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Biomedical subjects

J M Shumway

Publications and source records attributed to J M Shumway.

At least 19 recordsLinked to original sources
PubMed2003

AMEE Guide No. 25: The assessment of learning outcomes for the competent and reflective physician.

Two important features of contemporary medical education are recognized. The first is an emphasis on assessment as a tool to ensure quality in training programmes, to motivate students and to direct what they learn. The second is a move to outcome-based education where the learning outcomes are defined and decisions about the curriculum are based on these. These two trends are closely related. If teachers are to do a better job of assessing their students, they need an understanding of the assessment process, an appreciation of the learning outcomes to be assessed and a recognition of the most appropriate tools to assess each outcome. Assessment tools selected should be valid, reliable, practical and have an appropriate impact on student learning. The preferred assessment tool will vary with the outcome to be assessed. It is likely to be some form of written test, a performance test such as an OSCE in which the student's competence can be tested in a simulated situation, and a test of the student's behaviour over time in clinical practice, based on tutors' reports and students' portfolios. An assessment profile can be produced for each student which highlights the learning outcomes the student has achieved at the required standard and other outcomes where this is not the case. For educational as well as economic reasons, there should be collaboration across the continuum of education in test development as it relates to the assessment of learning outcomes and in the implementation of a competence-based approach to assessment.

Attitude of Health Personnel↗
PubMed1998

The economic and demographic restructuring of nonmetropolitan counties in the Mountain West.

"The purpose of this paper is to examine the fluctuating economic and demographic landscapes within nonmetro Mountain West counties [of the United States], describe relationships between the economic restructuring and shifting demographic patterns, and to discuss the potential significance of these transformations for the Mountain West nonmetro region. We begin by articulating a conceptual framework linking economic restructuring (development) and population change due to migration. The remainder of the paper empirically examines these linkages. A concluding section summarizes our findings and provides suggestions for future research."

Americas↗
PubMed1996

Interpretive and procedural skills of the internal medicine clerkship: performance and supervision.

This descriptive study prospectively examined the performance and supervision of interpretive and procedural skills during an internal medicine clerkship. Students (N = 150) documented having done 7 required and 12 elective skills. Preceptors of required skills were interns (44%), residents (29%), attending physicians (12%), and others (16%). The elective procedures and the percentage of students doing them were as follows: skin tests, 78%; nasogastric tube insertion, 57%; paracentesis, 44%; bone marrow sampling, 35%; lumbar puncture, 34%; thoracentesis, 34%; Papanicolaou smear, 29%; central line placement, 27%; cardioversion, 13%; bladder catheter insertion, 11%; arthrocentesis, 9%; and skin biopsy, 7%. Elective procedures per student ranged from 0 to 9 (mean = 4) and were done less often in the first clerkship group than later in the academic year. Preceptors of electives were interns (46%), residents (39%), and attending physicians (9%). House staff were more likely and faculty less likely to precept electives than required procedures. Students' exposures to these skills are unequal. Their preceptor are generally house staff. To prepare medical students for postgraduate training, technical skills should be specifically addressed in the curriculum.

Analysis of Variance↗
PubMed1996

Self-selection, earnings and Chicano migration: differences between return and onward migrants.

"The purpose of this article is to extend the empirical literature on Chicano return migration by examining earnings differentials between return and onward Chicano migrants. Our approach reflects the complexity of estimating such effects in terms of selectivity biases and the interaction between individual and locational attributes. We use data derived from the public use microdata sample (PUMS) of the 1990 U.S. census. After controlling for migration and labor force self-selection, results indicate that Chicano return migrants are not negatively self-selected. Chicano return migrants have smaller earnings profiles largely due to the negative effects of living in areas with higher concentrations of co-ethnics. Apparently, return migrants, at least in the short run, are willing to accept lower earnings for the nonpecuniary benefits of living in the Southwest."

Americas↗
PubMed1996

Attitudes of community pharmacists, university-based pharmacists, and students toward on-line information resources.

The study sought to explore the attitudes of community pharmacists, university-based pharmacists, and pharmacy students before and after exposure to computerized systems of on-line information services. A 42-item attitudinal survey was administered to 21 community pharmacists, 7 university clinical pharmacist faculty, and 17 senior pharmacy students, prior to and at the end of a year of access to Grateful Med and BRS Colleague. Few significant differences were noted among the participants at baseline. No significant interaction-effect differences for type of participant or system used were found. Participants were generally positive about computers in general, the accuracy of on-line information services, their impact on knowledge and confidence, and their usefulness for pharmacists.

Adult↗
PubMed1992

Use of two online services as drug information sources for health professionals.

