Challenges in multisource feedback: intended and unintended outcomes.

Context: Multisource feedback (MSF) is a type of formative assessment intended to guide learning and performance change. However, in earlier research, some doctors questioned its validity and did not use it for improvement, raising questions about its consequential validity (i.e.

Characteristics of communication guidelines that facilitate or impede guideline use: a focus group study.

Background: The quality of doctor-patient communication has a major impact on the quality of medical care. Communication guidelines define best practices for doctor patient communication and are therefore an important tool for improving communication. However, adherence to communication guidelines remains low, despite doctors participating in intensive communication skill training.

Differences in knowledge development exposed by multi-curricular progress test data.

Progress testing provides data on the growth of students' knowledge over the course of the curriculum obtained from the results of all students in the curriculum on periodical similar tests pitched at end-of-curriculum level. Since 2001, three medical schools have jointly constructed and administered four progress tests annually. All students in the 6-year undergraduate curricula of these schools take the same tests resulting in 24 distinct measurements per academic year (four tests for six student year groups), which may be used to compare performance between and within schools.

Are specialist certification examinations a reliable measure of physician competence?

High stakes postgraduate specialist certification examinations have considerable implications for the future careers of examinees. Medical colleges and professional boards have a social and professional responsibility to ensure their fitness for purpose. To date there is a paucity of published data about the reliability of specialist certification examinations and objective methods for improvement.

Assessment of Advanced Life Support competence when combining different test methods--reliability and validity.

Unlabelled: Robust assessment of Advanced Life Support (ALS) competence is paramount to the credibility of ALS-provider certification and for estimating the learning outcome and retention of ALS competence following the courses. The European Resuscitation Council (ERC) provides two sets of MCQs and four Cardiac Arrest Simulation Test (CASTest) scenarios for the assessments according to guidelines 2005.

Aims: To analyse the reliability and validity of the individual sub-tests provided by ERC and to find a combination of MCQ and CASTest that provides a reliable and valid single effect measure of ALS competence.

Factors determining students' global satisfaction with clerkships: an analysis of a two year students' ratings database.

Clerkships would benefit from teachers' improved understanding of the didactic aspects of their task. The purpose of this study is to identify factors that determine the teaching quality of clerkships and to examine the predictive value of these factors for students' global satisfaction. Thus, results would be further reflected to clinical teachers' tasks.

How video cases should be used as authentic stimuli in problem-based medical education.

Purpose: To examine problem-based learning (PBL) students' views on the added value of video cases compared to text-based cases in the pre-clinical phase of undergraduate medical education and on the conditions for productive use of video in tutorial group discussions.

Method: Participants were 2nd-year students who had completed a PBL programme featuring video cases. Three groups of 6-8 randomly selected students participated in focus-group interviews guided by a moderator using a 'questioning route'.

Much variety and little evidence: a description of guidelines for doctor-patient communication.

Aim: To explore the quality of the content of communication skills training programmes, we analysed and assessed guidelines for doctor-patient communication used in communication programmes for general practitioner (GP) trainees.

Method: Guidelines for doctor-patient communication were extracted from educational materials supplied by the 8 Dutch university centres for vocational training in general practice. Four themes guided the analysis of the guidelines: content, type of contact, format and structure and status.

Psychometric properties of an instrument to measure the clinical learning environment.

Objectives: The clinical learning environment is an influential factor in work-based learning. Evaluation of this environment gives insight into the educational functioning of clinical departments. The Postgraduate Hospital Educational Environment Measure (PHEEM) is an evaluation tool consisting of a validated questionnaire with 3 subscales.

A Description of a Validated Effective Teacher-Training Workshop for Medical Residents.

Unlabelled: A teacher-training program for residents was designed and piloted in the St. Elisabeth Hospital in Curaçao, Netherlands Antilles. The program comprised of six modules namely: effective teaching, self-knowledge and teaching ability, feedback, assessing prior knowledge, trouble shooting and time management.

Teachers' interactions and their collaborative reflection processes during peer meetings.

Teachers' reflections are often narrowly focused on technical questions ('how to') and less on the underlying moral, political and emotional aspects of their functioning. However, for a better understanding of teaching practice it is important to uncover beliefs and values that usually remain implicit. Meeting with others is considered crucial for enhancing the quality of teachers' reflections.

Broadening perspectives on clinical performance assessment: rethinking the nature of in-training assessment.

