Background Saudi Arabia is considered one of the most influential Muslim countries being as the host of the two most holy places for Muslims, namely Makkah and Madina. This was reflected in the emphasis on teaching medical ethics in a lecture-based format as a part of the subject of Islamic culture taught to medical students. Over the last few years, both teaching and evaluation of medical ethics have been changing as more Saudi academics received specialized training and qualifications in bioethics from western universities. Methods This study aims at studying the current teaching methods and evaluation tools used by the Saudi public medical schools. It is done using a self-administered online questionnaire. Results Out of the 14 medical schools that responded, the majority of the responding schools (6; 42.8%), had no ethics departments; but all schools had a curriculum dedicated to medical ethics. These curricula were mostly developed by the faculty staff (12; 85.7%). The most popular teaching method was lecturing (13; 92.8%). The most popular form of student assessment was a paper-based final examination (6; 42.8%) at the end of the course that was allocated 40% or more of the total grade of the ethics course. Six schools (42.8%) allocated 15-30% of the total grade to research. Conclusion Although there is a growing interest and commitment in teaching ethics to medical students in Saudi schools; there is lack of standardization in teaching and evaluation methods. There is a need for a national body to provide guidance for the medical schools to harmonize the teaching methods, particularly introducing more interactive and students-engaging methods on the account of passive lecturing. PMID:24020917
Background Evaluation is a challenging but necessary part of the development cycle of clinical information systems like the electronic medical records (EMR) system. It is believed that such evaluations should include multiple perspectives, be comparative and employ both qualitative and quantitative methods. Self-administered questionnaires are frequently used as a quantitative evaluation method in medical informatics, but very few validated questionnaires address clinical use of EMR systems. Methods We have developed a task-oriented questionnaire for evaluating EMR systems from the clinician's perspective. The key feature of the questionnaire is a list of 24 general clinical tasks. It is applicable to physicians of most specialties and covers essential parts of their information-oriented work. The task list appears in two separate sections, about EMR use and task performance using the EMR, respectively. By combining these sections, the evaluator may estimate the potential impact of the EMR system on health care delivery. The results may also be compared across time, site or vendor. This paper describes the development, performance and validation of the questionnaire. Its performance is shown in two demonstration studies (n = 219 and 80). Its content is validated in an interview study (n = 10), and its reliability is investigated in a test-retest study (n = 37) and a scaling study (n = 31). Results In the interviews, the physicians found the general clinical tasks in the questionnaire relevant and comprehensible. The tasks were interpreted concordant to their definitions. However, the physicians found questions about tasks not explicitly or only partially supported by the EMR systems difficult to answer. The two demonstration studies provided unambiguous results and low percentages of missing responses. In addition, criterion validity was demonstrated for a majority of task-oriented questions. Their test-retest reliability was generally high, and the non-standard scale was found symmetric and ordinal. Conclusion This questionnaire is relevant for clinical work and EMR systems, provides reliable and interpretable results, and may be used as part of any evaluation effort involving the clinician's perspective of an EMR system. PMID:15018620
Oda, Yasutomo; Onishi, Hirotaka; Sakemi, Takanobu; Fujimoto, Kazuma; Koizumi, Shunzo
Fifteen years of undergraduate medical education curriculum reform at Saga Medical School was evaluated by measuring medical students' communication and interpersonal skills with a patient satisfaction questionnaire developed by the American Board of Internal Medicine. A multiphase cross-sectional study was conducted at the General Medicine Clinic of Saga Medical School Hospital in phase I (1998-1999), phase II (2001-2002), and phase III (2009-2010). A total of 1,963 patient ratings for 437 medical students' performance was analyzed. The average scores of phases II and III were significantly higher than for phase I. The average score of female students showed a significant difference between phases I and II, but no difference between phases II and III. The average score of male students showed no difference between phases I and II, but significant difference between phases II and III. The phase II curriculum introduced basic clinical skills and examination and improved female students' performance. The phase III curriculum was effective for male students because it emphasized the clinical skill program more and introduced problem-based learning. Curriculum reform at Saga Medical School is considered to have made good progress in improving students' clinical competence and patient-centered attitudes. PMID:25120283
Program Complete this one-time questionnaire form if you wear N-95 filtering face piece respirators MEDICAL HISTORY QUESTIONNAIRE FOR N-95 FILTERING FACE PIECE RESPIRATORS Occupational Medicine No Restriction on N-95 Filtering Face Piece Respirator Use Further Evaluation Needed Physician's Review Signature
Monzen, Satoru; Matsutani, Hideya; Kashiwakura, Ikuo
The purpose of this study was to identify the level of awareness among undergraduate students regarding medical informatics and to ascertain whether educational training has progressed with time in the Department of Health Sciences at Hirosaki University, Japan, which is a co-medical staff training institution that conducts a 4-year university course in medical informatics. The university accepts students who have completed the 3rd grade of medical licensing tests and who have attended the medical informatics lectures for 4 years (2007-2010). The ratio of first sight terminology percentage in any given fiscal year in all the 30 terminology categories varied widely from 0% to 80%, but the trend in various categories did not vary between fiscal years. The terminology of informatics under medical technology students obtained high scores of 52.5-77.3% after attending courses, which was higher compared with students from other classes. On the other hand, student nurses and occupational therapy students obtained 0-44.2%. Each class scored a high percentage of correct answers in the medical information-related terminology. Among the radiology students who attended the classes, the percentage of correct answers in categories of "digital imaging and communication in medicine" and "picture archiving and communication system" were lower than other medical terminology categories. These results reflect the gaps in educational curriculum of 1st and 2nd grades of medical licensing tests. PMID:23358336
Giesler, Marianne; Forster, Johannes; Biller, Silke; Fabry, Götz
Introduction: While preparing a graduate survey for medical education in 2008 we realized that no instrument existed that would be suitable to evaluate whether the learning outcomes outlined in the Medical Licensure Act (ÄAppO) would be met. Therefore we developed the Freiburg Questionnaire to Assess Competencies in Medicine (Freiburger Fragebogen zur Erfassung von Kompetenzen in der Medizin, FKM)1 which has been revised and extended several times since then. Currently the FKM includes 45 items which are assigned to nine domains that correspond to the CanMEDS roles: medical expertise, communication, team-work, health and prevention, management, professionalism, learning, scholarship, and personal competencies. Methods: In order to test the reliability and validity of the questionnaire we have repeatedly surveyed medical students and residents since May 2008. In this article we report on the results of a cross-sectional study with 698 medical students from the preclinical and clinical years. In addition, we report the results of a survey of 514 residents who were up to two years into their residency. Results and conclusions: In summary, results show that the scales of the FKM are reliable (Cronbach’s ? between .68 and .97). Significant differences in means between selected groups of students support the measure’s construct validity. Furthermore, there is evidence that the FKM might be used as a screening tool e.g. in graduate surveys to identify weaknesses in the medical education curriculum. PMID:21818241
Alhalaiqa, Fadwa; Masa'Deh, Rami; Batiha, Abdul-Monim; Deane, Katherine
To assess the validity and reliability of the Arabic version of the Beliefs About Medication Questionnaire, a cross-sectional design was used and the data were collected from 605 patients with chronic diseases. The study was conducted between July 2013 and December 2013. The results showed that the Cronbach's alpha coefficient (.71) was satisfactory. There was a significant strong positive correlation between test-retest for the same group subsample, with a correlation coefficient range of .45 to .78. There were no statistically significant differences between retest subgroups and remaining samples in the questionnaire subscales. The percentage of missing value was around 0.03, which confirmed the feasibility of the Arabic version of the questionnaire. These findings suggested that having a culturally acceptable, valid and reliable instrument to identify patients' beliefs toward medication in Jordan will play an important role in tailoring appropriate intervention to enhance patient compliance with their prescribed medication. PMID:25106809
Mavis, Brian; Sousa, Aron; Lipscomb, Wanda; Rappley, Marsha D
Although evidence of medical student mistreatment has accumulated for more than 20 years, only recently have professional organizations like the Association of American Medical Colleges (AAMC) and the American Medical Association truly acknowledged it as an issue. Since 1991, the AAMC's annual Medical School Graduation Questionnaire (GQ) has included questions about mistreatment. Responses to the GQ have become the major source of evidence of the prevalence and types of mistreatment. This article reviews national mistreatment data, using responses to the GQ from 2000 through 2012; examines how students' experiences have changed over time; and highlights the implications of this information for the broader medical education system. The authors discuss what mistreatment is, including the changing definitions from the GQ; the prevalence, types, and sources of mistreatment; and evidence of students reporting incidents. In addition, they discuss next steps, including better defining mistreatment, specifically public humiliation and belittling, taking into account students' subjective evaluations; understanding and addressing the influence of institutional culture and what institutions can learn from current approaches at other institutions; and developing better systems to report and respond to reports of mistreatment. They conclude with a discussion of how mistreatment currently is conceptualized within the medical education system and the implications of that conceptualization for eradicating mistreatment in the future. PMID:24667505
Background Demographic development is accompanied by an increasingly aging society. Concerning medical education, the treatment of older people as well as the scientific research and exploration of ageing aspects in the coming years need to be considered. Aim of the study was to ascertain medical students’ knowledge, interest, and attitudes regarding older patients and geriatric medicine. Methods Each participant completed a self-designed questionnaire. This questionnaire was based on three validated internationally recognised questionnaires (“Facts on Aging Quiz – FAQ”, “Expectations Regarding Aging – ERA” and the “Aging Semantic Differential – ASD”). The inquiry and survey were performed at the beginning of the summer term in 2012 at the University of Regensburg Medical School. Results A total of n?=?184/253 (72.7%) students participated in this survey. The results of the FAQ 25+ showed that respondents were able to answer an average of M?=?20.4 of 36 questions (56.7%) correctly (Median, Md?=?21; SD ±6.1). The personal attitudes and expectations of ageing averaged M?=?41.2 points on the Likert-scale that ranged from 0 to 100 (Md?=?40.4; SD ±13.7). Respondents’ attitudes towards the elderly (ASD 24) averaged M?=?3.5 points on the Likert-scale (range 1–7, Md 3.6, SD ±0.8). Conclusions In our investigation, medical students’ knowledge of ageing was comparable to previous surveys. Attitudes and expectations of ageing were more positive compared to previous studies. Overall, medical students expect markedly high cognitive capacities towards older people that can actively prevent cognitive impairment. However, medical students’ personal interest in medicine of ageing and older people seems to be rather slight. PMID:25062568
Kramer, Lena; Hirsch, Oliver; Becker, Annette; Donner-Banzhoff, Norbert
Introduction: The implementation of complex medical interventions in daily practice is often fraught with difficulties. According to the iterative phase model proposed by the British Medical Research Council (MRC), the development, implementation and evaluation of complex interventions should be theory-driven. A conceptual model that seems to be a promising framework is the Theory of planned behaviour (TPB). In our study we aimed to develop and validate a generic and multifaceted questionnaire based on the TPB to detect physicians’ willingness to implement complex medical interventions and the factors influencing this willingness. Methods: The questionnaire was developed according to the literature and was informed by previous qualitative research of our department. It was validated on the example of an electronic library of decision aids, arriba-lib. The sample consisted of 181 General Practitioners (GPs) who received a training regarding arriba-lib and subsequently filled in the questionnaire, assessing the TPB variables attitude, subjective norm, perceived behaviour control and intention. Follow-up assessments were conducted after two (assessing retest reliability) and eight weeks (assessing target behaviour). We performed a confirmatory factor analysis investigating the factorial structure of our questionnaire according to the TPB. Beside the calculation of the questionnaire’s psychometric properties we conducted a structural equation model and an ordinal regression to predict actual behaviour regarding the installation and application of arriba-lib. Results: The postulated three factorial model (attitude, subjective norm, perceived behaviour control) of our questionnaire based on the TPB was rejected. A two factorial model with a combined factor subjective norm/perceived behaviour control was accepted. The explained variance in the ordinal regression was low (Nagelkerke’s R2=.12). Neither attitude nor intention were able to predict the use or non-use of arriba-lib (attitude: p=.68, intention: p=.44). For the combined factor subjective norm/perceived behaviour control a significant, but small effect (p=.03) was shown. Conclusions: The TPB is not an adequate theoretical framework to guide the development of a generic questionnaire in the context of the implementation of complex interventions. To enable the successful implementation of complex medical interventions evaluators have to go through the whole development and evaluation process according to the MRC-model, without short cuts. Further, it has to be discussed if a generic instrument can be valid and useful. Regarding the TPB a publication bias regarding the theory’s applicability might have to be considered. PMID:24696674
It has been pointed out that currently, Iwaki City faces an insufficiency of doctors working at hospitals, compared with before. Such an insufficiency became more remarkable after the 2011 Tohoku Earthquake and Fukushima Nuclear Disaster, as about 30,000 people relocated to Iwaki City from the evacuation areas. In this regard, the Iwaki Medical Association conducted a questionnaire survey to investigate the problems of medical cooperation and utilize the data to improve medical cooperation within hospitals and clinics. A total of 159 doctors answered the questionnaires: 64% were community physicians, 36% were doctors working at hospitals, and 42% were physicians. About 60% of the doctors were satisfied with the present medical cooperation. Home health care was performed by 25% of the doctors working at hospitals and 45% of the community physicians. Approximately 80% of the doctors felt the need for additional physicians to perform home health care, although more than half of the doctors answered that they do not perform it. Various problems exist in the context of medical cooperation, but many doctors still hope for its improvement, according to the answers in the questionnaires. Efforts have to be exerted further in order to enhance medical cooperation among the health care team. PMID:24712146
Ashoorian, Deena; Davidson, Rowan; Rock, Daniel; Gudka, Sajni; Clifford, Rhonda
Side effects of psychotropic medications are important determinants of adherence to treatment. Discussion between the patient and clinician facilitated through the use of a side effect self-report questionnaire (SRQ) could lead to improved communications and treatment adherence. The aim of this review was to 1) identify all currently available side effect SRQs used in the assessment of mental health patients' subjective experiences, 2) evaluate the characteristics of the studies and 3) assess the psychometric properties of each of the questionnaires. Eight electronic databases were searched for peer-reviewed published articles. Six side effect SRQs were identified. Two independent reviewers assessed the quality of the study designs and psychometric properties of the identified SRQs. All questionnaires consisted of closed questions relating to antipsychotic side effects and completion times ranged from 5 to 20 min. Five questionnaires had undergone some form of psychometric testing, ranging from basic to comprehensive. There is a need in everyday clinical practice for a side effect communication tool applicable to all psychotropic medications, which allows the patient to express their subjective beliefs about their medications. This could provide an important contribution to the working relationship between patients and clinicians leading to informed decision-making and improved adherence. PMID:25034414
Duan, Wenjie; Ho, Samuel M. Y.; Bai, Yu; Tang, Xiaoqing
Objectives: The present study examined the psychometric properties of the Chinese Virtues Questionnaire (CVQ). The reliability, factor structure, construct validity, and temporal stability of the inventory were examined. Method: A university student sample ("n" = 878) and a working adult sample ("n" = 153) were recruited.…
Mary McGrae McDermott; Michael H. Criqui; Philip Greenland; Alan Hirsch; Elizabeth A. Hahn; Martin Lipsky; Donna Brogan; Linda Odom; David Cella; Kendra Hanley; Judith Ockene; Shaheen Khan; William H. Pearce
This study investigated whether the opportunity to obtain Continuing Medical Education (CME) credit together with a five-dollar bill increased response rates and questionnaire completion rates in a physician survey involving mailed questionnaires. One thousand, three hundred and fourteen cardiologists, family practitioners, general internists (non-surgeons) and 264 vascular surgeons randomly identified from the American Medical Association database participated. After two, of
Kegan, Daniel L.
