Validating an objective structured clinical examination (OSCE) as a method for selecting foreign medical graduates for a pre-internship program.
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Clinical Clerkship↗
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Results for “Structural validation”
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Factor structure and construct validity of "what I think and feel": The Revised Children's Manifest Anxiety Scale.
Responses to the Revised-CMAS of 329 children from grades 1 through 12 were factor analyzed. Consistent with current multidimensional theories of anxiety, three primary anxiety factors emerged, supporting the construct validity of the new scale. Implications for interpretation of the revised scale are discussed.
Adolescent↗
Factor structure and construct validity of the Denman Neuropsychology Memory Scale.
Correlational data on the recently published Denman Neuropsychology Memory Scale (DNMS; Denman, 1984) were subjected to a series of factor analyses. Although a major feature of the DNMS is computation of Verbal, Non-Verbal and Full Scale Memory Quotients, the factor analyses did no support this practice. Since the factor results demonstrated initial support for the construct validity of some of the DNMS subtests, it is recommended that interpretation be based on subtest performance. The present results and suggested future investigations of DNMS construct validity are discussed in relation to current issues in clinical memory assessment.
Adolescent↗
Cross validation of a structural relationship model of student performance.
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Aptitude Tests↗
Two-dimensional real-time ultrasonic imaging of the heart and great vessels. Technique, image orientation, structure identification, and validation.
Conventional M-mode echocardiography has become established as a diagnostic tool for noninvasive evaluation of cardiovascular diseases. Now the advent of two-dimensional real-time echocardiography has opened a new era of investigation. This paper describes in detail the technique of a complete two-dimensional ultrasonic examination of the heart and great vessels. Four transducer locations were commonly utilized--namely, parasternal, apical, subxiphoid, and suprasternal notch positions. The tomographic sections of the heart obtained along the long and short axes of the heart and great vessels by utilizing the above positions were validated by detailed anatomic and contrast echocardiographic techniques.
Echocardiography↗
The notion of time in medical records--structure of chronology, validation and calculation of a time interval.
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Chronology as Topic↗
Cross-validation of the factor structure of the Toronto Alexithymia Scale.
The Toronto Alexithymia Scale (TAS) is a self-report measure of the alexithymia construct. In previous studies with college students, the TAS demonstrated excellent psychometric properties including a 4-factor structure theoretically congruent with the alexithymia construct. The present study attempted to cross-validate the factor structure of the TAS with samples of normal adults, psychiatric outpatients and college students. Congruence coefficients comparing the similarity of the factor structures for these three samples indicated good congruence for all four factors. The results provide further support for the validity of both the TAS and the alexithymia construct. In addition, the results provide evidence of the applicability of the scale to normal adult and clinical samples.
Adult↗
Reliability and validity of the objective structured clinical examination in assessing surgical residents.
The purpose of this research was to assess reliability and construct validity of the objective structured clinical examination (OSCE) for evaluating the clinical skills of surgical residents. Reliability refers to precision of the examination and construct validity to the degree to which the examination can discriminate between different levels of training. Twenty-seven second postgraduate year surgical residents took a 38-station OSCE representing seven surgical specialties and that tested history-taking, physical examination, problem-solving, technical skills, and attitudes. A couplet methodology was used wherein a patient encounter was followed by written questions aimed at testing problem-solving and patient management capabilities. Thirty-six standardized patients were trained and 36 surgeons served as examiners marking from structured checklists. Overall reliability, Cronbach's alpha, was 0.89. Construct validity was examined by comparing the scores of the residents with those of a group of graduates of foreign medical schools applying for a "pre-internship" program. For 17 of 19 stations that both groups took, the residents performed significantly better (p less than 0.01). Individual station validity was significant for 32 of 38 stations (r = 0.36 to 0.82, p less than 0.05). The examinations took 3.83 hours at a cost of $5,293 (Canadian dollars). The OSCE has been shown to be a reliable method of assessing clinical skills of surgical residents, construct validity has been established, and inter-item validity confirmed. Reliabilities achieved exceed those traditionally required for both acceptance and promotion decisions.
Analysis of Variance↗
Validity, reliability, and factor structure of the Anorectic Cognitions Questionnaire.
Several authors have hypothesized cognitive distortion as central to the psychopathology of anorexia nervosa and bulimia. However, there have been few investigations of these hypotheses. Equally as important, psychometrically sound devices for assessing these cognitions are notably lacking. The purpose of this investigation is to examine the psychometric characteristics of the Anorectic Cognitions Questionnaire (MAC). This study reports on initial item development, initial concurrent validity, factor structure, initial item refinement, and internal consistency. Results indicated that the MAC has good concurrent validity, three theoretically defined factors were empirically supported, and the scale is internally consistent.
