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Biomedical subjects

G Nowacek

Publications and source records attributed to G Nowacek.

13 recordsLinked to original sources
PubMed2000

Comparison of the Objective Structured Clinical Examination with the performance of third-year medical students in surgery.

BACKGROUND: The purpose of this study was to investigate the validity of the Objective Structured Clinical Examination (OSCE) as an evaluation technique by comparing medical student performance on the OSCE with traditional forms of evaluation. SUBJECTS AND METHODS: We analyzed the performance of 129 third-year medical students in the 1997-1998 academic year on clinical evaluations, oral examinations, and NBME subject examinations, and on OSCE, which was not included in the final grade. RESULTS: The OSCE showed high correlation with the final grades received for the clerkship. Seventy-one percent of students receiving High Pass or Honors had high OSCE scores whereas 67% of students with low OSCE scores received poor or Defer grades. Pearson product-moment correlations demonstrated significant bivariate correlations with the other test parameters. CONCLUSIONS: This study demonstrates that the OSCE is similar to the traditional methods in evaluating general ability and is also able to evaluate clinical ability in a standardized manner.

Analysis of Variance↗
PubMed1997

A regionalized perinatal continuing education programme: successful adaptation to a foreign health care system and language.

Much of the decline in perinatal mortality over the past two decades in the United States has been attributed to regionalization of perinatal care. Outreach education from regional medical centres to community hospitals is an essential component of regionalization. The Perinatal Continuing Education Program (PCEP) has been successfully used for outreach education in more than 30 states since 1979. This project tested the efficacy of implementing the PCEP strategy in Poland. PCEP was adapted to Polish conditions, translated, and implemented in four phases. The scheme allowed gradual transfer of ownership to Polish leaders and use of the existing regional structure to disseminate information from regional centres to community hospitals. Evaluation included measures of programme use (participation and completion rates) and acceptance (participant evaluation forms), cognitive knowledge (pre- vs. post-tests), and patient care (chart reviews). Of 2093 doctors, nurses and midwives who began, 1615 (77%) completed the programme, with higher completion by regional centre than community hospital staff. All participant groups responded favourably to the materials and expressed moderate confidence in their mastery of the information and skills. Test scores improved significantly for all phases and for all disciplines, with baseline and final scores consistent with degrees of previous professional education. Large baseline and inter-hospital variations in chart review data restricted analysis of care practices. A comprehensive perinatal education programme can be successfully transferred to a foreign health care system. We believe the following to be particularly important: multidisciplinary instructors and students; a self-instructional format; content aimed at practice rather than theory; and an organized implementation strategy co-ordinated by local personnel.

Community Health Services↗
PubMed1996

Medical students' attitudes toward the autopsy.

BACKGROUND: The autopsy is an educational experience that helps students correlate clinical findings with basic science issues. Because of the sensitive nature of the autopsy, students' attitudes should be considered prior to its design and implementation. METHOD: In 1992-1993, all 147 second-year students at the Medical College of Ohio completed a 26-item Likert questionnaire about their attitudes toward the autopsy. After participating in an elective autopsy experience, 26 students completed the same questionnaire plus 18 additional questions about the environment and behavior of the pathologist. Pre- and post-autopsy responses were factor analyzed using principal-components analysis with a varimax rotation. Student's t-tests were used to compare (1) the pre-autopsy factor scores of the elective participants and the rest of the class and (2) the pre- and post-autopsy scores of the participants. RESULTS: Factor analysis of the attitude questions identified seven factors. Comparison of the pre- and post-autopsy scores of the elective participants revealed statistically significant positive increases on four factors; three factors remained positive or neutral. CONCLUSION: It was concluded that the autopsy elective had a positive influence on the student's attitudes. In addition, the pathologist's behavior and the environment in which the autopsy occurred influenced the students. Twenty-two (85%) of the students indicated the autopsy should be mandatory for all students.

Adult↗
PubMed1995

Issues and challenges in the design of curriculum information systems.

Medical schools are increasingly using curriculum information systems to better manage their curricula, to incorporate alternative learning environments, to expand subject-specific instruction, or to adapt the curricula to the changing health care environment. A curriculum information system contains key features, selected by the system's designers, that describe the objectives, the specific content, and/or the educational activities that compose the curriculum. The underlying purpose of such a system is to document and describe the knowledge, behaviors, skills, attitudes, or activities students will be expected to develop or learn. While it might be ideal to have one system that would meet the needs of all possible users, the programming and maintenance requirements of such a single system would exceed most medical schools' resources. Thus, designers of curriculum information systems must first identify the primary intended-user group: students, faculty, or administrators. The system designed for one group will typically differ from the systems for other groups in the emphasis on and level of content detail and curriculum structure information. The general structure and purposes of curriculum information systems are expressed in three distinct system designs: a curriculum database (most helpful for administrators), a curriculum textbase (for faculty), and an electronic syllabus (for students). The authors describe these different designs, and they discuss challenges faced by system designers.

