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Biomedical subjects

R Deterding

Publications and source records attributed to R Deterding.

4 recordsLinked to original sources
PubMed2001

Measuring critical thinking in problem-based learning discourse.

BACKGROUND: Critical thinking (CT) is a composite of skills linked to problem-based learning (PBL). PURPOSES: This study has 3 purposes: (a) to determine if PBL discourse could be coded for CT, (b) to demonstrate reliable coding, and (c) to determine whether a CT ratio would provide a valid measure to compare 2 PBL groups. METHODS: Using prior research, we refined the code for a content analysis of PBL transcripts. Raters coded 6 hr of transcripts and computed CT ratios for each of the 5 CT stages. Average interrater agreement was 85.5%. CT ratios appeared to differ between 2 PBL groups delivered in 2 modalities. RESULTS: PBL discourse could be coded following a CT framework. Independent raters reliably applied the code, and the resulting CT ratios detected tenable differences. CONCLUSIONS: This approach could provide useful information about the effect of case modality.

Educational Measurement↗
PubMed1999

Effect of a longitudinal course on student performance in clerkships.

OBJECTIVE: To determine the effect that a 3-year primary-care course experience with family medicine, internal medicine, or pediatric preceptors would have on clerkship performance in pediatrics and internal medicine. DESIGN: In 1 academic year, third-year students were divided retrospectively into 3 groups based on preceptor type in the primary care course. An analysis of variance was conducted. When the analysis of variance showed statistical significance, a multiple-comparison t test was performed. SETTING: University medical school with a longitudinal preceptor experience. PARTICIPANTS: One hundred nine third-year medical students who participated in the primary care course and completed the pediatric and internal medicine clerkships. Fifty-six students took part in the self-assessment portion of the study. MAIN OUTCOME MEASURES: Student performance scores in the pediatric clerkship and internal medicine clerkship were analyzed for significant differences based on preceptor type. Student self-assessment on pediatric objectives was analyzed for significant differences based on preceptor experience. RESULTS: Students with pediatric preceptors received higher clinical scores in the pediatric clerkship (P = .04) and perceived themselves as more advanced on 18 of the 39 pediatric curriculum pretest self-assessment items. Students with pediatric or internal medicine preceptors received significantly higher scores on the written patient medical history and physical examinations (P = .02). There were no significant differences on the pediatric written examination. There were no significant performance differences in the internal medicine clerkship. All hypothesis testing was conducted at the 95% confidence level. CONCLUSION: Experiences with pediatric preceptors in the early years of medical school may improve a student's performance and confidence in the pediatric clerkship.

Analysis of Variance↗
PubMed1997

Laparoscopic fundoplication to enhance pulmonary function in children with severe reactive airway disease and gastroesophageal reflux disease.

BACKGROUND: The relationship between severe reactive airway disease (RAD) and gastroesophageal reflux disease (GERD) has been noted but the relationship is poorly understood. This study reports our experience with laparoscopic fundoplication and its effect on the pulmonary status of children with severe steroid-dependent reactive airway disease. METHODS: Fifty-six patients with severe steroid-dependent RAD and medically refractory GERD underwent laparoscopic Nissen fundoplications. Mean age was 7 years and mean weight was 20 kg. All patients had the procedure completed successfully laparoscopically with an average operative time of 62 min. Average hospital stay was 1.6 days. RESULTS: Forty-eight of 56 patients noted significant improvement in their respiratory symptoms in the first week. Fifty of 56 patients have been weaned off their oral steroids and four others have had a greater than 50% decrease in their dose. Sixteen patients had a documented increase in their FEV1 in the initial postoperative period (avg. 26%). CONCLUSION: Patients with steroid-dependent RAD and GERD refractory to medical management show improvement in their respiratory status following fundoplication and the majority can be weaned off of their oral steroids. Laparoscopic techniques allow this procedure to be performed safely even in this high-risk group of patients.

Adolescent↗