A 60-item questionnaire measuring believed effects of sensitivity training, evaluations of these effects, and logical inconsistencies of respondents is presented. The questionnaire was developed from phrases describing sensitivity training found in newspaper articles written during a week of intense publicity following an incident at a local high…
Ammenwerth, Elske; Kaiser, Frieda; Wilhelmy, Immanuel; Höfer, Stefan
The use of modern information technology (IT) offers tremendous opportunities such as reducing clinical errors and supporting health care professionals in providing care. Evaluation of user satisfaction is often seen as a surrogate for the success of an information systems. We will present the evaluation of a report writing system at the Innsbruck University Medical Center based on a standardized, validated psychometric questionnaire. The results show high reliability and validity of the questionnaire. They also show some interesting differences in user satisfaction between departments, due to differences in working processes and preconditions. Psychometric questionnaires can be seen as a reliable and valid method to measure certain psychological constructs. Their development requires, however, methodological rigour and sufficient time. Psychometric questionnaires allow only a limited interaction between researcher and user, their results may be very dependant on the time of measurement, and their interpretation often needs external knowledge. Those limitations have to be taken into account when preparing evaluation studies. PMID:14664060
Robinson, M B
OBJECTIVE--To review current knowledge of the effectiveness of medical audit programmes as a whole and of specific interventions within these programmes, as a means of changing clinical behaviour. CRITERIA FOR INCLUSION AND EXCLUSION OF PUBLISHED REPORTS--Articles listed on Medline from 1985-92 with key words "quality assurance" or "medical audit", and "evaluation" and relevant references from these articles, and from recently published reviews and reports on medical audit, were included. Excluded were simple descriptions of audit activity, replications of previous work, and publication in a language other than English. RESULTS--Evaluation of entire programmes of medical audit is unusual. Most reports concern specific interventions and focus particularly on the scientific and technical aspects of quality. These interventions may be classified by the means through which they attempt to achieve desired changes: patient characteristics; physician characteristics; administrative and organisational structures; and financial incentives. CONCLUSIONS--Knowledge about effective methods of bringing about specific changes in clinical behaviour is rudimentary. Impact is highly dependent on local factors, so generalisation of results to other settings is difficult. More qualitative research is needed to define the local factors which influence results. PMID:7964351
Rice, Kenneth G.; Suh, Hanna; Ege, Engin
Data from clinical and nonclinical samples ("Ns" = 2,096, 618) were used to evaluate and replicate the measurement structure of the Outcome Questionnaire-45.2. Different measurement models and invariance tests were evaluated and the best psychometric support was found for a shortened measure of two factors: overall maladjustment and…
Background After a survey of medical graduates' skills found a lack of confidence in developmental assessment, a program was introduced with the broad aims of increasing medical student confidence and respect for the parents' role in childhood developmental assessment. Research has shown that parents' concerns are as accurate as quality screening tests in assessing development, so the program utilised the Ages and Stages Questionnaire, a parent completed, child development assessment tool. Method To evaluate the program, an interpretative analysis was completed on the students' reports written during the program and a questionnaire was administered to the parents to gain their perception of the experience. As well, student confidence levels in assessing growth and development were measured at the end of the paediatric term. Results Although there was an increase in student confidence in developmental assessment at the end of the term, it was not statistically significant. However the findings indicated that students gained increased understanding of the process and enhanced recognition of the parental role, and the study suggested there was increased confidence in some students. Parents indicated that they thought they should be involved in the teaching of students. Conclusion The ASQ was shown to have been useful in an education program at the level of advanced beginners in developmental assessment. PMID:16716208
Schilling, Lisa M; Kozak, Katarzyna; Lundahl, Kristy; Dellavalle, Robert P
Although critical analysis of survey research is limited when reviewers and readers cannot view a study's questionnaire, access to novel questionnaires used in published research has not been systematically examined. The authors identified publications reporting the results of novel questionnaires in three medical journals (JAMA, The New England Journal of Medicine, and The Lancet) in January 2000-May 2003 and searched portable document format (PDF) versions of the studies for the complete questionnaire or a Uniform Resource Locator (URL) providing access to the questionnaire. When the questionnaire was not provided in the publication or a published URL, the authors requested it from the corresponding author in writing up to three times over a 6-week period. Of 93 publications with novel questionnaires, four printed the questionnaire in the article and three provided online access. Corresponding authors failed to provide questionnaires for 37 of 81 (46%) studies. Novel questionnaires used in published research are frequently not available to readers or researchers. Policies that improve access to novel questionnaires will allow better assessment of study results, reduce duplicated efforts, and improve authorship attribution for questionnaire design. PMID:17041128
Top, Mehmet; Yilmaz, Ali; Karabulut, Erdem; Otieno, Ochieng George; Saylam, Melahat; Bak?r, Sevgi; Top, Sümbül
Using of EMR in health services and organizations is steadily increasing for quality improvement, cost effectiveness and performance development. However, no validated national and international instruments (scale, questionnaire, index, and inventory) have assessed the effectiveness, satisfaction, health care savings, patient safety and cost minimization of electronic medical and health systems from the viewpoint and perceptions of nurses in Turkish health services. The perceptions of health care professionals especially physicians and nurses can contribute important information that may predict their acceptance of EMR and desired mode of use for EMR, evaluation performance of EMR thus guiding EMR implementation in hospitals. This article is a report of validation of the instrument to measure nurses' views on the use, quality and user satisfaction with EMR in Turkish health system. Items in the questionnaire were designed and obtained following O.G. Otieno, H. Toyama, M. Asonuma, M. Kanai-Pak, K. Naitoh's questionnaire about Use, Quality and User Satisfaction with EMR systems. Reliability and validity were examined and investigated in terms of responses from 487 nurses from one education hospital in Ankara, Turkey. This study was planned and conducted at a university hospital. The validation process was based on construct validity in this study. The response rate was 74.92%. Cronbach's alphas of three factors (use, quality and satisfaction of EMR) ranged from 0.78 to 0.94. Goodness-of-fit indices from the confirmatory factor analysis showed a reasonable model fit. Results of confirmatory factor analysis showed that ?2 statistic indicated significant result (p?0.001) and model fit was acceptable according to relative ?2 statistic (?2/df?=?2.8?5). Further validation of the instrument could yield positive results in health systems in the different countries. Also further validation and reliability studies could be planned on physicians and other health professionals. PMID:25957164
Background Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare. Methods A questionnaire, founded on the Minnesota Innovation Survey (MIS), was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted. Results The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach’s alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbach’s alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work. Conclusions The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities. PMID:23391160
Hilles, William C.; And Others
The process for completing four national questionnaires was analyzed following site visits and detailed documentation at each of six representative medical schools. A number of problems with the process were found that inhibited the provision of reliable data. Corrective action for institutions and sponsoring agencies are suggested. (Editor/LBH)
Pooyafared, Adeleh; Hashemipour, Maryam Alsadat; Baharloey, Kheyzaran; Shafiei, Leili; Montajeb, Forogheh
Background: Today, the dental practitioners are finding many more medically compromised patients in their practice. Aims: The aim of this study was standardization of the European Medical Risk Related History (EMRRH) questionnaire for use among Persian population. Materials and Methods: The English original version of the EMRRH questionnaire was translated into Persian language by a forward–backward translation method. Then reliability was tested on 50 subjects. Also, the sensitivity, specificity, and validity of the questionnaire were assessed. Statistical Analysis Used: Cohen's kappa, a measure of agreement between observers that includes an adjustment for chance agreement, was likewise calculated. Results: The reliability coefficient (Cronbach's alpha) of the EMRRH was above the recommended 0.7 threshold and considered excellent (alpha 0.87). Specificity of the questions was 94% and of per EMRRH item was 93%. Sensitivity per question was 86.1% and of per EMRRH item was 94%. Cohen's kappa for the questionnaire was 0.89 and for subsequent questions was 0.82. Conclusions: The EMRRH (Persian version) has been shown to be valid in comparison with the gold standard (a medical history taken by a physician experienced) and this instrument would be an effectual method of history taking for the dentist. PMID:26097855
Malawana, Johann; Aitken, Maryanne; Heard, Shelley
A survey of London medical students asked for their views of the changes to postgraduate medical education starting in August 2005. The majority had clear ideas about their career plans and did not want their career held back by the introduction of an extra year. They overwhelmingly preferred to start their early training in or reasonably near to where they had undertaken their medical studies. PMID:15287349
Minner, Daphne Diane
The intention of this research project was to bridge the gap between social science research and application to the environmental domain through the development of a theoretically derived instrument designed to give educators a template by which to evaluate environmental education curricula. The theoretical base for instrument development was provided by several developmental theories such as Piaget's theory of cognitive development, Developmental Systems Theory, Life-span Perspective, as well as curriculum research within the area of environmental education. This theoretical base fueled the generation of a list of components which were then translated into a questionnaire with specific questions relevant to the environmental education domain. The specific research question for this project is: Can a valid assessment instrument based largely on human development and education theory be developed that reliably discriminates high, moderate, and low quality in environmental education curricula? The types of analyses conducted to answer this question were interrater reliability (percent agreement, Cohen's Kappa coefficient, Pearson's Product-Moment correlation coefficient), test-retest reliability (percent agreement, correlation), and criterion-related validity (correlation). Face validity and content validity were also assessed through thorough reviews. Overall results indicate that 29% of the questions on the questionnaire demonstrated a high level of interrater reliability and 43% of the questions demonstrated a moderate level of interrater reliability. Seventy-one percent of the questions demonstrated a high test-retest reliability and 5% a moderate level. Fifty-five percent of the questions on the questionnaire were reliable (high or moderate) both across time and raters. Only eight questions (8%) did not show either interrater or test-retest reliability. The global overall rating of high, medium, or low quality was reliable across both coders and time, indicating that the questionnaire can discriminate differences in quality of environmental education curricula. Of the 35 curricula evaluated, 6 were high quality, 14 were medium quality and 15 were low quality. The criterion-related validity of the instrument is at current time unable to be established due to the lack of comparable measures or a concretely usable set of multidisciplinary standards. Face and content validity were sufficiently demonstrated.
J. F. Martí-Massó; J. J. Poza
Doctors, nurses, and medical and nursing students administered a questionnaire on memory disturbances, tremor and clumsiness in their first-degree relatives who live or lived near them. We obtained data on 1,479 relatives, of whom 805 were alive and 674 had died. Of those alive and older than 65, 8.69% had severe memory disturbances, 1.11% a parkinsonian syndrome and 5.59% essential
Dimoliatis, Ioannis D. K.; Lyrakos, Georgios N.; Tseretopoulou, Xanthippi; Tzamalis, Theodoros; Bazoukis, George; Benos, Alexis; Gogos, Charalambos; Malizos, Konstantinos; Pneumatikos, Ioannis; Thermos, Kyriaki; Kaldoudi, Eleni; Tzaphlidou, Margaret; Papadopoulos, Iordanis N.; Jelastopulu, Eleni
The Tuning-Medicine Project produced a set of "level one" and "level two" learning outcomes/competences to be met by European medical graduates. In the learner-centered era self-assessment becomes more and more important. Our aim was to develop a self-completion questionnaire ("iCAN!") evaluating graduates' learning…
Kember, David; Leung, Doris Y. P.
This article uses the case of designing a new course questionnaire to discuss the issues of validity, reliability and diagnostic power in good questionnaire design. Validity is often not well addressed in course questionnaire design as there are no straightforward tests that can be applied to an individual instrument. The authors propose the…
Dehghan, Habibollah; Habibi, Ehsanollah; Habibi, Peymaneh; Maracy, Mohammad Reza
Introduction: Physiological, anthropometrical and thermal perceptual are the most important factors affecting thermoregulation of men and women in workplaces. The purpose of this study was determining the validity of a questionnaire method for assessing women's heat strain in workplaces. Methods: This cross-sectional study was carried out on 96 healthy women. Data were continuously collected over a period of 3 months (July-September) in 2012. Mean ± (SD) of age was found to be 31.5 ± 7.48 years, of height 1.61 ± 0.05 m, of weight 61.55 ± 10.35 kg, and of body mass index 23.52 ± 3.75 kg/m2 in different workplaces. Heart rate and oral temperature were measured by heart rate monitoring and a medical digital thermometer, respectively. Subjects completed a draft questionnaire about the effective factors in the onset of heat strain. After collecting the questionnaires, the data were analyzed by applying Cronbach’sa calculation, factor analysis method, Pearson correlation and receiver operator characteristic curves using the SPSS 18 software. Results: The value for Cronbach's ? was found to be 0.68. The factor analysis method on items of draft questionnaire extracted three subscale (16 variables) which they explained 63.6% of the variance. According to the results of receiver operator characteristic curve analysis, the cut-off questionnaire score for separating people with heat strain from people with no heat strain was obtained to be 17. Conclusions: The results of this research indicated that this quantitative questionnaire has an acceptable reliability and validity, and a cut-off point. Therefore it could be used in the preliminary screening of heat strain in women in warm workplaces, when other heat stress evaluation methods are not available. PMID:23930180
Ponce de León-Castañeda, M E; Ponce de León-Castañeda, R; Garduño-Navarro, M
A precodified questionnaire was applied to detect the needs of continuing medical education (CME) of 848 house officers; it covered personal background characteristics, identified needs as well as motivation and accessibility conditions to get involved in the process. After analyzing the data it was concluded that most of the physicians are interested in CME in order to avoid oblivion to keep, abreast of new scientific and technological advances and to increase self confidence. The detected needs were, in decreased order, as follows: pediatrics, general surgery, pediatric emergencies, orthopedics, traumatology and hospital administration. The most ashed areas wise therapeutics and pharmacology, diagnostic procedures and physiopathology. In relation to the teaching/learning activities they preferred courses, medical meetings and hospital sessions. Previously they had participated attending courses (79%), hospital sessions (54%), medical meeting (78%) and self study, mainly reading books and journals (98%). PMID:1959763
Kalayci, Nurdan; Cimen, Orhan
The aim of this study is to examine the questionnaires used to evaluate teaching performance in higher education institutes and called "Instructor and Course Evaluation Questionnaires (ICEQ)" in terms of questionnaire preparation techniques and components of curriculum. Obtaining at least one ICEQ belonging to any state and private universities in…
Savulescu, J; Crisp, R; Fulford, K W; Hope, T
We critically evaluate the ways in which competence in medical ethics has been evaluated. We report the initial stage in the development of a relevant, reliable and valid instrument to evaluate core critical thinking skills in medical ethics. This instrument can be used to evaluate the impact of medical ethics education programmes and to assess whether medical students have achieved a satisfactory level of performance of core skills and knowledge in medical ethics, within and across institutions. PMID:10536759
Stewart, Chris; Kirisci, Levent; Long, Abigail L; Giancola, Peter R
Neglect poses a significant risk for children throughout their development and is often linked with serious consequences that reach into adulthood. The Child Neglect Questionnaire (CNQ) fills existing gaps by incorporating multiple perspectives from both parents and the child, as well as measuring the complex phenomenon of neglect multidimensionally. Furthermore, this measure addresses the need for an instrument specifically developed for late childhood (ages 10-12), as much of the extant evidence and corresponding measures focus on young children and their mothers. A panel of three psychologists, using Cicchetti's model of child neglect as a theoretical guide, began by selecting items from an existing database. Results of exploratory and confirmatory factor analyses and item response theory demonstrated the unidimensionality of physical, emotional, educational, and supervision neglect as well as a second-order construct of child neglect. Analyses controlling for risk status due to father's substance use disorder, socioeconomic status, and child's ethnicity demonstrated that father's and mother's (parental) neglect, particularly in the child's versions, had sound concurrent and predictive validity. Concurrently, at age 10-12, the child's version of both parents' neglect correlated with their parenting behaviors evaluated by other available measures. Prospectively, from 10-12 years of age to 11-13 years of age, parental neglect predicted child's drug use frequency with coexisting psychological dysregulation, psychiatric symptoms, antisocial behavior, non-normative sexual behavior, involvement with deviant peers and leisure activities thus demonstrating sound predictive validity. Also, internal consistency and inter-rater reliability were excellent. The CNQ, particularly the child's version, may thus be useful for detecting children at high risk for parental neglect. PMID:25535250
Ashrafi-rizi, Hasan; Khorasgani, Zahra Ghazavi; Zarmehr, Fateme; Kazempour, Zahra
Introduction: Media literacy is a 21st century approach to education. It provides a framework to access, analyze, evaluate, and create messages in a variety of forms - from print to video to the Internet. Also, it builds an understanding of the role of media in society as well as essential skills of inquiry and self-expression necessary for citizens of a democracy. The purpose of this research was to determine the rate of media literacy among Isfahan University of Medical Sciences’ students using Iranian Media Literacy Questionnaire (IMLQ). Materials and Methods: This is a survey research in which the data were collected by a researcher-made questionnaire. Its validity and reliability were confirmed by Library and Information Sciences specialists and Chronbach's alpha (r = 0.89), respectively. Statistical population consisted of all students in Isfahan University of Medical Sciences (7000 cases) and the samples were 364. Sampling method was random stratified sampling. Data were analyzed by descriptive (frequency distribution, mean) and inferential (T-test, ANOVA, and one-sample t-test) statistics through SPSS16 software. Results: The findings showed that the mean level of media literacy among Isfahan University of Medical Sciences’ students was 3.20 ± 0.558 (higher than average). The highest mean was skill in avoiding confusion and focus on activates such as watching television, listening to radio, reading newspaper, and using internet; and the lowest mean was skill in membership and subscription in useful society networks. The mean of evaluation of media messages dimension was more than others. The lowest mean of dimensions was for selective and purposeful use of media with 2.99 ± 0.761. Comparison between gender, married status, educational degree, and college type and the rate of media literacy among Isfahan University of Medical Sciences’ students showed no significant difference. Conclusion: The results showed that the rate of media literacy among Isfahan University of Medical Sciences’ students was higher than average. But students didn't have enough skill in membership and subscription in useful society networks and Skill in tracking news about your favorite artists and musicians. Generally, all students and education practitioners should pay special attention to factors affecting in improving media literacy as a basic capability in using media. PMID:25013842
Richardson, M T; Leon, A S; Jacobs, D R; Ainsworth, B E; Serfass, R
The accuracy of the Minnesota Leisure Time Physical Activity (LTPA) Questionnaire (a 1-year survey of non-occupational activity used in MRFIT) was studied in 78 men and women, age 20-59 years, by comparing survey results to the following measures obtained over a year's duration: six 48-hour physical activity records; fourteen 48-hour Caltrac accelerometer readings (Caltrac); 14 administrations of a 4-week version of the LTPA Questionnaire (FWH); 3 VO2peak determinations and percent body fat (% BF). The LTPA Questionnaire demonstrated: weak to moderate associations with % BF (r = -0.24) and with VO2peak (r = 0.47); a weak association with Caltrac readings expressed as MET.minutes.day-1 (r = 0.23); strong associations with corresponding activities reported on the FWH; and moderate associations with total and heavy activities reported in the physical activity record, but no associations with moderate and light activities. Furthermore, several types of LTPA were found to be either under-represented or not currently included in the Minnesota LTPA Questionnaire. It is concluded that although validation results were found to be quite good, several possible refinements were identified, which should improve the accuracy of the Minnesota LTPA Questionnaire in assessing habitual physical activity. PMID:8138837
Hanigan, Marie H.; Cruz, Brian L. dela; Thompson, David M.; Farmer, Kevin C.; Medina, Patrick J.
Background Cancer patients take medications for coexisting disease and self medicate with over-the-counter drugs (OTCs). A complete analysis of the use of prescription drugs, OTCs and supplements during cancer treatment has never been done. Methods The study developed and validated a self-administered questionnaire on the use of concomitant medications by patients undergoing treatment with chemotherapy. The questionnaire listed 510 prescription medications, OTCs, and supplements (including vitamins, minerals and herbs). Fifty-two subjects completed the questionnaire while visiting the infusion clinic to receive chemotherapy. On a subsequent visit the subjects brought their medications to the clinic and a pharmacist reviewed their completed questionnaire. Results Ninety-six percent of the subjects reported taking prescription medications within three days prior to chemotherapy, 71% reported taking OTCs and 69% reported use of supplements. The subjects took an average of 5.5 (range 0-13) prescription drugs, 2.2 (0-20) OTCs and 1.9 (0-11) supplements. Twenty-one drugs were each taken by at least 10% of the subjects. Acetaminophen was taken by 59.6% of the subjects. One subject reported taking five acetaminophen-containing drugs. The questionnaire’s sensitivity was 92.0%, specificity 99.9%. Conclusion Within 3 days prior to chemotherapy, subjects took an average of 9.6 concomitant medications, many of which alter drug metabolism and or disposition. In clinical trials, multivariate analysis of all concomitant medications could add to clinically relevant data to identify drug interactions that negate or potentiate the efficacy of cancer treatment regimens. In some instances, apparent resistance of tumors to chemotherapy may be the result of drug interactions. PMID:18719067
Kopp, Jason P.; Zinn, Tracy E.; Finney, Sara J.; Jurich, Daniel P.
