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Biomedical subjects

J H Shatzer

Publications and source records attributed to J H Shatzer.

6 recordsLinked to original sources
PubMed2000

Standardized patient assessment of ambulatory clerks: effect of timing and order of the clerkship.

BACKGROUND: A standardized patient examination may assess unique learning in an ambulatory clerkship but, as with written tests, may be affected by student maturation. PURPOSE: To explore the effect of timing and order of a medicine ambulatory clerkship on student performance of a standardized patient examination (SPE). METHODS: All students rotating through an ambulatory medicine clerkship in 1 academic year completed an SPE designed to reflect specific learning objectives of the clerkship as well as nonclerkship case content. Students were grouped according to prior inpatient clerkship experience. RESULTS: When compared to students with only ambulatory experience, students with both inpatient and ambulatory experiences in internal medicine did not perform better on the ambulatory cases of the SPE but did perform better on nonclerkship cases. Performance on the SPE was not affected by month of training. At completion of the inpatient clerkship, students with prior ambulatory experience did not perform better than students with inpatient-only experience on the National Board of Medical Examiners Medicine Subject Examination. CONCLUSIONS: The SPE is an appropriate assessment tool for the ambulatory clerkship when case content is linked to learning objectives of the clerkship. Unlike other knowledge-based assessments, the SPE is not affected by student maturation.

Ambulatory Care↗
PubMed1998

Instructional methods.

This chapter addresses one of the goals of The Robert Wood Johnson Foundation's "Preparing Physicians for the Future: Program in Medical Education" grants: to introduce new methods of instructions along with curricular revisions. Methods of instruction emphasize "how to teach," in contrast to the curricular reform's "what to teach." The author explores the various ways in which the eight participating schools adopted new instructional methods. The author first sets out the conditions for effective learning, as expressed in earlier research in cognitive psychology. He then reviews the issues in new instructional methods: problem-based learning, small-group learning, self-directed learning, and instructional methods in the service of integration, as well as learning in outpatient settings and computer-based learning. The author concludes, among other things, that schools must respect the variety of ways in which students learns, that some faculty will have to become skilled in unfamiliar teaching methods, that new instructional methods should be based on empirical evidence of effectiveness, and that sometimes method may be less important than the skill and enthusiasm of the teacher.

Education, Medical↗
PubMed1997

Performance of "standardized examinees" in a standardized-patient examination of clinical skills.

PURPOSE: As a first step in testing the utility of using trained "standardized examinees" (SEs) as a quality-assurance measure for the scoring process in a standardized-patient (SP) examination, to test whether medical residents could simulate students in an SP examination and perform consistently to specified levels under test conditions. METHOD: Fourth-year students from the Baltimore-Washington Consortium for SPs participated in a National Board of Medical Examiners Prototype Examination of clinical skills consisting of twelve 15-minute student-patient encounters in 1994-95. For this examination, internal medicine residents were trained to act as ordinary candidates and to achieve target scores by performing to a set level on specific checklist items used by SPs for recording interviewing, physical-examination, and communication skills. The "strong SEs" were trained to score 80% correct on six of the examination's 12 cases (study cases), and the "weak SEs" were trained to score 40% correct on the same six cases. The strong and weak SEs' checklist scores on the study cases were compared through independent, two-tailed t-tests. When there was less than 85% agreement on specific checklist items in each case between the SE training and the SP recording, videotapes of the cases were reviewed; in such cases an SE's performance was the final score agreed upon after review. RESULTS: Seven SEs took the SP examination and were not detected by the SPs. There was a total of 84 discrepancies between predicted and recorded checklist scores across 659 checklist items in 40 encounters scored by the SPs. After correcting the discrepancies based on videotape review, the estimated actual mean score was 77.3% for the strong SEs and 44.0% for the weak SEs, and was higher for the strong SEs in each study case. The overall fidelity of the SEs to their training was estimated to be 97%, and the overall SP accuracy was estimated to be 91%. The videotape review revealed 47 training-scoring discrepancies, most in the area of communication skills. CONCLUSION: This study suggests that SEs can be trained to specific performance levels and may be an effective internal control for a high-stakes SP examination. They may also provide a mechanism for refining scoring checklists and for exploring the validity of SP examinations.

Clinical Competence↗
PubMed1993

Station-length requirements for reliable performance-based examination scores.

PURPOSE: To directly compare the generalizability of medical students' performance scores under systematically varied station times in two surgery end-of-clerkship performance-based examinations. METHOD: The participants were 36 third-year students randomly assigned to the first two rotations of the core surgery clerkship during 1991-92 at Southern Illinois University School of Medicine. The students rotated through a 12-station examination that employed standardized patients (SPs). In the first rotation, the student took six five-minute stations and six ten-minute stations. In the second rotation, the time lengths were reversed for the same stations. The students' total scores were based on (1) subscores on checklists that were completed by the SPs and (2) subscores on the students' written responses to short questions about each station (these responses were provided at station couplets that were five minutes long, regardless of station length). Generalizability coefficients were computed from the pooled rotation results to provide reliabilities for scores from the two station lengths. RESULTS: Generalizability decreased in the ten-minute stations, mostly attributable to less variability among students' performances. The checklist subscores accounted for most of this variability, while couplet subscores remained stable between station lengths. CONCLUSION: The longer station length actually decreased the generalizability of the scores by decreasing the variability among students' performances; thus, allocating different times to stations can affect the score reliability, as well as impact on the overall testing time, of performance-based examinations.

Clinical Clerkship↗