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Biomedical subjects

J J Veloski

Publications and source records attributed to J J Veloski.

At least 19 recordsLinked to original sources
PubMed1997

The virtues of extended matching and uncued tests as alternatives to multiple choice questions.

The objectives of this study were to compare the reliability and validity of written test formats that are widely used in medical education (multiple choice, uncued, extended matching, and true/false) and evaluate the effects of uncued examinations on long-term retention of medical knowledge. Uncued tests were introduced into a traditional course in general and systemic pathology (six interim tests). In the following year, students were given eight tests written in the four formats, each being used twice. The academic achievement of students in these 2 years was compared with that of students in 2 previous years, in which multiple choice tests were used. Measures of academic achievement included performance on a final comprehensive examination and the United States Medical Licensing Examination (USMLE). Student performance on uncued tests was consistent over time (i.e., there was no learning curve). Mean scores ranged from 77% to 84%, and coefficient alpha reliability estimates on 100-item tests were excellent (0.79 to 0.90). Extended matching tests were also reliable, with a mean coefficient alpha of 0.90. There was no significant relationship between test format and student performance on subsequent comprehensive examinations. Our results indicate that extended matching and uncued tests have considerable advantages over multiple choice and true/false examinations. They are more reliable, better able to discriminate the well-prepared from the marginal student, and well suited for tested core knowledge. Contrary to our expectation, extended matching questions with 20 choices presented to the student were as statistically reliable and valid as uncued queries with several hundred choices.

Educational Measurement↗
PubMed1997

Comparisons between older and usual-aged medical school graduates on the factors influencing their choices of primary care specialties.

PURPOSE: To examine whether there are differences between older (30+ years) and usual-aged graduates in the factors that influence their decisions to enter primary care. METHOD: A national survey of primary care physicians was conducted by mail in early 1993. The survey population comprised physicians who had graduated from U.S. allopathic medical schools in 1983 and 1984. The questionnaire consisted of four parts: practice characteristics, 19 variables influencing the physicians' decisions to enter primary care (rated on a scale from 5 = very strong influence to 1 = no influence), the timing of the decision to enter primary care, and demographic and personal information. Data were analyzed through several statistical methods. RESULTS: In all, 355 (22%) older and 1,241 (78%) usual-aged graduates who were practicing in primary care specialties responded. Compared with the usual-aged graduates, the older graduates were more likely to have grown up in rural or inner-city areas, to have obtained a second academic degree, and to have made the decision to enter primary care earlier. The older graduates' decisions to enter primary care had been more influenced by children and familial responsibilities, whereas the usual-aged graduates had been more influenced by internship and residency experiences and by parents and role models before medical school. CONCLUSION: This study provides empirical evidence to support the notion that nontraditional students (i.e., older ones) are more likely to commit themselves earlier to a career decision and less likely to be influenced by the socialization process during medical school. In this regard, age-specific factors should receive more attention in the analysis of the physician workforce.

Adult↗
PubMed1997

Assessment of physicians' interest in primary care training/retraining.

PURPOSE: To assess generalists and specialists interest in primary care training and the factors associated with this interest. METHOD: The study sample was drawn from the alumni of the Jefferson Medical College of Thomas Jefferson University (classes of 1970-1990) who were practicing in Pennsylvania. Family practitioners and general internists were defined as generalists; obstetrician-gynecologists (ob-gyns) and internal medicine subspecialists were defined as specialists. In 1995 a questionnaire was mailed consisting of 46 items assessing the physicians' interest in participating in primary care educational programs, reasons for any such interest, and preferences for content. Two items on the specialists' questionnaire asked about changing careers from specialist to generalist, and two items on the generalists' questionnaire asked about broadening the scope of their practices. RESULTS: The response rate was 54% (381/707). In all, 78% of the physicians expressed interest in primary care training. The generalists were more interested in primary care training than were the specialists (p < .001). The ob-gyns were more interested in primary care training than were the medical subspecialists (p = .01). Few of the medical subspecialists and no ob-gyns were influenced by plans to change careers to primary care. More of the ob-gyns than the medical subspecialists were motivated by plans to shift emphasis to provide more primary care. CONCLUSION: The results suggest (1) that although many specialists have an interest in primary care training, it is rarely motivated by plans to change to primary care practice, and (2) that generalists are very interested in expanding their abilities. Both of these findings should be considered in workforce planning.

Adult↗
PubMed1997

The relationship between the race/ethnicity of generalist physicians and their care for underserved populations.

OBJECTIVES: The purpose of this study was to examine empirically the relationship between physicians' race or ethnicity and their care for medically underserved populations. METHODS: Generalist physicians who received the MD degree in 1983 or 1984 (n = 1581) were surveyed. The personal and background characteristics of four racial/ethnic groups of physicians were compared with the characteristics of their patients. RESULTS: When the potentially confounding variables of gender, childhood family income, childhood residence, and National Health Services Corps financial aid obligations were controlled, generalist physicians from underrepresented minorities were more likely than their nonminority counterparts to care for medically underserved populations. CONCLUSIONS: Physicians from underrepresented minorities are more likely than others to care for medically underserved populations.

Adult↗
PubMed1996

A national study of factors influencing the career choice of osteopathic and allopathic family physicians.

