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Biomedical subjects

J R Philp

Publications and source records attributed to J R Philp.

10 recordsLinked to original sources
PubMed1992

The consistency of students' self-assessments in short-essay subject matter examinations.

This longitudinal study compares the accuracy of self-assessments of 22 students across four examinations during their first 2 years of medical school. The four examinations used a similar short-essay format and covered many of the same basic science disciplines at similar levels of difficulty. Immediately after answering an average of 20 questions on each examination, students predicted their performance on those questions. After assigned subject matter experts had scored the questions, the differences between students' predictions and the experts' scores were calculated for each question. The degree to which students had over- and underestimated their performance across all questions was determined by separately averaging all positive and negative differences between students' and experts' assessments on each examination. The results of the study indicated that accuracy in self-assessment improved from examination 1 to examination 3 (with less overestimation) and dropped on examination 4 (with more underestimation). The results revealed no relationship between self-assessment estimations and actual scores received. Furthermore, the self-assessment estimations tended to be statistically correlated between contiguous examinations (i.e., examinations 1 and 2, 2 and 3, etc.) but not between non-contiguous ones (i.e., examinations 1 and 3, etc.). The results of the study are interpreted to suggest that the students in the study have a self-assessment tendency towards over- or underestimation that is somewhat stable but that gradually evolves over time with experience, maturity and self-assessment practice. The most frequent direction of change is towards decreased overestimation and increased underestimation. These results are consistent with the findings of other recent longitudinal self-assessment studies.

Clinical Competence↗
PubMed1989

Scoring the objective structured clinical examination using a microcomputer.

The objective structured clinical examination (OSCE) is being used increasingly to assess students' clinical competence in a variety of controlled settings. The OSCE consists of multiple stations composed of a variety of clinically relevant problems (e.g. examining simulated patients, diagnosing X-rays, etc.) Generally, three types of performance data are collected: answers to multiple choice or true/false questions, written short answers, and performance check-lists completed by observers. In most OSCEs these student performance measures are scored by hand. This is time-consuming, increases the probability of mistakes and reduces the amount of data available for analysis. This paper describes a method of computer scoring OSCEs with over 100 students using statistical and test-scoring software regularly used for multiple choice examinations. During the examination, students, markers and raters code answers and performance data directly on optical mark-sheets which are read into the computer using an optical mark reader. The resultant computer data can be efficiently scored and rescored, grouped into different types of subscales, weighted to reflect questions' relative importance, and easily printed in a variety of report formats.

Clinical Competence↗
PubMed1989

Is it worth it? A look at the costs and benefits of an OSCE for second-year medical students.

For the past two years, the Bowman Gray School of Medicine has used an Objective Structured Clinical Exam (OSCE) to measure the performance of 117 first- and second-year medical students at the end of introductory courses on differential and physical diagnosis. Given the surprisingly high costs of conducting the OSCE ($1300 for supplies and 527 person-hours of donated time), data about the format's perceived benefits were collected. All of the faculty involved in the examination who responded to a questionnaire (80%) reported that it was worth the time they had volunteered to evaluate students by observation and that the format should be used in the future. The majority of student examinees also reported that the OSCE format was appropriate for the course and should continue to be used.

Clinical Medicine↗
PubMed1977

The defense of the lung: studies of the role of cell-mediated immunity.

The defense of the lung against infections, toxins and allergens is accomplished by an excretory transport mechanism and by the interaction of cellular and humoral defense systems. Pulmonary alveolar macrophages represent a common effector pathway for both nonspecific cellular phagocytic defenses and for specifically triggered cell-mediated immunity, via T lymphocytes. Nonspecific activation of macrophages is induced by toxic substances. Studies of the immunocytologic system indicate partial compartmentalization and "local" immunity for both cellular and humoral systems. Further studies on pulmonary cell-mediated immunity have characterized an amplification mechanism by which antigen-induced stimulation of T lymphocytes leads to recruitment of nonsensitive lymphocytes through the production of a low-molecular weight "transfer factor." Other lymphocyte-produced mediators (lymphokines) act to attract, aggregate and accumulate macrophages in areas of inflammation. In addition, macrophages are "activated" and show enhanced microbicidal capabilities as well as enhanced resistance to the cytotoxic effects of certain ingested microorganisms. It is postulated that cellular (nonspecific) and cell-mediated (specific) immune defenses play important roles in protection against several categories of microorganisms in a hierarchy of virulence.

Animals↗
PubMed1976

Bacterial endocarditis. Echocardiographic and clinical evaluation during therapy.

In two patients with bacterial endocarditis and apparent vegetations, the echocardiographic findings included thickening but normal excursion of the mitral leaflet and abnormal shaggy echoes superimposed on the mitral leaflet echogram. Both patients had had endocarditis several weeks before the study was performed. In both patients the abnormal echoes disappeared after antibiotic therapy. Whether or not the echocardiographic findings are specific to bacterial endocarditis must be determined by further studies. One patient had evidence of "immune complex disease" with vasculitis, hypocomplementemia, and renal failure which persisted for weeks after disappearance of vegetations on the echocardiogram. This sequence was unexpected, as a continued source of antigen for this reaction was not apparent.

Adult↗
PubMed1976

Amplified migration inhibition effect.

Upon exposure to specific antigen in tissue culture, sensitive lymphocytes released macrophage migration inhibition factor and other lymphokines into the supernatant culture medium. Migration of peritoneal macrophages from nonsensitive animals was inhibited in the presence of such supernatants. However, with previous techniques it was found that an inhibitory effect was present at only low low titers (less than 10(2)). It is therfore of great interest that by increasing cellular density, the total number of cells being kept constant, inhibitory activity can be amplified by a factor as great as 10(10). This amplification was observed only when lymphocytes and macrophages were loosely packed, as by spontaneous sedimentation in a conical test tube. The effect was abolished by dispersing the cell suspension in a flat-bottomed flask or, alternatively, by shaking the test tube so that intimate prolonged intercellular contact was prevented.

Animals↗