Debating PMP research.
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Biomedical subjects
Publications and source records attributed to D Juul.
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OBJECTIVE: The aim of this study was to examine the reliability (examination stability) of the American Board of Psychiatry and Neurology (ABPN) Part II (oral) examination in psychiatry. METHOD: The authors analyzed the consistency (agreement between grades given by two independent examiners) for a 1-year examination cycle using a weighted kappa statistic and compared different parts of the examination (live patient and videotape), different examination sites, different days, and different times of the day. RESULTS: There was no significant difference in agreement between examiners by different parts of the examination, examination site, day of the week, or time of day. CONCLUSIONS: The stability of the Part II ABPN examination in psychiatry is not influenced significantly by the format or site of administration. Candidate performance is the predominant factor in the determination of passing or failing grades.
OBJECTIVE: The aim of the study was to examine the reliability (interexaminer consistency) of the American Board of Psychiatry and Neurology (ABPN) Part II (oral) examination in psychiatry. METHOD: Grades were assigned independently by two examiners who observed the same examination in a 1-year cycle (1,422 candidates, two examinations each). The consistency between these pairs of grades (pass, condition, fail) was analyzed using a weighted kappa statistic. RESULTS: There was perfect agreement between examiners in 67% of examinations, minor disagreement in 26%, and major disagreement in 7% (weighted kappa = 0.54-0.56). CONCLUSIONS: The Part II ABPN examination demonstrates fair to good reliability as measured by interexaminer consistency. Development of more explicit grading criteria should further improve examiner agreement in future examinations.
This study demonstrates the usefulness of applying Rasch analysis to PMPs. The item and person fit statistics provide the data necessary for determining how well items are functioning and hence how the test might be improved. The results both enhance our understanding of the trait being measured, medical problem solving, and suggest issues that faculty need to be aware of in constructing and scoring PMPs.
A total of 208 fourth-year students at five medical schools participated in an evaluation of a cardiology patient simulator (CPS). One group (116 students) used the CPS during a fourth-year cardiology elective, while another group (92 students) completed a cardiology elective that did not include use of the CPS. There were no differences between the two groups on a multiple-choice test on cardiology and a skills test on the CPS at the beginning of the clerkship. After the clerkship, the students in the CPS group achieved significantly higher scores on a multiple-choice test, a skills test on the CPS, and a skills test on cardiology patients. Both the students and faculty members expressed very favorable attitudes toward the CPS, but the patients perceived no differences between the two student groups. These data demonstrate that the CPS enhances learning both the knowledge and the skills necessary to perform a bedside cardiovascular evaluation and that the skills obtained from use of the simulator are transferable to use with patients.
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"Harvey," the cardiology patient simulator (CPS), is the result of a new type of simulation technology that allows for repetitive practice of bedside cardiology skills and provides feedback to the learner. "Harvey" is able to realistically simulate an essentially unlimited number of both common and rare cardiac disease. This report describes the use of the CPS in continuing medical education programs conducted for members of the American Academy of Family Physicians. Cardiovascular disorders constitute a significant percentage of the practice of family physicians. The CPS teaching system has great potential for helping them keep their cardiovascular diagnostic skills current and for promoting better understanding of recent advances in the diagnosis and treatment of heart disease. The participants in this study were nearly unanimous in their feeling that the CPS accurately simulates cardiology bedside findings and is a valuable teaching tool with which they would like to again be taught in the future.
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