This study examines the differences between osteopathic and allopathic physicians regarding those factors influencing their career choice of family practice. A total of 256 osteopathic physicians and 717 allopathic family physicians were surveyed. The surveyed physicians graduated in 1983 and 1984. Comparisons were made on 19 variables that influenced the physicians' decisions to enter family practice as well as on the six factor scores derived from these 19 variables. Osteopathic physicians' decisions to choose family practice was more influenced by financial obligations, medical school experiences, and family values, whereas the allopathic physicians were more influenced by personal social value. Overall, medical school experience and personal social value were two important factors that explained the largest variances of the 19 predictors influencing physicians' decisions to enter family practice. Those allopathic medical schools whose mission emphasizes the production of generalist physicians may be able to model some approaches already in place at osteopathic medical schools. Because of the influence of the personal social value factor in medical students' choosing family practice medicine, this factor warrants further study.

Career Choice↗
PubMed1995

Testing of medical students with open-ended, uncued questions.

A written examination based on material covered in the first year of medical school (anatomy, physiology, biochemistry, and neuroscience) was administered to medical students immediately before they began the pathology course to assess their knowledge of the basic science content that is important for the study of pathology. In alternate years the questions were presented in the standard multiple choice question (MCQ) format or in an open-ended, uncued question (Un-Q) format. The students' mean scores obtained by these two testing methods were comparable. The discrimination indices, which measure the ability of the test questions to distinguish between students of varying ability, were comparable. The Kuder-Richardson Formula 20 (KR-20), an estimate of the precision of the test given, was 0.53 for MCQ and 0.63 for Un-Q. We conclude that the Un-Q format is an acceptable alternative to the MCQ format and it has several advantages over MCQ. Because the answer sheets for Un-Q tests can be scanned optically and graded by computers, we recommend them as an alternative to MCQ tests.

Education, Medical↗
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 national study of the factors influencing men and women physicians' choices of primary care specialties.

BACKGROUND: Despite a recent increase in the percentage of graduating U.S. medical students planning to pursue generalist careers, interest in primary care among students is still far below what it was in the early 1980s and falls well short of the stated goal of the Association of American Medical Colleges that half of all graduates should choose generalist careers. Also during the past decade, the number of women students and physicians has increased. Given the importance of concerns regarding the primary care work force, it is timely to examine the relationship between gender and other factors that influence the decision to enter primary care. METHOD: Totals of 1,038 (65%) men and 558 (35%) women primary care physicians selected from the 1983 and 1984 graduates of all allopathic U.S. medical schools were surveyed in early 1993. Gender comparisons were made on the 19 variables that influenced the physicians' decisions to enter primary care specialties and on the six factor scores derived from a factor analysis of these 19 variables. Also included in the gender comparisons were characteristics of practice, populations served, timing of making the decision to enter primary care, and personal demographic information. RESULTS: Men, more than women, were influenced to become primary care physicians by early role models. Women, more than men, were influenced by personal and family factors. Overall, medical school experience and personal values are two important factors that explained the largest variances of the 19 predictor variables influencing the physicians' choices of primary care disciplines. There was no gender difference in place of origin, family income as a child, timing of the decision to become a primary care physician, or the amount of debt upon graduation. CONCLUSION: This nationwide study of primary care physicians indicates that men and women physicians differ in their perceptions of the relative importances of factors influencing the choice of a primary care specialty. Gender-specific factors should receive more attention in the development of successful strategies to attract more medical students into primary care specialties.

Career Choice↗
PubMed1995

Should half of all medical school graduates enter primary care? Perceptions of faculty members at Jefferson Medical College.

PURPOSE: This study was undertaken to promote communication among faculty regarding the impact of a proposed goal that 50% of the graduates of Jefferson Medical College enter generalist careers. Since the opinions and attitudes of faculty regarding career decisions may directly or indirectly influence students, the authors investigated faculty's views of the optimal ratio of primary care to non-primary care physicians in the workforce and their perceptions of the effect on medical education, research, and health care delivery if the 50% goal were to be mandated. METHOD: A questionnaire was mailed in January 1994 to all 684 salaried faculty of Jefferson Medical College. Respondents' opinions about the optimal primary care to non-primary care ratio and their perceptions of the effects of implementing the 50% goal on 21 areas related to medical education, research, and health care delivery were examined using a Likert-type scale. Obstacles perceived by non-primary care physicians as preventing their practice of primary care were also among the outcome measures. RESULTS: A total of 275 completed questionnaires were received (40% response rate; 72 primary care physicians, 141 non-primary care physicians, and 62 non-physicians). The median and mode of an optimal primary care to non-primary care ratio were both 50/50. Faculty, in general, perceived that implementing the 50% goal would enhance public access to primary care, physician-patient relationships, utilization of non-physicians, and the career satisfaction of generalists. They predicted decreases in costs of care, freedom of career choice, funding, and interest in research. The primary care physicians perceived greater enhancements of the image of physicians, quality of care, and satisfaction of generalists and subspecialists than did the non-primary care physicians. Gender and age did not affect the perceptions. A lack of appropriate training was identified by 45% and a lack of interest by 28% of the non-primary care physicians as major obstacles to their practice of primary care medicine. CONCLUSION: The faculty members' positive and negative views of the proposed reform can provide useful information to the institution in understanding the potential impediments to increasing the numbers of generalist graduates. The generalists had significantly different views from the subspecialists about the impact of increasing the proportion of primary care physicians on health care delivery and research. In general the primary care physicians were more likely to view the proposed changes as beneficial than were the non-primary care physicians.

Attitude of Health Personnel↗