Effects of alternative positioning of open-ended questions in multiple-choice questionnaires.

Conducted 2 studies with 110 black high school and college students and 156 white college students to study the effect of the placement of open-ended questions, relative to multiple-choice questions, on the responses elicited. Both studies found that positionings at both the beginning and the end of a predominantly multiple-choice questionnaire elicited significantly more responses than did either placement alone. When the 2 positions were used singly, the one at the beginning was found to elicit more discrete ideas and response categories. This was true for black samples and white samples and for different questionnaire topics and lengths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of correct response location on the difficulty level of multiple-choice questions.

The influence of position response sets on a multiple-choice achievement test was investigated. Data on 434 students were obtained from 4 alternate test forms of 100 items each. The arrangement of correct choices and distractors was randomized throughout the test by a scheme which allowed each position an equal number of correct choices. The correct choice for each item appeared in a different position on each of the forms. Results indicate that objective multiple-choice tests are relatively free of position preferences. With this type of test it appears that position response sets are negligible and certainly not a significant source of invalidity. It is suggested that the position of the most plausible distractor more logically accounts for any significant response bias than does a position preference. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Success in college for students with discrepancies between performance on multiple-choice and essay tests.

Students with high scores (top third) on the essay portion of an Advanced Placement examination and low scores (bottom third) on the multiple-choice portion of the examination were compared with students with the opposite pattern (top third on the multiple-choice questions and bottom third on the essay questions). Across examinations in different subject areas (history, English, and biology), students who were relatively strong in the essay format and weak in the multiple-choice format were as successful in their college courses as students with the opposite pattern, especially in those courses where grades are typically not determined by multiple-choice tests. Although differential essay and multiple-choice test performance was not related to course grades, it was related to performance on other tests. Students in the high multiple-choice/low essay group performed much better than the other group on other multiple-choice tests, especially the verbal section of the SAT. In relation to their performance on multiple-choice tests, students in the high essay/low multiple-choice group performed well on other essay tests. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of a breaking bad news course for medical students

This paper presents the evaluation of a Breaking Bad News course run for three groups of medical students (fourth and fifth year from the London Hospital Medical College and fourth year from St Bartholomew's Hospital Medical College). The course, which is student centred, uses group discussion, videotape presentations and role-play including actors. All teachers, clinicians and human science tutors, had been through a staff training programme on teaching methods. At the end of the course, students' knowledge of important principles in giving bad news had increased, particularly in relation to interpersonal communication; they were more confident in their ability to break bad news well; and the course learning methods were highly rated. The course was just as well received by fourth year as by fifth year students and several said they would like more of this training. The evaluation shows that if reservations about role-play can be overcome then this experiential learning is highly valued by students.     

Teaching smoking-cessation counseling to medical students using simulated patients

The controversy continues over the appropriate use of vaginal hysterectomy for many indications that were previously treated only with abdominal or laparoscopic methods. Current outcomes data have pointed up the need for established guidelines to ensure that patients receive appropriate surgical treatment that is most cost-effective and that meets the standard of quality care. Dr Kovac reviews recent data regarding the various surgical options for hysterectomy and offers guidelines based on objective pathologic criteria.     

Evaluation of status of tuberculin skin sensitivity test among medical students

BACKGROUND: The role of lipoproteins as markers of peripheral arterial disease (PAD) is not well defined. METHODS: We measured both lipid and non-lipid risk factors in 51 male patients with angiographically proven PAD and in 56 control subjects. The independent association of risk factors with PAD was evaluated by means of a multiple logistic regression analysis. RESULTS: The levels of cholesterol bound to high density lipoprotein (HDLc) and to its subfraction HDL2 were lower and triglycerides were higher in patients than in control subjects (1.0 +/- 0.3 vs 1.2 +/- 0.3, p < 0.003; 0.4 +/- 0.2 vs 0.5 +/- 0.3, p < 0.03; and 1.8 +/- 1.2 vs 1.3 +/- 0.7, p < 0.02, respectively). Total cholesterol and LDLc levels were similar in both groups. In the multiple logistic regression analysis that was done with lipid parameters, a statistically significant association of triglycerides (OR = 1.73; CI95% = 1.06-2.80) and HDLc (OR = 0.15; CI95% = 0.05-0.50) with PAD was observed, while HDL subfractions and apolipoproteins were not significantly associated. In the multiple logistic regression analysis that was done with non-lipid parameters, hypertension (OR = 5.35; CI95% = 1.86-15.4) and smoking (packs-year) (OR = 1.04; CI95% = 1.10-1.06) were the only significantly associated with PAD. When lipid and non-lipid parameters were included in the regression analysis, a statistically significant association between hypertension, smoking and HDLc with PAD was observed. CONCLUSIONS: Among lipid risk factors, a low HDLc and high triglycerides, and among non-lipid risk factors hypertension and smoking, are significantly and independently associated with lower limb arteriopathy.     