Adult↗
Reliability and validity of an objective structured clinical examination for assessing the clinical performance of residents.
Clinical performance of residents should be assessed as reliably and validly as possible. This study investigated the reliability and validity of an objective structured clinical examination (OSCE) for assessing clinical performance of internal medicine residents. Residents were required to take a 17-patient OSCE in their first and second year. Reliability of the OSCE was 0.40. Validity studies indicated second-year students were significantly better than third-year students for five of six OSCE skill scores; first-year students were significantly better for three scores. Resident's scores for diagnosis, plan, and total significantly increased on their second OSCE. Generally faculty overall ratings of residents' clinical performance did not correlate with OSCE scores. American Board of Internal Medicine certifying examination scores were consistently positively correlated only with diagnosis. This 17-case OSCE is a feasible method for obtaining moderately reliable, valid data not available from other sources about the clinical performance of residents. More cases should be added to increase its reliability.
Clinical Competence↗
On the validity of an Augmented Structured Interview for measuring subcomponents of the Type A behavior pattern.
This study was designed to provide validity data for the Augmented Structured Interview (ASI), which has been developed to measure subcomponents (as opposed to the global) Type A behavior pattern (TABP). Eighty subjects from a large private southwestern medical center were administered a self-report measure of the TABP (the Jenkins Activity Survey--JAS) and the ASI. Forty of the subjects were being treated for post-infarction coronary heart disease (CHD). The remaining forty subjects did not possess documented CHD. The obtained ratings for all the six ASI-measured Type A subcomponents were significantly higher for the CHD than for the non-CHD group. A discriminant functions analysis revealed that the ASI was superior to the JAS in correctly classifying CHD and non-CHD subjects. These outcomes are interpreted as providing initial support for the validity of the ASI.
Adult↗
Cross-cultural validity of the Miami Structured Interview--1 for type A in children: the American-Hellenic Heart Study.
The Miami Structured Interview--1 was developed (1) to assess Type A behaviour in a broader age range of children than tested with previous interviews, and (2) for cross-cultural studies. This study examined the validity of the Miami Structured Interview--1 for assessing Type A behavior in 507 American and Greek preadolescent (ages 7-11) and adolescent (ages 12-16) boys. The interview was scored on voice stylistics such as speed of speech, word emphasis, and latency of response. Validity was tested using the Matthews Youth Test for Health (MYTH), a teacher rating scale of Type A behaviors. Interview determined Type A's received significantly higher MYTH scores than non Type A's for American adolescents (p less than 0.05), Greek preadolescents (p less than 0.01), and Greek adolescents (p less than 0.05). The interview also identified extreme groups of Type A's and Type B's for American adolescents (p less than 0.01) and Greek preadolescents (p less than 0.05). The findings support the cross-cultural validity of the Miami Structured Interview--1 and the Type A construct for children. Limitations of the Miami Structured Interview--1 are discussed.
Adolescent↗
Cross-validation of the factor structure of the Aberrant Behavior Checklist for persons with mental retardation.
The original factor structure of the Aberrant Behavior Checklist was cross-validated with an American sample of 470 persons with moderate to profound mental retardation, including nonambulatory individuals. The results of the factor analysis with varimax rotation essentially replicated previous findings, suggesting that the original five factors (Irritability, Lethargy, Stereotypic Behavior, Hyperactivity, and Inappropriate Speech) could be cross-validated by factor loadings of individual items. The original five scales continue to show high internal consistency. These factors are easily interpretable and should continue to provide valuable research and clinical information.
Adult↗
Comparison of DSM-III and DSM-III-R diagnoses for prepubertal children: changes in prevalence and validity.
A structured and reliable diagnostic procedure based on a revised version of the Diagnostic Interview Schedule for Children for children, parents, and teachers was used to assign both DSM-III and DSM-III-R diagnoses to 177 outpatient boys aged 7 to 12 years. Compared to their DSM-III counterparts, DSM-III-R oppositional defiant disorder was 25.5% less prevalent, DSM-III-R dysthymia was 37.8% less prevalent, and DSM-III-R conduct disorder (CD) was 44.3% less prevalent. However, DSM-III-R attention deficit hyperactivity disorder was 14.4% more prevalent than DSM-III attention deficit disorder with hyperactivity. The two definitions of CD were compared to exemplify an empirical approach to diagnostic validation. The DSM-III-R diagnosis of CD appears to be more valid as it is more strongly associated with police contacts, school suspensions, and history of antisocial personality disorder in the biological father, but both CD diagnoses are associated with family histories of criminal convictions.
Child↗
Reliability and validity of the objective structured clinical examination in paediatrics.
