The effect of defined violations of test security on admissions outcomes using multiple mini-interviews.

Introduction: Heterogeneous results exist regarding the impact of security violations on student performances in objective structured clinical examinations (OSCEs). Three separate studies investigate whether anticipated security violations result in undesirable enhancement of MMI performance ratings.

Methods: Study 1: low-stakes: MMI station stems provided to a random half of 57 medical school applicants 2 weeks in advance of participation in a research study.

Comparison of aboriginal and nonaboriginal applicants for admissions on the Multiple Mini-Interview using aboriginal and nonaboriginal interviewers.

Background: Achievement on grade point average and Medical College Admissions Test contribute as unintentional barriers to advancement of underrepresented minorities. So long as noncognitive measures mimic random number generators, they merely perpetuate such discrepancies. As reliable noncognitive measures are developed, it is crucial to ensure immunity from bias, enabling them to better dilute unintended discrimination of cognitive measures.

Reassessing the methods of medical record review studies in emergency medicine research.

Study Objective: An assessment of the methods of medical record review studies published in emergency medicine journals during a 5-year period ending in 1993 provided strategies for improvements. We assess and quantify the current methodologic quality of medical record review studies in emergency medicine journals using published guidelines and compare these results among journals and with those of 10 years previously.

Methods: Independent, systematic searches of emergency medicine journals identified all medical record review studies published in 2003.

Reflecting the relative values of community, faculty, and students in the admissions tools of medical school.

Background: In defining the characteristics of medical students that society and the medical profession find desirable, little effort has been spent assessing the relative value of the dozens of characteristics that have been identified. Furthermore, many institutions go to great lengths to ensure equal representation across stakeholder groups in an effort to maximize the heterogeneity of the pool of students accepted to study medicine; however, the extent to which different stakeholders value different characteristics has yet to be determined.

Purpose: This study was an attempt to assess the relative value of the characteristics of medical students that society and the medical profession find desirable.

What every teacher needs to know about clinical reasoning.

Context: One of the core tasks assigned to clinical teachers is to enable students to sort through a cluster of features presented by a patient and accurately assign a diagnostic label, with the development of an appropriate treatment strategy being the end goal. Over the last 30 years there has been considerable debate within the health sciences education literature regarding the model that best describes how expert clinicians generate diagnostic decisions.

Purpose: The purpose of this essay is to provide a review of the research literature on clinical reasoning for frontline clinical teachers.

Attitudes of women who are currently using or recently stopped estrogen replacement therapy with or without progestins: results of the AWARE survey.

Objective: To examine the level of awareness of the findings of the Women's Health Initiative (WHI) study among recent users of hormone therapy (HT).

Methods: A survey was conducted on Canadian women older than 45 years of age who had used either an oral, topical, or vaginal HT within the preceding 3 years. Questionnaires were mailed to a random sample of 210 eligible women within an academic subspecialty rheumatology/osteoporosis practice between April and June 2003.

The ability of the multiple mini-interview to predict preclerkship performance in medical school.

Problem Statement And Background: One of the greatest challenges continuing to face medical educators is the development of an admissions protocol that provides valid information pertaining to the noncognitive qualities candidates possess. An innovative protocol, the Multiple Mini-Interview, has recently been shown to be feasible, acceptable, and reliable. This article presents a first assessment of the technique's validity.

How can I know what I don't know? Poor self assessment in a well-defined domain.

As the rapidity with which medical knowledge is generated and disseminated becomes amplified, an increasing emphasis has been placed on the need for physicians to develop the skills necessary for life-long learning. One such skill is the ability to evaluate one's own deficiencies. A ubiquitous finding in the study of self-assessment, however, is that self-ratings are poorly correlated with other performance measures.

Do clinical clerks provide candidates with adequate formative assessment during Objective Structured Clinical Examinations?

Context: Various research studies have examined the question of whether expert or non-expert raters, faculty or students, evaluators or standardized patients, give more reliable and valid summative assessments of performance on Objective Structured Clinical Examinations (OSCEs). Less studied has been the question of whether or not non-faculty raters can provide formative feedback that allows students to take advantage of the educational opportunity that OSCEs provide. This question is becoming increasingly important, however, as the strain on faculty resources increases.

The relationship between interviewers' characteristics and ratings assigned during a multiple mini-interview.

Purpose: To assess the consistency of ratings assigned by health sciences faculty members relative to community members during an innovative admissions protocol called the Multiple Mini-Interview (MMI).

Method: A nine-station MMI was created and 54 candidates to an undergraduate MD program participated in the exercise in Spring 2003. Three stations were staffed with a pair of faculty members, three with a pair of community members, and three with one member of each group.

Where judgement fails: pitfalls in the selection process for medical personnel.

Despite the critical importance of maintaining a valid and transparent selection process that serves the values held by all stakeholders involved in medical education (i.e., students, faculty, society), there continue to be problems with the current state of available admissions protocols.

Issues to consider when planning and conducting educational research.

This article is intended to provide students and clinicians aspiring to perform educational research with some background information pertaining to many of the issues inherent in performing research within this domain. It is not intended to provide a comprehensive review of the quantitative methods one might adopt, nor will it fully reflect all of the debate that currently exists within the educational research community. Rather, it is intended to offer an overview of issues and controversies within the field that will hopefully provide a starting point from which interested individuals can begin to engage in the study of educational effectiveness.

An admissions OSCE: the multiple mini-interview.

Context: Although health sciences programmes continue to value non-cognitive variables such as interpersonal skills and professionalism, it is not clear that current admissions tools like the personal interview are capable of assessing ability in these domains. Hypothesising that many of the problems with the personal interview might be explained, at least in part, by it being yet another measurement tool that is plagued by context specificity, we have attempted to develop a multiple sample approach to the personal interview.

Methods: A group of 117 applicants to the undergraduate MD programme at McMaster University participated in a multiple mini-interview (MMI), consisting of 10 short objective structured clinical examination (OSCE)-style stations, in which they were presented with scenarios that required them to discuss a health-related issue (e.

The privileged status of prestigious terminology: impact of "medicalese" on clinical judgments.

Purpose: Health professionals frequently use medical terminology like dyspnea or nasopharyngitis. These two studies examine how the use of medical terms affects the judgments of seriousness, prevalence, and disease; and diagnostic judgments.

Method: In study 1, a survey containing the names of 22 diseases with either a medical or lay description was completed by 47 undergraduate psychology students and 25 medical students, who were asked to judge seriousness, prevalence, and how "disease-like" it was.

Can the strength of candidates be discriminated based on ability to circumvent the biasing effect of prose? Implications for evaluation and education.

Purpose: Residents have greater confidence in diagnoses when indicative features are presented in medical terminology. The current study examines the implications of this result by assessing its relationship to clinical ability.

Method: Candidates writing the Medical Council of Canada's Qualifying Examination completed six questions in which the terminology used was manipulated.

Stemming the tide: cognitive aging theories and their implications for continuing education in the health professions.

As demographic drift among health care providers mimics that of the larger population, it becomes increasingly clear that theory pertaining to the impact of aging on cognitive processing should inform the continuing education efforts designed for health care professionals. The purpose of this article is to offer a critical review of the major theories in this area and outline a sample of the implications that can be derived from these views. Research articles examining the relationship between age and physician performance were identified using MEDLINE, PsychLit, and ERIC.