Does candidate race influence simulated patient ratings in standardised assessments of clinical practice? A single-blinded randomised study in UK medical schools.

Objectives: Standardisation of medical examinations involves minimising assessor stereotyping and bias for a fair process. This study aimed to determine whether being a non-white candidate affected scoring by simulated patients, compared with a white candidate, at three different performance grades in the same history-taking station.

Design: Single-blinded, video-based, randomised study.

The influence of candidates' race on examiners' ratings in standardised assessments of clinical practice.

Purpose: Delivering fair and reliable summative assessments in medical education assumes examiner decision making is devoid of bias. We investigated whether candidate racial appearances influenced examiner ratings in undergraduate clinical exams.

Methods: We used an internet-based design.

UK Prescribing Safety Assessment (PSA): The development, implementation and outcomes of a national online prescribing assessment.

Aims: The United Kingdom (UK) Prescribing Safety Assessment (PSA) is a 2-h online assessment of basic competence to prescribe and supervise the use of medicines. It has been undertaken by students and doctors in UK medical and foundation schools for the past decade. This study describes the academic characteristics and performance of the assessment; longitudinal performance of candidates and schools; stakeholder feedback; and surrogate markers of prescribing safety in UK healthcare practice.

Automated Item Generation: impact of item variants on performance and standard setting.

Background: Automated Item Generation (AIG) uses computer software to create multiple items from a single question model. There is currently a lack of data looking at whether item variants to a single question result in differences in student performance or human-derived standard setting. The purpose of this study was to use 50 Multiple Choice Questions (MCQs) as models to create four distinct tests which would be standard set and given to final year UK medical students, and then to compare the performance and standard setting data for each.

The impact of patient skin colour on diagnostic ability and confidence of medical students.

Previous literature has explored unconscious racial biases in clinical education and medicine, finding that people with darker skin tones can be underrepresented in learning resources and managed differently in a clinical setting. This study aimed to examine whether patient skin colour can affect the diagnostic ability and confidence of medical students, and their cognitive reasoning processes. We presented students with 12 different clinical presentations on both white skin (WS) and non-white skin (NWS).

Standard setting Very Short Answer Questions (VSAQs) relative to Single Best Answer Questions (SBAQs): does having access to the answers make a difference?

Background: We investigated whether question format and access to the correct answers affect the pass mark set by standard-setters on written examinations.

Methods: Trained educators used the Angoff method to standard set two 50-item tests with identical vignettes, one in a single best answer question (SBAQ) format (with five answer options) and the other in a very short answer question (VSAQ) format (requiring free text responses). Half the participants had access to the correct answers and half did not.

Twelve tips for introducing very short answer questions (VSAQs) into your medical curriculum.

Most undergraduate written examinations use multiple-choice questions, such as single best answer questions (SBAQs) to assess medical knowledge. In recent years, a strong evidence base has emerged for the use of very short answer questions (VSAQs). VSAQs have been shown to be an acceptable, reliable, discriminatory, and cost-effective assessment tool in both formative and summative undergraduate assessments.

The influence of candidates' physical attributes on patient ratings in simulated assessments of clinical practice.

Background: We have previously shown that clinical examiners' scoring is not negatively impacted when a candidate has a tattoo, unnatural hair colour, or a regional accent. We investigated whether these physical attributes in exam candidates impact patient scoring.

Methods: Simulated/real patients were randomly assigned to watch five videos of simulated candidate performances of a cranial nerve examination: clear fail, borderline, good, 'clear pass' without an attribute, and 'clear pass' with one of the attributes (tattoo, purple hair, accent).

Using very short answer errors to guide teaching.

Background: Student performance in examinations reflects on both teaching and student learning. Very short answer questions require students to provide a self-generated response to a question of between one and five words, which removes the cueing effects of single best answer format examinations while still enabling efficient machine marking. The aim of this study was to pilot a method of analysing student errors in an applied knowledge test consisting of very short answer questions, which would enable identification of common areas that could potentially guide future teaching.

Are remote clinical assessments a feasible and acceptable method of assessment? A systematic review.

The COVID-19 pandemic presented an enormous and immediate challenge to assessing clinical skills in healthcare professionals. Many institutions were unable to deliver established face-to-face assessment methods such as Objective Structured Clinical Examinations (OSCEs). Assessors needed to rapidly institute alternative assessment methods to ensure that candidates met the clinical competences required for progression.

