PubMed Health⌕ Search

Biomedical subjects

Mohammadreza Hojat

Publications and source records attributed to Mohammadreza Hojat.

At least 19 recordsLinked to original sources
PubMed2006

Assessing physicians' orientation toward lifelong learning.

BACKGROUND: Despite the importance of lifelong learning as an element of professionalism, no psychometrically sound instrument is available for its assessment among physicians. OBJECTIVE: To assess the validity and reliability of an instrument developed to measure physicians' orientation toward lifelong learning. DESIGN: Mail survey. PARTICIPANTS: Seven hundred and twenty-one physicians, of whom 444 (62%) responded. MEASUREMENT: The Jefferson Scale of Physician Lifelong Learning (JSPLL), which includes 19 items answered on a 4-point Likert scale, was used with additional questions about respondents' professional activities related to continuous learning. RESULTS: Factor analysis of the JSPLL yielded 4 subscales entitled: "professional learning beliefs and motivation,""scholarly activities,""attention to learning opportunities," and "technical skills in seeking information," which are consistent with widely recognized features of lifelong learning. The validity of the scale and its subscales was supported by significant correlations with a set of criterion measures that presumably require continuous learning. The internal consistency reliability (coefficient alpha) of the JSPLL was 0.89, and the test-retest reliability was 0.91. CONCLUSIONS: Empirical evidence supports the validity and reliability of the JSPLL.

Education, Medical, Continuing↗
PubMed2005

Relationships between scores of the Jefferson Scale of Physician Empathy (JSPE) and the Interpersonal Reactivity Index (IRI).

This study was designed to examine the relationships between scores of two measures of empathy. One was specifically developed for measuring empathy in patient care situations; the other was developed for the general population. It was hypothesized that the overlap between scores of the two measures would be greater for their constructs that are more relevant to patient care. Study participants were 93 first-year internal medicine residents at Thomas Jefferson University Hospital in Philadelphia. The Jefferson Scale of Physician Empathy (JSPE, specifically developed for administration to health professionals), and the Interpersonal Reactivity Index (IRI, developed for the general population) were administered. A statistically significant correlation of a moderate magnitude between the total scores of the JSPE and IRI (r = 0.45, p < 0.01) was found. The research hypothesis was confirmed by observing higher correlations between those scales of the IRI that were relevant to patient care (e.g. empathic concern, perspective taking) and related factors of the JSPE (compassionate care, perspective taking) than other scales of the IRI that seemed less relevant to patient care (e.g. personal distress and fantasy). These findings provide further support for the validity of the JSPE. It is concluded that physician empathy as measured by the JSPE and its underlying factors are distinct personal attributes that have a limited overlap with fantasy and no overlap with personal distress defined as dimensions of an empathy measure that was developed for the general population.

Data Collection↗
PubMed2005

Empathy scores in medical school and ratings of empathic behavior in residency training 3 years later.

The authors designed the present study to examine the association between individuals' scores on the Jefferson Scale of Physician Empathy (JSPE; M. Hojat, J. S. Gonnella, S. Mangione, T. J. Nasca, & M. Magee, 2003; M. Hojat, J. S. Gonnella, T. J. Nasca, S. Mangione, M. Vergare, & M. Magee, 2002; M. Hojat, S. Mangione, T. J. Nasca, M. J. M. Cohen, J. S. Gonnella, J. B. Erdmann, J. J. Veloski, & M. Magee, 2001), a self-report empathy scale, during medical school and ratings of their empathic behavior made by directors of their residency training programs 3 years later. Participants were 106 physicians. The authors examined the relationships between scores on the JSPE (with 20 Likert-type items) at the beginning of the students' 3rd year of medical school and ratings of their empathic behavior made by directors of their residency training programs. Top scorers on the JSPE in medical school, compared to Bottom scorers, obtained a significantly higher average rating of empathic behavior in residency 3 years later (p < .05, effect size = 0.50). The findings support the long-term predictive validity of the self-report empathy scale, JSPE, despite different methods of evaluations (self-report and supervisors' ratings) and despite a time interval between evaluations (3 years). Because empathy is relevant to prosocial and helping behavior, it is important for investigators to further enhance our understanding of its correlates and outcomes among health professionals.

