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Biomedical subjects

Debra L Klamen

Publications and source records attributed to Debra L Klamen.

5 recordsLinked to original sources

See one, do one, teach one--exploring the core teaching beliefs of medical school faculty.

This paper explores the core teaching beliefs of medical school faculty and establishes whether these beliefs differ among basic science, clinical, and instruction specialist faculty. One hundred and twenty-five medical school teachers who were members of professional organizations dedicated to the improvement of medical school teaching completed a Q-sort of 56 statements reflecting their core teaching beliefs. The statements described beliefs about motivation, knowledge and skill acquisition, retention, feedback, transfer, teacher characteristics, and teaching strategies. Q-sorts were completed by 37 basic scientists (30% of respondents), 59 clinicians (47%) and 29 instruction specialists (23%) working in medical schools. Fifty-two participants were classroom teachers (42%), 66 were classroom and clinical teachers (53%), and seven reported that they do not teach (6%). The Q-sort results indicate how medical school faculty members differ in their core beliefs about teaching and learning. Thirty-two respondents (26%) focused on the student as a person first. Eight (6%) were content oriented. Thirty-four (27%) were performance oriented; their focus was on having students learn and apply knowledge and skills to accomplish clinical tasks. Fifty-one respondents (41%) were found to have a blend of these viewpoints. Respondents' type of training or type of teaching did not provide a reliable indication of core teaching beliefs classification.

Culture↗

Forecasting residents' performance--partly cloudy.

The authors offer a practical guide for improving the appraisal of a resident's performance. They identify six major factors that compromise the process of observing, measuring, and characterizing a resident's current performance, forecasting future performance, and making decisions about the resident's progress. Factors that compromise any of these steps lead to individual and collective uncertainty and decrease faculty confidence when making decisions on a resident's progress. The six factors, addressed in order of importance, are inaccuracies due to (1) incomplete sampling of performance, (2) rater memory constraints, (3) hidden performance deficits of the resident, (4) lack of performance benchmarks, (5) faculty members' hesitancy to act on negative performance information, and (6) systematic rater error. The description of each factor is followed by a number of specific suggestions on what residency programs can do to eliminate or minimize the impact of these factors. While this article is couched in the context of the performance evaluation of residents, everything included pertains to measuring and appraising medical students' and practicing physicians' clinical performance as well.

Academic Medical Centers↗

Improving resident performance assessment data: numeric precision and narrative specificity.

PURPOSE: To evaluate the use of a systems approach for diagnosing performance assessment problems in surgery residencies, and intervene to improve the numeric precision of global rating scores and the behavioral specificity of narrative comments. METHOD: Faculty and residents at two surgery programs participated in parallel before- and-after trials. During the baseline year, quality assurance data were gathered and problems were identified. During two subsequent intervention years, an educational specialist at each program intervened with an organizational change strategy to improve information feedback loops. Three quality-assurance measures were analyzed: (1) percentage return rate of forms, (2) generalizability coefficients and 95% confidence intervals of scores, and (3) percentage of forms with behaviorally specific narrative comments. RESULTS: Median return rates of forms increased significantly from baseline to intervention Year 1 at Site A (71% to 100%) and Site B (75% to 100%), and then remained stable during Year 2. Generalizability coefficients increased between baseline and intervention Year 1 at Site A (0.65 to 0.85) and Site B (0.58 to 0.79), and then remained stable. The 95% confidence interval around resident mean scores improved at Site A from baseline to intervention Year 1 (0.78 to 0.58) and then remained stable; at Site B, it remained constant throughout (0.55 to 0.56). The median percentage of forms with behaviorally specific narrative comments at Site A increased significantly from baseline to intervention Years 1 and 2 (50%, 57%, 82%); at Site B, the percentage increased significantly in intervention Year 1, and then remained constant (50%, 60%, 67%). CONCLUSIONS: Diagnosing performance assessment system problems and improving information feedback loops improved the quality of resident performance assessment data at both programs.

Adult↗

Using standardized patients for formative feedback in an introduction to psychotherapy course.

Standardized patients (SPs) were used in a 9-week Introduction to Psychodynamic Psychotherapy course for 11 first-year psychiatry residents. After 7 weeks of coursework, each resident conducted a simulated initial psychotherapy session. The SPs used were experienced in simulating psychiatric disorders and were free to use as much or as little personal history as they wished. Session ratings by the SPs afforded written feedback to the residents. The sessions were videotaped and selected segments viewed and discussed by the class. Residents kept their tapes and were encouraged to review them on their own and with their supervisors. Residents, SPs, and class instructor all rated the experience very positively. Standardized patients may be a useful adjunct to psychotherapy education. They can provide valuable learning opportunities without giving rise to concerns that complicate the videotaping of actual patients.

Journal Article↗