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Linda L Blank

Publications and source records attributed to Linda L Blank.

5 recordsLinked to original sources

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↗

The mini-CEX: a method for assessing clinical skills.

OBJECTIVE: To evaluate the mini-clinical evaluation exercise (mini-CEX), which assesses the clinical skills of residents. DESIGN: Observational study and psychometric assessment of the mini-CEX. SETTING: 21 internal medicine training programs. PARTICIPANTS: Data from 1228 mini-CEX encounters involving 421 residents and 316 evaluators. INTERVENTION: The encounters were assessed for the type of visit, sex and complexity of the patient, when the encounter occurred, length of the encounter, ratings provided, and the satisfaction of the examiners. Using this information, we determined the overall average ratings for residents in all categories, the reliability of the mini-CEX scores, and the effects of the characteristics of the patients and encounters. MEASUREMENTS: Interviewing skills, physical examination, professionalism, clinical judgment, counseling, organization and efficiency, and overall competence were evaluated. RESULTS: Residents were assessed in various clinical settings with a diverse set of patient problems. Residents received the lowest ratings in the physical examination and the highest ratings in professionalism. Comparisons over the first year of training showed statistically significant improvement in all aspects of competence, and the method generated reliable ratings. CONCLUSIONS: The measurement characteristics of the mini-CEX are similar to those of other performance assessments, such as standardized patients. Unlike these assessments, the difficulty of the examination will vary with the patients that a resident encounters. This effect is mitigated to a degree by the examiners, who slightly overcompensate for patient difficulty, and by the fact that each resident interacts with several patients. Furthermore, the mini-CEX has higher fidelity than these formats, permits evaluation based on a much broader set of clinical settings and patient problems, and is administered on site.

Clinical Competence↗