Validity evidence was gathered for the Academic Entitlement Questionnaire (AEQ). After reviewing entitlement literature, items were written to cover the breadth of academic entitlement. Results provide evidence for the substantive, structural, and external aspects of validity of the AEQ. Implications for research and use of the AEQ are discussed.…
Liang, Huizhi "Elly"
Evaluating Medical Information Retrieval Bevan Koopman Australian e-Health Research Centre, CSIRO retrieval of medical records. We use the BLULab corpus, a large collection of real-world de-identified medical records. The collection has been hand coded by clinical terminolo- gists using the ICD-9 medical
Background Over 50,000 non-medical healthcare professionals across the United Kingdom now have prescribing capabilities. However, there is no evidence available with regards to the extent to which non-medical prescribing (NMP) has been implemented within organisations across a strategic health authority (SHA). The aim of the study was to provide an overview of NMP across one SHA. Methods NMP leads across one SHA were asked to supply the email addresses of NMPs within their organisation. One thousand five hundred and eighty five NMPs were contacted and invited to complete an on-line descriptive questionnaire survey, 883 (55.7%) participants responded. Data was collected between November 2010 and February 2011. Results The majority of NMPs were based in primary care and worked in a team of 2 or more. Nurse independent supplementary prescribers were the largest group (590 or 68.6%) compared to community practitioner prescribers (198 or 22.4%), pharmacist independent supplementary prescribers (35 or 4%), and allied health professionals and optometrist independent and/or supplementary prescribers (8 or 0.9%). Nearly all (over 90%) of nurse independent supplementary prescribers prescribed medicines. Approximately a third of pharmacist independent supplementary prescribers, allied health professionals, and community practitioner prescribers did not prescribe. Clinical governance procedures were largely in place, although fewer procedures were reported by community practitioner prescribers. General practice nurses prescribed the most items. Factors affecting prescribing practice were: employer, the level of experience prior to becoming a non-medical prescriber, existence of governance procedures and support for the prescribing role (p?0.001). Conclusion NMP in this strategic health authority reflects national development of this relatively new role in that the majority of non-medical prescribers were nurses based in primary care, with fewer pharmacist and allied health professional prescribers. This workforce is contributing to medicines management activities in a range of care settings. If non-medical prescibers are to maximise their contribution, robust governance and support from healthcare organisations is essential. The continued use of supplementary prescribing is questionable if maximum efficiency is sought. These are important points that need to be considered by those responsible for developing non-medical prescribing in the United Kingdom and other countries around the world. PMID:22657272
Mucklow, J C
Aims To seek the views of medically qualified members of the Clinical Section of the British Pharmacological Society (BPS) on their perceived needs for Continuing Medical Education (CME); on how and by whom these needs should be addressed; and on how the outcome of any educational intervention might best be assessed. Methods A structured questionnaire. Results Of 233 recipients, 140 (60%) responded, but only 123 of these fulfilled the criteria for analysis. A large majority of respondents were clinicians, most of whom devoted at least 25% of their working week to their NHS commitment. There was widespread reliance on textbooks and journals as sources of CME, supplemented by discussions with specialist peers at national and international meetings. Many felt that fulfilling even this agenda was stretching their commitment to the limit, and their greatest need was for protected time in which to learn. There was a desire among 49% of all respondents for the BPS Clinical Section to take some responsibilty for addressing the future needs of its members, and 75% took the view that academic departments should contribute to the development and updating of materials. There was no clear agreement about what these should comprise, but around half of all respondents favoured web-based, journal-based or computer-assisted educational material offering self-assessment opportunities; and CME symposia or workshops at BPS meetings. Almost half (46%) felt that assessment of CME should be integrated with a well-organized appraisal system and the use of portfolios. Six out of 10 respondents were already, or were about to be, regularly appraised at their place of work. Conclusions The questionnaire survey revealed a broad canvas of views and little evidence of consensus except for a general plea for more time in which to learn. The aim of the Clinical Section should be to facilitate and help its members to organize their learning, in a way that is consistent with national trends in Continuing Professional Development. The Clinical Section should co-ordinate the setting up of an electronic library of appropriate published material, compiled by academic and industrial sources, that would guide members seeking up-to-date knowledge of Clinical Pharmacology and Therapeutics. The British Journal of Clinical Pharmacology (BJCP) should commission review articles on recent developments where no suitable published material exists. Academic departments should also be invited to identify or develop self-assessment material that members could use to reinforce their learning, and demonstrate their knowledge to relevant professional bodies. The Clinical Section should organize Symposia and Workshops at which contentious issues in Clinical Pharmacology and Therapeutics can be discussed and resolved. PMID:11453885
Msaouel, Pavlos; Kappos, Theocharis; Tasoulis, Athanasios; Apostolopoulos, Alexandros P.; Lekkas, Ioannis; Tripodaki, Elli-Sophia; Keramaris, Nikolaos C.
Purpose The aim of this study is to determine the perceived familiarity of medical residents with statistical concepts, assess their ability to integrate these concepts in clinical scenarios, and investigate their susceptibility to the gambler’s fallacy and the conjunction fallacy. Methods A multi-institutional, cross-sectional survey of Greek medical residents was performed. Participants were asked to indicate their familiarity with basic statistical concepts and answer clinically oriented questions designed to assess their biostatistics knowledge and cognitive biases. Univariate, bivariate, and multivariate statistical models were used for the evaluation of data. Results Out of 153 respondents (76.5% response rate), only two participants (1.3%) were able to answer all seven biostatistics knowledge questions correctly while 29 residents (19%) gave incorrect answers to all questions. The proportion of correct answers to each biostatistics knowledge question ranged from 15 to 51.6%. Residents with greater self-reported familiarity were more likely to perform better on the respective knowledge question (all p<0.01). Multivariate analysis of the effect of individual resident characteristics on questionnaire performance showed that previous education outside Greece, primarily during medical school, was associated with lower biostatistics knowledge scores (p<0.001). A little more than half of the respondents (54.2%) answered the gambler’s fallacy quiz correctly. Residents with higher performance on the biostatistics knowledge questions were less prone to the gambler’s fallacy (odds ratio 1.38, 95% confidence intervals 1.12–1.70, p=0.003). Only 48 residents (31.4%) did not violate the conjunction rule. Conclusions A large number of medical residents are unable to correctly interpret crucial statistical concepts that are commonly found in the medical literature. They are also especially prone to the gambler’s fallacy bias, which may undermine clinical judgment and medical decision making. Formalized systematic teaching of biostatistics during residency will be required to de-bias residents and ensure that they are proficient in understanding and communicating statistical information. PMID:24646439
Eaden, J.; Mayberry, M.; Mayberry, J.
We present a working review of survey methods based on market research technology. The structure of questionnaires, their distribution and analysis, are considered, together with techniques for increasing response rates.???Keywords: questionnaires; research methods PMID:10474722
Richards, L. G.; Jacobson, I. D.
As part of a larger effort to assess passenger comfort in aircraft, two questionnaires were administered: one to ground-based respondents; the other to passengers in flight. Respondents indicated the importance of various factors influencing their satisfaction with a trip, the perceived importance of various physical factors in determining their level of comfort, and the ease of time spent performing activities in flight. The in-flight sample also provided a rating of their level of comfort and of their willingness to fly again. Comfort ratings were examined in relation to (1) type of respondent, (2) type of aircraft, (3) characteristics of the passengers, (4) ease of performing activities, and (5) willingness to fly again.
Goud, Manjunatha; Pamidi, Narendra; Devi, Oinam S.; Nayal, Bhavn; Kamath, Ullas; Raghuveer
Background: The physical activity in teaching faculties is an important aspect to maintain good health. This not only prevents the various non - communicable diseases but also has role in secondary prevention of diseases. It is also proven that the growing epidemic of obesity mostly in children is linked to recent decline in physical activity levels both in home, school and working places. Social class is thought to have a bearing on physical activity. On basis of this, the survey was done to assess the physical activity levels in higher social class population i.e. on teaching faculty of Melaka Manipal Medical College, Manipal, Karnataka, India. Materials and Methods: Questionnaire study was implemented in 2010 as the design of this research without any manual intervention. No experiment was conducted in the research. Questions were specific and related to the physical activities in home and also in working environment. Results: The study found that in medical college the lifestyle is restricted mostly to sedentary and moderate work. Most of faculties were using bike and cars to reach there working place and also we found the physical activities in the form of exercise and sports activity were lacking. Discussion: In addition to the importance of a physical activity professional's potential influence on others as a model, engaging in a physically active lifestyle is very important for personal reasons. Achieving and maintaining a health-enhancing level of physical fitness is one of the basic standards for good teaching and maintaining good health. Physical activity in professionals leads to both personal health benefits, and improve job satisfaction. Conclusion: Infrastructure improvements such as sports activity in colleges among faculties, combined with regular exercise provide additional physical activity that would help reduce obesity and non-communicable diseases. PMID:25013840
Gaspar, Maria Filomena; Pinto, Anabela Mota; da Conceicao, Hugo Camilo F.; da Silva, Jose Antonio Pereira
The purpose of this study was to develop a teaching quality assessment questionnaire and assess its reliability by using it with a sample of first-year medical students. Principal components analysis with varimax orthogonal rotation resulted in the development of a 12-item, two-component tool, adequate for use in lectures and small-group sessions.…
Lee, Seung Jae; Choi, Young Hee; Rim, Hyo Deog; Won, Seung Hee
Objective The Young Schema Questionnaire (YSQ) is a self-report measure of early maladaptive schemas and is currently in its third revision; it is available in both long (YSQ-L3) and short (YSQ-S3) forms. The goal of this study was to develop a Korean version of the YSQ-S3 and establish its psychometric properties in a Korean sample. Methods A total of 542 graduate medical students completed the Korean version of the YSQ-S3 and several other psychological scales. A subsample of 308 subjects completed the Korean YSQ-S3 both before and after a 2-year test-retest interval. Correlation, regression, and confirmatory factor analyses were performed on the data. Results The internal consistency of the 90-item Korean YSQ-S3 was 0.97 and that of each schema was acceptable, with Cronbach's alphas ranging from 0.59 to 0.90. The test-retest reliability ranged from 0.46 to 0.65. Every schema showed robust positive correlations with most psychological measures. The confirmatory factor analysis for the 18-factor structure originally proposed by Young, Klosko, and Weishaar (2003) showed that most goodness-of-fit statistics were indicative of a satisfactory fit. Conclusion These findings support the reliability and validity of the Korean version of the YSQ-S3. PMID:26207121
Kingkaew, Pritaporn; Teerawattananon, Yot
While many of the principles that guide the economic evaluation of medical devices are somewhat similar to those that guide the evaluation of other health technologies, most outline a methodology that focuses on pharmaceutical products rather providing specific guidance for medical devices. Given that medical devices use a wide range of technologies and can be used for many purposes, conducting an economic analysis for medical devices is not straightforward. The cost and effectiveness of a given technology may depend on a number of factors. The objective of this paper is to provide a summary of issues that need to be addressed before undertaking an economic evaluation of medical devices and to outline a number of suggested approaches for undertaking an economic evaluation of medical devices. PMID:24964706
Safer, Vildan Binay; Yavuzer, Gunes; Demir, Sibel Ozbudak; Yanikoglu, Inci; Guneri, Fulya Demircioglu
[Purpose] Currently, there are a limited number of amputee-specific instruments for measuring prosthesis-related quality of life with good psychometric properties in Turkey. This study translated the Prosthetic Evaluation Questionnaire to Turkish and analyzed as well as discussed its construct validity and internal consistency. [Subjects and Methods] The Prosthetic Evaluation Questionnaire was adapted for use in Turkish by forward/backward translation. The final Turkish version of this questionnaire was administered to 90 unilateral amputee patients. Second evaluation was possible in 83 participants within a median 28 day time period. [Results] Point estimates for the intraclass correlation coefficient ranged from 0.69 to 0.89 for all 9 Prosthetic Evaluation Questionnaire scales, indicating good correlation. Overall Cronbach's alpha coefficients ranged from 0.64 to 0.92, except for the perceived response subscale of 0.39. The ambulation subscale was correlated with the physical functioning subscales of Short Form-36 (SF-36) (r=0.48). The social burden subscale score of the Prosthetic Evaluation Questionnaire was correlated with social functioning subscales of SF-36 (r= 0.63). [Conclusion] The Turkish version of the Prosthetic Evaluation Questionnaire is a valid and reliable tool for implementation in the Turkish unilateral amputee population. PMID:26180296
Safer, Vildan Binay; Yavuzer, Gunes; Demir, Sibel Ozbudak; Yanikoglu, Inci; Guneri, Fulya Demircioglu
[Purpose] Currently, there are a limited number of amputee-specific instruments for measuring prosthesis-related quality of life with good psychometric properties in Turkey. This study translated the Prosthetic Evaluation Questionnaire to Turkish and analyzed as well as discussed its construct validity and internal consistency. [Subjects and Methods] The Prosthetic Evaluation Questionnaire was adapted for use in Turkish by forward/backward translation. The final Turkish version of this questionnaire was administered to 90 unilateral amputee patients. Second evaluation was possible in 83 participants within a median 28 day time period. [Results] Point estimates for the intraclass correlation coefficient ranged from 0.69 to 0.89 for all 9 Prosthetic Evaluation Questionnaire scales, indicating good correlation. Overall Cronbach’s alpha coefficients ranged from 0.64 to 0.92, except for the perceived response subscale of 0.39. The ambulation subscale was correlated with the physical functioning subscales of Short Form-36 (SF-36) (r=0.48). The social burden subscale score of the Prosthetic Evaluation Questionnaire was correlated with social functioning subscales of SF-36 (r= 0.63). [Conclusion] The Turkish version of the Prosthetic Evaluation Questionnaire is a valid and reliable tool for implementation in the Turkish unilateral amputee population. PMID:26180296
This article focuses on organizational learning, particularly in the context of evaluation and organizational change. These concepts are discussed in terms of academic libraries. As part of this discussion, a model entitled Processes and Phases of Organizational Learning (PPOL) was developed which is a visual representation of the range of…
Rayhan, Rakib U.; Zheng, Yin; Uddin, Ebsan; Timbol, Christian; Adewuyi, Oluwatoyin; Baraniuk, James N.
Aim Questionnaires are an invaluable resource for clinical trials. They serve to estimate disease burden and clinical parameters associated with a particular study. However, current researchers are tackling budget constraints, loss of funding opportunities, and rise of research associated fees. We aimed at exploring alternative avenues taking advantage of the free Google docs software for questionnaire administration. This presents an opportunity to reduce costs while simultaneously increasing efficiency and data fidelity. Material and Methods Google documents were used as a platform to create online questionnaires that were automatically hosted via a unique URL. Password protected access to the URL link and a unique study ID gave patients around the clock access from anywhere in the world. Unique study ID ensured confidentially of all self-reported data. Patient responses were secured using a “Cloud” database where the data was automatically sorted, scaled and scored by custom Excel formulas. Researchers downloaded real-time questionnaire responses in multiple formats (e.g. excel) which was then analyzed with a statistical software of choice. Results This simple workflow provided instant questionnaire scores that eliminated the use for paper-based responses and subsequent manual entry of data. Ease of access to online questionnaires provided convenience to patients leading to better response rates and increase in data fidelity. The system also allowed for real time monitoring of patient's progress on completing questionnaires. Online questionnaires had 100% completion rate compared to paper-based questionnaires. Conclusions Google docs can serve as an efficient and free platform to administer questionnaires to a clinical population without sacrificing quality, security, and fidelity of data. PMID:24415903
Coluci, Marina Zambon Orpinelli; Alexandre, Neusa Maria Costa
The objectives of this study were to develop a questionnaire that evaluates the perception of nursing workers to job factors that may contribute to musculoskeletal symptoms, and to evaluate its psychometric properties. Internationally recommended methodology was followed: construction of domains, items and the instrument as a whole, content validity, and pre-test. Psychometric properties were evaluated among 370 nursing workers. Construct validity was analyzed by the factorial analysis, known-groups technique, and convergent validity. Reliability was assessed through internal consistency and stability. Results indicated satisfactory fit indices during confirmatory factor analysis, significant difference (p < 0.01) between the responses of nursing and office workers, and moderate correlations between the new questionnaire and Numeric Pain Scale, SF-36 and WRFQ. Cronbach's alpha was close to 0.90 and ICC values ranged from 0.64 to 0.76. Therefore, results indicated that the new questionnaire had good psychometric properties for use in studies involving nursing workers. PMID:24931478
Andrade, Susan E.; Davis, Robert L.; Cheetham, T. Craig; Cooper, William O.; Li, De-Kun; Amini, Thushi; Beaton, Sarah J.; Dublin, Sascha; Hammad, Tarek A.; Pawloski, Pamala A.; Raebel, Marsha A.; Smith, David H.; Staffa, Judy A.; Toh, Sengwee; Dashevsky, Inna; Haffenreffer, Katherine; Lane, Kimberly; Platt, Richard; Scott, Pamela E.
To describe a program to study medication safety in pregnancy, the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP). MEPREP is a multi-site collaborative research program developed to enable the conduct of studies of medication use and outcomes in pregnancy. Collaborators include the U.S. Food and Drug Administration and researchers at the HMO Research Network, Kaiser Permanente Northern and Southern California, and Vanderbilt University. Datasets have been created at each site linking healthcare data for women delivering an infant between January 1, 2001 and December 31, 2008 and infants born to these women. Standardized data files include maternal and infant characteristics, medication use, and medical care at 11 health plans within 9 states; birth certificate data were obtained from the state departments of public health. MEPREP currently involves more than 20 medication safety researchers and includes data for 1,221,156 children delivered to 933,917 mothers. Current studies include evaluations of the prevalence and patterns of use of specific medications and a validation study of data elements in the administrative and birth certificate data files. MEPREP can support multiple studies by providing information on a large, ethnically and geographically diverse population. This partnership combines clinical and research expertise and data resources to enable the evaluation of outcomes associated with medication use during pregnancy. PMID:22002179
Liotta, G; Scarcella, P; Mancinelli, S; Palombi, L; Cancelli, A; Marazzi, M C
The evaluation of the demand for assistance requires instruments and procedures scientifically validated as being effective. The aim of this paper is to present the results of a survey on the demand for assistance by a sector of the population, with an approach based on validated instruments and standardised procedures. The survey was carried out on a sample of 1,245 elderly persons (610 in Rome and 635 in Viterbo), who represent the over sixty-five year olds, resident in the Local Health Authority Roma D area and in the Local Health Authority of Viterbo. All the subjects were given the questionnaire for the Geriatric Functional Evaluation (GFE). Around 30% of over sixty-five year olds needs assistance. The Final Brief Evaluation indicates that 8% (CL 95%: 7.2-8.8) of the people interviewed need health and social services at the time of the study, and 20.6% more (CL95%: 19.5-21.7), should be carefully monitored in order to provide supportive, even if only social, services. Around 20.7% (CL95% 19.6-21.8) suffers from neurological pathologies and is characterised by a reduced functional capacity, as pointed out by the Multiple Correspondence Analysis. The combination of neuropathy and need of physical rehabilitation service is relevant part of the need for assistance. The approach used makes it possible to find out about situations of frailty in advance, so that a suitable plan of assistance in the area surveyed is possible. PMID:16821500
Petrides, KV; McManus, IC
Background The medical specialities chosen by doctors for their careers play an important part in the workforce planning of health-care services. However, there is little theoretical understanding of how different medical specialities are perceived or how choices are made, despite there being much work in general on this topic in occupational psychology, which is influenced by Holland's RIASEC (Realistic-Investigative-Artistic-Social-Enterprising-Conventional) typology of careers, and Gottfredson's model of circumscription and compromise. In this study, we use three large-scale cohorts of medical students to produce maps of medical careers. Methods Information on between 24 and 28 specialities was collected in three UK cohorts of medical students (1981, 1986 and 1991 entry), in applicants (1981 and 1986 cohorts, N = 1135 and 2032) or entrants (1991 cohort, N = 2973) and in final-year students (N = 330, 376, and 1437). Mapping used Individual Differences Scaling (INDSCAL) on sub-groups broken down by age and sex. The method was validated in a population sample using a full range of careers, and demonstrating that the RIASEC structure could be extracted. Results Medical specialities in each cohort, at application and in the final-year, were well represented by a two-dimensional space. The representations showed a close similarity to Holland's RIASEC typology, with the main orthogonal dimensions appearing similar to Prediger's derived orthogonal dimensions of 'Things-People' and 'Data-Ideas'. Conclusions There are close parallels between Holland's general typology of careers, and the structure we have found in medical careers. Medical specialities typical of Holland's six RIASEC categories are Surgery (Realistic), Hospital Medicine (Investigative), Psychiatry (Artistic), Public Health (Social), Administrative Medicine (Enterprising), and Laboratory Medicine (Conventional). The homology between medical careers and RIASEC may mean that the map can be used as the basis for understanding career choice, and for providing career counselling. PMID:15461786
Hill, Wendell T.