Context: In-training assessment (ITA), defined as multiple assessments of performance in the setting of day-to-day practice, is an invaluable tool in assessment programmes which aim to assess professional competence in a comprehensive and valid way. Research on clinical performance ratings, however, consistently shows weaknesses concerning accuracy, reliability and validity. Attempts to improve the psychometric characteristics of ITA focusing on standardisation and objectivity of measurement thus far result in limited improvement of ITA-practices.

Understanding the influence of emotions and reflection upon multi-source feedback acceptance and use.

Introduction: Receiving negative performance feedback can elicit negative emotional reactions which can interfere with feedback acceptance and use. This study investigated emotional responses of family physicians' participating in a multi-source feedback (MSF) program, sources of these emotions, and their influence upon feedback acceptance and use.

Methods: The authors interviewed 28 volunteer family physician participants in a pilot study of MSF, purposefully recruited to represent the range of scores.

[Qualitative ranking of medical curricula is useful].

Benchmarking lists are indicators of the quality of medical curricula. The measurement on which a list in order of merit is based must of course have validity, but this is generally the case. The irresponsible use of ranking lists is to be deplored, but that does not constitute a reason not to publish them.

Implementing an Objective Structured Clinical Examination (OSCE) in dental education: effects on students' learning strategies.

Objectives: To investigate the effect of an Objective Structured Clinical Examination (OSCE) on dental students' learning strategies and competence to manage periodontal diseases in patients. The implemented OSCE was expected to be superior to the existing Written Exam in fostering the acquisition of clinical competencies in terms of study strategies that are more oriented towards clinical practice, longer study time, greater clinical proficiency, and more realistic self-assessment.

Material And Methods: After a clinical course in periodontology, 72 third year dental students were assessed summatively, either using a Written Exam or an OSCE (P-OSCE).

Regulatory end-point assessment of the consultation competence of family practice trainees in Kuwait.

Background: No single approach to the regulatory assessment of global consultation competence has been shown to possess the required levels of validity, reliability and feasibility.

Objective: To evaluate the approach adopted in Kuwait to the regulatory end-point assessment of the global consultation competence of family practice trainees with particular reference to validity, reliability and feasibility.

Methods: Family practice trainees in Kuwait were individually and directly observed for 3 hours in consultation with a minimum of 10 patients by a pair of examiners.

The predictive validity of grade point average scores in a partial lottery medical school admission system.

Purpose: To ascertain whether the grade point average (GPA) of school-leaving examinations is related to study success, career development and scientific performance. The problem of restriction of range was expected to be partially reduced due to the use of a national lottery system weighted in favour of students with higher GPAs.

Method: We studied the students (n = 398) admitted to the Faculty of Medicine, University of Groningen, the Netherlands in 1982 and 1983.

Design of integrated practice for learning professional competences.

To acquire professional competences that entail performance of complex skills, an authentic learning environment is required focused on the integration of all aspects of competences. However, most educational programmes offer separate building blocks, such as separate modules for knowledge and skills. Students accumulate what they have learned in these modules as they progress through the curriculum.

Challenges for educationalists.

Medical education has to change to meet the shifts in public and professional attitudes. Experts gathering at the annual meeting of the Association for Medical Education in Europe next week have plenty to discuss

Student perceptions about the characteristics of an effective discussion during the reporting phase in problem-based learning.

To explore student perceptions of factors contributing to the effectiveness of discussions in the reporting phase of the problem-based learning (PBL) process, where students report and synthesise the results of self-study. Forty-eight Year 1 and 2 medical students participated in 6 focus group interviews about the characteristics of effective group discussions and possible improvements. The data were analysed qualitatively in several stages.

Validity of portfolio assessment: which qualities determine ratings?

The portfolio is becoming increasingly accepted as a valuable tool for learning and assessment. The validity of portfolio assessment, however, may suffer from bias due to irrelevant qualities, such as lay-out and writing style. We examined the possible effects of such qualities in a portfolio programme aimed at stimulating Year 1 medical students to reflect on their professional and personal development.

Assessment of clinical reasoning in the context of uncertainty: the effect of variability within the reference panel.

The Script Concordance Test (SCT) assesses reasoning in the context of uncertainty. Because there is no single correct answer, scoring is based on the comparison of answers provided by examinees with those provided by members of a reference panel made up of experienced practitioners. The study aimed to assess the discriminatory power of the SCT based on the variability of the reference panel's answers.

Effective improvement of doctor-patient communication: a randomised controlled trial.

Background: Doctor-patient communication is an essential component of general practice. Improvement of GPs' communication patterns is an important target of training programmes. Available studies have so far failed to provide conclusive evidence of the effectiveness of educational interventions to improve doctor-patient communication.