Holiday review. Are all the taken men good? An indirect examination of mate-choice copying in humans.
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Adult↗
Biomedical subjects
Timothy J Wood
Publications and source records attributed to Timothy J Wood.
Standard setting in a small scale OSCE: a comparison of the Modified Borderline-Group Method and the Borderline Regression Method.
When setting standards, administrators of small-scale OSCEs often face several challenges, including a lack of resources, a lack of available expertise in statistics, and difficulty in recruiting judges. The Modified Borderline-Group Method is a standard setting procedure that compensates for these challenges by using physician examiners and is easy to use making it a good choice for small scale OSCEs. Unfortunately, the use of this approach may introduce a new challenge. Because a small scale OSCE has a small number of examinees, there may be few examinees in the borderline range, which could introduce an unintentional bias. A standard setting method called The Borderline Regression Method will be described. This standard setting method is similar to the Modified Borderline-Group Method but incorporates a linear regression approach allowing the cut score to be set using the scores from all examinees and not from a subset. The current study uses confidence intervals to analyze the precision of cut scores derived from both approaches when applied to a small scale OSCE.
Bias↗
Why do physicians volunteer to be OSCE examiners?
Recruitment of physician examiners for an objective structured clinical examination (OSCE) can be difficult. The following study will explore reasons why physicians volunteer their time to be OSCE examiners. A questionnaire was collected from 110 examiners including a fourth year formative student OSCE (SO) (n=49), formative internal medicine OSCE (IM) (n=21) and the Medical Council of Canada Qualifying Exam Part II (MCCQE II) (n=40). A 5-point Likert scale was used. Statements with high mean ratings overall included: enjoy being an examiner (4.05), gain insights into learners' skills and knowledge (4.27), and examine out of a sense of duty (4.10). The MCC participants produced higher ratings (p<0.05). Overall, OSCE examiners volunteer their time because they enjoy the experience, feel a sense of duty and gain insight into learners' skills and knowledge. The MCC examiners appear to value the experience more. The ability to provide feedback and the provision of CME credits were not significant factors for increasing examiner satisfaction.
Attitude of Health Personnel↗
A comparison of physician examiners and trained assessors in a high-stakes OSCE setting.
BACKGROUND: The Medical Council of Canada (MCC) administers an objective structured clinical examination for licensure. Traditionally, physician examiners (PE) have evaluated these examinees. Recruitment of physicians is becoming more difficult. Determining if alternate scorers can be used is of increasing importance. METHOD: In 2003, the MCC ran a study using trained assessors (TA) simultaneously with PEs. Four examination centers and three history-taking stations were selected. Health care workers were recruited as the TAs. RESULTS: A 3x2x4 mixed analyses of variance indicated no significant difference between scorers (F1,462=.01, p=.94). There were significant interaction effects, which were, localized to site 1/station 3, site 3/station 2, and site 4/station1. Pass/fail decisions would have misclassified 14.4-25.01% of examinees. CONCLUSION: Trained assessors may be a valid alternative to PE for completing checklists in history-taking stations, but their role in completing global ratings is not supported by this study.
Canada↗
The development of a participant questionnaire to assess continuing medical education presentations.
OBJECTIVE: Feedback on presentation skills is important for developing skilled educators, but often this feedback is based on evaluation tools that have been developed with little concern for psychometric issues or for how the information will be used for feedback. The purpose of this study was to develop a reliable participant questionnaire to assess the quality of continuing medical education (CME) presentations and to provide presenters with feedback. DESIGN: The questionnaire was developed using an iterative approach, with doctors as raters, and tested during a variety of CME presentations. The resulting questionnaire consists of 9 items rated on a 7-point Likert scale. The psychometric analysis reported in this paper was completed using data from grand rounds presentations. RESULTS: Psychometric analysis, based on 319 evaluations from 17 presentations (average of 19 evaluations/presentation), revealed a high level of reliability (0.91), indicating that the items met a reasonable standard and that the raters were discriminating between the quality of the presentations adequately. CONCLUSION: This 9-item, participant questionnaire provides a reliable measure of the quality of CME presentations, while also providing presenters with useful feedback. Further studies will investigate if this instrument can be used to assess other CME formats and how best to provide feedback to presenters.
Education, Medical, Continuing↗
Can the strength of candidates be discriminated based on ability to circumvent the biasing effect of prose? Implications for evaluation and education.
PURPOSE: Residents have greater confidence in diagnoses when indicative features are presented in medical terminology. The current study examines the implications of this result by assessing its relationship to clinical ability. METHOD: Candidates writing the Medical Council of Canada's Qualifying Examination completed six questions in which the terminology used was manipulated. The influence of aptitude was examined by contrasting groups based on performance on the medicine section of Part I. RESULTS: The difference between the candidates was greatest in the mixed conditions in which the features consistent with one diagnosis were presented in medicalese and those consistent with a second diagnosis were presented using lay terminology; weaker candidates were more biased by language than stronger candidates. CONCLUSIONS: The results suggest that the language used in presenting case histories will influence the reliability of medical examinations. Furthermore, they suggest that weaker candidates might benefit from practice in making the translation between lay terminology and medicalese.
Age Factors↗
Expert-novice differences in memory: a reformulation.
BACKGROUND: One of the most discriminating measures of expertise in multiple domains has been performance on memory tasks. In medicine, however, the relation between expertise and memory is more equivocal. PURPOSE: To compare and contrast the sufficiency of multiple explanations of this finding by using three probes of memory rather than the traditional free recall task alone. METHODS: Students, residents, and internists were asked to read case histories and assign diagnoses before undertaking free recall, cued recall, and recognition tests. RESULTS: Students consistently outperformed internists. Resident performance was more variable. CONCLUSIONS: Our data appear to rule out (a) the notion that expert memory for cases takes on an encapsulated form, (b) the idea that experts simply say less than students in response to a free recall task, and (c) the possibility that experts attend differentially to highly diagnostic features. The results can best be explained by the idea that students process the featural details of a case history more elaborately than do expert diagnosticians who, instead, read medical cases more holistically.
Clinical Competence↗
Validation of a decision regret scale.
BACKGROUND: As patients become more involved in health care decisions, there may be greater opportunity for decision regret. The authors could not find a validated, reliable tool for measuring regret after health care decisions. METHODS: A 5-item scale was administered to 4 patient groups making different health care decisions. Convergent validity was determined by examining the scale's correlation with satisfaction measures, decisional conflict, and health outcome measures. RESULTS: The scale showed good internal consistency (Cronbach's alpha = 0.81 to 0.92). It correlated strongly with decision satisfaction (r = -0.40 to -0.60), decisional conflict (r = 0.31 to 0.52), and overall rated quality of life (r = -0.25 to -0.27). Groups differing on feelings about a decision also differed on rated regret: F(2, 190) = 31.1, P < 0.001. Regret was greater among those who changed their decisions than those who did not, t(175) = 16.11, P < 0.001. CONCLUSIONS: The scale is a useful indicator of health care decision regret at a given point in time.
Abstracting and Indexing↗