UNIVERSITY OF MARYLAND · UNIVERSITY HEALTH CENTER Physical Therapy Unit Medical History MEDICAL HISTORY Diagnosis: Orthopedic Physician Physician who referred you to Physical Therapy When dates Exercise level (non-active) 1 2 3 4 5 6 7 8 9 10 (very active) Have you had Physical Therapy
Tucker, Beatrice; Jones, Sue; Straker, Leon
This paper reports the use of an online student evaluation system, Course Experience on the Web (CEW), in a physiotherapy program to improve their Course Experience Questionnaire (CEQ) results. CEW comprises a course survey instrument modeled on the CEQ and a tailored unit survey instrument. Closure of the feedback loop is integral in the CEW…
Fledderus, Martine; Oude Voshaar, Martijn A. H.; ten Klooster, Peter M.; Bohlmeijer, Ernst T.
The Acceptance and Action Questionnaire-II (AAQ-II) is a self-report measure designed to assess experiential avoidance as conceptualized in acceptance and commitment therapy (ACT). The current study is the first to evaluate the psychometric properties of the AAQ-II in a large sample of adults (N = 376) with mild to moderate levels of depression…
Tanaka, Masako; Wekerle, Christine; Leung, Eman; Waechter, Randall; Gonzalez, Andrea; Jamieson, Ellen; MacMillan, Harriet L.
Despite advances in child maltreatment research, accurate measurement of exposure remains a key issue. In this study, we evaluated a short form (CEVQ-SF) of the Childhood Experiences of Violence Questionnaire (CEVQ) in a sample of adolescents involved with child protection services in an urban city in Ontario, Canada. Focusing on the two most…
May, Susan A.
A questionnaire was developed to evaluate the effectiveness of Fox Valley Technical College's (FVTC's) marketing communications with prospective students. The literature on customer service, marketing communications, and institutional image was reviewed, and 17 construct criteria and 7 content criteria were developed as the framework for the…
Rhee, Min Kyu; Rex, Katharine M.
Objective Delayed sleep phase disorder (DSPD) is a condition in which patients often fall asleep some hours after midnight and have difficulty waking up in the morning. Circadian chronotype questionnaires such as Horne-Östberg Morningness-Eveningness Questionnaire (MEQ) and Basic Language Morningness (BALM) scale have been used for screening for DSPD. This study was to evaluate these two chronotype questionnaires for screening of DSPD. Methods The study samples were 444 DSPD and 438 controls. Cronbach's alpha coefficient was calculated to evaluate for internal consistency. An exploratory factor analysis was conducted using principal-axis factoring. The diagnostic performance of a test was evaluated using Receiver Operating Characteristic (ROC) curve analysis. A discriminant function analysis was also performed. Results For internal consistency, Cronbach's alpha of 0.898 for BALM was higher than the 0.837 for MEQ, though both have acceptable internal consistency. BALM has better construct validity than the MEQ because some MEQ items measure different dimensions. However, when we evaluated the efficiency of two questionnaires for DSPD diagnosis by using the ROC curve, the BALM was similar to the MEQ. In a discriminant analysis with the BALM to classify the two groups (DSPD vs. normal), 6 items were identified that resulted in good classification accuracy. Upon examination of the classification procedure, 94.2% of the originally grouped cases were classified correctly. Conclusion These findings suggest that the BALM has better psychometric properties than the MEQ in screening and discriminating DSPS. PMID:22993522
P. Carratù; G. Karageorgiou; P. Bonfitto; G. Di Gioia; D. Lacedonia; M. P. Foschino Barbaro; O. Resta
Long term evaluation of mental fatigue by Maastricht Questionnaire in patients with OSAS treated with CPAP. P. Carratù, G. Karageorgiou, P. Bonfitto, G. Di Gioia, D. Lacedonia, M.P. Foschino Barbaro, O. Resta. Background. Patients with obstructive sleep apnoea syndrome (OSAS) suffer from disrupted sleep. Impaired nightly sleep leads to increase physical and mental fatigue. The effect of long term continuous
Lemos, M. S.; Queiros, C.; Teixeira, P. M.; Menezes, I.
The authors describe the development and validation of a multidimensional instrument of students' evaluation of university teaching (the Pedagogical Questionnaire of the University of Porto). The goal was to develop an instrument based on a sound psychometric analysis and simultaneously supported by the learning theory. Based on the data from 4875…
Trampas J. Rowden; Steven M. Harris; Robert F. Stahmann
No research to date addresses premarital assessment questionnaire (PAQ) use within group settings. The current study evaluated the benefits and drawbacks of group use of one PAQ (the RELATE Inventory). Results were obtained via semi-structured interviews of group leaders and indicate overall leader agreement on the perceived desirability, benefits, and drawbacks of using PAQs in group premarital efforts. Recommended principles\\/guidelines
Holloway, D C; Wiczai, L J; Carlson, E T
The purpose of this study was to evaluate a computerized information system, the Professional Activity Study-Medical Audit Program (PAS-MAP), when used by the medical staff of a hospital to conduct medical care evaluation studies. PAS-MAP was compared to a manual system for collecting data not contained on the face sheets of medical records. The results indicated that, compared to the manual system, PAS-MAP: was less costly if more than 41 per cent of hospitalized patients were included in medical care evaluation studies; was as timely as the manual system for data it could provide but provided fewer clinical data elements than physicians requested; and was less protective against human error. Three decision makers assigned weights indicating the relative importance of these results. The weights were combined in an additive model to arrive at a score for each system. Based on these scores, the manual system was recommended for implementation. PMID:1121195
...2014-07-01 2014-07-01 false Initial medical evaluation and management. 549.63...OF JUSTICE INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate § 549.63 Initial medical evaluation and management....
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Belden, J.; Williams, J.; Richardson, B.; Schuster, K.
Summary Background Federated medical search engines are health information systems that provide a single access point to different types of information. Their efficiency as clinical decision support tools has been demonstrated through numerous evaluations. Despite their rigor, very few of these studies report holistic evaluations of medical search engines and even fewer base their evaluations on existing evaluation frameworks. Objectives To evaluate a federated medical search engine, MedSocket, for its potential net benefits in an established clinical setting. Methods This study applied the Human, Organization, and Technology (HOT-fit) evaluation framework in order to evaluate MedSocket. The hierarchical structure of the HOT-factors allowed for identification of a combination of efficiency metrics. Human fit was evaluated through user satisfaction and patterns of system use; technology fit was evaluated through the measurements of time-on-task and the accuracy of the found answers; and organization fit was evaluated from the perspective of system fit to the existing organizational structure. Results Evaluations produced mixed results and suggested several opportunities for system improvement. On average, participants were satisfied with MedSocket searches and confident in the accuracy of retrieved answers. However, MedSocket did not meet participants’ expectations in terms of download speed, access to information, and relevance of the search results. These mixed results made it necessary to conclude that in the case of MedSocket, technology fit had a significant influence on the human and organization fit. Hence, improving technological capabilities of the system is critical before its net benefits can become noticeable. Conclusions The HOT-fit evaluation framework was instrumental in tailoring the methodology for conducting a comprehensive evaluation of the search engine. Such multidimensional evaluation of the search engine resulted in recommendations for system improvement. PMID:25298813
Giang, Leesa; Selinger, Christian P; Lee, Alice Unah
AIM: To assess adherence rates to nucleos(t)ide analogues (NUCs) therapy in patients with chronic hepatitis B virus infection and determine factors associated with adherence. METHODS: The questionnaire study was conducted in the liver clinics at Concord Repatriation General Hospital. All patients who were currently taking one or more NUCs were asked to complete a structured, self-administered 32-item questionnaire. Adherence was measured using visual analogue scales. The patient’s treating clinician was also asked to assess their patient’s adherence via a structured questionnaire. RESULTS: A total of 80 patients completed the questionnaire. Sixty six percent of the patients (n = 49) reported optimal adherence whilst 25 (33.8%) graded their adherence to NUCs as suboptimal. Thirty four (43%) patients reported to have omitted taking their NUCs sometime in the past. Recent non-adherence was uncommon. Amongst the patients who reported skipping medications, the most common reason cited was ”forgetfulness“ (n = 27, 56.25%). Other common reasons included: ran out of medications (n = 5, 10.42%), being too busy (n = 4, 8.33%) and due to a change in daily routine (n = 5, 10.42%). Patients who reported low adherence to other prescription pills were also more likely to miss taking NUCs (P = 0.04). Patients who were under the care of a language-discordant clinician were also more likely to report suboptimal adherence to NUCs (P = 0.04). CONCLUSION: Adherence rates were much less than that expected by the physician and has potential adverse affect on long term outcome. Communication and education appear central and strategies need to be implemented to improve ongoing adherence. PMID:22400085
D'Alonzo, Karen T
As more Spanish speaking immigrants participate in and become the focus of research studies, questions arise about the appropriateness of existing research tools. Questionnaires have often been adapted from English language instruments and tested among college-educated Hispanic-Americans. Little has been written regarding the testing and evaluation of research tools among less educated Latino immigrants. The purpose of this study was to evaluate and revise a battery of Spanish-language questionnaires for an intervention among immigrant Hispanic women. A three-step process was used to evaluate, adapt and test Spanish versions of the Self-Efficacy and Exercise Habits Survey, an abbreviated version of the Hispanic Stress Inventory-Immigrant version and the Latina Values Scale. The revised tools demonstrated acceptable validity and reliability. The adaptations improved the readability of the tools, resulting in a higher response rate, less missing data and fewer extreme responses. Psychometric limitations to the adaptation of Likert scales are discussed. PMID:22030592
Chew, Yu Wei; Rajakrishnan, Sudeash; Low, Chin Aun; Jayapalan, Prakash Kumar; Sreeramareddy, Chandrashekhar T
Information about medical students' choice of specialty can be helpful for planning health manpower. However, such information from medical students in Malaysian medical schools is lacking. We carried out a cross-sectional questionnaire survey among fourth- and fifth-year medical undergraduate students at Melaka-Manipal Medical College. A total of 425 students responded to the survey questionnaire. Nearly a quarter of the students indicated internal medicine as their choice of specialty. Other choices were general surgery (13.2%), pediatrics (11.3%), orthopedics (12.7%) and obstetrics & gynecology (Ob/Gyn) (12.1%). Female students (OR 1.91; 95% CI 1.18-3.08), fourth-year students (OR 1.9; 95% CI 1.15-3.12), and students who reported a higher self-rated knowledge of their subject of choice were more likely to choose internal medicine and allied specialties (OR 1.53; 95% CI 1.07-2.19). The influence of teaching faculty and consultants at the teaching hospitals (74.4%) and inspiration obtained during clinical postings (71.9%) were the factors which were rated by the most students as 'important' for choosing a specialty. About half of the students intended to pursue their postgraduate studies in Malaysia, most of the rest in the United Kingdom or Australia. While internal medicine and surgical subspecialties were preferred, students were not inclined towards primary care or diagnostic subspecialties. Incentives should be provided and other measures should be taken to make these branches more attractive. PMID:21572250
Urval, Rathnakar P.; Ullal, Sheetal; Shenoy, Ashok K.; Shenoy, Nandita; Udupa, Laxminarayana A.
While there are several tools to study learning styles of students, the visual-aural-read/write-kinesthetic (VARK) questionnaire is a simple, freely available, easy to administer tool that encourages students to describe their behavior in a manner they can identify with and accept. The aim is to understand the preferred sensory modality (or modalities) of students for learning. Teachers can use this knowledge to facilitate student learning. Moreover, students themselves can use this knowledge to change their learning habits. Five hundred undergraduate students belonging to two consecutive batches in their second year of undergraduate medical training were invited to participate in the exercise. Consenting students (415 students, 83%) were administered a printed form of version 7.0 of the VARK questionnaire. Besides the questionnaire, we also collected demographic data, academic performance data (marks obtained in 10th and 12th grades and last university examination), and self-perceived learning style preferences. The majority of students in our study had multiple learning preferences (68.7%). The predominant sensory modality of learning was aural (45.5%) and kinesthetic (33.1%). The learning style preference was not influenced by either sex or previous academic performance. Although we use a combination of teaching methods, there has not been an active effort to determine whether these adequately address the different types of learners. We hope these data will help us better our course contents and make learning a more fruitful experience. PMID:25179610
Urval, Rathnakar P; Kamath, Ashwin; Ullal, Sheetal; Shenoy, Ashok K; Shenoy, Nandita; Udupa, Laxminarayana A
While there are several tools to study learning styles of students, the visual-aural-read/write-kinesthetic (VARK) questionnaire is a simple, freely available, easy to administer tool that encourages students to describe their behavior in a manner they can identify with and accept. The aim is to understand the preferred sensory modality (or modalities) of students for learning. Teachers can use this knowledge to facilitate student learning. Moreover, students themselves can use this knowledge to change their learning habits. Five hundred undergraduate students belonging to two consecutive batches in their second year of undergraduate medical training were invited to participate in the exercise. Consenting students (415 students, 83%) were administered a printed form of version 7.0 of the VARK questionnaire. Besides the questionnaire, we also collected demographic data, academic performance data (marks obtained in 10th and 12th grades and last university examination), and self-perceived learning style preferences. The majority of students in our study had multiple learning preferences (68.7%). The predominant sensory modality of learning was aural (45.5%) and kinesthetic (33.1%). The learning style preference was not influenced by either sex or previous academic performance. Although we use a combination of teaching methods, there has not been an active effort to determine whether these adequately address the different types of learners. We hope these data will help us better our course contents and make learning a more fruitful experience. PMID:25179610
Psychological Assessment can be defined as a complex procedure of information collection, analysis and processing. Formal Psychological Assessment (FPA) tries to improve this procedure by providing a formal framework to build assessment tools. In this paper, FPA is applied to depression. Seven questionnaires widely used for the self-evaluation of depression were selected. Diagnostic criteria for major depressive disorder were derived from the DSM-5, literature and Seligman’s and Beck’s theories. A Boolean matrix was built, including 266 items from the questionnaires in the rows and 20 selected attributes, obtained through diagnostic criteria decomposition, in the columns. In the matrix, a 1 in a cell meant that the corresponding item investigated the specific attribute. It was thus possible to analyze the relationships between items and attributes and among items. While none of the considered questionnaires could alone cover all the criteria for the evaluation of depressive symptoms, we observed that a set of 30 items contained the same information that was obtained redundantly with 266 items. Another result highlighted by the matrix regards the relations among items. FPA allows in-depth analysis of currently used questionnaires based on the presence/absence of clinical elements. FPA allows for going beyond the mere score by differentiating the patients according to symptomatology. Furthermore, it allows for computerized-adaptive assessment. PMID:25875359
Endo, Gen; Iemura, Yu; Fukushima, Edwardo F; Hirose, Shigeo; Iribe, Masatsugu; Ikeda, Ryota; Onishi, Kohei; Maeda, Naoto; Takubo, Toshio; Ohira, Mineko
Home oxygen therapy (HOT) is a medical treatment for the patients suffering from severe lung diseases. Although walking outdoors is recommended for the patients to maintain physical strength, the patients always have to carry a portable oxygen supplier which is not sufficiently light weight for this purpose. Our ultimate goal is to develop a mobile robot to carry an oxygen tank and follow a patient in an urban outdoor environment. We have proposed a mobile robot with a tether interface to detect the relative position of the foregoing patient. In this paper, we report the questionnaire-based evaluation about the two developed prototypes by the HOT patients. We conduct maneuvering experiments, and then obtained questionnaire-based evaluations from the 20 patients. The results show that the basic following performance is sufficient and the pulling force of the tether is sufficiently small for the patients. Moreover, the patients prefer the small-sized prototype for compactness and light weight to the middle-sized prototype which can carry larger payload. We also obtained detailed requests to improve the robots. Finally the results show the general concept of the robot is favorably received by the patients. PMID:24187296
Riesenmy, Kelly Rouse
Physicians play a unique role in the adoption of electronic medical records (EMR) within the healthcare organization. As leaders, they are responsible for setting the standards for this new technology within their sphere of influence while concurrently being required to learn and integrate EMR into their own workflow and process as the recipients…
Choi, Heejung; Kim, Sungjae; Kim, Beomjong; Kim, Inja
Psychometric properties of the Korean versions of three sleep evaluation questionnaires were described to provide tools for practitioners and researchers interested in transcultural studies in Korea. The Pittsburgh Sleep Quality Index (PSQI), the General Sleep Disturbance Scale (GSDS), and the Leeds Sleep Evaluation Questionnaire (LSEQ) were analyzed using data from 959 community-dwelling adults in Korea. Furthermore, cut-off points and prevalence of sleep disturbance were identified. Reliability and concurrent validity for all measures were acceptable. Optimal cut-off points of PSQI, GSDS, and LSEQ with highest Youden's index were 5, 33, and 66, and prevalence of sleep disturbance was 22.1%, 26.3%, and 25.8%, respectively. The Korean PSQI, GSDS, and LSEQ are all valid and reliable tools for detecting sleep disturbance. We provide suggestions for selecting the right tools according to the purpose, setting, and participants of transcultural studies. PMID:25287067
Akabayashi, Akira; Slingsby, Brian T; Kai, Ichiro; Nishimura, Tadashi; Yamagishi, Akiko
Background Most medical schools in Japan have incorporated mandatory courses on medical ethics. To this date, however, there is no established means of evaluating medical ethics education in Japan. This study looks 1) To develop a brief, objective method of evaluation for moral sensitivity and reasoning; 2) To conduct a test battery for the PIT and the DIT on medical students who are either currently in school or who have recently graduated (residents); 3) To investigate changes in moral sensitivity and reasoning between school years among medical students and residents. Methods Questionnaire survey: Two questionnaires were employed, the Problem Identification Test (PIT) for evaluation of moral sensitivity and a portion of the Defining Issues Test (DIT) for moral reasoning. Subjects consisted of 559 medical school students and 272 residents who recently graduated from the same medical school located in an urban area of Japan. Results PIT results showed an increase in moral sensitivity in 4th and 5th year students followed by a decrease in 6th year students and in residents. No change in moral development stage was observed. However, DIT results described a gradual rising shift in moral decision-making concerning euthanasia between school years. No valid correlation was observed between PIT and DIT questionnaires. Conclusion This study's questionnaire survey, which incorporates both PIT and DIT, could be used as a brief and objective means of evaluating medical students' moral sensitivity and reasoning in Japan. PMID:15005804
Jones, Les A.; And Others
A project to introduce PLATO IV computer-assisted instruction (CAI) in medical sciences education for health professionals was implemented at the School of Basic Medical Sciences at the University of Illinois. This paper describes the plan for evaluation of the project. Using a student questionnaire and additional general questions, the…
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Menges, David P.; McCrady, Barbara S.; Epstein, Elizabeth E.; Beem, Charles
Purpose The Drinking Patterns Questionnaire (DPQ) is a self-report instrument designed to identify high-risk (HR) drinking situations. While prior investigation has established the preliminary psychometric properties of the DPQ, additional research is needed. The current study evaluated the construct validity of the Work-Related, Financial, Parents, and Children subscales of the DPQ as well as the internal consistency of all subscales. Method One hundred and thirty-four alcohol-dependent inpatients completed a questionnaire packet containing the DPQ, a demographics questionnaire, four measures used to evaluate the convergent validity of DPQ subscales, and three measures of alcohol use disorder symptoms. Results DPQ subscales evidenced adequate to strong internal consistency (coeffficient alphas of .691 to .921). Significant Pearson’s r correlations were found between scores on the Work-Related, Financial, and Children subscales and those on their corresponding correlate measures. Findings for the validity of the Parents subscale were mixed. Conclusion Study results provide support for the construct validity for the Work-Related, Financial, and Children subscales and indicate that all DPQ subscales exhibit solid internal consistency. PMID:18472351
Zarbock, Gerhard; Drews, Marko; Bodansky, Alexander; Dahme, Bernhard
This study evaluated the psychometric properties of two parallel questionnaires (for the supervisor and supervisee, respectively). Ninety supervisees and 37 supervisors from different parts of Germany took part in the study. The three dimensions of clarifying, problem solving, and relationship were confirmed, but for both supervisor and supervisee versions of the scale medium intercorrelations also allowed a combined scale to be formed. In exploratory regression analysis, the relationship dimension related to both perspectives (i.e., supervisor and supervisee) served as the best predictor for overall supervision satisfaction. Despite the fact that general session satisfaction correlated in the medium range between supervisor and supervisee, there was no correlation between the perspectives as measured by the questionnaires. Possible reasons for this unexpected correlational pattern are discussed. PMID:19396650
Franco-Contreras, Javier; Coatrieux, Gouenou; Massari, Philippe; Darmoni, Stefan; Cuppens-Boulahia, Nora; Cuppens, Frédéric; Roux, Christian
The use of watermarking in the protection of medical relational databases requires that the introduced distortion does not hinder records interpretation. In this paper, we present the preliminary results of a watermarked data quality evaluation protocol developed so as to analyze the perception the practitioner has of the watermark. These results show that some attributes are more appropriate for watermarking than others and also that incoherent or unlikely records resulting from careless watermarking are easily identified by an expert. PMID:25991149
Resources made available by DCEG for use in developing study questionnaires. Includes questionnaires reviewed and approved by DCEG’s Technical Evaluation Committee, as well as non-reviewed questionnaire modules to be used as starting points for development.
