PubMed Health⌕ Search

Biomedical subjects

S J Singleton

Publications and source records attributed to S J Singleton.

4 recordsLinked to original sources

Clarifying the concepts of confidence and competence to produce appropriate self-evaluation measurement scales.

INTRODUCTION: This paper reviews the literature on self-evaluation and discusses the findings of a small-scale qualitative study which explored the terms 'confidence' and 'competence' as useful measures in a self-evaluation scale. Four pre-registration house officers took part in interviews and completed a provisional instrument to assess their perceived competence. FINDINGS: Competence and confidence are useful terms for house officers expressing beliefs about their ability to perform their job but the terms should not be used synonymously. In our study, 'competent' represented what individuals knew about their ability and was based on the individual's previous experience of the task. 'Confident' described a judgement which influenced whether an individual was willing or not to undertake an activity. Confidence was not necessarily based on known levels of competence and therefore performance of tasks which were unfamiliar to the house officer also involved the assessment of risk. The authors give examples of task and skill scales which may be useful in the process of self-evaluation by pre-registration house officers. CONCLUSIONS: The authors suggest that the process of assessing oneself is complicated, and by its very nature can never be objective or free from the beliefs and values individuals hold about themselves. Therefore self-evaluation instruments are best used to help individuals analyse their work practices and to promote reflection on performance. They should not be used to judge the 'accuracy' of the individual's evaluation.

Attitude↗

Identifying appropriate tasks for the preregistration year: modified Delphi technique.

OBJECTIVES: To identify the tasks that should constitute the work of preregistration house officers to provide the basis for the development of a self evaluation instrument. DESIGN: Literature review and modified Delphi technique. SETTING: Northern Deanery within the Northern and Yorkshire office NHS executive. SUBJECTS: 67 educational supervisors of preregistration house officers. MAIN OUTCOME MEASURES: Percentage of agreement by educational supervisors to tasks identified from the literature. RESULTS: Over 61% of communication items, 70% of on call patient care items, 75% of routine patient care items, 45% of practical procedure items, and over 63% of self management items achieved over 95% agreement that they should be part of the house job of preregistration house officers. Poor agreement was found for the laboratory and clinical investigations that house officers could perform with or without supervision. CONCLUSIONS: The tasks of house officers were identified but issues in using this method and in devising a universally acceptable list of tasks for preregistration house officers were apparent.

Clinical Laboratory Techniques↗

Causes and prognosis of delirium in elderly patients admitted to a district general hospital.

BACKGROUND: delirium is common and is associated with a high early mortality, but less is known about the longer term prognosis. DESIGN: case-controlled prospective study. METHODS: all relevant wards were contacted weekly by a research nurse and the nurses were asked to report all patients presenting with confusion. Patients satisfying the American Psychiatric Association's Diagnostic and Statistical Manual III criteria were included. The diagnosis of delirium was confirmed by a consultant physician. Delirious patients were then followed-up throughout their hospital admission to ascertain the cause of their delirium, and assessed for visual and hearing impairment. The patients were assessed again at 6 and 12 months. Control patients, who were in hospital at the same time and on similar wards, but were not confused, were also examined and followed-up. RESULTS: 171 patients with delirium were identified (78 men and 93 women, mean age 81 years). The commonest cause of delirium was infection (34% of cases), but in 25% there were multiple equally contributory causes. Vision and hearing impairment was significantly more common in patients with delirium [odds ratio (OR) 12.62; confidence intervals (CI) 2.86-114.04, P < 0.001). After 1 year, patients presenting with delirium had an increased mortality (OR 2.30; 95% CI 1.25-4.35, P = 0.006), an increased institutionalization rate (OR 4.53; 95% CI 1.80-13.56, P = 0.001) and an increased likelihood of having been re-admitted (OR 2.05; 95% CI 1.19-3.54, P = 0.008). CONCLUSION: delirium has a poor long-term prognosis and may be a marker for functional deterioration and decline in elderly people.

Aged↗