Sharing Is Caring: Helping Institutions and Health Organizations Leverage Data for Educational Improvement.

Competency-based medical education (CBME) has produced large collections of data, which can provide valuable information about trainees and medical education systems. Many organizations continue to struggle with accessing, collecting, governing, analyzing, and visualizing their clinical and/or educational data. This hinders data sharing efforts within and across organizations, which are foundational in supporting system-wide improvements.

Analysis of Surgeon and Program Characteristics Associated with Success on American Board of Surgery Examination Outcomes.

Background: Existing research exploring predictors of success on American Board of Surgery (ABS) examinations focused on either resident or residency program characteristics, but limited studies focus on both. This study examines relationships between both resident and program characteristics and ABS qualifying (QE) and certifying examination (CE) outcomes.

Study Design: Multilevel logistic regression was used to analyze the relationship between resident and program characteristics and ABS QE and CE first attempt pass and eventual certification.

Cognitive Complaint Types Can Correlate With Cognitive Testing, Perceived Stress, and Symptom Distress in Older Adults With Normal Cognition and Dementia.

Objective: We examined how cognitive complaint types (CCTs) correlate with cognitive testing, perceived stress, and symptom distress in older adults with normal cognition and dementia.

Methods: Older adults (n = 259) with normal cognition, mild cognitive impairment, or mild-stage Alzheimer disease completed cognitive testing and self-report measures (Cognitive Difficulties Scale, Global Distress Index, Perceived Stress Scale). Cross-sectional analyses examined: (1) CCT composition by classification method,( 2) CCTs by diagnostic group, (3) correlations of CCTs with cognitive testing scores, and (4) correlations of CCTs with perceived stress and symptom distress.

Awareness of diagnosis predicts changes in quality of life in individuals with mild cognitive impairment and mild stage dementia.

Background And Objective: This observational study examined how awareness of diagnosis predicted changes in cognition and quality of life (QOL) 1 year later in older adults with normal cognition and dementia diagnoses.

Research Design And Methods: Older adults (n = 259) with normal cognition, mild cognitive impairment (MCI), or mild stage Alzheimer's disease (AD) completed measures of diagnostic awareness, cognition, and multiple domains of QOL. We compared 1-year change in cognition and QOL by diagnostic group and diagnostic awareness.

A confirmatory factor analysis of the novice nurse practitioner role transition scale.

As interest in supporting new nurse practitioners' (NPs) transition to practice increases, those interested in measuring the concept will need an instrument with evidence of reliability and validity. The Novice NP Role Transition (NNPRT) Scale is the first instrument to measure the concept. The preliminary exploratory factor analysis revealed a five-factor structure: organizational alignment, mentorship, sense of purpose, perceived competence and self-confidence, and compensation.

Revisiting Retake Policy: Analyzing the Success Rates of Examinees With Multiple Attempts on the United States Medical Licensing Examination.

Purpose: A testing program's decision making on retake policy considers a number of factors, including fairness to examinees, examination security, examination purpose, and classification accuracy. For high-stakes licensure and certification examinations charged with protection of the public, this includes balancing fairness issues inherent in the potential for false negatives with the public protection need to minimize false positives. Since 2012, the United States Medical Licensing Examination (USMLE) has maintained a policy of ≤ 6 attempts on any examination component.

Differential Item Functioning Analysis of United States Medical Licensing Examination Step 1 Items.

Purpose: Previous studies have examined and identified demographic group score differences on United States Medical Licensing Examination (USMLE) Step examinations. It is necessary to explore potential etiologies of such differences to ensure fairness of examination use. Although score differences are largely explained by preceding academic variables, one potential concern is that item-level bias may be associated with remaining group score differences.

Development of the novice nurse practitioner role transition scale: An exploratory factor analysis.

Background: Novice nurse practitioner role transition (NNPRT) can be described as stressful and turbulent, leading to decreased job satisfaction and increased intent to leave. No published instrument exists to measure NNPRT. Thus, researchers, educators, and administrators are limited in their ability to measure the concept and therefore understand the factors that lead to a successful, or unsuccessful, role transition experience.