Okamoto, K; Ohno, Y; Horisawa, R; Wakai, K; Tamakoshi, A; Kawamura, T
We examined agreement between the subjects' self- and partner-reports of such epidemiological information as medical and family history, smoking and drinking habit and physical activity. Information was obtained by a self-administered questionnaire which was completed by 224 workers (subjects) and by their partners in 1997. Agreement was assessed by calculating kappa statistic, intraclass correlation coefficient (ICC), and per cent agreement. Per cent agreement ranged from a low of 76.2 for general life stress to a high of 98.0 for angina/myocardial infarction and diabetes mellitus as present illness. Kappa values ranged from a low of 0.34 for general life stress to a high of 0.86 for smoking habit. Compared to subjects, their partners tended to report lower level of both exposures (continuous variables) and presence (dichotomous variables). The average kappa was 0.64 for wife-surrogates, whereas 0.53 for husband-surrogates. Overall, our finding suggested that partners could provide acceptable information for the concrete and directly-observable variables (e.g. such present illness as hypertension which required daily medication, or smoking/drinking habit itself), but not so for detailed/subjective variables (e.g. number of cigarettes smoked per day or general life stress). PMID:10412251
Evaluation Questionnaire Just as evaluation is important for our students, evaluation is extremely Student/Parent Response Form Your grade level in school (if applicable) _________ Your Eastman teacher circle your response: 0 not applicable 1 strongly disagree 5 strongly agree Student Teacher Rapport
Šter, Marija Petek; Švab, Igor; Klemenc-Ketiš, Zalika; Kersnik, Janko
The development of the EURACT (European Academy of Teachers in General Practice) Educational Agenda helped many family medicine departments in development of clerkship and the aims and objectives of family medicine teaching. Our aims were to develop and validate a tool for assessment of students' attitudes towards family medicine and to evaluate the impact of the clerkship on students' attitudes regarding the competences of family doctor. In the pilot study, experienced family doctors were asked to describe their attitudes towards family medicine by using the Educational Agenda as a template for brainstorming. The statements were paraphrased and developed into a 164-items questionnaire, which was administered to 176 final-year students in academic year 2007/08. The third phase consisted of development of a final tool using statistical analysis, which resulted in the 60-items questionnaire in six domains which was used for the evaluation of students' attitudes. At the beginning of the clerkship, person-centred care and holistic approach scored lower than the other competences. Students' attitudes regarding the competences at the end of 7 weeks clerkship in family medicine were more positive, with exception of the competence regarding primary care management. The students who named family medicine as his or her future career choice, found holistic approach as more important than the students who did not name it as their future career. With the decision tree, which included students' attitudes to the competences of family medicine, we can successfully predict the future career choice in family medicine in 93.5% of the students. This study reports on the first attempt to develop a valid and reliable tool for measuring attitudes towards family medicine based on EURACT Educational Agenda. The questionnaire could be used for evaluating changes of students' attitudes in undergraduate curricula and for prediction of students' preferences regarding their future professional career in family medicine. PMID:26040061
Voigt, Robert G; Johnson, Shirley K; Hashikawa, Andrew H; Mellon, Michael W; Campeau, Lynnelle J; Williams, Arthur R; Yawn, Barbara P; Juhn, Young J
The reasons underlying parents' decisions to seek medical evaluations for their mildly ill children are not well understood. This cross-sectional study tracked parents' requests for on-site medical evaluations at a sick child care program. A logistic regression model identified factors associated with parents' decisions to seek medical evaluations for their children based on the data from parent-completed questionnaires. A convenience sample of 196 parents completed all questionnaires; 62 (31.6%) parents sought medical evaluations. Parents were more likely to seek medical evaluations if they were concerned about missing work (odds ratio = 8.6; 95% confidence interval, 3.3-22.0; P = .0001), if they smoked (odds ratio = 3.7; 95% confidence interval, 1.1-12.4; P = .037), or if their spouse's highest educational attainment was some high school (odds ratio = 0.4; 95% confidence interval, 0.1-1.0; P = .044). The data highlight the problems working parents have in accessing health care during usual working hours and the potential value of convenient health care programs. PMID:18057151
Factor analysis of treatment outcomes from a UK specialist addiction service: Relationship between the Leeds Dependence Questionnaire, Social Satisfaction Questionnaire and 10-item Clinical Outcomes in Routine Evaluation
Fairhurst, Caroline; Böhnke, Jan R; Gabe, Rhian; Croudace, Tim J; Tober, Gillian; Raistrick, Duncan
Introduction and Aims To examine the relationship between three outcome measures used by a specialist addiction service (UK): the Leeds Dependence Questionnaire (LDQ), the Social Satisfaction Questionnaire (SSQ) and the 10-item Clinical Outcomes in Routine Evaluation (CORE-10). Design and Method A clinical sample of 715 service user records was extracted from a specialist addiction service (2011) database. The LDQ (dependence), SSQ (social satisfaction) and CORE-10 (psychological distress) were routinely administered at the start of treatment and again between 3 and 12 months post-treatment. A mixed pre/post-treatment dataset of 526 service users was subjected to exploratory factor analysis. Parallel Analysis and the Hull method were used to suggest the most parsimonious factor solution. Results Exploratory factor analysis with three factors accounted for 66.2% of the total variance but Parallel Analysis supported two factors as sufficient to account for observed correlations among items. In the two-factor solution, LDQ items and nine of the 10 CORE-10 items loaded on the first factor >0.41, and the SSQ items on factor 2 with loadings >0.63. A two dimensional summary appears sufficient and clinically meaningful. Discussion and Conclusions Among specialist addiction service users, social satisfaction appears to be a unique construct of addiction and is not the same as variation due to psychological distress or dependence. Our interpretation of the findings is that dependence is best thought of as a specific psychological condition subsumed under the construct psychological distress. [Fairhurst C, Böhnke JR, Gabe R, Croudace TJ, Tober G, Raistrick D. Factor analysis of treatment outcomes from a UK specialist addiction service: Relationship between the Leeds Dependence Questionnaire, Social Satisfaction Questionnaire and 10-item Clinical Outcomes in Routine Evaluation. Drug Alcohol Rev 2014;33:643–650] PMID:24802233
Pilatti, Angelina; Tuzinkievich, Francisco Benjamín
The purpose of the present study was to evaluate, in a sample of young people and adults from the general community, the psychometric properties of two models developed for assessing gambling motives (Gambling Motives Questionnaire and Gambling Motives Questionnaire-Financial; GMQ and GMQ-F). Specifically, a confirmatory factor analysis was carried out to assess the fit of the two models to the data. Internal consistency of the scales was then analyzed. A multiple regression analysis was conducted to analyze the utility of gambling motives for predicting levels of gambling problem severity. The final sample was made up of 341 young people and adults, aged 18 to 60, who reported any gambling activity during the last six months. The maximum likelihood (ML) method with robust Satorra-Bentler correction was used to evaluate the fit of the models to the data. The results indicated that both the GMQ and the GMQ-F models show a reasonable fit to the data. All scales have adequate internal consistency values. Enhancement, coping and financial gambling motives were associated with greater severity of gambling problems. Overall, the results indicate that both models have adequate psychometric properties, though the GMQ-F appears to provide a more comprehensive alternative for assessing gambling motives in the general community. PMID:25879474
Pook, Martin; Tuschen-Caffier, Brunna; Brähler, Elmar
The Body Shape Questionnaire (BSQ) is a widely used scale to assess body dissatisfaction. Several short forms of the BSQ have been introduced. In the present study, the full-length 34-item version of the BSQ and seven derivations were evaluated. Factorial validity was analyzed by confirmatory factor analyses in a representative sample of German females (n=1080). Treatment sensitivity was evaluated in a sample of 43 women with bulimia nervosa who completed the BSQ before and after cognitive-behavioral therapy. While fit indices of the full-length version of the BSQ were poor, three of the derivations had reasonable fit. If treatment sensitivity is considered, one of the short forms performed best. This derivation is one of the eight-item versions of the BSQ (suggested abbreviation: BSQ-8C). In conclusion, the present study presents the empirical background for choosing between eight different versions of the BSQ. Thus, it is no longer necessary for researchers and clinicians to make their choice based on subjective criteria. Nevertheless, research on the derivations of the BSQ as stand-alone questionnaires is needed. PMID:18037499
Gebicki, Marek; Mooney, Ed; Chen, Shi-Jie Gary; Mazur, Lukasz M
As supply chain costs constitute a large portion of hospitals' operating expenses and with $27.7 billion spent by the US hospitals on drugs alone in 2009, improving medication inventory management provides a great opportunity to decrease the cost of healthcare. This study investigates different management approaches for a system consisting of one central storage location, the main pharmacy, and multiple dispensing machines located in each department. Each medication has a specific unit cost, availability from suppliers, criticality level, and expiration date. Event-driven simulation is used to evaluate the performance of several inventory policies based on the total cost and patient safety (service level) under various arrangements of the system defined by the number of drugs and departments, and drugs' criticality, availability, and expiration levels. Our results show that policies that incorporate drug characteristics in ordering decisions can address the tradeoff between patient safety and cost. Indeed, this study shows that such policies can result in higher patient safety and lower overall cost when compared to traditional approaches. Additional insights from this study allow for better understanding of the medication inventory system's dynamics and suggest several directions for future research in this topic. Findings of this study can be applied to help hospital pharmacies with managing their inventory. PMID:24014095
Background A mission statement (MS) sets out the long-term goals of an institution and is supposed to be suited for studying learning environments. Yet, hardly any study has tested this issue so far. The aim of the present study was the development and psychometric evaluation of an MS-Questionnaire (MSQ) focusing on explicit competencies. We investigated to what extent the MSQ captures the construct of learning environment and how well a faculty is following - in its perception - a competency orientation in a competency-based curriculum. Methods A questionnaire was derived from the MS “teaching” (Medical Faculty, Heinrich-Heine University Düsseldorf) which was based on (inter-) nationally accepted goals and recommendations for a competency based medical education. The MSQ was administered together with the Dundee Ready Education Environment Measure (DREEM) to 1119 students and 258 teachers. Cronbach’s alpha was used to analyze the internal consistency of the items. Explorative factor analyses were performed to analyze homogeneity of the items within subscales and factorial validity of the MSQ. Item discrimination was assessed by means of part-whole corrected discrimination indices, and convergent validity was analyzed with respect to DREEM. Demographic variations of the respondents were used to analyze the inter-group variations in their responses. Results Students and teachers perceived the MS implementation as “moderate” and on average, students differed significantly in their perception of the MS. They thought implementation of the MS was less successful than faculty did. Women had a more positive perception of educational climate than their male colleagues and clinical students perceived the implementation of the MS on all dimensions significantly worse than preclinical students. The psychometric properties of the MSQ were very satisfactory: Item discrimination was high. Similarly to DREEM, the MSQ was highly reliable among students (? = 0.92) and teachers (? = 0.93). In both groups, the MSQ correlated highly positively with DREEM (r = 0.79 and 0.80, p < 0.001 each). Factor analyses did not reproduce the three areas of the MS perfectly. The subscales, however, could be identified as such both among teachers and students. Conclusions The perceived implementation of faculty-specific goals can be measured in an institution to some considerable extent by means of a questionnaire developed on the basis of the institution’s MS. Our MSQ provides a reliable instrument to measure the learning climate with a strong focus on competencies which are increasingly considered crucial in medical education. The questionnaire thus offers additional information beyond the DREEM. Our site-specific results imply that our own faculty is not yet fully living up to its competency-based MS. In general, the MSQ might prove useful for faculty development to the increasing number of faculties seeking to measure their perceived competency orientation in a competency-based curriculum. PMID:23134815
Matheson, N W; West, R T
The Extramural Programs, NLM, undertook a staff study to evaluate the Medical Library Resource Improvement Grant Program in order to determine impact on hospital library development and to assess factors significant to regional medical library (RML) network development. Initiated in fiscal year 1971, the improvement grant program provides one-year, one-time grant awards of a maximum of $3,000 to assist in establishing a basic collection of books, journals, and other health science information resources for community hospitals and comparable health facilities. Applicants who received grant awards were compared to applicants who did not receive awards and to nonapplicants, using nine dependent variables, four independent variables, and responses to an RML questionnaire. Results show that the applicants who received awards outperformed the other groups, and that the improvement grant program has been successful in stimulating library development. As a result of this study, the improvement grant program will be modified to support consortium arrangements as well as individual institutions, and to extend the period of grant support to two years. Future grant support will be a maximum of $4,000 in the first year, and up to $3,000 with a provision of $1,000 in matching funds from the grantee in the second year. PMID:938778
323 Evaluating and Predicting Patient Safety for Medical Devices with Integral Information in medical device use account for a large portion of medical errors. Most of these errors are due safety in medical device use is critical for developing interventions to reduce such errors either
Turner, Solveig M.; Karlsson, Britta
Information is presented to help medical technology schools abroad evaluate their credentials in comparison to U.S. requirements. After defining the subfields of medical technology, also called medical laboratory science, a summary is provided of the educational requirements, the professional titles, and the certification recognition of medical…
Casanova, J M; Sanmartín, V; Martí, R M; Morales, J L; Soler, J; Purroy, F; Pujol, R
The acquisition of competences (the set of knowledge, skills and attitudes required to perform a job to a professional level) is considered a fundamental part of medical training. Dermatology competences should include, in addition to effective clinical interviewing and detailed descriptions of skin lesions, appropriate management (diagnosis, differentiation, and treatment) of common skin disorders and tumors. Such competences can only be acquired during hospital clerkships. As a way of certifying these competences, we propose evaluating the different components as follows: knowledge, via clinical examinations or critical incident discussions; communication and certain instrumental skills, via structured workplace observation and scoring using a set of indicators; and attitudes, via joint evaluation by staff familiar with the student. PMID:23664251
Tian, Jing; Atkinson, Nancy L.; Portnoy, Barry; Gold, Robert S.
Introduction: Physicians spend a considerable amount of time in Continuing Medical Education (CME) to maintain their medical licenses. CME evaluation studies vary greatly in evaluation methods, levels of evaluation, and length of follow-up. Standards for CME evaluation are needed to enable comparison among different studies and to detect factors…
Background Pregnancy is a specific condition that is neither a disease nor a normal state of health. The attention has been devoted to the relation between the normal, physiological process of pregnancy and the quality of life of women in this period is paid much less attention. Our study focuses on the evaluation of the quality of life by means of a specific questionnaire for physiological pregnancy. The main objective was to evaluate psychometric characteristics of a newly developed, specific QoL. Methods Two measures were used: a Czech version of the generic WHOQOL-BREF, validated in 2006, and a new specific-QoL measure. Both measures were administered in each trimester to a sample of 225 pregnant women in the first trimester of a routine pregnancy. Results The reliability of the WHOQOL-BREF scales at different trimesters was evaluated, including the correlation between trimesters. Based on exploratory factor analyses of the specific-QoL measure with the working title QOL-GRAV, one 9-item scale was constructed expressing the degree of specific experiences during pregnancy. All scales were found to have satisfactory internal consistency (Cronbach alphas?>?.7) apart from the social relations subscale of the WHOQOL-BREF. Conclusions The general quality and the specific quality of a pregnant woman’s life varies. The specific QOL-GRAV scale is more sensitive to the specific experiences during pregnancy that significantly affect a pregnant woman’s quality of life. A simple specific questionnaire, applicable within prenatal care as well, was designed and validated. PMID:24365336
Roos, Marco; Kadmon, Martina; Kirschfink, Michael; Koch, Eginhard; Jünger, Jana; Strittmatter-Haubold, Veronika; Steiner, Thorsten
Background It is well accepted that medical faculty teaching staff require an understanding of educational theory and pedagogical methods for effective medical teaching. The purpose of this study was to evaluate the effectiveness of a 5-day teaching education program. Methods An open prospective interventional study using quantitative and qualitative instruments was performed, covering all four levels of the Kirkpatrick model: Evaluation of 1) ‘Reaction’ on a professional and emotional level using standardized questionnaires; 2) ‘Learning’ applying a multiple choice test; 3) ‘Behavior’ by self-, peer-, and expert assessment of teaching sessions with semistructured interviews; and 4) ‘Results’ from student evaluations. Results Our data indicate the success of the educational intervention at all observed levels. 1) Reaction: The participants showed a high acceptance of the instructional content. 2) Learning: There was a significant increase in knowledge (P<0.001) as deduced from a pre-post multiple-choice questionnaire, which was retained at 6 months (P<0.001). 3) Behavior: Peer-, self-, and expert-assessment indicated a transfer of learning into teaching performance. Semistructured interviews reflected a higher level of professionalism in medical teaching by the participants. 4) Results: Teaching performance ratings improved in students’ evaluations. Conclusions Our results demonstrate the success of a 5-day education program in embedding knowledge and skills to improve performance of medical educators. This multimethodological approach, using both qualitative and quantitative measures, may serve as a model to evaluate effectiveness of comparable interventions in other settings. PMID:24679671
Tennant, Alan; Tyson, Sarah F.; Nordenskiöld, Ulla; Hawkins, Ruth; Prior, Yeliz
Objectives. The Evaluation of Daily Activity Questionnaire (EDAQ) includes 138 items in 14 domains identified as important by people with RA. The aim of this study was to test the validity and reliability of the English EDAQ. Methods. A total of 502 participants completed two questionnaires 3 weeks apart. The first consisted of the EDAQ, HAQ, RA Quality of Life (RAQoL) and the Medical Outcomes Scale (MOS) 36-item Short-Form Health Survey (SF-36v2), and the second consisted of the EDAQ only. The 14 EDAQ domains were tested for: unidimensionality—using confirmatory factor analysis; fit, response dependency, invariance across groups (differential item functioning)—using Rasch analysis; internal consistency [Person Separation Index (PSI)]; concurrent validity—by correlations with the HAQ, SF-36v2 and RAQoL; and test–retest reliability (Spearman’s correlations). Results. Confirmatory factor analysis of the 14 EDAQ domains indicated unidimensionality, after adjustment for local dependency in each domain. All domains achieved a root mean square error of approximation <0.10 and satisfied Rasch model expectations for local dependency. DIF by age, gender and employment status was largely absent. The PSI was consistent with individual use (PSI = 0.94 for all 14 domains). For all domains, except Caring, concurrent validity was good: HAQ (rs = 0.72–0.91), RAQoL (rs = 0.67–0.82) and SF36v2 Physical Function scale (rs = ?0.60 to ?0.84) and test–retest reliability was good (rs = 0.70–0.89). Conclusion. Analysis supported a 14-domain, two-component structure (Self care and Mobility) of the EDAQ, where each domain, and both components, satisfied Rasch model requirements, and have robust reliability and validity. PMID:25863045
Moehr, Jochen R
The currently prevailing paradigms of evaluation in medical/health informatics are reviewed. Some problems with application of the objectivist approach to the evaluation of real-rather than simulated-(health) information systems are identified. The rigorous application of the objectivist approach, which was developed for laboratory experiments, is difficult to adapt to the evaluation of information systems in a practical real-world environment because such systems tend to be complex, changing rapidly over time, and often existing in a variety of variants. Practical and epistemological reasons for the consequent shortcomings of the objectivist approach are detailed. It is argued that insistence on the application of the objectivist principles to real information systems may hamper rather than advance insights and progress because of this. Alternatives in the form of the subjectivist approach and extensions to both the objectivist and subjectivist approaches that circumvent the identified problems are summarized. The need to include systems engineering approaches in, and to further extend, the evaluation methodology is pointed out. PMID:11922929
Searching for medical information on the Web is popular and important. However, medical search has its own unique requirements that are poorly handled by existing medical Web search engines. This paper presents iMed, the first intelligent medical Web search engine that extensively uses medical knowledge and questionnaire to facilitate ordinary Internet users to search for medical information. iMed introduces and
...and Medical Qualifications § 339.205 Medical evaluation programs. Agencies may establish periodic examination or immunization programs by written policies or directives to safeguard the health of employees whose work may subject them or others to...
