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Biomedical subjects

R Brent Stansfield

Publications and source records attributed to R Brent Stansfield.

6 recordsLinked to original sources
PubMed2007

Conditional reliability of admissions interview ratings: extreme ratings are the most informative.

CONTEXT: Admissions interviews are unreliable and have poor predictive validity, yet are the sole measures of non-cognitive skills used by most medical school admissions departments. The low reliability may be due in part to variation in conditional reliability across the rating scale. OBJECTIVES: To describe an empirically derived estimate of conditional reliability and use it to improve the predictive validity of interview ratings. METHODS: A set of medical school interview ratings was compared to a Monte Carlo simulated set to estimate conditional reliability controlling for range restriction, response scale bias and other artefacts. This estimate was used as a weighting function to improve the predictive validity of a second set of interview ratings for predicting non-cognitive measures (USMLE Step II residuals from Step I scores). RESULTS: Compared with the simulated set, both observed sets showed more reliability at low and high rating levels than at moderate levels. Raw interview scores did not predict USMLE Step II scores after controlling for Step I performance (additional r2 = 0.001, not significant). Weighting interview ratings by estimated conditional reliability improved predictive validity (additional r2 = 0.121, P < 0.01). CONCLUSIONS: Conditional reliability is important for understanding the psychometric properties of subjective rating scales. Weighting these measures during the admissions process would improve admissions decisions.

Education, Medical, Undergraduate↗
PubMed2006

The effect of the obstetrics and gynecology clerkship on students' interest in a career in obstetrics and gynecology.

OBJECTIVE: The goal of this study was to determine the influence of the third-year obstetrics and gynecology (OB/GYN) clerkship on male and female medical students' interest in a career in OB/GYN. STUDY DESIGN: Third-year medical students were surveyed about anticipated career field before and at the completion of the OB/GYN clerkship. The percentage of students considering OB/GYN as a career was computed before and after the clerkship. A multiple regression analysis was performed to examine the influence of various demographic factors on interest in OB/GYN. A Chi-square test was performed to establish different effects on males and females. RESULTS: A total of 268 students (55%) completed both surveys. Eight percent (mostly females) considered an OB/GYN career pre-clerkship and 15% post-clerkship. Interest in OB/GYN pre-clerkship was the strongest predictor of interest post-clerkship. CONCLUSION: The OB/GYN clerkship increases students' interest in a career in OB/GYN. Most males are not considering OB/GYN as a career choice before the start of the clerkship.

Adult↗
PubMed2006

The resident view of professionalism behavior frequency in outstanding and "not outstanding" faculty.

BACKGROUND: Professionalism assessment has become necessary for all postgraduate training programs because it is now required for accreditation. To validate the novel items we generated to assess professionalism, we tested whether residents' ratings of faculty they judged as outstanding in professionalism would be distinguishable from those they judged as not outstanding. METHODS: Educators from core clinical disciplines generated 20 items assessing professionalism behaviors on a 7-point frequency scale anchored by "always" and "never." Thirty-five surgical and pediatric residents completed the form twice, anonymously rating 1 faculty member they judged as outstanding and another they judged as not outstanding. RESULTS: The residents produced 69 faculty ratings with means that differed significantly on all items between the outstanding and not-outstanding faculty. The form was highly unidimensional, with the primary factor's eigenvalue being 11.5 and Cronbach's alpha being 0.97. Groups differed most on items, ie, "listens well," "inspires trust," "answers questions directly," and "demonstrates respect for all." CONCLUSION: The behaviors that best distinguished clinical faculty judged by residents as outstanding professionals were listening, trustworthiness, answering directly, and respect.

Clinical Competence↗
PubMed2005

Pilot of a hospice-based elective to learn comfort with dying patients in undergraduate medical education.

BACKGROUND: A majority of medical students feel uncomfortable with dying patients. OBJECTIVE: We designed a pilot program to train medical students to be hospice volunteers to determine (1) the value of contact with dying patients in changing medical students' comfort level and (2) the mechanics of starting such a course in cooperation with a nonacademic agency. DESIGN: Students were required to undergo hospice training provided by the local hospice. Students were eligible for Hospice volunteer placement after the training was completed. This provided students with an opportunity to interact with dying patients in a nonclinical capacity. Quantitative data and qualitative data were collected about the students' experiences with patients as well as about the effectiveness of the rotation. SETTING/SUBJECTS: First- through fourth-year medical students were recruited to participate in this semester long project via a medical school-wide e-mail. MEASUREMENTS: (1) A self-rating questionnaire on emotions and attitudes about death and dying at three points in time: before training, after training, and after placement; (2) A Likert-type questionnaire on barriers to participation and the usefulness of the components of an end-of-life course; (3) The "Attitudes About End-of-Life Scale"; (4) An in-depth structured interview with students after completion of the course. RESULTS: Fourteen students participated in the evaluation phase of the program and reported increased comfort in interacting with dying patients after participating in the program. Students had less anxiety and fear of being around a dying person after placement as compared to before training. In-depth student interviews provided valuable qualitative data on the impact of the pilot, and insight into the strengths and areas for improvement in this type of elective. CONCLUSIONS: A Hospice based elective can be an effective model for facilitating learning about how to approach the patient with a terminal illness.

Analysis of Variance↗
PubMed2003

Pelvic floor nerve conduction studies: establishing clinically relevant normative data.

OBJECTIVE: The purpose of this study was to establish data for normative distributions for pudendal and perineal nerve compound muscle action potential data in healthy women across a wide age range and varied history of vaginal deliveries. STUDY DESIGN: We studied 42 continent women, aged 20 to 67 years, including 29% nulliparous women with a disposable St. Mark's electrode to stimulate the pudendal nerve at the ischial spine by a transvaginal approach. The pudendal terminal motor latency and amplitude were detected with the use of surface patch electrodes overlying the external anal sphincter; the perineal responses were measured with the use of a surface ring electrode at the proximal urethra. RESULTS: None of the data were distributed normally and required the use of negative inverse and cube root transformations to create a normal distribution. Clinical correlations were found with advancing age and vaginal delivery. CONCLUSION: The collection of these data allows for the definition of normal limits and begins the study of clinically important variables on test results and clinical outcomes.

Action Potentials↗