Examining Demographics, Prior Academic Performance, and United States Medical Licensing Examination Scores.

Purpose: To examine whether demographic differences exist in United States Medical Licensing Examination (USMLE) scores and the extent to which any differences are explained by students' prior academic achievement.

Method: The authors completed hierarchical linear modeling of data for U.S.

Relationships Between Cognitive Complaints and Quality of Life in Older Adults With Mild Cognitive Impairment, Mild Alzheimer Disease Dementia, and Normal Cognition.

Purpose: To examine in persons with varying degrees of cognitive impairment the relationship between self-reports of cognitive complaints and quality of life (QOL).

Methods: Older adults (n=259) with normal cognition, mild cognitive impairment (MCI), and mild stage Alzheimer disease (AD) dementia completed tests of cognition and self-report questionnaires about QOL and 3 kinds of cognitive complaints: cognitive difficulties, distress from cognitive difficulties, and believing you had more memory problems than most people. Bivariate, multivariable, and multivariate regression analyses assessed relationships between domains of QOL and each cognitive complaint.

What features of stigma do the public most commonly attribute to Alzheimer's disease dementia? Results of a survey of the U.S. general public.

Introduction: Understanding the prevalence of beliefs, attitudes, and expectations about Alzheimer's disease dementia in the public could inform strategies to mitigate stigma.

Methods: Random sample of 317 adults from the U.S.

Awareness of Mild Cognitive Impairment and Mild Alzheimer's Disease Dementia Diagnoses Associated With Lower Self-Ratings of Quality of Life in Older Adults.

Objective: This study examined how awareness of diagnostic label impacted self-reported quality of life (QOL) in persons with varying degrees of cognitive impairment.

Method: Older adults (n = 259) with normal cognition, Mild Cognitive Impairment (MCI), or mild Alzheimer's disease dementia (AD) completed tests of cognition and self-report questionnaires that assessed diagnosis awareness and multiple domains of QOL: cognitive problems, activities of daily living, physical functioning, mental wellbeing, and perceptions of one's daily life. We compared measures of QOL by cognitive performance, diagnosis awareness, and diagnostic group.

Fit for purpose and modern validity theory in clinical outcomes assessment.

Purpose: The US Food and Drug Administration (FDA), as part of its regulatory mission, is charged with determining whether a clinical outcome assessment (COA) is "fit for purpose" when used in clinical trials to support drug approval and product labeling. In this paper, we will provide a review (and some commentary) on the current state of affairs in COA development/evaluation/use with a focus on one aspect: How do you know you are measuring the right thing? In the psychometric literature, this concept is referred to broadly as validity and has itself evolved over many years of research and application.

Review: After a brief introduction, the first section will review current ideas about "fit for purpose" and how it has been viewed by FDA.

Performance on the Cardiovascular In-Training Examination in Relation to the ABIM Cardiovascular Disease Certification Examination.

The American College of Cardiology In-Training Exam (ACC-ITE) is incorporated into most U.S. training programs, but its relationship to performance on the American Board of Internal Medicine Cardiovascular Disease (ABIM CVD) Certification Examination is unknown.

Bayesian Prior Choice in IRT Estimation Using MCMC and Variational Bayes.

This study investigated the impact of three prior distributions: matched, standard vague, and hierarchical in Bayesian estimation parameter recovery in two and one parameter models. Two Bayesian estimation methods were utilized: Markov chain Monte Carlo (MCMC) and the relatively new, Variational Bayesian (VB). Conditional (CML) and Marginal Maximum Likelihood (MML) estimates were used as baseline methods for comparison.

The Penn Parkinson's Daily Activities Questionnaire-15: Psychometric properties of a brief assessment of cognitive instrumental activities of daily living in Parkinson's disease.

Introduction: To describe the psychometric properties of the Penn Parkinson's Daily Activities Questionnaire-15 (PDAQ-15), a 15-item measure of cognitive instrumental activities of daily living for Parkinson's disease (PD) patients derived from the original 50-item PDAQ.

Methods: PDAQ-15 items were chosen by expert consensus. Knowledgeable informants of PD participants (n = 161) completed the PDAQ-15.

