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Biomedical subjects

J B Erdmann

Publications and source records attributed to J B Erdmann.

At least 19 recordsLinked to original sources
PubMed2002

Empathy in medical students as related to academic performance, clinical competence and gender.

CONTEXT: Empathy is a major component of a satisfactory doctor-patient relationship and the cultivation of empathy is a learning objective proposed by the Association of American Medical Colleges (AAMC) for all American medical schools. Therefore, it is important to address the measurement of empathy, its development and its correlates in medical schools. OBJECTIVES: We designed this study to test two hypotheses: firstly, that medical students with higher empathy scores would obtain higher ratings of clinical competence in core clinical clerkships; and secondly, that women would obtain higher empathy scores than men. MATERIALS AND SUBJECTS: A 20-item empathy scale developed by the authors (Jefferson Scale of Physician Empathy) was completed by 371 third-year medical students (198 men, 173 women). METHODS: Associations between empathy scores and ratings of clinical competence in six core clerkships, gender, and performance on objective examinations were studied by using t-test, analysis of variance, chi-square and correlation coefficients. RESULTS: Both research hypotheses were confirmed. Empathy scores were associated with ratings of clinical competence and gender, but not with performance in objective examinations such as the Medical College Admission Test (MCAT), and Steps 1 and 2 of the US Medical Licensing Examinations (USMLE). CONCLUSIONS: Empathy scores are associated with ratings of clinical competence and gender. The operational measure of empathy used in this study provides opportunities to further examine educational and clinical correlates of empathy, as well as stability and changes in empathy at different stages of undergraduate and graduate medical education.

Analysis of Variance↗
PubMed2001

Correlates of young physicians' support for unionization to maintain professional influence.

PURPOSE: A resolution in support of physicians' unionization was recently approved by the American Medical Association's House of Delegates. This study investigated the factors associated with young physicians' approval of unionization. METHOD: A survey was mailed to all 1987-1992 Jefferson Medical College graduates (n = 1,272); 835 (66%) responded. RESULTS: Of the respondents, 43% supported unionization, 31% did not support unionization, and 26% expressed no opinion. Surgeons, medical subspecialists, pediatricians, and hospital-based specialists were more likely to support unionization than were family physicians. Significant predictors of support for unionization were negative views of the changes in the health care system, negative perceptions of the quality of care provided by managed care, the belief that physicians' independence had been impaired by changes in the health care system, and the belief that physicians' personal satisfaction should take precedence over societal needs in determining the future of health care. Support for unionization correlated with physicians' perceptions that mental health patients should be referred to psychiatrists, physician-assisted suicide should be legalized, and the involvement of nurse practitioners in diagnosis and treatment could compromise the quality of care. CONCLUSIONS: Young physicians' support for unionization is a function of frustration with market-driven policies that compromise the quality of care and negatively affect physicians' autonomy and personal satisfaction.

Female↗
PubMed2000

Gender comparisons of income expectations in the USA at the beginning of medical school during the past 28 years.

This study was designed to investigate gender differences in the USA, in anticipated professional income. Participants were 5314 medical students (3880 men, 1434 women) who entered Jefferson Medical College between 1970 and 1997. The annual peak professional income estimated at the beginning of medical school was the dependent variable and gender within selected time periods was the independent variable. Results showed significant differences between men and women on their anticipated future incomes in different time periods. Women generally expected 23% less income than men. The effect size estimates of the differences were moderately high. The gender gap in income expectations was more pronounced for those who planned to pursue surgery than their counterparts who planned to practice family medicine or pediatrics. A unique feature of this study is that its outcomes could not be confounded by active factors such as experience, working hours, age and productivity. Findings suggest that social learning may contribute to gender gap in anticipated income.

Economics, Medical↗
PubMed2000

Physicians' perceptions of the changing health care system: comparisons by gender and specialties.

This study was designed to investigate physicians' perceptions of changes in the United States health care system impacting academic medicine, quality of care, patient referrals, cost, ethical and sociopolitical aspects of medicine. A survey was mailed in 1998 to 1,272 physicians (graduates of Jefferson Medical (College between 1987 and 1992); 835 physicians (66%) responded. Results showed that a substantial majority (92%) believed that learning to work in a managed care environment should become an essential component of medical education. Physicians perceived that current changes impair physicians' autonomy (94%), and restrain physicians' freedom to provide optimal care (84%). A sizable majority (76%) endorsed patients' freedom to seek specialist care, and 55% believed that capitation reduces physicians' motivation for long-term monitoring of patients. The majority endorsed universal health coverage (80%), and agreed to support rather than resist the changes (62%). Only 18% hold a positive view of the changes in the future. The majority believed that medical education should prepare physicians to provide end-of-life care (92%), and that organized medicine should take a stand on social issues that can influence the well-being of society (79%). Only 34% endorsed the legalization of physician-assisted suicide. No gender differences were observed, but a few differences were found between generalists and specialists. Results can help in understanding physicians' perceptions of current changes in the United States health care system, and in providing guidelines for the development of educational programs to prepare physicians to face new challenges.