Adult↗
PubMed2005

Curricular reform may improve students' performance on externally administered comprehensive examinations.

AIM: To determine whether changes in the format of teaching pathology and the introduction of active learning principles can improve medical students' performance on external examinations and enhance clinical skills. METHOD: The sophomore Pathology Course at Jefferson Medical College (JMC) in Philadelphia, Pennsylvania, USA, was completely restructured in 1986, with greater emphasis placed on independent study, small group teaching, and case study discussion. We used the scores of JMC medical students on the National Board of Medical Examiners (NBME) Part I Examination to compare the performance of JMC students who completed their medical education before curricular change (entering classes 1982-1984) with the performance of subsequent generations of students who were taught according to the reformed curriculum (entering classes 1985-1988). RESULTS: The two groups of students were comparable in terms of standard social and psychometric parameters, such as mean age at matriculation, female/male ratio, ratio of minority students in the class, premedical college grade point averages, and mean scores on the preadmission Medical College Admissions Test. JMC students who studied pathology prior to the curricular reform received on the pathology subsection of the NBME Part I Examination reform scores that were close to the national average. In contrast, mean scores for students who studied pathology after curricular changes were significantly higher than the national average (P<0.001). Based on their pathology subscores, the number of JMC students scoring below the cutoff line for passing (380 points) decreased significantly after the curricular reform, whereas the number of high-scoring students whose scores ranked them in the 90th percentile nationally increased. Curricular reform was also associated with an increase in overall student satisfaction. CONCLUSION: Curricular changes that include an emphasis on active learning can improve the performance of medical students on externally administered, objective examinations. We have shown that the means of the medical school class can be improved, the number of failing students reduced, and the number of high-scoring students increased. The improvement of students' scores was not limited to the first class after curricular reform, but persisted throughout the entire observation period of four years.

Curriculum↗
PubMed2004

A visitor's guide to effect sizes: statistical significance versus practical (clinical) importance of research findings.

Effect Sizes (ES) are an increasingly important index used to quantify the degree of practical significance of study results. This paper gives an introduction to the computation and interpretation of effect sizes from the perspective of the consumer of the research literature. The key points made are: 1. ES is a useful indicator of the practical (clinical) importance of research results that can be operationally defined from being "negligible" to "moderate", to "important". 2. The ES has two advantages over statistical significance testing: (a) it is independent of the size of the sample; (b) it is a scale-free index. Therefore, ES can be uniformly interpreted in different studies regardless of the sample size and the original scales of the variables. 3. Calculations of the ES are illustrated by using examples of comparisons between two means, correlation coefficients, chi-square tests and two proportions, along with appropriate formulas. 4. Operational definitions for the ES s are given, along with numerical examples for the purpose of illustration.

Adult↗
PubMed2004

Medical education and health services research: the linkage.

The medical community is coming under increased scrutiny. Challenges to the integrity of the healthcare system have been raised due to reports about the prevalence of medical errors. A heightened level of vigilance is required. Equally important is the need to isolate and correct the source of any problem, perceived or real. We are faced with challenging questions. Is the selection of students and residents appropriate? Are their education and evaluation valid? These questions must be answered at least in part by understanding the climate in which the services to the patients are rendered. Otherwise deficiencies noted in practice may be inappropriately attributed to the educational process. This article addresses the importance, implications and impact of the link between medical education and health services research. The goal of medical education is to prepare physicians to meet the challenges of practice by fulfilling their roles of clinician, educator and resource manager. Health services research can be linked to any of these physician roles. An understanding of health services is necessary to assess how well this goal is being met in the context of the changing healthcare system. A partnership between medical education and health services research is essential for academic health centers and health services institutions in assessing issues of health manpower and for the public good. Academic health centers have an important role in this partnership providing an infrastructure and expertise for both education and health services research.

Education, Medical↗
PubMed2004

An empirical study of the predictive validity of number grades in medical school using 3 decades of longitudinal data: implications for a grading system.