The assessment of clinical competence has traditionally been carried out through standard evaluations such as multiple choice question and bedside oral examinations. The attributes which constitute clinical competence are multidimensional, and we have modified the objective structured clinical examination (OSCE) to measure these various competencies. We have evaluated the validity and reliability of the OSCE in a paediatric clinical clerkship. We divided the examination into the four components of competence (clinical skills, problem-solving, knowledge, and patient management) and evaluated the performance of 77 fourth-year medical students. The skill and content domains of the OSCE were carefully defined, agreed upon, sampled and reproduced. This qualitative evaluation of the examination was both adequate and appropriate. We achieved both acceptable interstation and intertask reliability. When correlated with concurrent methods of evaluation we found the OSCE to be an accurate measure of paediatric knowledge and patient management skills. The OSCE did not correlate, however, with traditional measures of clinical skills including history-taking and physical examination. Our OSCE, as outlined, offers an objective means of identifying weaknesses and strengths in specific areas of clinical competence and is therefore an important addition to the traditional tools of evaluation.
Clinical Clerkship↗
The solution structures of Escherichia coli trp repressor and trp aporepressor at an intermediate resolution.
We have determined the solution structures and examined the dynamics of the Escherichia coli trp repressor (a 25-kDa dimer), with and without the co-repressor L-tryptophan, from NMR data. This is the largest protein structure thus far determined by NMR. To obtain a set of data sufficient for a structure determination it was essential to resort to isotopic spectral editing. Line broadening observed in this molecular mass range precludes for the most part the measurement of coupling constants and stereospecific assignments, with the inevitable result that the attainable resolution of the final structure will be somewhat lower than the resolution reported for smaller proteins and peptides. Nevertheless the general topology of the protein can be deduced from the subsets of NOEs defining the secondary and tertiary structure, providing a basis for further refinement using the full set of NOEs and energy minimization. We report here (a) an intermediate resolution structure that can be deduced from NMR data, covalent, angular and van-der-Waals constraints only, without resort to detailed energy calculations, and (b) the limits of uncertainty within which this structure is valid. An examination of these structures combined with backbone amide exchange data shows that even at this resolution three important conclusions can be drawn: (a) the protein structure changes upon binding tryptophan; (b) the putative DNA binding region is much more flexible than the core of the molecule, with backbone amide proton exchange rates 1000 times faster than in the core; (c) the binding of tryptophan stabilizes the repressor molecule, which is reflected in both the appearance of additional NOEs, and in the slowing of backbone proton exchange rates by factors of 3-10. Sequence-specific 1H-NMR assignments and the secondary structure of the holopressor (L-tryptophan-bound form) have been reported previously [C. H. Arrowsmith, R. Pachter, R. B. Altman, S. B. Iyer & O. Jardetzky (1990) Biochemistry 29, 6332-6341]. Those for the trp aporepressor (L-tryptophan-free form), made using the same methods and conditions as described in the cited paper, are reported here. The secondary structure of the aporepressor was calculated from sequential and medium-range NOEs and is the same as reported for the holorepressor except that helix E is shorter. The tertiary solution structures for both forms of the repressor were calculated from long-range NOE data.(ABSTRACT TRUNCATED AT 400 WORDS)
Amino Acid Sequence↗
Obsessions and compulsions: dimensional structure, reliability, convergent and divergent validity of the Padua Inventory.
This study presents data on dimensional structure, reliability, convergent and divergent validity of the Padua Inventory (PI). In a sample (n = 430) of normal Dutch subjects. The dimensional structure and the strength of the factors were comparable to those found in the Italian sample. The reliability of the PI was found to be satisfactory. As hypothesized substantial correlations were found between the PI and related scales of the Maudsley Obsessive-Compulsive Inventory (MOCI) and between the PI and the subscales Sensitivity, Hostility and Depression of the revised version of the Symptom Checklist. Low correlations were found between the PI on the one side and the Eysenck Personality Questionnaire revised Extraversion, Psychoticism and Social Desirability scale on the other side. Finally, the mean score of the PI differs across the Italian, American and Dutch samples. This is of theoretical interest and deserves further study.
Adolescent↗
Age differences in personality structure revisited: Studies in validity, stability, and change.
Construct validity and longitudinal stability evidence for three cluster dimensions of personality identified as Anxiety, Extraversion, and Openness is examined in a sample of adult males. Correlations with Allport-Vernon-Lindsay Value scales, Cornell Medical Index scores, Eysenck E and N scales, and factors from the SVIB are presented in support of the interpretation of the three clusters. Nine-year longitudinal evidence of stability is presented for Anxiety and Extraversion scores. Previous evidence for change in the structure of Openness to Experience is reconsidered in the light of eleven-year longitudinal data. While the earlier structural differences were not longitudinally replicated, a pattern of external correlates provided evidence for validity of an Openness dimension. Finally, the structural approach to personality development is illustrated by examining the differing relations between field-dependence and tendermindedness in younger and older men.
Adult↗