Adult↗
PubMed1999

Perceptions of medical school seniors of the current changes in the U.S. health care system.

Perceptions of medical school seniors about changes occurring in the health care environment were investigated. A survey was completed by 196 Jefferson Medical College seniors in the class of 1997. Of the respondents, 79% believed that cost reduction rather than quality of care is the primary consideration behind recent changes, 78% felt that managed care organizations hamper physicians' abilities to render optimal care, 83% maintained that the control of health care by insurance companies would lead to lower quality of care, 69% agreed that patients should have the freedom to seek a specialist's care without being referred by a primary care physician, 82% recommended that mentally ill patients should be referred to a mental health professional, and 82% believed that learning to work in a managed care environment should be an essential component of medical education. Assessment of student perceptions can assist in the development and implementation of appropriate curricular changes.

Attitude of Health Personnel↗
PubMed1999

Relationship between identification with the role of sport fan and trait aggression.

The current research was designed to test the hypothesis that there is no significant relationship between people's identification of themselves as sport fans and trait aggression. 70 participants were asked to complete the Sport Fandom Questionnaire to assess their fandom and the Buss-Durkee Hostility Inventory to assess their trait aggression. As expected, no significant relationship between fandom and aggression was found.

Adolescent↗
PubMed1998

Factors influencing students' borrowing that may affect their specialty choices and other after-graduation behaviors.

PURPOSE: To assess the factors that influence medical students' borrowing and how these factors may affect access to the profession, specialty choice, and medical graduates' repayment behaviors. METHOD: The borrowing patterns of the 3,495 indebted students enrolled at Jefferson Medical College of Thomas Jefferson University between 1989-90 and 1994-95 were analyzed. (Debt included both subsidized and unsubsidized debt.) These borrowing patterns were assessed in relation to changes in the cost of education, family (i.e., parents') income, availability of grant funding, legislative changes to loan-eligibility criteria (specifically, the Higher Education Amendments of 1992), and average interest rates on federal unsubsidized loans. RESULTS: The annual changes in average debt levels suggest that while cost of education, family resources, and availability of grant funding may be significant factors, changes in loan eligibility and prevailing interest rates on unsubsidized loan source also influence medical students' borrowing. A comparison of the borrowing patterns for three income groups (low, middle, high) further demonstrated that while overall fluctuations for low-income group mirrored changes in the cost and resource variables, annual borrowing fluctuations for the middle- and high-income groups were more reflective of the expansion of loan eligibility and reduced interest rates on unsubsidized loans. From 1989-90 to 1994-95 the average cost of education increased by $2,368. Average unsubsidized debt increased by $1,544 for the low-income group, $3,960 for the middle-income group, and $4,439 for the high-income group. The percentage of unsubsidized funding included in the borrowers' financing packages increased by just under 6% for the low-income group but almost 10% and 11% for the middle- and high-income groups, respectively. CONCLUSION: The results suggest that medical students borrow for a variety of reasons, ranging from financial need to personal financing or lifestyle choices. These reasons should be considered in relation to institutional and governmental financial aid policies and future research on the relationship between debt and speciality choice.

Academic Medical Centers↗
PubMed1995

Primary care and non-primary care physicians: a longitudinal study of their similarities, differences, and correlates before, during, and after medical school.

PURPOSE--To investigate similarities and differences between physicians in primary care and non-primary care specialties on performance measures prior to, during, and after medical school, and on demographic characteristics, professional plans and preferences in medical school, professional activities, career satisfaction, perceived problems and research activities, and to predict primary--non-primary care career choices from information obtained in medical school. A questionnaire was mailed to 1,076 physicians who graduated from Jefferson Medical College between 1982 and 1986. Of those who responded (62%), 232 were primary care and 406 were non-primary care physicians (29 physicians in mixed specialties were excluded). Data from the questionnaire concerning professional activities, satisfaction, problems, and research productivities were merged with the college's longitudinal study database. RESULTS--Comparisons of primary care--non-primary care physicians indicated no significant difference between them on performance measures before, during, and after medical school, with the exception that non-primary care physicians had higher scores on quantitative tests before medical school, and primary care physicians scored higher on a licensing examination of general clinical skills and patient management taken during residency training. Also, compared with non-primary care physicians, those in primary care were less likely to be employed full-time, were less likely to locate in metropolitan areas, had a lower rate of academic appointment, and had a higher rate of board certification. Other results showed differences between the groups in terms of age at entrance to medical school, proportion of women, estimates during medical school of anticipated income, career plans during medical school, satisfaction with career and income, and research and scientific activities. A logistic regression model could predict primary care--non-primary care status from specialty interest, professional plans and interests expressed in medical school.