Stress in medical students

The object of this study was to examine the main stressors experienced by students in an Irish medical school and their effects on the attitude of the students towards their training. It also determined the students' knowledge of how they could receive help and their attitudes towards seeking such help. Data was collected by an anonymous self-report questionnaire distributed to a fifth year medical school class in the Hilary Term of the academic year. These 63 students had chosen medicine as a career mainly because of vocational and academic factors and almost two thirds of them had always wanted to do medicine. However four were no longer happy with that choice. Fifty-four percent of them had felt like making a complaint on at least one occasion, but did not do so. The perceived problems were mainly verbal in nature. 41% said that this had affected their attendance. The main source of perceived mistreatment was consultant staff. Rates of perceived racial and sexual discrimination were low. Other stressors included examinations, financial issues and family issues. 52% of students did not know the process by which they could make a complaint and 30% felt that seeking help or advice from staff would be damaging to their future career. This study analyses these issues and suggests ways of addressing them.     

Evaluation of a method to teach cardiothoracic surgery to medical students

This report describes a method to teach undergraduate students the knowledge base and skills needed to maximize the educational value of a subsequent cardiothoracic surgical clerkship. Sixty-three fourth year medical students underwent a structured teaching programme in which groups of five students rotated through a series of six teaching stations. Subject material, presented during 20 min at each station, covered the key issues relating to coronary artery disease, congenital heart disease, chest trauma, lung cancer, prosthetic heart valves, pacemakers, thoracic sepsis and dysphagia. Group knowledge increased significantly (P < 0.001) from a mean mark of 23% (s.d. 12) in a pre-test to a mean mark of 46% (s.d. 12) in a test conducted 1 month after the teaching. The time taken to conduct the structured teaching/assessment was 5 h compared with 32 h to run the same programme by the traditional ward tutorial system. The dollar cost to stage the structured teaching was less than that to run the traditional tutorial programme. It was concluded that the teaching method is effective, economical and practical and that it has a role in an undergraduate curriculum to prepare students for clinical clerkship.     

Evaluation of drug formulations using LD50 testing in mice

The LD50 values were utilized to assess the relative rate of absorption of two very poorly soluble drugs. Formulations of these drugs were studied by micronization; addition of surfactant, alkaline or buffering agents, and/or bile salts; coprecipitation; melt or fusion techniques; or granulation with hydrophilic agents. Differences in toxicities were demonstrated from formulations compared to pure drugs by the LD50 method. This study shows that the LD50 is a practical, rapid method of achieving comparative evaluations of drug formulations.     

Calculating the costs of undergraduate medical education in radiology

RATIONALE AND OBJECTIVES: The current stringent financial constraints mandate that radiology departments carefully assess the costs involved in undergraduate medical education. We performed a cost-accounting analysis of the radiology department's participation in an introductory clinical medicine course, which could serve as a methodologic model for realistic cost assessment of any new or existing course. MATERIALS AND METHODS: Each day of the 5-week radiology portion of the second-year course consists of 1 hour of lecture and 5 hours of small-group discussions regarding chest, abdominal, and skeletal radiology; neuroradiology; and nuclear medicine. Marginal cost is defined as the additional real cost involved in creating or conducting a course. Opportunity costs represent alternative use of instructional resources. RESULTS: The marginal cost (additional real cost) of providing the course for the first time was $37,475. Subsequent offerings of the course will cost approximately $24,375. CONCLUSION: Resources expended for any instructional purpose must be weighed in terms of marginal and opportunity costs. It is mandatory that adequate cost analysis for undergraduate education in radiology be developed so that sound choices can be made regarding resource consumption.     

Explaining testing to students and their parents.

Presents correspondence that informs high school students and their parents about the use of testing and explains the purpose of achievement, ability, interest, and personality measures. A number of schools have used the letter effectively and perhaps avoided test-related problems. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Black students in medical schools

This paper presents an assessment and comparison of two groups of black medical students and the problems they confronted in medical school. Data were obtained from a sample of blacks who attended medical school during the years 1971 to 1974 and from black physicians who graduated from medical school in 1970 or before. A comparison of the two groups revealed statistically significant differences in the impact of others on the decision to enter medicine and in the sources of financial support; also the data suggest differences in perceived discrimination and in the time at which the individual decided to become a physician. The information from the 1971-1974 group illuminates the type and intensity of problems they encountered and the importance of various programs designed to aid black medical students. Overall, the findings of this study indicate a need for new efforts to recruit and to retain black students in medical schools.     

