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Biomedical subjects

S S Obenshain

Publications and source records attributed to S S Obenshain.

At least 19 recordsLinked to original sources
PubMed2001

Uncertainty and opposition of medical students toward assisted death practices.

To explore medical students' views of assisted death practices in patient cases that describe different degrees and types of physical and mental suffering, an anonymous survey was administered to all students at one medical school. Respondents were asked about the acceptability of assisted death activities in five patient vignettes and withdrawal of life support in a sixth vignette. In the vignettes, actions were performed by four possible agents: the medical student personally; a referral physician; physicians in general; or non-physicians. Of 306 medical students, 166 (54%) participated. Respondents expressed opposition or uncertainty about assisted death practices in the five patient cases that illustrated severe forms of suffering which were secondary to amyotrophic lateral sclerosis, treatment-resistant depressive and somatoform disorders, antisocial and sexually violent behavior, or AIDS. Students supported the withdrawal of life support in the sixth vignette depicting exceptional futility secondary to AIDS. Students were especially opposed to their own involvement and to the participation of non-physicians in assisted death activities. Differences in views related to sex, religious beliefs, and personal philosophy were found. Medical students do not embrace assisted death practices, although they exhibit tolerance regarding the choices of medical colleagues. How these attributes of medical students will translate into future behaviors toward patients and peers remains uncertain. Medical educators must strive to understand the perspectives of physicians-in-training. Expanded, empirically informed education that is attuned to the attitudes of medical students may be helpful in fulfilling the responsibility of imparting optimal clinical care skills.

Adult↗
PubMed1999

Assessing medical students' competence in obtaining informed consent.

BACKGROUND: Medical schools increasingly place emphasis on preparing students to perform routine, ethically important clinical activities with sensitivity and acumen. A method for evaluating students' skills in obtaining informed consent that was created at our institution is described. METHODS: Formal assessment of medical students' professional attitudes, values, and ethics skills occurs in the context of three required and developmentally attuned comprehensive examinations. A videotaped station tested senior medical students' ability to obtain informed consent from a standardized patient who expresses concern about undergoing cardiac catheterization. Two checklists were completed by the patient. Videotapes were reviewed by a faculty member, and students' reactions to the assessment experience were documented. RESULTS: Seventy-one senior students participated, and all performed well. Mean scores of 6.3 out of 7 (range 5 to 7, SD = 0.5) on the informed consent checklist and 8.7 out of 9 (range 6 to 9, SD = 0.5) on the communication skills checklist were obtained. Students endorsed the importance of the skills tested. CONCLUSIONS: This method of examining medical students' abilities to obtain informed consent has several positive features and holds promise as an ethics competence assessment tool.

Adult↗
PubMed1999

Use of student-centred, computer-mediated communication to enhance the medical school curriculum.

OBJECTIVES: While it is clear that computers will play an important role in the study and practice of medicine their introduction into the curriculum remains controversial. Computer purchase has been made compulsory for incoming students. DESIGN: Members of the incoming class were allowed to purchase any computer and modem capable of using the communication program chosen by the school. No formal computer training was given. Students were encouraged to call for assistance or bring in their computers for configuration. The primary object of the system was for communication between the students and between students and faculty. SETTING: The School of Medicine of the University of New Mexico. SUBJECTS: First-year medical students. RESULTS: The vast majority of students set up their computers and connected to the system with little assistance. At the end of the first week of studies all the students were connected. Most of the students used the system on a daily basis. The greatest interest was in discussions concerning examinations with 93% of students reading these postings. The least-used aspect of the system was the exchange of learning issues from small group case discussions. Students also downloaded the curricular material provided but were discriminating in accessing this content. CONCLUSIONS: The student use of the computer as a communication tool has been a success. Students used the system in a variety of ways and by so doing also learned the basics of computer use and maintenance. The area of faculty training is often ignored but is considered crucial to the success of such a project.

Computer Communication Networks↗
PubMed1998

Assessing clinical competence of medical students in women's health care: use of the objective structured clinical examination.