The utility of the online computer services BRS Colleague and Dialog Medical Connection, when used primarily as drug information sources by physicians, nurses, and pharmacists and attitudes toward their use, are described. Study sites included office-based medical practices, a university clinic family medicine group, and a university clinical pharmacy department. Participants had access to either of the computer services during two 9 1/2-month periods. All searches were automatically recorded and analyzed. A total of 1,112 search sessions were conducted (78% by pharmacists, 16% by nurses, 6% by physicians) by 38 of 65 participants. Information which completely answered questions was found for slightly less than one-third of searches. Errors occurred in about 81% of searches which retrieved incomplete information. Lack of time was a major factor which limited use of the services, and infrequent users felt that the services did not fit in well with their daily work routine.

Attitude to Computers↗
PubMed1990

Analysis of physicians', pharmacists', and nurses' attitudes toward the use of computers to access drug information.

The appropriate utilization of computerized drug information systems is widely recognized as an area of concern by health care professionals. For this reason, attitudes of health care professionals in office-based practices toward computer-based drug information were examined. Sixty individuals in five different practice settings completed an attitude instrument. Of the 36 items categorized into five attitudinal categories, the answers to six items (in three distinct categories) were found to be statistically different among physicians, nurses, and pharmacists. These differences indicate that physicians and nurses are less knowledgeable about the benefits that can be obtained through the use of computerized information resources and, consequently, are more skeptical concerning the role of computer information systems in reducing the costs and improving the quality of health care. Of interest as well was the finding that pharmacists felt more strongly than physicians and nurses that computer information systems would readily fit into their daily work routine.

Attitude of Health Personnel↗
PubMed1989

Combined internal medicine/pediatric residency training programs.

Combined residency training in both internal medicine and pediatrics has become a popular choice for postgraduate education in the 1980s. Most programs are relatively new, and little is known about their specific curricular structure and what program graduates do when they complete their training. Data collected from a survey of these combined program directors are described.

Curriculum↗
PubMed1984

[Methods for teaching problem-solving in medical schools].

The need to include in the medical curriculum instructional activities to promote the development of problem-solving abilities has been asserted at the national and international levels. In research on the mental process involved in the solution of problems in medicine, problem-solving has been defined as a hypothetical-deductive activity engaged in by experienced physicians, in which the early generation of hypotheses influences the subsequent gathering of information. This article comments briefly on research on the mental process by which medical problems are solved. It describes the methods that research has shown to be most applicable in instruction to develop problem-solving abilities, and presents some educational principles that justify their application. The "trail-following" approach is the method that has been most commonly used to study the physician's problem-solving behavior. The salient conclusions from this research are that in the problem-solving process the diagnostic hypothesis is generated very early on and with limited data; the number of hypotheses is small; the problem-solving approach is specific to the type of medical problem and case in hand; and the accumulation of medical knowledge and experience forms the basis of clinical competence. Four methods for teaching the solution of problems are described: case presentation, the rain of ideas, the nominal groups technique and decision-making consensus, the census and analysis of forces in the field, and the analysis of clinical decisions. These methods are carried out in small groups. The advantages of the small groups are that the students are active participants in the learning process, they receive formative evaluation of their performance in a setting conductive to learning, and are able to interact with their instructor if he makes proper use of the right questioning techniques. While no single problem-solving method can be useful to all students or in all the problems they encounter, teachers of medicine can improve their students' performance by adjusting these available methods to their particular needs and to those of their schools. The problem-solving methods described can help teachers shape the learning environment so as to develop in their students the most coherent, logical, concrete and complete set of skills possible. These methods can so be of value in improving the training of future doctors and the quality of their decisions to the benefit of their patients.

Curriculum↗
PubMedDate not supplied

Planning with elderly outpatients for contingencies of severe illness: a survey and clinical trial.

The authors examined whether elderly patients would report positive or adverse emotional effects after their doctor, during a routine clinic visit, asked them to begin planning for future serious illness. Seventy-four patients, 65 years old or older, who were followed at a university hospital medical clinic were randomly allocated to an intervention or a control group. The intervention was a detailed discussion with the patient's physician of the patient's wishes about decision making and life support therapy in the event of extreme or incapacitating illness. A blinded interviewer then asked all consenting patients how they felt about the physician, the clinic visit, and their medical care. Intervention-group patients were questioned about their reactions to the physician and the discussion. Four important findings emerged: 1) Some emotional uncertainty was created when doctors raised these questions unexpectedly: one patient became visibly upset during the discussion, and three who gave consent to be interviewed afterward said that the discussion had made them wonder about their health. Nonetheless, all patients who received the intervention and completed the study were pleased that their doctor had asked. 2) Only 44% of all consenting patients reported having discussed these issues previously; only one had done so with a doctor. 3) 97% of patients who responded wanted to be kept informed by the doctor about their medical situations in times of serious illness. 4) Patients' replies to specific questions about life-sustaining therapy in the event of their own severe illnesses were quite variable. During routine clinic visits doctors can encourage most elderly patients to begin specific planning for potential severe illnesses.

Aged↗