Context It is important to establish the predictive validity of medical school grades. The strength of predictive validity and the ability to identify at-risk students in medical schools depends upon assessment systems such as number grades, pass/fail (P/F) or honours/pass/fail (H/P/F) systems. Objective This study was designed to examine the predictive validity of number grades in medical school, and to determine whether any important information is lost in a shift from number to P/F and H/P/F grading systems. Subjects The participants in this prospective, longitudinal study were 6656 medical students who studied at Jefferson Medical College over 3 decades. They were grouped into 10 deciles based on their number grades in Year 1 of medical school. Methods Participants were compared on academic accomplishments in Years 2 and 3 of medical school, medical school class rank, delayed graduation and attrition, performance on medical licensing examinations and clinical competence ratings in the first postgraduate year. Results Results supported the short- and longterm predictive validity of the number grades. Ratings of clinical competence beyond medical school were predicted by number grades in medical school. We demonstrated that small differences in number grades are statistically meaningful, and that important information for identifying students in need of remedial education is lost when students who narrowly meet faculty's expectations are included with the rest of the class in a broad 'pass' category. Conclusions The findings refute the argument that knowledge of sciences basic to medicine is not critical to subsequent performance in medical school and beyond if an appropriate evaluation system is used. Furthermore, the results of this study raise questions about abandoning number grades in favour of a pass/fail system. Consideration of these findings in policy decisions regarding assessment systems of medical students is recommended.

Achievement↗
PubMed2004

An empirical study of decline in empathy in medical school.

CONTEXT: It has been reported that medical students become more cynical as they progress through medical school. This can lead to a decline in empathy. Empirical research to address this issue is scarce because the definition of empathy lacks clarity, and a tool to measure empathy specifically in medical students and doctors has been unavailable. OBJECTIVE: To examine changes in empathy among medical students as they progress through medical school. MATERIALS AND SUBJECTS: A newly developed scale (Jefferson Scale of Physician Empathy [JSPE], with 20 Likert-type items) was administered to 125 medical students at the beginning (pretest) and end (post-test) of Year 3 of medical school. This scale was specifically developed for measuring empathy in patient care situations and has acceptable psychometric properties. METHODS: In this prospective longitudinal study, the changes in pretest/post-test empathy scores were examined by using t-test for repeated measure design; the effect size estimates were also calculated. RESULTS: Statistically significant declines were observed in 5 items (P < 0.01) and the total sores of the JSPE (P < 0.05) between the 2 test administrations. CONCLUSIONS: Although the decline in empathy was not clinically important for all of the statistically significant findings, the downward trend suggests that empathy could be amenable to change during medical school. Further research is needed to identify factors that contribute to changes in empathy and to examine whether targeted educational programmes can help to retain, reinforce and cultivate empathy among medical students for improving clinical outcomes.

Clinical Competence↗
PubMed2004

Academic performance of psychiatrists compared to other specialists before, during, and after medical school.

OBJECTIVE: This study was designed to compare psychiatrists with other physicians on measures of academic performance before, during, and after medical school. METHOD: More than three decades of data for graduates of Jefferson Medical College (N=5,701) were analyzed. Those who pursued psychiatry were compared to physicians in seven other specialties on 18 performance measures. Analysis of covariance was used to control for gender effect. RESULTS: Compared to other physicians, psychiatrists scored higher on measures of verbal ability and general information before medical school and on evaluations of knowledge and skills in behavioral sciences during medical school, but they scored lower on United States Medical Licensing Examinations step 3. CONCLUSIONS: The results generally confirmed the authors' expectations about psychiatrists' academic performance. More attention should be paid to the general medical education of psychiatrists.

Achievement↗
PubMed2004

Comparisons of nurses and physicians on an operational measure of empathy.