OBJECTIVE: To assess clinical competency of third-year medical students completing a problem-oriented, primary care emphasis clerkship in obstetrics and gynecology using an objective structured clinical examination, and to determine the feasibility of implementing the objective structured clinical examination in the curriculum. METHODS: Sixteen groups of third-year medical students were evaluated prospectively on their exit performances with a six-station objective structured clinical examination designed to test clinical competency in basic primary care obstetrics-gynecology. Consistency of scores across stations, differences in performance for separate groups, and relationship of objective structured clinical examination scores compared with other indicators of medical proficiency, such as written examinations and faculty evaluations, were assessed. RESULTS: One hundred ninety-eight students were evaluated over 25 months. Test reliability across stations revealed alpha values ranging between .50 and .56. Correlations between performance on the objective structured clinical examination and the written test (r = .10) were low, demonstrating that the objective structured clinical examination clearly tests a separate domain of student capability. Cost of the objective structured clinical examination was $81.66 per student. CONCLUSION: The objective structured clinical examination is a reliable and valid test of the clinical competence of medical students in the primary health care of women. It provides information that is not obtained by more traditional assessment modalities at a reasonable cost.

Clinical Clerkship↗
PubMed1994

Cheating by students: findings, reflections, and remedies.

Cheating among students is surprisingly frequent and may be increasing. The 1991 study reported herein was prompted by an episode of cheating involving three second-year medical students at the University of New Mexico School of Medicine (UNM SOM) and was undertaken (1) to elicit the opinions of faculty members and students at that institution about whether selected descriptions of students' behaviors were unethical; (2) to document possible discrepancies between the opinions of the two groups concerning these behaviors; (3) to define the prevalence of unethical behavior among current students as estimated by faculty and students; and (4) to determine how best to approach future instances of unethical behavior. Questionnaires were distributed to all faculty and students. The first two parts, sent to both groups, concerned reactions to a series of described physician and student behaviors. For each described behavior, respondents were asked whether or not it was unethical and, for the described student behaviors, whether they had personal knowledge of such behavior by local medical students. The third portion of the questionnaire concerned faculty perceptions regarding students' behaviors over time. With the exception of the class involved in the cheating incident, faculty and students were surprisingly similar in their opinions regarding the ethical nature of the described behaviors. According to both faculty and students, there was a significant incidence ( > or = to 10% of the respondents) of unethical behavior at the school of medicine, most commonly in relation to cheating on examinations.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude↗
PubMed1993

Background essential to the proper use of results of step 1 and step 2 of the USMLE.

This first of the four-part set of articles published in this issue provides general information and concepts about the Step 1 and Step 2 examinations of the United States Medical Licensing Examination (USMLE) needed for the proper use of these tests' results in three general, related, non-licensure applications: for the evaluation of the examinees' levels of academic achievement, for the evaluation of educational programs the examinees have experienced, and for the selection of examinees into residency programs. Several aspects of the tests are discussed: (1) their original and continuing purpose (which is to assess certain qualifications required for licensure of physicians); (2) their content; (3) their format and the emphases (relative to knowledge or skills testing) that different formats can give, and the concept that the ways the same content areas are formatted in a test will produce different results; (4) test administration, with a discussion of "speeded" versus "power" tests and the organization of test items by difficulty and by (or not by) topic; (5) reliability, with a discussion of standard error and the importance of understanding measurement error in order to discern real differences in scores; (6) scoring, with definition of anchor scores; and (7) interpretation, with discussions of pass/fail criteria in the past, present, and future of the USMLE tests. The authors close by saying that to interpret test performance properly, it is important not only to bear in mind the ideas in the present article but also to carefully review an actual test or at least a representative sample of test questions.

Educational Measurement↗
PubMed1993

Evaluation of the noncognitive professional traits of medical students.