Is Academic Attainment or Situational Judgment Test Performance in Medical School Associated With the Likelihood of Disciplinary Action? A National Retrospective Cohort Study.

Purpose: Disciplinary action imposed on physicians indicates their fitness to practice medicine is impaired and patient safety is potentially at risk. This national retrospective cohort study sought to examine whether there was an association between academic attainment or performance on a situational judgment test (SJT) in medical school and the risk of receiving disciplinary action within the first 5 years of professional practice in the United Kingdom.

Method: The authors included data from the UK Medical Education Database for 34,865 physicians from 33 U.

The influence of candidates' physical attributes on assessors' ratings in clinical practice.

Background: Assessments of physician competence in the work-place are common and often contribute to high-stakes assessments. Previous research suggests that assessors' judgements can be influenced by candidates' physical attributes. We investigated whether simulated candidates' scores were influenced by assessor bias based on tattoos, hair colour, and a regional accent.

National inter-rater agreement of standardised simulated-patient-based assessments.

Purpose: The forthcoming UK Medical Licensing Assessment will require all medical schools in the UK to ensure that their students pass an appropriately designed Clinical and Professional Skills Assessment (CPSA) prior to graduation and registration with a licence to practice medicine. The requirements for the CPSA will be set by the General Medical Council, but individual medical schools will be responsible for implementing their own assessments. It is therefore important that assessors from different medical schools across the UK agree on what standard of performance constitutes a fail, pass or good grade.

Diabetic myonecrosis: A case series of two dialysis-dependent patients.

Diabetic myonecrosis (DMN) is a rare microangiopathic disorder that can present as an acutely painful and swollen limb in patients with established diabetes mellitus. The condition can be diagnosed noninvasively with magnetic resonance imaging and resolves with analgesia, bed rest, and glycemic control. Due to a relative lack of awareness regarding the condition, avoidable interventions such as muscle biopsies and even surgery are sometimes pursued, which have been associated with prolonged recovery times.

Inelastic scattering of OH radicals from organic liquids: isolating the thermal desorption channel.

Inelastic scattering of OH radicals from liquid surfaces has been investigated experimentally. An initially translationally and rotationally hot distribution of OH was generated by 193 nm photolysis of allyl alcohol. These radicals were scattered from an inert reference liquid, perfluorinated polyether (PFPE), and from the potentially reactive hydrocarbon liquids squalane (C30H62, 2,6,10,15,19,23-hexamethyltetracosane) and squalene (C30H50, trans-2,6,10,15,19,23-hexamethyltetracosa-2,6,10,14,18,22-hexaene).

Osteoclastomas ('brown tumours') and spinal cord compression: a review.

Brown tumours are an uncommon manifestation of primary and secondary hyperparathyroidism. There are numerous case reports of brown tumours arising in various parts of the skeleton. They can therefore present a wide range of clinical manifestations.

Current issues in care and support for HIV-positive gay men in Sydney.

We explored current access to care among HIV-positive people in Australia. In 2006, 270 HIV-positive gay men from a community-based Positive Health cohort in Sydney were asked about their health (including medical and social) service needs and, subsequently, about difficulty in accessing services. We report the prevalence of specific needs, barriers and associated factors.

Molecular dynamics simulation of the cooperative adsorption of barley lipid transfer protein and cis-isocohumulone at the vacuum-water interface.

Molecular dynamic simulations have been carried out on systems containing a mixture of barley lipid transfer protein (LTP) and cis-isocohumulone (a hop derived iso-alpha-acid) in one of its enol forms, in bulk water and at the vacuum-water interface. In solution, the cis-isocohumulone molecules bind to the surface of the LTP molecule. The mechanism of binding appears to be purely hydrophobic in nature via desolvation of the protein surface.

The interface between water and a hydrophobic gas.

Classical molecular dynamics simulations have been performed to investigate the interface between liquid water and methane gas under methane hydrate forming conditions. The local environments of the water molecules were studied using order parameters which distinguish between liquid water, ice and methane hydrate phases. Bulk water and water/air interfaces were also studied to allow comparisons to be made between water molecules in the different environments and to determine the effects of the different methane densities studied.