Further psychometric evaluations of a class-ranking model as a predictor of graduates' clinical competence in the first year of residency.

Purpose: To investigate further the psychometrics of a class-ranking model in which a weight of one-third was assigned to performance measures in basic sciences and a weight of two-thirds to ratings on six core clerkships.

Method: The first part of the study involved 215 graduates of Jefferson Medical College who--based on the ranking model--had been in the top and bottom quarters of the classes of 1991 and 1992. Six faculty, who did not know the graduates' ranks but were familiar with their performances and characteristics, were asked to judge the graduates' potential to become competent physicians.

Students' certainty during course test-taking and performance on clerkships and board exams.

Psychometric aspects of multiple-choice tests were investigated using a confidence-weighted scoring technique. The contributions of two indices, overconfidence and underconfidence, in the prediction of subsequent academic performance of examinees were studied. A total of 444 sophomore students (entering classes of 1982 and 1983) in one medical school were asked to indicate their confidence, on a 5-point scale (100, 75, 50, 25, and 0), in the correctness of their responses to each multiple-choice item on an Introduction to Clinical Medicine examination.

A genetic influence on alveolar cell carcinoma.

Analysis of three siblings with alveolar carcinoma is presented. HLA markers were performed on the index cases and on a normal sibling control. The three affected patients shared HLA-A 28, which was absent in the control sibling.

Cutaneous melanoma in a patient with neurofibromatosis.

Although neurofibromatosis and cutaneous melanoma are both diseases of neuroectodermal origin, reports of their association are rare. The case history of a patient with histologically documented neurofibromatosis and a nodular melanoma unrelated to a cafe-au-lait spot or congenital nevus is reported, and the literature reviewed. The appearance of only one patient with neurofibromatosis in a series of 900 patients with melanoma suggests that these diseases are probably not associated with greater frequency than that predicted by chance alone.