BACKGROUND: Professional attributes such as honesty, integrity, and reliability are critical to success in medical school and postgraduate practice, yet such noncognitive attributes have traditionally been poorly evaluated. METHOD: A program of evaluating students' noncognitive professional attributes at the University of New Mexico School of Medicine was reviewed over a four-year period, from 1987-88 through 1990-91, involving the approximately 525 students enrolled at the school at that time. The evaluation program enabled faculty and staff to quantify their impressions of problem students in a uniform manner, by using an evaluation form that listed and described seven basic professional traits. RESULTS: Over the study years the program identified ten students with difficulties in the basic science and clinical years regarding their character and professionalism. For these ten students, interventions ranged from nothing being done, in one case, to such significant remediations as recommendations of extensive counseling and a leave of absence. One student was dismissed, on the basis of poor academic performance, and the other nine have graduated. In some cases, students noticeably improved their professional behaviors, but whether their behaviors changed as a result of the interventions can't be determined. CONCLUSION: By identifying and tracking students with difficulties, the program offers the opportunity for intervention and, ideally, remediation. This program can complement systems that evaluate academic performance. Such a program can help an institution assure not only the cognitive competence of its graduates, but the competence of their professional behaviors as well.

Character↗
PubMed1992

Assessment of ethical decisions and values.

The development and pilot testing of the Professional Decisions and Values Test (PDV) is described. The PDV is designed to assess how ethical conflicts are dealt with by medical and law students and which moral values motivate them. Data from two consecutive classes of entering medical and law students are presented and their action tendencies and ethical values are compared. The findings support the construct validity of the test. Regarding reliability, stability over time is present for action tendencies but not for values. Perhaps the ethical values of entering medical and law students do not become stable until later. Change in ethical values can be studied with the PDV for groups, not individuals, during the first year of professional education.

Attitude↗
PubMed1991

Comparison of faculty members' and students' perceptions concerning performance criteria and evaluation strategies at the University of New Mexico School of Medicine.

Faculty members' and students' perceptions concerning the relative importances of (1) various performance criteria for students and (2) strategies of evaluation were determined in 1989 by a questionnaire in a single medical school that had both a problem-based, student-centered curriculum and an organ-block curriculum (i.e., regular track). The greatest differences in the rankings of both areas were found between those given by the freshman and sophomore students in the problem-based curriculum and those given by the same groups in the regular track. The faculty members' perceptions tended to be closer to those of the students in the regular track.

Attitude to Health↗
PubMed1989

The New Mexico experiment: educational innovation and institutional change.

Over the past ten years the University of New Mexico School of Medicine has conducted an educational experiment featuring learner-centered, problem-based, community-oriented learning. The experiment was introduced into an established institution by means of an innovative educational track running parallel to the more conventional curriculum. Students in the innovative track, compared with those in the conventional tract, tended to score lower on the National Board of Medical Examiners (NBME) Part I examination (basic sciences) and higher on NBME Part II (clinical sciences), received higher clinical grades on clinical clerkships, and experienced less distress. They were more likely than conventional-track students to retain their initial interest in or switch their preference to careers in family medicine. The parallel-track strategy for introducing curriculum reform succeeded in fostering institutional acceptance of continuing educational innovation. Generic steps in overcoming institutional barriers to change are identified.

Curriculum↗
PubMed1982

Undergraduate medical education for primary care: a case study in New Mexico.

To address the dual problems of maldistribution of physicians and an increasing need for physicians who are lifelong learners, an experimental curricular track was developed at the University of New Mexico School of Medicine. Increased student responsibility for learning is encouraged by student-centered, small-group, problem-based tutorial learning, and early, primary care role modeling is offered during an early, lengthy, rural preceptorship. Preliminary outcomes reveal there is reinforcement of career interest in rural primary care with important linkages forged between the university and communities as a program by-product. Further, the experimental students, as compared to students in the conventional track, showed a greater appreciation of their learning environment, showed less stress, and failed to become cynical. The reorientation of undergraduate medical education toward the future health care needs of communities and the learning needs of physicians may require major modifications of curriculum design and role modeling experiences.

Curriculum↗