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Biomedical subjects

Gregory E Gilbert

Publications and source records attributed to Gregory E Gilbert.

8 recordsLinked to original sources
PubMed2006

Medical school application interview score has limited predictive validity for performance on a fourth year clinical practice examination.

BACKGROUND AND PURPOSE: : Data supporting the predictive validity of the medical school admission interview are mixed. This study tested the hypothesis that the admission interview is predictive of interpersonal interactions between medical students and standardized patients. METHOD: : We determined correlations between admission interview scores and performance on a senior-year Clinical Practice Examination piloting US National Board of Medical Examiners stations. We also completed regression analyses controlling for undergraduate academic performance, gender and ethnicity. Outcome measures included an Interpersonal Skills score and a separate Overall Checklist performance score, completed by standardized patients. RESULTS: : The applicant interview had limited but statistically significant correlation with the Interpersonal Skills (r = 0.15; p < 0.05) score. The applicant interview had a correlation of 0.13 with the Overall Checklist score (p = .056). In linear regression models, the applicant interview had limited but statistically significant correlations with the Interpersonal Skills score and the Overall Checklist score. CONCLUSION: : As practiced at this medical school, the admission interview has limited predictive validity for future interactions with standardized patients. More comprehensive assessment of interpersonal skills during the medical school selection process will be needed in order to better select matriculants with desirable interpersonal skills.

Clinical Competence↗
PubMed2003

Continuity of care and recognition of diabetes, hypertension, and hypercholesterolemia.

BACKGROUND: Continuity of care has been shown to have a variety of health benefits, but the effect of continuity of care on recognition of common chronic diseases has been underinvestigated. OBJECTIVE: To examine the relationship between continuity of care and the recognition of 3 prevalent chronic diseases: diabetes, hypertension, and hypercholesterolemia. METHODS: We analyzed data from the third National Health and Nutrition Examination Survey, a nationally representative sample of 18 162 adult noninstitutionalized residents of the United States collected from 1988 through 1994. We examined the proportion of unrecognized disease among all individuals with diabetes, hypertension, and hypercholesterolemia according to self-reported level of continuity of care. We used logistic regression to control for possible confounders, including number of disease risk factors. RESULTS: Among persons with diabetes, in adjusted models, those with a usual provider of care had a lower likelihood of having unrecognized disease (odds ratio, 0.30; 95% confidence interval, 0.10-0.95) than those with no usual site or provider of care. Unrecognized hypertension had an unadjusted relationship with level of continuity of care, but continuity of care was not a significant predictor after possible confounders were adjusted for. Unrecognized hypercholesterolemia was not predicted by level of continuity of care. CONCLUSIONS: Continuity of care has some benefits in terms of recognizing chronic disease, although benefits appear to be disease specific. More research needs to be conducted to elucidate the complex relationship between continuity and disease recognition.

Adolescent↗
PubMed2003

Delayed prenatal care and the risk of low birth weight delivery.

To determine if the timing of prenatal care is associated with low birth weight delivery after adjusting for sociodemographic and behavioral risk factors, we performed a retrospective cross-sectional study of singleton births to white (2,945,595) or African-American (552,068) women in the United States in 1996. When adjusted for race, maternal age, educational level attained, and the use of alcohol and tobacco during pregnancy, women beginning care in the 2nd (adjusted RR = 0.85; 95% CI: 0.83-0.86) and 3rd trimesters (RR = 0.87; 95% CI: 0.84-0.91) had a reduced risk of low birth weight compared to women beginning care in the 1st trimester. Our findings suggest that no benefit exists for early initiation of prenatal care for reducing the risk of low birth weight. Findings related to differences in low birth weight among women who start prenatal care later are likely due to sociodemographic differences that may influence access to early care.

Adult↗
PubMed2003

Practice profiles, procedures, and personal rewards according to the sex of the physician.

BACKGROUND: The objective of this study was to explore physician and practice characteristics according to sex. METHOD: All graduates of a southeastern state's family practice residency programs were surveyed. RESULTS: Seven hundred fourteen (53.5%; 79.7% men, 20.3% women) surveys were returned and analyzed. Practice arrangements and practice settings did not differ significantly between the two study groups. Male graduates saw a significantly higher percentage of geriatric patients (28.9% versus 24.7%; P = 0.008) and made significantly more nursing home visits (50.6% versus 35.5%; P = 0.002) and home visits (49.0% versus 33.8%; P = 0.001) than female graduates. With the exception of skin biopsies, a greater percentage of male physicians performed procedures than female physicians. Female graduates and male graduates had the same initial salary but had a significantly different current salary range. No significant differences were seen in personal or career satisfaction. CONCLUSION: Practice patterns of male and female physicians were generally similar. However, significant differences were noted in geriatric care, procedures, and salary.

Adult↗
PubMed2003

Assessing students' communication and interpersonal skills across evaluation settings.

BACKGROUND AND OBJECTIVES: Medical students' interpersonal and communication skills are a fundamental dimension of their clinical competence and will be measured on the anticipated US Medical Licensure Examination (USMLE) standardized patient (SP) exam. We compared students' performance on measures of SP satisfaction on a third-year family medicine Objective Structured Clinical Examination (OSCE) with measures of SP satisfaction on a fourth-year Clinical Practice Examination (CPX). METHODS: A total of 127 students completed both the clerkship OSCE and a CPX. The CPX was a pilot of the National Board of Medical Examiners Standardized Patient Exam. To assess students' interpersonal skills, both exams used modified versions of the American Board of Internal Medicine Patient Satisfaction Questionnaire. Students' scores were standardized, and correlations were calculated. A logistic regression model examined the ability of the OSCE to predict poor performance on the CPX. RESULTS: The correlation between the OSCE and CPX patient satisfaction scores was.08. There was no significant predictive ability of the OSCE for poor performance on the CPX. CONCLUSIONS: Our study calls into question the ability of a routine end-of-clerkship OSCE to identify students' interpersonal skills abilities on fourth-year clinical performance exams and potentially that component of the anticipated USMLE SP exam.

Adult↗
PubMed2002

Predictive validity of the Medical College Admissions Test Writing Sample for the United States medical licensing examination steps 1 and 2.

Despite the amount of published research on the predictive validity of the Medical College Admissions Test (MCAT) taken as a whole, few published reports separate the individual predictive validity of the Writing Sample. The purpose of this study is to provide data on the predictive validity of the Writing Sample for the national licensing exam used in the United States. Subjects consisted of 1992-1995 matriculants from a publicly owned medical school in the Southeastern United States. Independent variables were undergraduate grade point average, and four section scores on a required admissions test (Biological Sciences, Physical Sciences, Verbal Reasoning, and Writing Sample). The dependent variables were Steps 1 and 2 on the three step licensing examination. Steps 1 and 2 of the examination are taken during medical school. Multiple regression models calculated additional variance accounted for by the addition of the Writing Sample to a model containing grade point average and the other admissions test section scores. In multivariate analyses, when grade point average and all admissions test scores were considered as predictors of licensing exam scores, the Writing Sample variable did not add to the ability to predicting the Step 1 or Step 2 scores. The results of this study suggest that the Writing Sample has limited predictive validity for assessing success on a national licensing exam. However, as others suggest, the value of the Writing Sample and other surrogates of communication probably lie in predicting performance in the clinical years of medical school and beyond. Additional work should include evaluating the predictive validity of the Writing Sample and other pre-medical school measures of communication with widely acceptable measures of performance in clinical settings, including physician-patient communication.

Adult↗