Development and initial testing of the Penn Parkinson's Daily Activities Questionnaire.

Objective: The aim of this work was to describe the development and psychometric analysis of the Penn Parkinson's Daily Activities Questionnaire. The questionnaire is an item response theory-based tool for rating cognitive instrumental activities of daily living in PD.

Methods: Candidate items for the Penn Parkinson's Daily Activities Questionnaire were developed through literature review and focus groups of patients and knowledgeable informants.

Identifying an appropriate measurement modeling approach for the Mini-Mental State Examination.

The Mini-Mental State Examination (MMSE) is a 30-item, dichotomously scored test of general cognition. A number of benefits could be gained by modeling the MMSE in an item response theory (IRT) framework, as opposed to the currently used classical additive approach. However, the test, which is built from groups of items related to separate cognitive subdomains, may violate a key assumption of IRT: local item independence.

Why are spousal caregivers more prevalent than nonspousal caregivers as study partners in AD dementia clinical trials?

Objectives: Most Alzheimer disease (AD) caregivers are not spouses and yet most AD dementia trials enroll spousal study partners. This study examines the association between caregiver relationship to the patient and willingness to enroll in an AD clinical trial and how caregiver burden and research attitudes modify willingness.

Design: Interviews with 103 AD caregivers who met criteria for ability to serve as a study partner.

Does success on the American Board of Surgery general surgery qualifying examination guarantee certifying examination success?

Objective: The purpose of this study was to explore the relationship between qualifying examination (QE) and certifying examination (CE) results and to determine whether an appropriate cut-point on the QE would predict success on the CE.

Design: The scaled American Board of Surgery (ABS) QE scores of all first-time examinees from 2006 to 2010 were retrospectively matched to their first-time CE pass/fail decisions. Contingency tables illustrating the QE-CE relationship were constructed and appropriate correlational statistics were computed.

Delay in taking the American Board of Surgery qualifying examination affects examination performance.

Background: The American Board of Surgery (ABS) Qualifying Examination (QE) represents an important step along the pathway to board certification. We investigated whether candidates who delayed taking the QE had worse performance on the examination.

Methods: QE pass rates and equated scaled scores for all first-time examinees from 2006 to 2010 (n = 5,193) were reviewed.

Measuring how people view biomedical research: Reliability and validity analysis of the Research Attitudes Questionnaire.

With increasing numbers of studies on research ethics and a need to improve the recruitment of research subjects, the ability to measure attitudes toward biomedical research has become important. The Research Attitudes Questionnaire is a significant predictor of the public's attitudes toward and willingness to participate in research, yet limited data are available on its psychometric properties. This study establishes the scale's internal consistency and dimensionality using a large Internet-based sample from the United States.

A memory and organizational aid improves Alzheimer disease research consent capacity: results of a randomized, controlled trial.

Objectives: Early and progressive cognitive impairments of patients with Alzheimer disease (AD) hinder their capacity to provide informed consent. Unfortunately, the limited research on techniques to improve capacity has shown mixed results. Therefore, the authors tested whether a memory and organizational aid improves the performance of patients with AD on measures of capacity and competency to give informed consent.

How redesigning AD clinical trials might increase study partners' willingness to participate.

Background: Timely recruiting and retaining participants into Alzheimer disease (AD) clinical trials is a challenge. We used conjoint analysis to identify how alterations in attributes of clinical trial design improve willingness to participate: risk, home visits, car service, or increased chance of receiving intervention.

Method: A total of 108 study partners of patients with very mild to severe stage AD rated willingness to allow their relative to participate in eight clinical trials that varied combinations of the four attributes.

Older adults' attitudes toward enrollment of non-competent subjects participating in Alzheimer's research.

Objective: Research that seeks to enroll noncompetent patients with Alzheimer's disease without presenting any potential benefit to participants is the source of substantial ethical controversy. The authors used hypothetical Alzheimer's disease studies that included either a blood draw or a blood draw and lumbar puncture to explore older persons' attitudes on this question.

Method: Face-to-face interviews were conducted with 538 persons age 65 and older.