In view of many changes taking place in today's health care marketplace, the theme of empathy in health provider-patient relations needs to be revisited. It has been proposed that patients benefit when all members of the health care team provide empathic care. Despite the role of empathy in patient outcomes, empirical research on empathy among health professionals is scarce partly because of a lack of a psychometrically sound tool to measure it. In this study, we briefly describe the development and validation of the Jefferson Scale of Physician Empathy (JSPE), an instrument that was specifically developed to measure empathy among health professionals (20 Likert-type items). The purpose of this study was to compare nurses and physicians on their responses to the JSPE. Study participants were 56 female registered nurses and 42 female physicians in the Internal Medicine postgraduate medical education program at Thomas Jefferson University Hospital. The reliability coefficients (Chronbach's coefficient alpha) were 0.87 for the nurses and 0.89 for physicians. Results of t test showed no significant difference between nurses and physicians on total scores of the JSPE; however, multivariate analyses of variance indicated statistically significant differences between the two groups on 5 of 20 items of the JSPE. Findings suggest that the JSPE is a reliable research tool that can be used to assess empathy among health professionals including nurses.

Adult↗
PubMed2004

Economic diversity in medical education: the relationship between students' family income and academic performance, career choice, and student debt.

Providing access to higher education across all income groups is a national priority. This analysis assessed the performance, career choice, and educational indebtedness of medical college students whose educational pursuits were assisted by the provision of financial support. The study looked at designated outcomes (academic performance, specialty choice, accumulated debt) in relation to the independent variable, family (parental) income, of 1,464 students who graduated from Jefferson Medical College between 1992 and 2002. Students were classified into groups of high, moderate, and low income based on their parental income. During the basic science years, the high-income group performed better; however, in the clinical years, performance measures were similar. Those in the high-income group tended to pursue surgery, while those in the low-income group preferred family medicine. The mean of accumulated educational debt was significantly higher for the low-income group. The study provides support for maintaining economic diversity in medical education.

Career Choice↗
PubMed2004

Modafinil improves recovery after general anesthesia.

UNLABELLED: Recovery from general anesthesia often involves residual sedation, drowsiness, fatigue, and lack of energy that may last hours to days. Modafinil is a wakefulness-promoting drug approved for patients with excessive daytime sleepiness associated with narcolepsy. We evaluated the effect of single doses of modafinil (200 mg) and placebo in patients recovering from general anesthesia. Thirty-four subjects participated in this prospective, randomized, double-blind study approved by our IRB. Preoperatively, patients were asked to rate various symptoms they had experienced over the previous 24-h using a verbal analog scale (VAS) of 0 to 10 as well as discrete scale when indicated. Postoperatively, once the patient was able to tolerate oral intake and met our institutional discharge criteria, the study drug (modafinil 200 mg or placebo) was administered with a sip of water. Patients were contacted 24 (1) hours after dosing to evaluate postdischarge symptoms. Patients in the placebo group reported significantly more postoperative fatigue (4.8 [3.3] versus 1.4 [1.8]), exhaustion (4.3 [3.3] versus 2.4 [3.1]), or degree of feeling worn out (4.7 [3.6] versus 2.9 [2.4]). Significantly more patients reported moderate to severe fatigue in the placebo group (65% versus 12%). Two major themes of "alertness" and "energy" were expressed by 71% of the patients receiving modafinil versus 18% of those receiving placebo. Patients recovering from general anesthesia can significantly benefit from modafinil. IMPLICATIONS: Modafinil significantly reduces fatigue and improves feelings of alertness and energy in postoperative patients. Patients recovering from general anesthesia can significantly benefit from modafinil administration.

Adolescent↗
PubMed2003

Comparisons of American, Israeli, Italian and Mexican physicians and nurses on the total and factor scores of the Jefferson scale of attitudes toward physician-nurse collaborative relationships.

This cross-cultural study was designed to compare the attitudes of physicians and nurses toward physician-nurse collaboration in the United States, Israel, Italy and Mexico. Total participants were 2522 physicians and nurses who completed the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (15 Likert-type items, (Hojat et al., Evaluation and the Health Professions 22 (1999a) 208; Nursing Research 50 (2001) 123). They were compared on the total scores and four factors of the Jefferson Scale (shared education and team work, caring as opposed to curing, nurses, autonomy, physicians' dominance). Results showed inter- and intra-cultural similarities and differences among the study groups providing support for the social role theory (Hardy and Conway, Role Theory: Perspectives for Health Professionals, Appelton-Century-Crofts, New York, 1978) and the principle of least interest (Waller and Hill, The Family: A Dynamic Interpretation, Dryden, New York, 1951) in inter-professional relationships. Implications for promoting physician-nurse education and inter-professional collaboration are discussed.

