Search Results for
"human"

[No abstract available]

This article may be of interest to physical therapy educators who are responsible for structuring station or practical examinations used to evaluate physical therapy students. The global intent of the article is to provide information that may be useful in selecting test items. Specifically, the purposes of this study were 1) to examine how two item-sampling strategies (one based on different diagnostic concepts, or diagnostic probes, and the other based on different anatomical sites) influenced the generalizability of a station examination, 2) to determine the interrater reliability during the station examination, and 3) to determine whether the status of the rater (that of observer or simulated patient) influenced the rating. Using a nested study design, 24 physical therapy students were assessed by eight raters. The raters were randomly and equally assigned to four teams. Each team assessed six students. One rater acted as the simulated patient for the first three students in each group, and the other rater acted as observer. This order was reversed for the last three students. Each student performed nine mini-diagnostic patient cases consisting of three diagnostic probes reproduced at three different anatomical sites. The results demonstrate that 1) similar diagnostic concepts can be generalized across anatomical sites, although different concepts or skills cannot be generalized at a given anatomical site or across sites; 2) interrater reliability was excellent; and 3) the status of the raters (ie, simulated patient or observer) did not bias the ratings. These findings suggest that increasing the number of diagnostic probes is a better strategy than increasing the number of anatomical sites for improving the overall test generalizability. Furthermore, costs (ie, expenditures of faculty time and funds) can be reduced by using a single rater acting as both the simulated patient and the rater.

Developmental pediatricians are being consulted by medical school promotion committees with regard to the course of action to be taken with learning-disabled medical students experiencing academic difficulties. Faculty attitude, a difficulty understanding the nature of learning disabilities, appears to be a major contributor to poor medical school performance on the part of learning-disabled adults. Utilizing the sequential-simultaneous information processing model as a simplified introduction to learning disability patterns, the authors argue that recommending intensive remediation of rote spelling and writing skills in students engaged in graduate education represents both a waste of time and a further emotional trauma to these young professionals. © 1989 by Williams & Wilkins Co.

This paper reviews the integration of an active teaching program into a busy treatment facility. All first and second year medical students at the University of California, San Diego take part in a series of didactic lectures and small group discussions, while third and fourth year students have the opportunity of joining a treatment team for 4 to 6 weeks. All psychiatric residents spend a minimum of 8 weeks working on the unit, and one fourth year resident is chosen to work with the staff for a year. The interactions between treatment teams and students in various stages of development help maximize enthusiasm and the commitment to the best patient care possible. Copyright © 1989, Wiley Blackwell. All rights reserved

This article reports the results of two questionnaire surveys conducted five years apart to evaluate the status and changes in obstetrics-gynecology (Ob-Gyn) units taught in physical therapy education programs. Sixteen new Ob-Gyn units were implemented in the five-year period between 1981 and 1986. Laboratory time for breathing and relaxation exercises decreased 50% between 1981 and 1986, whereas total hours for the Ob-Gyn unit remained the same. Fifteen respondents in the 1986 survey indicated gynecologic topic area content included reproductive anatomy, gynecological disorders, and evaluation techniques. The authors recommend increased laboratory time, development of Ob-Gyn internships, and further research. Threading Ob-Gyn concepts throughout the curriculum as well as having a concentrated Ob-Gyn unit are recommended.

[No abstract available]

In the 1960s general practitioners were a dying race in Norway. Today general practice is a highly approved specialty among doctors as well as patients. Better education is one of the revitalizing factors. General practice is currently taught as a mandatory subject at all four universities in Norway. The practice apprenticeship is the essential element in our undergraduate curricula. In their fifth year, the students spend three to eight weeks in a structured training program supervised by general practice faculty. Approximately 500 general practitioners take part in this decentralized training network. In 1985 general practice was recognized as a specialty in Norway. The obligatory requirements in the five-year educational program are: courses, 400 hours; hospital training, one year; general practice training, four years; group-based training program, two years. The last element is based on a decentralized concept where a group of two to 10 trainees meet for three hours every two weeks during a two-year period. The group is headed by an appointed and qualified trainer. Besides being in accordance with the geography and demography of Norway, this model gives substance to the slogan 'general practice can only be learnt in general practice'.

Among the many factors that have altered the practice of obstetrics-gynecology are the following: the numbers of obstetrician-gynecologists, the increasing percentage of women entering the specialty, the expansion of ambulatory services with a simultaneous reduction in hospital admissions, a decrease in gynecologic surgical procedures, a stabilized number of total births with an anticipated increase in those to socially deprived and unmarried women, an increasing number of elderly women, general social and behavioral changes, and increasing outside control of practice. A proposal is presented for improving the education of residents and obstetrician-gynecologists in practice. © 1989 The American College of Obstetricians and Gynecologists.

We compared the schedules and responsibilities of medical interns at an urban university hospital in 1967 with those in 1987. We analyzed admissions, length of stay, diagnostic problems, demographic data on interns, changes in diagnostic and therapeutic options, and number and type of consultations. The intern in 1987 spent less time in the hospital but had more admissions, more interruptions, more clerical responsibilities, and more therapeutic and diagnostic options, and was more dependent on senior colleagues with special expertise. For these reasons the intern in 1987 had less time with individual patients and less autonomy than his 1967 counterpart. Recognition and modification of the negative aspects of medicine interns’ experience will increase the attractiveness of internal medicine residencies. © 1989 Southern Medical Association.

Previous attempts to predict resident clinical performance based solely on measures of cognitive skills have been uniformly unsuccessful. For the past 8 years, a formative residency evaluation system has been used that includes yearly comprehensive oral in-training examinations (OITEs) assessing each resident's performance in the three areas of professional competence: cognitive, psychomotor, and affective. The results of these examinations and scores received on the written in-training examination (WITE) given by the American Board of Pediatrics were compared with faculty ratings received during the subsequent year of residency. No significant correlation was found at any level of training between WITE scores and clinical performance. Analysis based on clinical setting did not improve these results. Oral in-training examination scores, however, were highly correlated with clinical performance ratings. In addition, with oral in-training examination scores, the 'problem' interns - those whose clinical performance rating placed them in the lower 10% of interns - were predicted with a high degree of significance, sensitivity, and specificity. Predictions based on WITEs were not significant. Simultaneous evaluation of all three areas of professional competence should be done when predictions of resident performance are attempted. The OITE is a powerful formative evaluation tool, providing valuable learning experiences as residents are objectively assessed while they perform patient-centered tasks that represent critical skills in the practice of medicine. It allows early detection and possible amelioration of future problems in the clinical performance of a resident.