Lowrey, Geoffrey; Lee, Esther; Gerber, Ben
Medication errors are responsible for a significant number of hospital admissions, and significant morbidity and mortality. Many of these errors result from differences in physicians’ and patients’ understanding of medications. Health care providers think in terms of medication name and dose, however patients remember size, shape, and markings of their medications more frequently than the names. The Medication Sketch Artist was developed to be a graphically interfaced medication identification system to aid in physician-patient communication. This pilot study evaluated the software’s ability to identify medications described from memory by volunteers. Out of 25 pills, each described 5 separate times, there were 80 correct identifications, and 9 identifications of the correct medication, but at a different dose. The Medication Sketch Artist shows promise as a tool to determine unknown medications. It could play an important role in reducing medication errors. PMID:14728203
Moksnes, Unni Karin; Byrne, Don G; Mazanov, Jason; Espnes, Geir Arild
The present study reports an evaluation of the factor structure of the Norwegian version of the Adolescent Stress Questionnaire (ASQ-N) among 723 students. Principal components analysis (PCA) revealed nine internally consistent dimensions of adolescent stress. Scales constructed from this PCA correlated positively with measures of depression and anxiety and negatively with self-esteem. Girls reported higher stress levels than boys in seven of the nine scales and age was also positively correlated with the scale scores of adolescent stress. The results revealed that the instrument has potential for measuring adolescent stress. The stability of the ASQ-N needs to be tested repeatedly, across cohorts and over time, to establish the adequacy for use in Norwegian adolescent studies. PMID:20149144
Your answers to the following questions will help us to understand your medical history and the concerns you'd like to discuss with your doctor. Please fill out as much of this questionnaire as possible. If you cannot answer
disease (244.9 hypo; 242.9 hyper) Stroke (436) Depression (311) Emphysema (496) Seizures (345? ____________________________________________________________________________________________ ADULT HEALTH QUESTIONNAIRE MEDICAL HISTORY #12;Please list all medications, including vitamins, herbal
...false Content of medical care evaluation studies. 456.143 Section 456.143 Public...Hospitals Ur Plan: Medical Care Evaluation Studies § 456.143 Content of medical care evaluation studies. Each medical care evaluation study...
...false Content of medical care evaluation studies. 456.243 Section 456.243 Public...Hospitals Ur Plan: Medical Care Evaluation Studies § 456.243 Content of medical care evaluation studies. Each medical care evaluation study...
...false Content of medical care evaluation studies. 456.143 Section 456.143 Public...Hospitals Ur Plan: Medical Care Evaluation Studies § 456.143 Content of medical care evaluation studies. Each medical care evaluation study...
...false Content of medical care evaluation studies. 456.243 Section 456.243 Public...Hospitals Ur Plan: Medical Care Evaluation Studies § 456.243 Content of medical care evaluation studies. Each medical care evaluation study...
Lloyd, Charles W.; Guess, Terrell M.; Whiting, Charles W.; Doarn, Charles R.
The medical investigations completed on the KC-135 during FY 1990 in support of the development of the Health Maintenance Facility and Medical Operations are discussed. The experiments are comprised of engineering evaluations of medical hardware and medical procedures. The investigating teams are made up of both medical and engineering personnel responsible for the development of medical hardware and medical operations. The hardware evaluated includes dental equipment, a coagulation analyzer, selected pharmaceutical aerosol devices, a prototype air/fluid separator, a prototype packaging and stowage system for medical supplies, a microliter metering system, and a workstation for minor surgical procedures. The results of these engineering evaluations will be used in the design of fleet hardware as well as to identify hardware specific training requirements.
Lloyd, Charles W.
The medical investigations completed on the KC-135 during FY 1991 in support of the development of the Health Maintenance Facility and Medical Operations are presented. The experiments consisted of medical and engineering evaluations of medical hardware and procedures and were conducted by medical and engineering personnel. The hardware evaluated included prototypes of a crew medical restraint system and advanced life support pack, a shuttle orbiter medical system, an airway medical accessory kit, a supplementary extended duration orbiter medical kit, and a surgical overhead canopy. The evaluations will be used to design flight hardware and identify hardware-specific training requirements. The following procedures were evaluated: transport of an ill or injured crewmember at man-tended capability, surgical technique in microgravity, transfer of liquids in microgravity, advanced cardiac life support using man-tended capability Health Maintenance Facility hardware, medical transport using a model of the assured crew return vehicle, and evaluation of delivery mechanisms for aerosolized medications in microgravity. The results of these evaluation flights allow for a better understanding of the types of procedures that can be performed in a microgravity environment.
Kristal, Alan R.; Kolar, Ann S.; Fisher, James L.; Plascak, Jesse J.; Stumbo, Phyllis J.; Weiss, Rick; Paskett, Electra D.
Computer-administered food frequency questionnaires (FFQs) can address limitations inherent in paper questionnaires, by allowing very complex skip patterns, portion size estimation based on food pictures and real-time error checking. This manuscript evaluates a web-based FFQ, the Graphical Food Frequency System (GraFFS). Participants completed the GraFFS, six, telephone-administered 24-hr dietary recalls over the next 12 weeks, followed by a second GraFFS. Participants were 40 men and 34 women, ages 18–69, living in the Columbus, OH area. Intakes of energy, macronutrients and 17 micronutrients/food components were estimated from the GraFFS and the mean of all recalls. Bias (recalls minus the second GraFFS) was ?9%, ?5%, +4% and ?4% for energy and percentages of energy from fat, carbohydrate and protein. De-attenuated, energy-adjusted correlations (inter-method reliability) between the recalls and the second GraFFS for fat, carbohydrate, protein and alcohol were 0.82, 0.79, 0.67 and 0.90; for micronutrients/food components the median was 0.61 and ranged from 0.40 for zinc to 0.92 for ?-carotene. The correlations between the two administrations of the GraFFS (test-retest reliability) for fat, carbohydrate, protein and alcohol were 0.60, 0.63, 0.73 and 0.87; among micronutrients/food components the median was 0.67 and ranged from 0.49 for vitamin B12 to 0.82 for fiber. The measurement characteristics of the GraFFS were at least as good as those reported for most paper FFQs, and its high inter-method reliability suggests that further development of computer-administered FFQs is warranted. PMID:24462267
Amberkar, Mohan babu; Alur S, Suhas; Bhat, Pavan Madhukar; Bansal, Siddharth
Background: Medical students today are tomorrow’s future doctors. One of the key skills that students should develop during their graduation training is to be prepared for emergency life saving measures like cardiopulmonary resuscitation (CPR) anytime, anywhere. The students play integral role in learning, mastering and inculcating the most pragmatic clinical skill of CPR. Objectives: a) To evaluate the CPR awareness among undergraduate medical students. b) To screen the knowledge regarding accurate, effective CPR procedural techniques and various barriers of CPR failure in clinical practice from student perspective. c) To ascertain interest in CPR training programs and also inculcating CPR as an active part of clinical practice in future. Materials and Methods: The questionnaire comprised of three parts, first one dealing with general questions to know the importance of CPR in clinical practice, second one comprised of the main goal and accuracy of CPR intervention and the last segment consisted of questions targeting the indications, methods and effectiveness of CPR. Statistical Analysis: Descriptive statistics and multiple response analyses were done by using SPSS 17. Results: The students had good knowledge about the importance of CPR in clinical practice and stand average in knowing its indications and effectiveness. Whereas, only 1.2% of them were completely aware about the universal compression ventilation ratio, and 20.4% were aware of the current order of CPR being compression, airway and breathing. Conclusion: Though, CPR awareness is good among the students but skills of CPR have to be mastered by proper certified training programs at regular intervals and knowledge has to be updated with the changing trends in CPR. PMID:25177588
Zhang, Hongkui; Wang, Bo; Zhang, Longlu
Explorating reform of the teaching evaluation method for vocational competency-based education (CBE) curricula for medical students is a very important process in following international medical education standards, intensify ing education and teaching reforms, enhancing teaching management, and improving the quality of medical education. This…
Das, Mandira; And Others
This study sought to evaluate faculty opinion of existing medical curricula in two medical schools in different countries in terms of six educational strategies using the "SPICES continuum." Significant differences between existing educational plans of the two medical schools were identified. (LZ)
Borges, Nicole J.; Hartung, Paul J.
Although medical education has long recognized the importance of community service, most medical schools have not formally nor fully incorporated service learning into their curricula. To address this problem, we describe the initial design, development, implementation, and evaluation of a service-learning project within a first-year medical…
Maidlow, Kristin; Schulz, John M.; Lloyd, Charles W.; Breeding, Tiffany
The effectivity was evaluated in zero gravity of several medical equipment and supply items flown in the Shuttle Orbiter Medical System (SOMS). Several procedures listed in Medical Operations Medical Checklist, JSC 1732 were also evaluated. Several items were drawn out of the kits and tested on the KC-135. In two different flights, the following elements were examined: (1) measuring IV flow (drip chamber, one way flow valve, and air/fluid separator); (2) chemstrip protocol for urine analysis in zero-gravity; and (3) tamper resistant seals for injectable medications.
...for medical care evaluation studies. 456.142 Section 456...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...Plan: Medical Care Evaluation Studies § 456.142 UR plan requirements for medical care evaluation studies. (a) The UR plan...
...of medical care evaluation studies. 456.143 Section...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...Medical Care Evaluation Studies § 456.143 Content of medical care evaluation studies. Each medical care...
...of medical care evaluation studies. 456.243 Section...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...Medical Care Evaluation Studies § 456.243 Content of medical care evaluation studies. Each medical care...
...of medical care evaluation studies. 456.243 Section...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...Medical Care Evaluation Studies § 456.243 Content of medical care evaluation studies. Each medical care...
...of medical care evaluation studies. 456.243 Section...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...Medical Care Evaluation Studies § 456.243 Content of medical care evaluation studies. Each medical care...
...for medical care evaluation studies. 456.142 Section 456...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...Plan: Medical Care Evaluation Studies § 456.142 UR plan requirements for medical care evaluation studies. (a) The UR plan...
...for medical care evaluation studies. 456.142 Section 456...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...Plan: Medical Care Evaluation Studies § 456.142 UR plan requirements for medical care evaluation studies. (a) The UR plan...
...of medical care evaluation studies. 456.143 Section...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...Medical Care Evaluation Studies § 456.143 Content of medical care evaluation studies. Each medical care...
...Medical Criteria for Evaluating Cystic Fibrosis AGENCY: Social Security Administration...to evaluate claims involving cystic fibrosis in adults and children under...Information for individuals with cystic fibrosis who apply for Social...
Erlen, Judith A.; Cha, EunSeok; Kim, Kevin H.; Caruthers, Donna; Sereika, Susan M.
Aim This paper is a report of an examination of the psychometric properties of the HIV Medication Taking Self-efficacy Scale. Background Self-efficacy is a critically important component of strategies to improve HIV medication-taking; however, valid and reliable tools for assessing HIV medication-taking self-efficacy are limited. Method We used a cross-sectional, correlational design. Between 2003 and 2007, 326 participants were recruited from sites in Pennsylvania and Ohio in the United States of America. Six self-report questionnaires administered at baseline and 12 weeks later during “Improving Adherence to Antiretroviral Therapy” were used to examine the variables of interest. Means and variances, reliability, criterion, and construct validity of the HIV Medication Taking Self-efficacy Scale were assessed. Findings Participants reported high self-confidence in their ability to carry out specific medication-related tasks (mean=8.31) and in the medication’s ability to effect good outcomes (mean=8.56). The HIV Medication Taking Self-efficacy Scale and subscales showed excellent reliability (? = .93 ~ .94). Criterion validity was well-established by examining the relationships between the HIV Medication Taking Self-efficacy Scale and selected physiological and psychological factors, and self-reported medication adherence (r = ?.20 ~ .58). A two-factor model with a correlation between self-efficacy belief and outcome expectancy fitted the data well (model ?2 = 3871.95, df = 325, p<001; CFA =.96; RMSEA =.046). Conclusion The HIV Medication Taking Self-efficacy Scale is a psychometrically sound measure of medication-taking self-efficacy for use by researchers and clinicians with people with HIV. The findings offer insight into the development of interventions to promote self-efficacy and medication adherence in persons with HIV. PMID:20722799
Factors Influencing Medical Students’ Choice of Future Specialization in Medical Sciences: A Cross-Sectional Questionnaire Survey from Medical Schools in China, Malaysia and Regions of South Asian Association for Regional Cooperation
Kumar, Arun; Mitra, Kasturi; Nagarajan, Sangeetha; Poudel, Bibek
Background: In future, increase in the number of healthcare professionals is dependent on the career interest among present undergraduate medical students. Based on their interest to pursue their specialty, the availability of medical doctors in each specialty could be done. Aims: This study was to find out future career interest and factors that influence undergraduate medical students to choose their future specialization. Materials and Methods: The study was carried out among first-year medical students from five countries. The students were asked to complete an 8-item questionnaire. Two thousand one hundred fifty three participants were enrolled in the study. Data were analyzed in Microsoft-Excel and Statistical Package for the Social Sciences. Results: Of the 2153 participants, only 1470 responded. Among the 1470 participants, 169 participants were excluded due to the ambiguity in responses, finally making it to 1301participants. Among them, Anatomy (49.3%) followed by Biochemistry (26.7%) and Physiology (24%) were the most preferred subjects. Conclusions: Anatomy was the most preferred basic science subject among the other subjects and the students were interested to pursuing surgery in future. Furthermore, the most preferred future specialties were surgery, internal medicine and pediatrics with gender variations; males preferring surgery and females in obstetrics and gynecology. PMID:24741550
Buchowski, Maciej S.; Matthews, Charles E.; Cohen, Sarah S.; Signorello, Lisa B.; Fowke, Jay H.; Hargreaves, Margaret K.; Schlundt, David G.; Blot, William J.
Background Low physical activity (PA) is linked to cancer and other diseases prevalent in racial/ethnic minorities and low-income populations. This study evaluated the PA questionnaire (PAQ) used in the Southern Cohort Community Study, a prospective investigation of health disparities between African-American and white adults. Methods The PAQ was administered upon entry into the cohort (PAQ1) and after 12–15 months (PAQ2) in 118 participants (40–60 year-old, 48% male, 74% African-American). Test-retest reliability (PAQ1 versus PAQ2) was assessed using Spearman correlations and the Wilcoxon signed rank test. Criterion validity of the PAQ was assessed via comparison with a PA monitor and a last-month PA survey (LMPAS), administered up to 4 times in the study period. Results The PAQ test-retest reliability ranged from 0.25–0.54 for sedentary behaviors and 0.22–0.47 for active behaviors. The criterion validity for the PAQ compared with PA monitor ranged from 0.21–0.24 for sedentary behaviors and from 0.17–0.31 for active behaviors. There was general consistency in the magnitude of correlations between the PAQ and PA-monitor between African-Americans and whites. Conclusions The SCCS-PAQ has fair to moderate test-retest reliability and demonstrated some evidence of criterion validity for ranking participants by their level of sedentary and active behaviors. PMID:21952413
Grant, Valerie V; Stewart, Sherry H; O'Connor, Roisin M; Blackwell, Ekin; Conrod, Patricia J
The psychometric properties of the Modified Drinking Motives Questionnaire--Revised (Modified DMQ-R) [Blackwell, E., & Conrod, P. J. (2003). A five-dimensional measure of drinking motives. Unpublished manuscript, Department of Psychology, University of British Columbia], based on a five-factor model of drinking motives with separate coping-anxiety and coping-depression factors, were evaluated in undergraduates. In Study 1, confirmatory factor analyses supported the correlated five-factor model in two samples of undergraduate drinkers (N=726 and N=603). Furthermore, the five-factor model fit the data better than a four-factor model conceptually equivalent to that of Cooper [Cooper, M. L. (1994). Motivations for alcohol use among adolescents: Development and validation of a four-factor model. Psychological Assessment, 6, 117-128] (i.e., with coping-anxiety and coping-depression items constrained to a single factor). In Study 1, drinking motives were predictive of concurrent drinking frequency and typical number of alcoholic beverages per occasion, over and above demographics. In Study 2, the Modified DMQ-R scores showed good to excellent test-retest reliability in a sample of undergraduates who were relatively frequent drinkers (N=169). Also, drinking motives prospectively predicted number of drinks consumed per week and alcohol-related problems, over and above demographics and initial alcohol use. Notably, coping-anxiety and coping-depression motives were distinctly related to alcohol consumption and alcohol problems. PMID:17716823
Raffetto, Allen M.; Zabarenko, Lucy M.
