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Biomedical subjects

Lesley Kay

Publications and source records attributed to Lesley Kay.

6 recordsLinked to original sources
PubMed2003

The attitudes and beliefs of clinicians involved in teaching undergraduate musculoskeletal clinical examination skills.

The aim of this study was to explore which regional musculoskeletal examination skills medical students should learn and be examined on. A qualitative research study was undertaken, and six focus groups were formed involving 36 consultants from four chosen specialties. The feeling was that greater emphasis should be placed on the functional assessment of a patient. Students should be able to discern through examination what the patient can and cannot do with his/her affected limb/joint. It was felt that many of the traditional eponymously named special tests (e.g.Thomas' test, Trendelenburg's test) should be dispensed with along with traditional descriptions such as varus, valgus, swan neck and Boutonniere deformities. It was felt these were often a cause of confusion for medical undergraduates. A broad view and diversity in opinions was detected with differences between specialties. The strongest theme to emerge by far was the desire to simplify and standardize the regional examination as much as possible.

Attitude of Health Personnel↗
PubMed2003

Regional musculoskeletal examination: what the students say.

Confusion exists over which musculoskeletal examination skills medical students should learn. This study aimed to explore the views of third-year medical students. This was a qualitative study to allow in-depth exploration of beliefs and attitudes. Twenty students were randomly assigned to 1 of 2 focus groups. Their attitudes towards musculoskeletal examination were explored and discussed. The groups' discussions were recorded, transcribed, and framework analysis was undertaken with the aid of NUD*IST computer software. The following themes were identified: students dislike eponymous names for clinical tests; students felt there is a need for a more structured approach to musculoskeletal examination; students appeared unaware that many clinical tests were not based on evidence; students complained of a lack of confidence in the use of musculoskeletal clinical tests. Student's confidence in their musculoskeletal examination skills may be improved by the development of an agreed set of so-called core examination skills.

Journal Article↗
PubMed2002

Measuring disability in ankylosing spondylitis: comparison of bath ankylosing spondylitis functional index with revised Leeds Disability Questionnaire.

OBJECTIVE: Disability has been identified as a core outcome measure in ankylosing spondylitis (AS). The Dougados Functional Index (DFI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) have been selected as core measures of function in this disease. However, neither of these instruments has undergone rigorous psychometric testing. METHODS: The psychometric properties of 2 measures of disability, the BASFI and the revised Leeds Disability Questionnaire (RLDQ), were compared in a cohort of 208 outpatients with AS. Rasch analysis was used to examine the properties of each measure and to compare them on a common scale. Test-retest was assessed in a cohort of 149 subjects who completed each instrument twice over an interval of 2 weeks. RESULTS: Both instruments gave an even spread of scores across the study group, but BASFI responses were positively skewed and RLDQ responses negatively skewed. There was a highly significant difference between perceived severity groups for both instruments (Kruskal-Wallis chi-squared: RLDQ, 75.1; BASFI, 80.4; both p < 0.0001). Both instruments gave acceptable test-retest scores (RLDQ ICC = 0.95, 95% CI 0.93-0.97; BASFI ICC = 0.94, 95% CI 0.92-0.96). Both instruments were found to be unidimensional according to the Rasch model, but the BASFI had more items displaying differential item functioning. Category disordering was apparent with the BASFI but not the RLDQ. However, both instruments displayed disordered item thresholds. Neither instrument can be used as an interval measure. Both measures had "towers" of thresholds whereby several thresholds were marking the same point on the underlying disability construct. This was particularly notable in the case of the BASFI. CONCLUSION: Both the BASFI and RLDQ provide a unidimensional measure of function in AS that is in accord with patient perception of disease severity. Neither instrument can be used as an interval measure. Changing the way that the instruments are scored, for example by collapsing categories, may improve their performance.

Activities of Daily Living↗