggested small negative behavioral and emotional effects of corporal punishment and almost no effect of such punishment on cognition. Analyses of several potentially moderating variables, such as gender or socioeconomic status, and the frequency or age of first experience of corporal punishment, the relationship of the person administering the discipline, and the technique of the discipline all had no affect on effect size outcome. There was insufficient data about a number of the moderator variables to conduct meaningful analyses. The results of the present meta-analysis suggest that exposure to corporal punishment does not substantially increase the risk to youth of developing affective, cognitive, or behavioral pathologies.

Affect↗
PubMed2003

A validity study of expert judgment procedures for setting cutoff scores on high-stakes credentialing examinations using cluster analysis.

This study compares an expert judgment process--minimal performance levels (MPL) using the Nedelsky and Ebel procedures--for setting cutoff scores for pass/fail on licensure examinations with an empirical approach--cluster analysis. Data from all three components of the Canadian Standard Assessment in Optometry (CSAO) examinations (knowledge, clinical judgment, and clinical skills) from 243 candidates were obtained. Results indicate that for the written components of the exams employing the Nedelsky method of MPL setting, there was a mean agreement of pass/fail of 81% with the cluster analysis approach on pass/fail categorization. For the performance exams using the Ebel method, the mean agreement of pass/fail with the cluster analysis was 93%. Thus the subjective approaches to setting cutoff scores (i.e., expert judgment methods) converge with the objective method (i.e., cluster analysis) of classifying test takers in the same categories.

Canada↗
PubMed2003

Likelihood of change: a study assessing surgeon use of multisource feedback data.

BACKGROUND: Multisource feedback, using questionnaire-based data from patients, coworkers, and medical colleagues, is designed to provide broad-based information about clinical performance to facilitate change. PURPOSE: To determine and explain the likelihood that surgeons would implement change following receipt of performance data. METHODS: Surgeons were surveyed to determine the likelihood they would make changes based on specific feedback about their clinical practices. RESULTS: One hundred fifty-three surgeons (76.5%) responded to the follow-up survey. There was little correlation between performance ratings provided by self or medical colleagues and the likelihood of change. A linear regression analysis indicated that 19.2% of the variance in likelihood to change could be explained by age, time spent reviewing feedback, the gap between self- and other ratings, and surgical specialty. CONCLUSION: Surgeons made few changes in practice in response to feedback data. Attention needs to be paid to methods that might increase surgeon use of performance data

Alberta↗
PubMed2002

Certification examinations for massage therapists: a psychometric analysis.

OBJECTIVE: To describe the components of the Alberta Registered Massage Therapists Society (ARMTS) examination and their psychometric properties. METHODS: All 3 components of the ARMTS examination (knowledge, clinical judgement, and clinical skills) were administered to 112 candidates. The examination consisted of 2 written components (140 multiple-choice questions on basic science knowledge and 60 multiple-choice questions on clinical judgment) and a clinical competency assessment of the following practical skills with standardized patients: (1) taking a case history, (2) assessing physical condition, and (3) treating the condition. All components of the examination were criterion-referenced with the methods of minimum performance level (MPL). RESULTS: The internal consistency reliability coefficients (Cronbach alpha) ranged from 0.60 to 0.88 for all test components. The descriptive statistics, performance levels, and reliability estimates indicate that the examination is functioning well. Concurrent, criterion-related validity evidence was provided by correlations between the examination components that ranged from r = 0.24 (P <.05) to r = 0.78 (P <.01). Factor analysis produced 3 factors: information processing, clinical treatment, and follow-up management. CONCLUSIONS: The results provide evidence of adequate-to-good internal consistency reliability and content validity. Empirical validity evidence based on concurrent, criterion-related measures is provided by the correlational analysis. The significant correlations indicate that although performance is related across the examination, the various components do assess unique and independent domains. This is further supported by the results of the factor analysis that provide evidence for discriminant validity of the measures (ie, they discriminate between domains of measurement such as information processing, treatment, and basic knowledge). Taken together, these results indicate that the ARMTS examination has evidence for both reliability and validity.

Canada↗