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J Jon Veloski

Publications and source records attributed to J Jon Veloski.

9 recordsLinked to original sources
PubMed2005

Disciplinary action by medical boards and prior behavior in medical school.

BACKGROUND: Evidence supporting professionalism as a critical measure of competence in medical education is limited. In this case-control study, we investigated the association of disciplinary action against practicing physicians with prior unprofessional behavior in medical school. We also examined the specific types of behavior that are most predictive of disciplinary action against practicing physicians with unprofessional behavior in medical school. METHODS: The study included 235 graduates of three medical schools who were disciplined by one of 40 state medical boards between 1990 and 2003 (case physicians). The 469 control physicians were matched with the case physicians according to medical school and graduation year. Predictor variables from medical school included the presence or absence of narratives describing unprofessional behavior, grades, standardized-test scores, and demographic characteristics. Narratives were assigned an overall rating for unprofessional behavior. Those that met the threshold for unprofessional behavior were further classified among eight types of behavior and assigned a severity rating (moderate to severe). RESULTS: Disciplinary action by a medical board was strongly associated with prior unprofessional behavior in medical school (odds ratio, 3.0; 95 percent confidence interval, 1.9 to 4.8), for a population attributable risk of disciplinary action of 26 percent. The types of unprofessional behavior most strongly linked with disciplinary action were severe irresponsibility (odds ratio, 8.5; 95 percent confidence interval, 1.8 to 40.1) and severely diminished capacity for self-improvement (odds ratio, 3.1; 95 percent confidence interval, 1.2 to 8.2). Disciplinary action by a medical board was also associated with low scores on the Medical College Admission Test and poor grades in the first two years of medical school (1 percent and 7 percent population attributable risk, respectively), but the association with these variables was less strong than that with unprofessional behavior. CONCLUSIONS: In this case-control study, disciplinary action among practicing physicians by medical boards was strongly associated with unprofessional behavior in medical school. Students with the strongest association were those who were described as irresponsible or as having diminished ability to improve their behavior. Professionalism should have a central role in medical academics and throughout one's medical career.

College Admission Test↗
PubMed2005

Board certification in obstetrics and gynecology: associations with physicians' demographics and performances during medical school.

OBJECTIVE: This study was undertaken to investigate the relationship of demographics, medical school performance, and licensing examination scores to board certification. STUDY DESIGN: A longitudinal follow-up study of graduates of Jefferson Medical College between 1968 and 1994 identified in the AMA Physicians' Professional Data (AMA-PPD) file as practicing obstetrics and gynecology in 2003. Demographics, grades, and licensing examination scores had been collected prospectively. Board certification status was obtained from the AMA-PPD in 2003. Bivariate differences were evaluated with t tests. Logistic regression was used to evaluate multivariate relationships to board certification status. RESULTS: Of 310 physicians in obstetrics and gynecology, 291 (94%) were board certified. Those without certification were more likely to be underrepresented minorities, to have been older in medical school, and to have weaker academic records. Logistic regression indicated that scores on step 2 of the United States Medical Licensing Examination were the single most important predictor of achieving board certification. Those with scores of 200 or higher were 7 times more likely to achieve certification than those below 200. CONCLUSION: Age, gender, and minority status are not independent predictors of achieving board certification. A low score on United States Medical Licensing Examination step 2 is a risk factor for not achieving certification.

Adult↗
PubMed2005

Measuring professionalism: a review of studies with instruments reported in the literature between 1982 and 2002.

PURPOSE: To describe the measurement properties of instruments reported in the literature that faculty might use to measure professionalism in medical students and residents. METHOD: The authors reviewed studies published between 1982 and 2002 that had been located using Medline and four other databases. A national panel of 12 experts in measurement and research in medical education extracted data from research reports using a structured critique form. RESULTS: A total of 134 empirical studies related to the concept of professionalism were identified. The content of 114 involved specific elements of professionalism, such as ethics, humanism, and multiculturalism, or associated phenomena in the educational environment such as abuse and cheating. Few studies addressed professionalism as a comprehensive construct (11 studies) or as a distinct facet of clinical competence (nine studies). The purpose of 109 studies was research or program evaluation, rather than summative or formative assessment. Sixty five used self-administered instruments with no independent observation of the participants' professional behavior. Evidence of reliability was reported in 62 studies. Although content validity was reported in 86 studies, only 34 provided strong evidence. Evidence of concurrent or predictive validity was provided in 43 and 16 studies, respectively. CONCLUSIONS: There are few well-documented studies of instruments that can be used to measure professionalism in formative or summative evaluation. When evaluating the tools described in published research it is essential for faculty to look critically for evidence related to the three fundamental measurement properties of content validity, reliability, and practicality.