Curriculum↗
PubMed1994

Assessment of adaptive transportation technology: a survey of users and equipment vendors.

In order to define the state of adaptive transportation equipment, wheelchair users with spinal cord injury (SCI) and equipment vendors were surveyed about equipment, funding, maintenance, and repair. SCI registries from two states, Virginia and Arkansas, were used to create the sample pool of users and 225 responses were received. A list of equipment vendors and vehicle modifiers was compiled from several national resources, and 123 responses were received from 36 states. User respondents were generally satisfied with their adaptive equipment, which typically required only minor inexpensive (< $100) repairs, if any. Personal or family money was used by over 90% of the respondents for equipment funding. Vendors reported that a substantial amount of custom modification or fabrication of equipment is required to meet the needs of their clients. Lifts, external controls, and six-way power seats were cited by vendors as the equipment requiring the most frequent repair. The survey results provide an examination of the opinions and experiences of users and vendors of adaptive transportation equipment, which should prove useful to those involved in evaluating equipment, equipment availability, and the need for industry-wide standards.

Automobiles↗
PubMed1990

Demographic variables in medical school admission.

Admission committees report that demographic variables, although accurate, reliable, and easily obtained from applicants to medical schools, are only moderately important in their decision making. This may be because the committees are concerned about the validity and legality of using such data as admissions criteria. This essay discusses the research on the validity of demographic variables and the recommendations for their legal use in selecting students for medical school. The relationships of age, gender, size of hometown, parental education, parental occupation, parental income, and marital status to medical school outcomes of preclinical performances, clinical performance, attrition, specialty choice, and practice location are summarized. [Race or ethnic group is discussed in a separate essay in this issue.] Although the authors focus on the predictive value of demographic variables, these variables play a more important role as the moderator variables for other predictors of medical school outcomes. The full value of using demographic variables derives from data obtained in local validity studies. To comply with the equal-protection and due-process requirements, admission officers must assure that the use of demographic information in the admission process is explicit in bulletins given to applicants and is uniformly applied in the evaluation of all applicants.

Adult↗
PubMed1985

Outpatient pediatric diabetes--I. Current practices.

A survey of pediatric diabetologists in the U.S. was made in an attempt to define current outpatient practices in diabetes subspecialty clinics. Survey questions addressed clinic organization, health care team members, content of histories and physical examinations, use of laboratory studies, patient education, therapeutic recommendations, self-management practices and screening procedures used to identify early diabetes-related complications. The results of the survey suggested similar clinic organization and operation in most settings; a high degree of reliance on glycosylated hemoglobin determinations; a preference for the use of NPH insulin; and a lack of credence given urinary glucose determinations. Additionally, screening tests for the development of complications are not performed with regularity.

Adolescent↗
PubMed1984

The relationship between psychological stress and insulin-dependent diabetic blood glucose control: preliminary investigations.

Clinical literature has frequently alluded to the role of psychological stress in diabetic blood glucose fluctuations. Past research in the area has been minimal and inconsistent. Recent methodological and measurement advances have made it possible to more accurately assess the impact of psychological stress on long-term diabetic control. Study 1 of this report found a significant positive correlation between the Hassles Scale and Hemoglobin A1 levels in a group of 59 adult insulin-dependent diabetic patients. Social Supports, Type A behavior, and reported therapeutic compliance neither correlated with hemoglobin A1 nor influenced the Hassles-Hemoglobin A1 relationship. In a separate sample of 123 subjects, Study II revealed that diabetic patients generally perceive stress as a very potent factor in blood glucose control, but that different stressors may have differential effects for different diabetic patients. A factor analysis of these data reveals three different stress dimensions of the perceived stress-blood glucose relationship: fight/flight, passive/ruminative, and positive affect.

Adolescent↗
PubMed1980

The high cost of recruiting residents.

We have developed estimates for the cost of recruiting first-year residents through the National Resident Matching Program. The cost to our medical center was estimated to be $1,469 for each resident obtained through the matching program. The cost to each applicant averaged $659, and the cost to the applicants' medical schools for processing letters of recommendation was approximately $99 per student. We describe our recruiting methods and costs in order to provide other medical centers with a source for comparison and to stimulate suggestions for increasing the effectiveness of recruiting. We suggest that limiting the number of programs at which an applicant may interview would reduce costs without damaging the recruiting process.

Costs and Cost Analysis↗
PubMedDate not supplied

Fear of hypoglycemia: quantification, validation, and utilization.

Hypoglycemia can lead to various aversive symptomatic, affective, cognitive, physiological, and social consequences, which in turn can lead to the development of possible phobic avoidance behaviors associated with hypoglycemia. On the other hand, some patients may inappropriately deny or disregard warning signs of hypoglycemia. This study presents preliminary reliability and validity data on a psychometric instrument designed to quantify this fear: the hypoglycemic fear survey. The instrument was found to have internal consistency and test-retest stability, to covary with elevated glycosylated hemoglobin, and to be sensitive to a behavioral treatment program designed to increase awareness of hypoglycemia.

Adolescent↗