Attitude of Health Personnel↗
PubMed1995

A model for predicting HEAL repayment patterns and its implications for medical student financing.

BACKGROUND: The current level of Health Education Assistance Loan (HEAL) defaults has exceeded the original estimate, and as such is producing an unforeseen federal expenditure. Predicting repayment patterns of HEAL borrowers is an important step in assessing the impact that this unforeseen expenditure will have on HEAL and other financial aid programs. METHOD: Since prior research on educational lending has not identified a practical model for predicting repayment patterns, the authors turned in 1994 to an alternative discipline, research on consumer lending. Using the multivariate discriminant analysis credit scoring model framework, the authors incorporated operational definitions of the borrower's character, capacity, and capital. To identify factors that are significant in establishing repayment category membership, the framework was applied to a group of 233 HEAL borrowers who graduated from five medical schools in 1988. Because of the small numbers of delinquent borrowers and defaulters, the repayment categories were restricted to repayment, deferment, and forbearance. RESULTS: The level of unsubsidized debt, in conjunction with financial resources (including the potential resource of parental support), may be significant in identifying those HEAL borrowers who may confront repayment difficulty. CONCLUSION: While the results are not surprising, they do lend documented support for a review of financial aid policies at both institutional and governmental levels, and a framework within which this review may be conducted.

Education, Medical, Undergraduate↗
PubMed1993

A case of mistaken identity: signal and noise in connecting performance assessments before and after graduation from medical school.

The authors examine the assumption that there is continuity from one level of training to another in structured and purposeful professional education. Thus, more advanced levels of training are built upon the foundations laid in the preceding levels. While the connection between performance before and performance after graduation from medical school is theoretically rational, such a connection has not been well documented in empirical studies. The issue has been debated but has not been settled because relevant findings are inconsistent. It is argued that these inconsistencies can stem from contaminating factors and the conceptual and methodologic limitations of empirical studies. Such limitations are described in terms of "noise" that obscures the maximal value of a true relationship (the "signal"). Contaminating factors such as the time interval between testings; institutional factors; specialty choices; conceptual dissimilarities between performance measures in medical school and in practice; methodologic limitations such as the shapes of rating distributions, nonlinearity, heteroscedasticity, restriction of range, multicollinearity, voluntary participation, psychometrics of assessment instruments and differing methods of assessments; and a lack of assessments of personal qualities can produce "noise" that inhibits the strength of the "signal." While suggesting solutions for extricating some of the tangled web of methodologic and conceptual issues, the authors feel that solutions do not exist for all of the problems. They conclude that researchers should be aware of the limitations if they are to avoid underestimating the "signal," which may fade because of background "noise."

Clinical Competence↗
PubMed1993

Is the glass half full or half empty? A reexamination of the associations between assessment measures during medical school and clinical competence after graduation.

The purpose of this study was to investigate the associations between performances during medical school and in the first year of residency. It was hypothesized that the strength of such associations is a function of several variables, including similarities of the measured concepts, the formats of the assessments, the time interval between the assessments, performance levels, and specialty areas. The total sample consisted of 2,368 graduates of Jefferson Medical College between 1980 through 1990. The performance measures in medical school were grades on objective examinations in basic and clinical sciences, global ratings of clinical competence in junior core clerkships, and scores on the Part I and Part II examinations of the National Board of Medical Examiners (NBME). The postgraduate performance measures were scores on the Part III NBME examination, postgraduate competence ratings, and board certification. The ratings of postgraduate clinical competence (available for 73% of graduates) were made by residency directors at the end of the first year of residency in the areas of data-gathering and processing skills, interpersonal skills and attitudes, and socioeconomic aspects of patient care. Results supported the research hypotheses. It was found that the associations varied for different measures, at different levels of performance, and in different specialties. The authors conclude that the glass is "half full" regarding the associations between assessment measures before and after graduation from medical school.

Achievement↗