Evaluation of purposeful reading skills in elementary-age students.

In a computer-controlled reading task, more and less able fourth-grade readers identified text segments containing question-relevant information and then attempted to answer assigned questions. Better readers were found to be more adept at locating critical information and at answering the questions. Whereas the better readers responded to assigned questions with a higher degree of accuracy when they were aware of the location of text relevant to the question, less able readers seemed unable to benefit in situations in which they were able to locate the relevant information. Although the ability to locate goal-relevant information was found to be important, readers also had to be able to process the important ideas as demanded by the goals to be accomplished. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of fatigue damage in materials using indentation testing and infrared thermography

Damage identification due to fatigue has been studied on 304-Stainless Steel and Al-Cu-Mg alloys 2014-T651 and 7175-T7351, using two different experimental methods: a) cyclic indentation, and b) infrared thermography. Indentation response during load controlled cyclic loading is used to characterize fatigue response of materials. The load vs. depth of penetration data obtained continuously during fatigue testing is used to obtain information on cyclic stress-strain behavior and onset of failure. Infrared thermography is used to study the heat generation during fatigue loading on specimens. The variables that affect the process are: frequency of loading, magnitude of strain (elastic-plastic), thermal properties. The temperature curve can be considered to be having three regions, initial region of rapid increase in temperature, followed by stable temperature rise and final rapid heat generation prior to failure. The slopes in the initial region and stable region are independent of prior damage history in materials in case of specimens subjected to pure elastic load reversals. In case of elastic-plastic loadings, the rate at which the temperature rises in initial region changes as a function of fatigue damage and can thus be used to estimate prior damage in materials.     

Asthma training in third-year medical students

In response to the increasing use of children's trade books in school reading programs, this article reviews the use of real text, drawing on the application and interaction of two distinct perspectives: reader response theory and comprehension instruction. The authors propose the need to combine knowledge of instruction with the new focus on the role of the reader within response theory and within comprehension research. This article suggests how comprehension instruction and response to literature activities can intersect in the classroom for students who are deaf or hard of hearing. Explicit models and instructional strategies are discussed in the framework of this bimodal approach to reading. A sample list of high quality children's books, including several trade books that feature deaf or hard of hearing characters and issues, is provided as a resource for teachers.     

Recent developments in assessing medical students

Most medical schools in the UK are revising their undergraduate courses in response to the recommendations published by the General Medical Council Education Committee in Tomorrow's doctors. However, achievement of the objectives of curricular change is attendant on revision of the assessment process. This paper reviews traditional and more recently developed methods for assessment of medical education in the light of the General Medical Council's recommendations which relate specifically to summative assessment of the core curriculum. The importance of reliability and validity is highlighted, and the case for criterion-referenced assessment is examined.     

A new role for psychology students in a medical setting.

Describes a 3-wk project in which psychology practicum students assumed primary responsibility for patient care on the psychiatric unit of a large medical center hospital. The project had interesting implications for issues related to clinical training and professional relationships. The pace was intense and demanding and students became totally involved in treating the patients and learning about themselves. Each student worked with about 7 patients primarily through group therapy and family counseling. It is felt that this training model was more likely to test the student's commitment to psychology and to solidify a professional identity than more traditional programs. The project was unique in that the only doctor-patient relationship that the patients had was with the psychology student. 2 physicians were available for medical consultation. Informal observations and analysis of rating scales filled out by the patients indicate that they valued highly the contribution of the students. It is concluded that current trends in medicine toward comprehensive care and family practice necessitate the physician's relinquishment of his exclusive relationship with the patient and to bring in nonmedical specialists on a peer basis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examination performance of medical students. A view from Trinidad

We analysed the outcome of the final MBBS (Bachelor of Medicine and Bachelor of Surgery) examinations at the St. Augustine Campus, University of the West Indies, for 686 students attempting them for the first time between 1975 and 1986. The mean failure rate was lowest in Medicine between 1975 and 1981, in Obstetrics & Gynaecology between 1982 and 1989 and in Surgery during the last 7 years. The students' poor performance in some areas indicates the need for recognizing the importance of creating and establishing an educational climate in which the quality of teaching comes under scrutiny. The marking system in Medicine should be reviewed.