Clinical Competence↗
PubMed2004

Do global rating forms enable program directors to assess the ACGME competencies?

PURPOSE: In 1999 the Accreditation Council for Graduate Medical Education (ACGME) mandated that GME programs require their residents to be proficient in six general competencies. The purpose of this study was to ascertain whether an existing global rating form could be modified to assess these competencies. METHOD: A rating form covering 23 skills described in the ACGME competencies was developed. The directors of 92 specialty and subspecialty programs at Thomas Jefferson University Hospital and the Albert Einstein Medical Center in Philadelphia were asked to rate residents at the end of the 2001-02 and 2002-03 academic years. RESULTS: Ratings for 1,295 of 1,367 (95%) residents were available. Residents were awarded the highest mean ratings on items tied to professionalism, compassion, and empathy. The lowest mean ratings were assigned for items related to consideration of costs in care and management of resources. Factor analysis indicated that the program directors viewed overall competence in two dimensions of medical knowledge and interpersonal skills. This factor structure was stable for groups of specialties, and residents' gender and training level. Mean ratings in each dimension were progressively higher for residents at advanced levels of training. CONCLUSION: Global rating forms, the tool that program directors use most frequently to document residents' competence, may not be adequate to assess the six general competencies. The results are consistent with earlier published research indicating that physicians view competence in just two broad dimensions, which questions the premise of the six ACGME competencies. Further research is needed to validate and measure six distinct dimensions of clinical competence.

Accreditation↗
PubMed2004

Evaluation of the UME-21 initiative at 18 medical schools between 1999 and 2001.

BACKGROUND: This study evaluated the processes of curricular change and the initial outcomes of the Undergraduate Medical Education for the 21st Century (UME-21) project at 18 schools. METHODS: Site visits were conducted at eight partner schools in 1999 and 2001. Written proposals, progress reports, and final reports of 18 schools were reviewed. Senior medical students' responses to questionnaires, including the annual Association of American Medical Colleges Graduation Questionnaire and a UME-21 supplemental graduation questionnaire, were analyzed. RESULTS: There was variation among the schools in the curriculum at baseline, in the structure of the UME-21 innovation that was introduced, and in the process of implementation. There was an increase in seniors' ratings of instruction in the newer areas of evidencebased medicine, quality assurance, and cost-effectiveness in relation to national norms between 1999 and 2001. There was less impact on the more traditional content areas of ethics, patient communications, prevention, and leadership skills. CONCLUSIONS: The circumstances of the national evaluation introduced many methodological complexities, some of which could have been avoided if planning for evaluation had started earlier. However, the evaluation revealed that even modest funding directed toward specific curricular goals can produce measurable change and can have effects that extend beyond the initial scope of the project.

Clinical Clerkship↗
PubMed2003

An operational measure of physician lifelong learning: its development, components and preliminary psychometric data.

Despite the emphasis placed on physicians' lifelong learning, no psychometrically sound instrument has been developed to provide an operational measure of the concept and its components among physicians. The authors designed this study to develop a tool for measuring physician lifelong learning, to identify its underlying components and to assess its psychometric properties. A 37-item questionnaire was developed, based on a review of literature and the results of two pilot studies. Psychometric analyses of the responses of 160 physicians identified 19 items that were included in the Jefferson Scale of Physician Lifelong Learning. Factor analysis of the 19 items showed five meaningful factors that were consistent with the definition and major features of lifelong learning. They were 'need recognition', 'research endeavor', 'self-initiation', 'technical skills' and 'personal motivation'. The method of contrasted groups provided evidence in support of the validity of the five factors. The factors' reliability was assessed by coefficient alpha. It is concluded that lifelong learning is a multifaceted concept, and its operational measure is feasible for evaluating different educational programs and for studying group differences among physicians.

Adult↗
PubMedDate not supplied

Development and evaluation of a 1-day interclerkship program for medical students on medical errors and patient safety.

Medical students need to be well informed about medical errors and patient safety. Pursuant to a needs assessment and pilot program, 229 third-year students participated in a 1-day program on patient safety including a plenary session and workshops. Attitudes and beliefs were measured by a survey at the beginning and end of the program. Completed surveys were returned by 124 (54%) students. Their level of agreement with 14 of 21 rating scale items changed in the expected direction. There were 7 items in which the students' baseline responses were already positive and did not change significantly. A 1-day program on patient safety in the third year of medical school can change students' attitudes and beliefs. There may be a subset of students needing closer attention. The findings provide evidence for the validity of the attitude survey and reinforce the effectiveness of interclerkship programs in medical schools.

Attitude of Health Personnel↗