Interpreting course evaluation results: insights from thinkaloud interviews with medical students.

Purpose: To determine whether some of the fundamental assumptions that frequently underlie interpretation of course evaluation results are justified by investigating what medical students are thinking as they complete a typical basic science course evaluation.

Methods: A total of 24 students participated in thinkaloud cognitive interviews, voicing their thoughts while completing a typical evaluation instrument that included items on overall course design, educational materials and methods, and faculty teaching. Students' responses were organised to consider how they interpreted questions, formed judgements and selected response options.

Development and testing of a new instrument for measuring concerns about dying in health care providers.

A new measure of concerns about dying was investigated in this psychometric study. The Concerns About Dying instrument (CAD) was administered to medical students, nursing students, hospice nurses, and life sciences graduate students (N = 207) on two occasions; on one occasion they also completed three related measures. Analyses included descriptive statistics, factor analysis, Cronbach's alpha, test-retest correlations, t tests, and correlations with other measures.

Communicating with patients about medical errors: a review of the literature.

Background: Ethical and professional guidelines recommend disclosure of medical errors to patients. The objective of this study was to review the empirical literature on disclosure of medical errors with respect to (1) the decision to disclose, (2) the process of informing the patient and family, and (3) the consequences of disclosure or nondisclosure.

Methods: We searched 4 electronic databases (MEDLINE, CINAHL, PsycINFO, and Social Sciences Citations Index) and the reference lists of relevant articles for English-language studies on disclosure of medical errors.

Health plan members' views about disclosure of medical errors.

Background: Various authorities and national organizations encourage disclosing medical errors, but there is little information on how patients respond to disclosure.

Objective: To examine how the type of error, severity of adverse clinical outcome, and level of disclosure affect patients' responses to error and disclosure.

Design: Mail questionnaire survey (8 versions were developed) varying 3 factors in a completely crossed, randomized, factorial design.

Does reading about stroke increase stroke knowledge? The impact of different print materials.

The purpose of this study was to determine whether print materials on stroke resulted in increased knowledge in a sample of lay people. One hundred and seventy-seven participants received (at random) one of five versions of a stroke information packet, or a control packet on colorectal cancer. Participants rated the materials on readability, understandability and usefulness immediately after reading.

Identification of physician and patient attributes that influence the likelihood of screening for intimate partner violence.

Purpose: Effective assessment of intimate partner violence (IPV) demands that everyone at risk be screened. To identify potential barriers, paper-and-pencil case scenarios identified possible practitioner and patient attributes that influence IPV screening.

Method: First-year residents responded to one of four short written scenarios describing a divorced female patient with nonlocalized abdominal pain; variables were patient's age and abdominal bruising.

Recombinant activated factor VII for life-threatening pulmonary hemorrhage after pediatric cardiac surgery.

Objective: To report intractable life-threatening pulmonary hemorrhage after cardiac surgery in an infant who was treated successfully with recombinant activated factor VII (rFVIIa).

Design: Descriptive case report.

Setting: An 18-bed pediatric intensive care unit at a tertiary-care children's hospital.

Validation of a new measure of concept of a good death.

Background: The concept of a good death is central to end-of-life care research. Despite its importance and the high interest in the topic, there are few measures currently available for use in clinical research.

Purpose: The present work describes the development and testing of a set of items intended to measure the importance of several components posited to be critical to the concept of a good death.

Development and implementation of an objective structured teaching exercise (OSTE) to evaluate improvement in feedback skills following a faculty development workshop.

Background: Faculty development programs focusing on teaching have become widespread.

Purpose: Despite the popularity of such programs, evidence as to their effectiveness is limited. This article reports on the development of an objective structured teaching exercise (OSTE) and its pilot implementation in an evaluation of a faculty development program module.

A demonstration of the impact of response bias on the results of patient satisfaction surveys.

Objectives: The purposes of the present study were to examine patient satisfaction survey data for evidence of response bias, and to demonstrate, using simulated data, how response bias may impact interpretation of results.

Data Sources: Patient satisfaction ratings of primary care providers (family practitioners and general internists) practicing in the context of a group-model health maintenance organization and simulated data generated to be comparable to the actual data.

Study Design: Correlational analysis of actual patient satisfaction data, followed by a simulation study where response bias was modeled, with comparison of results from biased and unbiased samples.

Managed care education: what medical students are telling us.