Paracognitive evaluation of medical training recognizes the linkage between training and specific maturational trends. After administering the Paracognitive Evaluation Form to assess medical students' performance in seminars and clinical teaching situations, hierarchical cluster analysis suggested that maturational trends were measured and that…
Weller, J M; Henning, M; Civil, N; Lavery, L; Boyd, M J; Jolly, B
When evaluating assessments, the impact on learning is often overlooked. Approaches to learning can be deep, surface and strategic. To provide insights into exam quality, we investigated the learning approaches taken by trainees preparing for the Australian and New Zealand College of Anaesthetists (ANZCA) Final Exam. The revised two-factor Study Process Questionnaire (R-SPQ-2F) was modified and validated for this context and was administered to ANZCA advanced trainees. Additional questions were asked about perceived value for anaesthetic practice, study time and approaches to learning for each exam component. Overall, 236 of 690 trainees responded (34%). Responses indicated both deep and surface approaches to learning with a clear preponderance of deep approaches. The anaesthetic viva was valued most highly and the multiple choice question component the least. Despite this, respondents spent the most time studying for the multiple choice questions. The traditionally low short answer questions pass rate could not be explained by limited study time, perceived lack of value or study approaches. Written responses suggested that preparation for multiple choice questions was characterised by a surface approach, with rote memorisation of past questions. Minimal reference was made to the ANZCA syllabus as a guide for learning. These findings indicate that, although trainees found the exam generally relevant to practice and adopted predominantly deep learning approaches, there was considerable variation between the four components. These results provide data with which to review the existing ANZCA Final Exam and comparative data for future studies of the revisions to the ANZCA curriculum and exam process. PMID:23977915
Fanikos, John; Jenkins, Kathryn L; Piazza, Gregory; Connors, Jean; Goldhaber, Samuel Z
Despite rigorous expert review, medications often fall into routine use with unrecognized and unwanted complications. Use of some medications remains controversial because information to support efficacy is conflicting, scant, or nonexistent. Medication use evaluation (MUE) is a performance improvement tool that can be used when there is uncertainty regarding whether a medication will be beneficial. It is particularly useful when limited evidence is available on how best to choose between two or more medications. MUEs can analyze the process of medication prescribing, preparation, dispensing, administration, and monitoring. MUEs can be part of a structured or mandated multidisciplinary quality management program that focuses on evaluating medication effectiveness and improving patient safety. Successful MUE programs have a structure in place to support completion of rapid-cycle data collection, analysis, and intervention that supports practice change. PMID:25521847
McKenzie, Karen; Paxton, Donna; Murray, George; Milanesi, Paula; Murray, Aja Louise
The study outlines the evaluation of an intellectual disability screening tool, the "Child and Adolescent Intellectual Disability Screening Questionnaire" ("CAIDS-Q"), with two age groups. A number of aspects of the reliability and validity of the "CAIDS-Q" were assessed for these two groups, including inter-rater reliability, convergent and…
Schultz-Jones, Barbara A.; Ledbetter, Cynthia E.
As part of a larger study, the How My Library Supports Inquiry and the How My Science Class Supports Inquiry questionnaires were developed for evaluating the extent of inquiry-based teaching in classrooms and school libraries and the effect of this instruction on student literacy and, by extension, the social good. Each has 28 items in seven…
Burlison, Jonathan D.; Murphy, Chanda S.; Dwyer, William O.
All 15 subscales of the Motivated Strategies for Learning Questionnaire (Pintrich, Smith, Garcia, & McKeachie, 1993) were administered to 352 undergraduate students taking Introductory Psychology. Their scores were evaluated with respect to incremental validity (in addition to ACT scores) they provided for predicting course grades. Results…
Almeida, Adriana Mortara; Martins, Maria Helena Pires
The article describes and discusses the use of focus groups and questionnaires to evaluate educational printed material for high school level art teachers prior to publication. The material consisted of "The Notebook of the Investigative Teacher," created by the Instituto Itau Cultural to help teachers develop critical skills in discussing…
Roberts, Lindsay S.; Sharma, Sushma; Hudes, Mark L.; Fleming, Sharon E.
Background: African-American and Latino children living in neighborhoods with a low-socioeconomic index are more at risk of obesity-associated metabolic disease than their higher socioeconomic index and/or white peers. Currently, consistent and reliable questionnaires to evaluate nutrition and physical activity knowledge in these children are…
Barsten, Kristina; Hurst, Victor, IV; Scheuring, Richard; Baumann, David K.; Johnson-Throop, Kathy
Introduction: Analogue environments assist the NASA Human Research Program (HRP) in developing capabilities to mitigate high risk issues to crew health and performance for space exploration. The Habitat Demonstration Unit (HDU) is an analogue habitat used to assess space-related products for planetary missions. The Exploration Medical Capability (ExMC) element at the NASA Johnson Space Center (JSC) was tasked with developing planetary-relevant medical scenarios to evaluate the concept of operations for mitigating medical issues in such an environment. Methods: Two medical scenarios were conducted within the simulated planetary habitat with the crew executing two space flight-relevant procedures: Eye Examination with a corneal injury and Skin Laceration. Remote guidance for the crew was provided by a flight surgeon (FS) stationed at a console outside of the habitat. Audio and video data were collected to capture the communication between the crew and the FS, as well as the movements of the crew executing the procedures. Questionnaire data regarding procedure content and remote guidance performance also were collected from the crew immediately after the sessions. Results: Preliminary review of the audio, video, and questionnaire data from the two scenarios conducted within the HDU indicate that remote guidance techniques from an FS on console can help crew members within a planetary habitat mitigate planetary-relevant medical issues. The content and format of the procedures were considered concise and intuitive, respectively. Discussion: Overall, the preliminary data from the evaluation suggest that use of remote guidance techniques by a FS can help HDU crew execute space exploration-relevant medical procedures within a habitat relevant to planetary missions, however further evaluations will be needed to implement this strategy into the complete concept of operations for conducting general space medicine within similar environments
Assessment of completion of early medical abortion using a text questionnaire on mobile phones compared to a self-administered paper questionnaire among women attending four clinics, Cape Town, South Africa.
Constant, Deborah; de Tolly, Katherine; Harries, Jane; Myer, Landon
In-clinic follow-up to assess completion of medical abortion is no longer a requirement according to World Health Organization guidance, provided adequate counselling is given. However, timely recognition of ongoing pregnancy, complications or incomplete abortion, which require treatment, is important. As part of a larger trial, this study aimed to establish whether women having a medical abortion could self-assess whether their abortion was complete using an automated, interactive questionnaire on their mobile phones. All 469 participants received standard abortion care and all returnees filled in a self-assessment on paper at clinic follow-up 2-3 weeks later. The 234 women allocated to receive the phone messages were also asked to do a mobile phone assessment at home ten days post-misoprostol. Completion of the mobile assessment was tracked by computer and all completed assessments, paper and mobile, were compared to providers' assessments at clinic follow-up. Of the 226 women able to access the mobile phone assessment, 176 (78%) completed it; 161 of them (93%) reported it was easy to do so. Neither mobile nor paper self-assessments predicted all cases needing additional treatment at follow-up. Prediction of complete procedures was good; 71% of mobile assessments and 91% of paper assessments were accurate. We conclude that an interactive questionnaire assessing completion of medical abortion on mobile phones is feasible in the South African setting; however, it should be done later than day 10 and combined with an appropriate pregnancy test to accurately detect incomplete procedures. PMID:25702072
Seixas, Camila; Osório, Flávia L.; Crippa, José Alexandre S.; de Abreu, José Neander; Menezes, Igor Gomes; Pidgeon, Aileen; Sudak, Donna; Wenzel, Amy
Objective: The aim of the study was to assess the initial psychometric properties of the Cognitive Distortions Questionnaire (CD-Quest) in its Brazilian Portuguese version tested in adult undergraduate students. Methods: Brazilian undergraduate medical and psychology students comprising the sample (n=184) completed the following measures: Cognitive Distortions Questionnaire, Beck Depression Inventory and Beck Anxiety Inventory. These self-report instruments were administered collectively in classrooms. Results: The Cognitive Distortions Questionnaire showed adequate internal consistency (Cronbach’s alpha=0.85) and concurrent validity with Beck Depression Inventory (r=0.65, p<0.001) and Beck Anxiety Inventory (r=0.52, p<0.001). Furthermore, it was able to discriminate between groups possessing depressive (Beck Depression Inventory composite score ?12) and anxious (Beck Anxiety Inventory composite score ? 11) indicators from those not possessing them (p<0.001). Principal components showed the measure was unidimensional, and it explained about 29 percent of the data variance. A confirmatory factor analysis showed that all the regression coefficients are greater than or equal to 0.40 Conclusion: The original Brazilian version of the Cognitive Distortions Questionnaire is adequate for use in the context of national undergraduate students and is able to separate different cognitive distortions. However, further studies using clinical samples are needed.
Rubin, Ann D.
This thesis describes some aspects of a computer system for doing medical diagnosis in the specialized field of kidney disease. Because such a system faces the spectre of combinatorial explosion, this discussion concentrates ...
Urval, Rathnakar P.; Kamath, Ashwin; Ullal, Sheetal; Shenoy, Ashok K.; Shenoy, Nandita; Udupa, Laxminarayana A.
While there are several tools to study learning styles of students, the visual-aural-read/write-kinesthetic (VARK) questionnaire is a simple, freely available, easy to administer tool that encourages students to describe their behavior in a manner they can identify with and accept. The aim is to understand the preferred sensory modality (or…
Hoti, Kreshnik; Forman, Dawn; Hughes, Jeffery
There is lack of literature data reporting an incorporation of medication management reviews in students' interprofessional education (IPE) and practice programs in aged care settings. This pilot study reports how an interprofessional disease state and medication management review program (DSMMR) was established in a residential aged care facility in Perth, Western Australia. Students from the professions of nursing, pharmacy and physiotherapy focused on a wellness check in the areas of cognition, falls and continence while integrating a medication management review. Students' attitudes were explored using a pre- and post-placement questionnaire. Students indicated positive experience with the IPE DSMMR program which also resulted in their positive attitudinal shift towards IPE and practice. These findings indicated that aged care can be a suitable setting for student interprofessional programs focusing on DSMMR. PMID:24246025
Tod, David; Morrison, Todd G; Edwards, Christian
The current study assessed relationships among four commonly used drive for muscularity questionnaires, along with their 7 and 14 day test-retest reliability. Sample 1 was comprised of young British adult males (N=272; M(AGE)=20.3) who completed the questionnaires once. Sample 2, a group of young British adult males (N=54, M(AGE)=19.3), completed the questionnaires three times spaced 7 and 14 days apart. Correlations among Sample 1 ranged from .20 to .82 providing evidence for concurrent and discriminant validities. Evidence for test-retest reliability emerged with intraclass correlations ranging from .78 to .95 (p<.001) and generally nonsignificant t-tests (p>.05). Overall, the data support the psychometric properties of the drive for muscularity inventories; however, the shared variance (35-67%) hints that refinement is possible. PMID:22398333
Inoue, Kazuo; Matsumoto, Masatoshi; Sawada, Tsutomu
Context: Jichi Medical School (JMS) is the first and only medical school in Japan that was founded exclusively to graduate/prepare rural doctors. Purpose: To evaluate the long-term effect of JMS on the nationwide distribution of doctors. Methods: Data from the Japanese population census of 1995 and from the Japanese physician census of 1994 were…
Frank, Diane; Bélanger, Marie C.; Bécuwe-Bonnet, Véronique; Parent, Joane
Fly biting describes a syndrome in which dogs appear to be watching something and then snapping at it. Medical work-up of fly biting in dogs has never been reported. The aims of this case series were to characterize fly biting and perform a complete medical evaluation of dogs displaying fly biting. PMID:23729825
Fogleman, Janice M.
An observational rating instrument was developed to measure affective traits of medical technology students. Fourteen categories of behavioral traits evaluated by medical technology programs were identified, based on results of a national survey. These traits were then grouped according to the affective domains established by Krathwohl, Bloom, and…
Compton, Peggy A.; Wu, Stephen M.; Schieffer, Beatrix; Pham, Quynh; Naliboff, Bruce D.
The Prescription Drug Use Questionnaire (PDUQ) is one of several published tools developed to help clinicians better identify the presence of opioid abuse or dependence in patients with chronic pain. This paper introduces a patient version of the PDUQ (PDUQp), a 31-item questionnaire derived from the items of the original tool designed for self-administration, and describes evidence for its validity and reliability in a sample of patients with chronic nonmalignant pain and on opioid therapy. Further, this study examines instances of discontinuation from opioid medication treatment related to violation of the medication agreement (MAVRD) in this population, and the relationship of these with problematic opioid misuse behaviors, PDUQ and PDUQp scores. A sample of 135 consecutive patients with chronic nonmalignant pain was recruited from a multidisciplinary Veterans Affairs chronic pain clinic, and prospectively followed over one year of opioid therapy. Utilizing the PDUQ as a criterion measure, moderate to good concurrent and predictive validity data for the PDUQp are presented, as well as item-by-item comparison of the two formats. Reliability data indicate moderate test stability over time. Of those patients whose opioid treatment was discontinued due to MAVRD (n = 38 or 28% of sample), 40% of these (n = 11) were due to specific problematic opioid misuse behaviors. Based upon specificity and sensitivity analyses, a suggested cut-off PDUQp score for predicting MAVRD is provided. This study supports the PDUQp as a useful tool for assessing and predicting problematic opioid medication use in a chronic pain patient sample. PMID:18508231
Watson, Kathy; Baranowski, Tom; Thompson, Debbe
Perceived self-efficacy (SE) for eating fruit and vegetables (FV) is a key variable mediating FV change in interventions. This study applies item response modeling (IRM) to a fruit, juice and vegetable self-efficacy questionnaire (FVSEQ) previously validated with classical test theory (CTT) procedures. The 24-item (five-point Likert scale) FVSEQ…
Clark, Sheldon B.; Boser, Judith A.
A context in which existing items may provide a convenient source of questions for questionnaires was explored through a case study making use of existing comparison groups. Two programs at Oak Ridge Associated Universities (ORAU), the Science and Engineering Research Semester (SERS) and the Laboratory Graduate Research Participation (Lab Grad)…
Ballantine, Joan; Guo, Xin; Larres, Patricia
This research provides new insights into the measurement of students' authorial identity and its potential for minimising the incidence of unintentional plagiarism by providing evidence about the psychometric properties of the Student Authorship Questionnaire (SAQ). Exploratory and confirmatory factor analyses (EFA and CFA) are employed to…
Kirschner Associates, Inc., Albuquerque, NM.
This document is part of a five-volume nationwide study of Nutrition Services operations and elderly citizens participating in congregate dining and home delivery services authorized by Title III-C of the Older Americans' Act. This volume contains the questionnaires used in the study. Section 1 gives a report overview and acknowledgements. Section…
...requirements for medical care evaluation studies. 456.142 Section 456.142 ...Ur Plan: Medical Care Evaluation Studies § 456.142 UR plan requirements for medical care evaluation studies. (a) The UR plan must...
...requirements for medical care evaluation studies. 456.242 Section 456.242 ...Ur Plan: Medical Care Evaluation Studies § 456.242 UR plan requirements for medical care evaluation studies. (a) The UR plan must...
Simonton, Linda J.; Haugland, S. M.
A diagnostic evaluation for a person with suspected Alzheimer's disease is usually initiated by family members whose concerns go beyond strictly medical issues. To determine precisely what questions families want answered, a 15-point questionnaire was developed at a multi-disciplinary geriatric assessment clinic. Caregivers were asked to rate each…
McKinley, R. K.; Manku-Scott, T.; Hastings, A. M.; French, D. P.; Baker, R.
OBJECTIVE: To develop a reliable, valid measure of patient satisfaction with out of hours care suitable for large scale service evaluation. DESIGN: Focus group meetings and semistructured interviews with patients to identify issues of importance to patients and possible questionnaire items; interviews and two pilot studies to test and identify new questionnaire items; modification or removal of items to eliminate ambiguity and reduce non-response and skewed responses; questionnaire survey of out of hours care. SETTING: Greater Manchester and Leicester. SUBJECTS: 11 general practice patients participated in the focus groups and 28 in the semistructured interviews; 41 in the preliminary interviews; 41 and 378 in the postal pilots; and 1466 in the survey of out of hours care. RESULTS: A 32 item questionnaire was developed. Component analysis indicated seven scales (satisfaction with communication and management, doctor's attitude, continuity of care, delay until visit, access to out of hours care, initial contact person, telephone advice) related to overall satisfaction and containing issues identified as important to patients. Levels of reliability were satisfactory, Cronbach's alpha correlation coefficient exceeding 0.60 for all scales. CONCLUSION: A reliable, valid measure of patient satisfaction has been developed, suitable for large scale evaluation of out of hours care. PMID:9022436
Bilir, Nazmi; Camur, Derya; Caman, Ozge Karadag
Objectives The study was conducted with the aim of evaluating applied occupational health teaching for final-year medical students at Hacettepe University, Faculty of Medicine. Methods The study included all sixth grade medical students (n=293) during one academic year. Pre- and post-training tests were used to assess the magnitude of change in knowledge and attitude of students on occupational health, whereas the opinion of students on several aspects of the quality of teaching sessions were assessed by using post-training questionnaires. Results Post-training tests revealed that the level of knowledge on all aspects of occupational health increased among medical students. An evaluation of the teaching sessions showed favorable results for the overall quality of the sessions: 81.3% of the students stated that the sessions were well organized, 81.7% remarked the workplace/factory visit was a valuable experience, and 91.0% stated feeling more competent on occupational health issues. Conclusion There was a greater increase in students' knowledge on technical precautions than their knowledge on issues related to medical practice in the workplace. Visiting a workplace was found to contribute to the overall aim of knowledge and attitude change on occupational health issues. The scope of undergraduate medical education should be extended by improving occupational health education with respect to educational content, duration, and methods. PMID:22993717
Visser, Benjamin J; Huiskes, Florian; Korevaar, Daniel A
Increasing numbers of medical practitioners and medical students are using online social and business-related networking websites such as Facebook, Doc2doc and LinkedIn. These rapidly evolving and growing social media have potential to promote public health by providing powerful instruments for communication and education. However, evidence is emerging from studies, legal cases, and media reports that the use of these new technologies is creating several ethical problems for medical practitioners as well as medical students. Improper online activities may harm not only individual reputations and careers, but also the medical profession as a whole, for example by breach of patient confidentiality, defamation of colleagues and employers, undisclosed conflict of interests that bias the medical practitioner's medical advice, posting of advice/information without an evidence base, and infringement of copyright. We developed a self-evaluation checklist for medical practitioners using social media. The checklist addresses three key elements in the use of social media: personal information and accessibility, connections, and postings. It contains questions specifically formulated to evaluate a medical practitioner's social media profile, to prevent unintended, improper online activities and to promote professional online behaviour. PMID:23099596
Wershof Schwartz, Andrea; Abramson, Jeremy S; Wojnowich, Israel; Accordino, Robert; Ronan, Edward J; Rifkin, Mary R
The inclusion of the humanities in medical education may offer significant potential benefits to individual future physicians and to the medical community as a whole. Debate remains, however, about the definition and precise role of the humanities in medical education, whether at the premedical, medical school, or postgraduate level. Recent trends have revealed an increasing presence of the humanities in medical training. This article reviews the literature on the impact of humanities education on the performance of medical students and residents and the challenges posed by the evaluation of the impact of humanities in medical education. Students who major in the humanities as college students perform just as well, if not better, than their peers with science backgrounds during medical school and in residency on objective measures of achievement such as National Board of Medical Examiners scores and academic grades. Although many humanities electives and courses are offered in premedical and medical school curricula, measuring and quantifying their impact has proven challenging because the courses are diverse in content and goals. Many of the published studies involve self-selected groups of students and seek to measure subjective outcomes which are difficult to measure, such as increases in empathy, professionalism, and self-care. Further research is needed to define the optimal role for humanities education in medical training; in particular, more quantitative studies are needed to examine the impact that it may have on physician performance beyond medical school and residency. Medical educators must consider what potential benefits humanities education can contribute to medical education, how its impact can be measured, and what ultimate outcomes we hope to achieve. PMID:19642151
dos Santos, Marcelo; Furuie, Sergio S.
