Evaluation of clinical competence: the gap between expectation and performance.

Objective: To evaluate a 3-year experience with the Objective Structured Clinical Examinations (OSCEs) and to compare faculty expectations with resident performance.

Design: Descriptive analysis of measures of resident performance.

Setting: Community-based pediatric residency program in Michigan.

Radiographic inversion of pulmonary blood flow in acute asthma.

Chest radiographs are obtained routinely in children hospitalized with asthma but are considered to be of low utility. We describe a previously unreported radiographic inversion of pulmonary artery flow patterns in the chest films of a majority of children and young adults hospitalized for asthma. Seventy-five hospital records of 65 patients aged 2 to 25 years (mean 9.

Objective structured clinical examination in a pediatric residency program.

This report describes and evaluates a 42-station objective structured clinical examination (OSCE) administered to 29 pediatric residents and six medical students. In half of the stations, residents spent 5 minutes performing a clearly defined clinical task while being rated by an observer. In the other half of the stations, they answered questions based on the data just gathered.

Medical information processing skills: guide posts to clinical assessment.

This is a review of the skills involved in processing medical information in order to solve medical problems. The review starts by describing recognized stages in problem solving then moves on to offer practical suggestions on how to obtain medical information, how to record it, and how to present it.

How to: Construct and Use a Problem-based Programmed Lecture.

In a programmed lecture a single teacher can transform an amphitheatre into a small-group tutorial. This paper, based on ten years' experience of using programmed lectures, provides details on their construction and administration and contrasts them with the classical lecture method.

How To…:Construct Problem-Solving MCQs.

This article gives ten guidelines for the construction of the one-from-five type problem-solving MCQs and provides some examples.

The emergence of cardiac nondisease among children in Iran.

In a prospective study over a one-year period, 476 new patients, aged three days to 21 years, were seen in a pediatric cardiology clinic held three times a week in two hospitals. Of these patients, 290 (61%) were normal; in 238 (82%) of these a physician had made a definite diagnosis of heart disease. The usual bases for a diagnosis of heart disease in these cases of "cardiac nondisease" were an "elevated" antistreptolysin O titer, growing pains, hyperventilation and functional murmurs, or a combination of these.

The Fassa Project-A Medical School without Walls.

A combination of a shortage and maldistribution of health manpower and growing public discontent about the quality of care available, associated with heightened expectations, has put a great strain on the health care delivery system of Iran, which even massive importation of foreign doctors has not eased. The Fassa project was conceived to address health needs by training first medical then other health personnel, based on the philosophy of community orientation, problem-based learning and student-based curriculum, combined with innovations in staff and student selection and training. This paper gives an account of what was planned and has taken place since the first intake of students in April 1978.

The beginning doctor: a problem-based course for first year medical and dental students.

A problem-based course designated as 'Beginning Doctor' was given to 136 first year medical and dental students. The students were divided into small groups and under guidance of a tutor studied largely unfamiliar clinical problems presented to them as written résumés. They determined what further information they required, obtained the information on their own and described it to the oters in plenary sessions.

Multiple choice questions. The debate goes on.

The clinical comprehensive examination given to Pahlavi University medical students in their last year was designed to include three types of questions: multiple choice questions (MCQ's) testing factual recall, MCQ's measuring clinical problems solving ability, and simulated patient management problems (PMP's). The scores of the three types of questions were compared with the five-year cumulative class standing and with each other. It was found that the class standing was very highly correlated with MCQ's testing for recall of information.

Effects of a short educational planning workshop on attitudes of three groups of medical educators.

A series of short (3 days) educational planning workshops was held in three African faculties of medicine. The purpose of this study was to ascertain the effect of such a workshop on educational attitudes of teachers from three conservative traditional schools. An attitudes questionnaire given before and after the workshop allowed the participants to express opinions and feelings on a number of statements with a bipolar theme of teacher-orientation vs.