Purpose: To examine graduating medical students' perceptions of the adequacy of instruction in managed care and in 11 curricular content areas identified by experts as a necessary part of managed care education. This study sought to determine whether medical students perceived these content areas as relevant to managed care and to evaluate the extent to which students' perceptions of the adequacy of instruction varied as a function of managed care penetration in the locations of their respective medical schools.

Method: Data from the Association of American Medical Colleges' 1999 Medical School Graduation Questionnaire (GQ) were analyzed.

Assessing third-year medical students' breast cancer screening skills.

Purpose: This study assesses the relationship between students' confidence and competency in breast screening practices, compares different measurement approaches to these competencies, and assesses the effect on clinical breast examination (CBE) performance of an additional training session with a standardized patient.

Method: In the spring of 1998, 96 third-year medical students (47 men and 49 women) at the University of Massachusetts Medical School completed knowledge items on breast cancer epidemiology and on perceived confidence in their counseling and CBE skills. The students were also rated on their performances of counseling and CBE skills.

Using differences between perceptions of importance and competence to identify teaching needs of primary care preceptors.

Background: An important goal of a comprehensive faculty development plan is to improve teaching. This is especially important for clinical preceptors.

Purpose: This study used a novel approach to assessing the teaching needs of preceptors, an essential and often neglected first step in faculty development.

The impact of a brief interclerkship about substance abuse on medical students' skills.

Purpose: To examine the immediate and delayed impact of an intensive one- or two-day interclerkship on substance abuse (SA) for third-year medical students. The program is a response to the problem of inadequacy of substance abuse education in the standard curriculum.

Method: Each year since 1997-98 all third-year students at the University of Massachusetts Medical School have participated in a one- or two-day SA interclerkship to enhance their knowledge and competence with SA assessment and brief intervention.

Educating the next generation of physicians about stroke: incorporating stroke prevention into the medical school curriculum.

Background And Purpose: In response to the need to educate physicians about stroke, we have implemented an educational program on stroke prevention for undergraduate medical students within the first-year neuroscience course. This study investigated whether first-year students learned and retained key information about stroke, and used students' feedback both to identify effective curricular components and to explore their attitudes regarding stroke prevention.

Methods: Stroke knowledge and self-assessed confidence in that knowledge before, immediately after, and 8 months after participation in the stroke curriculum were analyzed and compared for 3 classes, using paired t tests and repeated-measures ANOVA.

Cancer control knowledge, attitudes, and perceived skills among medical students.

Background: The Cancer Prevention and Control Education (CPACE) program aims to strengthen and coordinate curriculum offerings in cancer prevention and control for medical, graduate nursing and public health students.

Methods: Students were surveyed on cancer-related knowledge and confidence as part of needs assessment and evaluation efforts. The students completed self-administered surveys (response rate 78%).

Muscular dystrophy due to dysferlin deficiency in Libyan Jews. Clinical and genetic features.

The cluster in Jews of Libyan origin of limb-girdle muscular dystrophy type 2B due to a dysferlin 1624delG mutation is described. The carrier frequency of this mutation is calculated to be approximately 10% in this population, in which the disease prevalence is at least 1 per 1300 adults. Twenty-nine patients from 12 families were all homozygous for the same mutation.

The effect of a domestic violence interclerkship on the knowledge, attitudes, and skills of third-year medical students.

Purpose: To determine whether participation in an intensive domestic violence interclerkship (DVI) improved the knowledge, attitudes, and skills of two successive cohorts of students at the University of Massachusetts Medical School.

Method: The authors measured the knowledge, attitudes, and skills pertaining to domestic violence of third-year students in the classes of 1997 and 1998 using a validated written examination administered before, immediately after, and six months after participation in a 3.5-day or two-day DVI, respectively; they compared the scores using paired t-tests.

The standardized family: an innovation in primary care education at the University of Massachusetts.

In 1995 as part of The Robert Wood Johnson Foundation's Generalist Physician Initiative, the University of Massachusetts (UMass) Medical School developed the "standardized family" as a new model for teaching the essential elements of primary care in a core curriculum format outside of the clinical setting. Using this model, a hypothetical family unit (the "McQ Family") serves as the focus for case-based clinical problem solving. This paper describes the standardized family model and provides two years of evaluation outcomes such as curriculum assessments, student performance outcomes, and correlation with external measures of clinical performance to support the effectiveness of this educational model.