Analysis of Variance↗
PubMed2003

Impartial judgment by the "gatekeepers" of science: fallibility and accountability in the peer review process.

High publication demands and the low acceptance rate of peer review journals place the journal editors and their reviewers in a powerful position. Journal reviewers have a vital role not only in influencing the journal editor's publication decisions, but also in the very nature and direction of scientific research. Because of their influence in peer review outcomes, journal reviewers are aptly described as the "gatekeepers of science." In this article we describe several pitfalls that can impede reviewers' impartial judgement. These include such issues as confirmatory bias, the negative results bias (the file drawer problem), the Matthew effect, the Doctor Fox effect, and gender, race, theoretical orientation, and "political correctness." We argue that procedures currently used by many professional journals, such as blind or masked review, may not completely alleviate the effects of these pitfalls. Instead, we suggest that increasing reviewers' awareness of the pitfalls, accountability, and vigilance can improve fairness in the peer review process. The ultimate responsibilities belong to the journal editors who are confronted with the difficult task of satisfying journal readers, contributors, reviewers, and owners. We recommend that the journal editors conduct periodic internal and external evaluations of their journals' peer review process and outcomes, with participation of reviewers, contributors, readers and owners.

Judgment↗
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↗
PubMed2003

Mindfulness-based stress reduction lowers psychological distress in medical students.

BACKGROUND: Medical students confront significant academic, psychosocial, and existential stressors throughout their training. Mindfulness-based stress reduction (MBSR) is an educational intervention designed to improve coping skills and reduce emotional distress. PURPOSE: The purpose of this study was to examine the effectiveness of the MBSR intervention in a prospective, nonrandomized, cohort-controlled study. METHODS: Second-year students (n = 140) elected to participate in a 10-week MBSR seminar. Controls (n = 162) participated in a didactic seminar on complementary medicine. Profile of Mood States (POMS) was administered preintervention and postintervention. RESULTS: Baseline total mood disturbance (TMD) was greater in the MBSR group compared with controls (38.7 +/- 33.3 vs. 28.0 +/- 31.2; p < .01). Despite this initial difference, the MBSR group scored significantly lower in TMD at the completion of the intervention period (31.8 +/- 33.8 vs. 38.6 +/- 32.8; p < .05). Significant effects were also observed on Tension-Anxiety, Confusion-Bewilderment, Fatigue-Inertia, and Vigor-Activity subscales. CONCLUSION: MBSR may be an effective stress management intervention for medical students.

Adaptation, Psychological↗
PubMed2003

African American and white physicians: a comparison of satisfaction with medical education, professional careers, and research activities.

BACKGROUND: Given the disparity between proportions of minority in the general population and in the physician workforce and the projected increase in the minority population, it is important and timely to examine factors that contribute to satisfaction of minority physicians. PURPOSE: To examine similarities and differences between African American and White physicians in their satisfaction with medical school, their medical careers, and their professional and research activities and achievements. METHODS: A questionnaire was mailed to the 148 active African American graduates of Jefferson Medical College (1960 to 1995). Control group was 148 active White classmates matched as to gender, year of graduation, and scores on Step 2 of the United States Medical Licensing Examination (formerly Part 2 of the National Board). RESULTS: Overall response rate--61% (African Americans--59%, White control group--63%). Both groups were equally satisfied with medical education, careers, and professional and research activities. No differences were noted between the groups in satisfaction with medical school financial support, preparation for a medical career, the educational experience and academic environment, medical careers, and practice incomes. African Americans reported greater dissatisfaction than Whites with interactions with medical school faculty and administrators and with the medical school social environment. African Americans were less likely than Whites to recommend Jefferson to minority applicants and to contribute to annual alumni giving. More African Americans than Whites practiced medicine in economically deprived areas and cared for poor minority patients. CONCLUSIONS: African American respondents were comparable with White respondents as to their medical careers, professional activities, and achievements as physicians. Their practice patterns reflected a greater sense of community need and involvement than their White counterparts. The sense of dissatisfaction with the social environment of medical school noted by African American respondents seems to persist during their professional careers.

Black or African American↗