This work presents the development of a framework to make available a free, online, multipurpose and multimodality medical image database for software and algorithm evaluation. We have implemented a distributed architecture for medical image database, including authoring, storage, and repository for documents and image processing software. The system aims to offer a complete test bed and a set of resources including software, link to scientific papers, gold standards, reference images and post-processed images, enabling medical image processing community (scientists, physicians, students and industrials) to be more aware of evaluation issues. Our focus of development was on convenience and easy of use of a generic system adaptable to different contexts.
Rew, Karl T; Clarke, S Lindsey; Gossa, Weyinshet; Savin, Daniel
Overseas medical screening by panel physicians for conditions that might jeopardize US public health is required for admission to the United States by immigrant visa or refugee status. According to protocols established by the Centers for Disease Control and Prevention, conditions such as active tuberculosis and substance dependence, when detected, prohibit entry to the United States, whereas close medical follow-up after arrival is required for individuals with other conditions. Refugees and asylees should undergo further medical assessment by a US civil surgeon as soon as possible after arrival. Applicants for legal permanent residence in the United States, whether by immigrant visa or adjustment of status, must receive vaccinations comparable to those recommended for citizens. When immigrants and refugees present to a primary care physician, the vaccination process may not be complete, and documentation of the extent to which it is complete might be lacking. Immigrants and refugees may have a variety of unrecognized or untreated musculoskeletal conditions, mental health conditions, infectious diseases, and chronic conditions. PMID:25127535
Hernández-Fernaud, Estefanía; Hernández, Bernardo; Ruiz, Cristina; Ruiz, Antonia
The aim of this work was to develop an instrument (Coping Strategies for Skin Problems Questionnaire) suitable for identifying the coping strategies people use for general skin problems. We analyzed its psychometric properties when applied to a sample of 299 individuals. Factor analysis shows a 6-factor structure referring to the wish to change, problem-solving strategies, the search for information and asking for social support, the ability to distance oneself from the problem and to see the positive aspects of the situation. These factors explain 60.77% of the variance and show an internal consistency higher than 0.67. We analyse the validity of the questionnaire and identify different coping profiles depending on the degree of skin damage as assessed by the participants and their search for health services. According to the psychometric properties obtained, we conclude that our instrument is valid and reliable for use with people presenting skin problems. PMID:19476248
Wienand, Ulrich; Cinotti, Renata; Nicoli, Augusta; Bisagni, Miriam
Background By means of the ICONAS project, the Healthcare Agency of an Italian Region developed, and used a standardised questionnaire to quantify the organisational climate. The aims of the project were (a) to investigate whether the healthcare institutions were interested in measuring climate, (b) to estimate the range of applicability and reliability of the instrument, (c) to analyse the dimensions of climate among healthcare personnel, (d) to assess the differences among employees with different contractual positions. Methods The anonymous questionnaire containing 50 items, each with a scale from 1 to 10, was offered to the healthcare organisations, to be compiled during ad hoc meetings. The data were sent to the central project coordinator. The differences between highly specialised staff (mostly physicians) and other employees were assessed after descriptive statistical analysis of the single items. Both Principal Component Analysis and Factor Analysis were used. Results Ten healthcare organisations agreed to partecipate. The questionnaire was completed by 8691 employees out of 13202. The mean value of organisational climate was 4.79 (range 1–10). There were significant differences among single items and between the 2 groups of employees. Multivariate methods showed: (a) one principal component explained > 40% of the variance, (b) 7 factors summarised the data. Conclusion Italian healthcare institutions are interested in assessing organisational phenomena, especially after the reforms of the nineties. The instrument was found to be applicable and suitable for measuring organisational climate. Administration of the questionnaire leads to an acceptable response rate. Climate can be discribed by means of 7 underlying dimensions. PMID:17519007
Background End stage renal disease (ESRD) profoundly impacts the lives of patients. Kidney transplantation provides the greatest health-related quality of life (HRQOL) improvement. Its measurement has become an important outcome parameter and a very important criterion in the evaluation of any type of medical treatment, especially in the field of renal transplantation. In 2007, a specific self-administered questionnaire for renal transplant recipients was developed in the French language: the ReTransQol (RTQ). After 5 years of use, the properties of the RTQ needed to be re-evaluated in a larger sample. This paper describes the analysis of the ReTransQol and its adaptation to achieve an improved and revised version. Methods The study design included three analysis phases for two samples of adult renal transplant recipients which came from two cross-sectional multicenter studies carried out in France in 2007 and 2012. Psychometrics properties like construct validity, acceptability and feasibility, reliability and convergent validity were evaluated and every analysis resulted in a new version of the questionnaire: the RTQ V2. The construct validity of the new RTQ was assessed with a Confirmatory Factor Analysis on a large sample of patients. Results The study samples included 1,059 patients and 1,591 patients, respectively. After a principal component analysis, item reduction was performed and a total of 13 items were deleted. A final version of the RTQ V2 was created and comprised of 32 items describing 5 domains: Physical Health, Social Functioning, Medical Care, Treatment and Fear of Losing Graft. The explained variance between the first and second RTQ versions improved from 46.3% to 53.1%. All psychometric properties of RTQ V2 were satisfactory: IIC >0.4, IDV (%) of 100% and Cronbach’s Alpha >0.7 in every dimension. The confirmatory analysis showed that the overall scalability of the RTQ V2 was satisfactory; all items showed a good fit to the Rasch model within each dimension, and showed INFIT statistics inside the acceptable range. Conclusions Psychometric properties allow this new version of the questionnaire to be used to assess different specific dimensions for the renal transplant population, more effectively than previously possible. PMID:24001187
Fudge, Jessie R; Bennett, Brad L; Simanis, Juris P; Roberts, William O
Risk of injury in cold environments is related to a combination of athlete preparedness, preexisting medical conditions, and the body's physiologic response to environmental factors, including ambient temperature, windchill, and wetness. The goal of this section is to decrease the risk of hypothermia, frostbite, and nonfreezing cold injuries as well as to prevent worsening of preexisting conditions in cold environments using a preparticipation screening history, examination, and counseling. Cold weather exercise can be done safely with education, proper preparation, and appropriate response to changing weather conditions. PMID:26340736
Mizuno, Norio; Miyajima, Masakatsu
Law on promotion of renovation for earthquake-resistant structures was revised in 2006. Since then administrative agencies have been promoting seismic diagnosis and retrofit of houses. But citizens living in densely built-up areas cannot rebuild their houses because of their economic reasons and Building Standards Act regulations. Therefore, we conducted questionnaire surveys of construction companies located in Ishikawa Prefecture and citizens living in Kanazawa City. The results of surveys show that many construction companies are not in favor of simple method of seismic retrofit, and that width of roads hardly influence the citizens' consciousness to renovation for earthquake-resistant structures.
Aroian, Karen J; Hough, Edythe S; Templin, Thomas N; Kaskiri, Eleni A
Little is known about parent and peer relationships in immigrant adolescents due to a dearth of culturally sensitive measures. We adapted the Family Peer Relationship Questionnaire (FPRQ) for Arab immigrant mothers and their adolescents. Mothers and adolescents completed parallel versions of the Arab FPRQ and measures of child behavior problems, child social relations, and maternal depression. Data analyses included confirmatory factor analysis and concurrent validity. The proposed four-factor structure was replicated in both the mother and child forms. Scores from the Arab FPRQ subscales and the other measures provided evidence of concurrent and discriminant validity, suggesting that the Arab FPRQ is a viable assessment tool. PMID:18389498
Winfree, Walter R; Ginley, Meredith K; Whelan, James P; Meyers, Andrew W
Growing evidence for the efficacy of cognitive-behavioral therapy for disordered gambling supports the need for a comprehensive set of gambling-related assessment measures that have been validated with treatment-seeking samples. The Gamblers' Beliefs Questionnaire (GBQ) is a self-report measure that was designed to identify gambling-related cognitive distortions (Steenbergh, Meyers, May, & Whelan, 2002). In this study, the GBQ demonstrated good internal consistency and adequate construct validity in a treatment-seeking sample of disordered gamblers. Additionally, scores on the measure significantly decreased across a brief cognitive-behavioral treatment, providing validity support for use of the GBQ with a clinical population. PMID:25596553
Background There is a relative lack of current research on the effects of specific communication training offered at the beginning of the medical degree program. The newly developed communication training "Basics and Practice in Communication Skills" was pilot tested in 2008 and expanded in the following year at the University Medical Centre Hamburg-Eppendorf in Germany. The goal was to promote and improve the communicative skills of participants and show the usefulness of an early offered intervention on patient-physician communication within the medical curriculum. Methods The students participating in the project and a comparison group of students from the standard degree program were surveyed at the beginning and end of the courses. The survey consisted of a self-assessment of their skills as well as a standardised expert rating and an evaluation of the modules by means of a questionnaire. Results Students who attended the communication skills course exhibited a considerable increase of communication skills in this newly developed training. It was also observed that students in the intervention group had a greater degree of self-assessed competence following training than the medical students in the comparison group. This finding is also reflected in the results from a standardised objective measure. Conclusions The empirical results of the study showed that the training enabled students to acquire specialised competence in communication through the course of a newly developed training program. These findings will be used to establish new communication training at the University Medical Centre Hamburg-Eppendorf. PMID:22443807
Ashrafi-rizi, Hasan; Ramezani, Amir; Koupaei, Hamed Aghajani; Kazempour, Zahra
Introduction: Media and Information literacy (MIL) enables people to interpret and make informed judgments as users of information and media, as well as to become skillful creators and producers of information and media messages in their own right. The purpose of this research was to determine the amount of Media and Information Literacy among Isfahan University of Medical Sciences’ students using Iranian Media and Information Literacy Questionnaire (IMILQ). Methods: This is an applied analytical survey research in which the data were collected by a researcher made questionnaire, provided based on specialists’ viewpoints and valid scientific works. Its validity and reliability were confirmed by Library and Information Sciences specialists and Cronbach’s alpha (r=0.89) respectively. Statistical population consisted of all students in Isfahan University of Medical Sciences (6000 cases) and the samples were 361. Sampling method was random stratified sampling. Data were analyzed by descriptive and inferential statistics. Results: The findings showed that the mean level of Media and Information Literacy among Isfahan University of Medical Sciences’ students was 3.34±0.444 (higher than average). The highest mean was promotion of scientific degree with 3.84±0.975 and the lowest mean was difficulties in starting research with 2.50±1.08. There was significant difference between educational degree, college type and family’s income and amount of Media and Information Literacy. Conclusion: The results showed that the students didn’t have enough skills in starting the research, defining the research subject as well as confining the research subject. In general, all students and education practitioners should pay special attention to factors affecting in improving Media and Information Literacy as a main capability in using printed and electronic media. PMID:25684848
We are revising the criteria in the Listing of Impairments (the listings) that we use to evaluate claims under titles II and XVI of the Social Security Act (Act) involving endocrine disorders in adults and children. The revisions reflect our adjudicative experience, advances in medical knowledge, information from medical experts, and comments we received from the public in response to an advance notice of proposed rulemaking (ANPRM), a notice of proposed rulemaking (NPRM), and at an outreach policy conference. PMID:21491806
...2011-10-01 false UR plan requirements for medical care evaluation studies. 456.142...HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL...Utilization Control: Hospitals Ur Plan: Medical Care Evaluation Studies §...
...2011-10-01 false UR plan requirements for medical care evaluation studies. 456.242...HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL...Control: Mental Hospitals Ur Plan: Medical Care Evaluation Studies §...
... 2013-10-01 false Content of medical care evaluation studies. 456.143...HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL...Utilization Control: Hospitals Ur Plan: Medical Care Evaluation Studies §...
Background Health assessment measurements for patients with Rheumatoid arthritis (RA) have to be meaningful, valid and relevant. A commonly used questionnaire for patients with RA is the Stanford Health Assessment Questionnaire Disability Index (HAQ), which has been available in Swedish since 1988. The HAQ has been revised and improved several times and the latest version is the Multi Dimensional Health Assessment Questionnaire (MDHAQ). The aim of this study was to translate the MDHAQ to Swedish conditions and to test the validity and reliability of this version for persons with RA. Methods Translation and adaption of the MDHAQ were performed according to guidelines by Guillemin et al. The translated version was tested for face validity and test-retest in a group of 30 patients with RA. Content validity, criterion validity and internal consistency were tested in a larger study group of 83 patients with RA. Reliability was tested with test-retest and Cronbach´s alpha for internal consistency. Two aspects of validity were explored: content and criterion validity. Content validity was tested with a content validity index. Criterion validity was tested with concurrent validity by exploring the correlation between the MDHAQ-S and the AIMS2-SF. Floor and ceiling effects were explored. Results Test-retest with intra-class correlation coefficient (ICC) gave a coefficient of 0.85 for physical function and 0.79 for psychological properties. Reliability test with Cronbach´s alpha gave an alpha of 0.65 for the psychological dimension and an alpha of 0.88 for the physical dimension of the MDHAQ-S. The average sum of the content validity index for each item was of the MDHAQ-S was 0.94. The MDHAQ-S had mainly a moderate correlation with the AIMS2-SF, except for the social dimension of the AIMS2-SF, which had a very low correlation with the MDHAQ-S. Conclusions The MDHAQ-S was considered to be reliable and valid, but further research is needed concerning sensitivity to change. PMID:23734791
Buckley, Todd C; Kamholz, Barbara Wolfsdorf; Mozley, Susannah L; Gulliver, Suzy Bird; Holohan, Dana R; Helstrom, Amy W; Walsh, Kate; Morissette, Sandra B; Kassel, Jon D
Rates of smoking among individuals with psychiatric conditions are much greater than those seen in the general population, yet little is known about the psychometric properties of commonly used instruments that assess smoking-related variables among smokers with psychiatric conditions. The present study examined the factor structure and psychometric characteristics of the Smoking Consequences Questionnaire-Adult (SCQ-A; Copeland, Brandon, & Quinn, 1995, Psychological Assessment, 7, 484-494) among smokers with psychiatric conditions. A confirmatory factor analysis of the instrument indicated that the factor structure derived by the instrument's authors provided an adequate fit to the data. In addition, many of the 10 subscales of the SCQ-A demonstrated adequate internal consistency as assessed by Cronbach's alpha as well as adequate test-retest reliability over the course of 1 week. Based on the data derived from this sample, the SCQ-A has adequate psychometric properties for applications involving smokers with psychiatric conditions. PMID:16191745
Hansen, Craig; Joski, Peter; Freiman, Heather C.; Andrade, Susan; Toh, Sengwee; Dublin, Sascha; Cheetham, T. Craig; Cooper, William O.; Pawloski, Pamala A.; Li, De-Kun; Beaton, Sarah J.; Scott, Pamela E.; Hammad, Tarek; Davis, Robert
Background Asthma is one of the most common chronic diseases in women of reproductive age, occurring in up to 8% of pregnancies. Objective Assess the prevalence of asthma medication use during pregnancy in a large diverse cohort. Methods We identified women aged 15 to 45 years who delivered a live born infant between 2001 and 2007 across 11 U.S. health plans within the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP). Using health plans’ administrative and claims data, and birth certificate data, we identified deliveries for which women filled asthma medications from 90 days before pregnancy through delivery. Prevalence (%) was calculated for asthma diagnosis and medication dispensing. Results There were 586,276 infants from 575,632 eligible deliveries in the MEPREP cohort. Asthma prevalence among mothers was 6.7%, increasing from 5.5% in 2001 to 7.8% in 2007. A total of 9.7% (n=55,914) of women were dispensed asthma medications during pregnancy. The overall prevalence of maintenance-only medication, rescue-only medication, and combined maintenance and rescue medication was 0.6%, 6.7%, and 2.4% respectively. The prevalence of maintenance-only use doubled during the study period from 0.4% to 0.8%, while rescue-only use decreased from 7.4% to 5.8%. Conclusions In this large population-based pregnancy cohort, the prevalence of asthma diagnoses increased over time. The dispensing of maintenance-only medication increased over time, while rescue-only medication dispensing decreased over time. PMID:23108737
An evaluation was made of the extent and impact of community-oriented medical education in the Khartoum and Gezira medical schools in the Sudan. Competency of graduates 3-7 years after graduation and health indicators of the provinces of both medical schools were examined. Gezira had a more community-oriented curriculum although it was deficient in other aspects. The degree of partnership of both schools with the Ministry of Health and the community was weak and the schools' research programmes had no community orientation. Graduates had similar profiles of job satisfaction, community service, knowledge, attitudes and self-learning. Although Gezira had more emphasis on community medical education, graduates of both schools adapted themselves to the environment dictated by the health care delivery system and cultural values. PMID:15562751
Grammatikopoulos, Vasilis; Linardakis, M.; Gregoriadis, A.; Oikonomidis, V.
The aim of the current study was to provide a valid and reliable instrument for the evaluation of the teaching effectiveness in the Greek higher education system. Other objectives of the study were (a) the examination of the dimensionality and the higher-order structure of the Greek version of Students' Evaluation of Educational Quality (SEEQ)…
Cushing, A M; Jones, A
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. PMID:8594407
Connolly, Kevin M.; Coffey, Scott F.; Baschnagel, Joseph S.; Drobes, David J.; Saladin, Michael E.
The current study compared the psychometric properties and clinical/research utility of four distinct factor/subscale models of alcohol craving (three factor-derived models, and one rationally-derived model) as measured by the Alcohol Craving Questionnaire-Now in social (n = 52) and alcohol dependent (n = 71) drinkers. All participants completed a self-report measure of alcohol abuse in addition to engaging in a structured interview and cue reactivity protocol. Participants provided self-reported craving, as well as desire to approach or avoid drinking, during a cue exposure task using separate analogue scales. Factor/subscale models were compared in terms of internal consistency, convergent and divergent validity, and ability to predict cue-elicited approach and craving in addition to diagnostic status. All models demonstrated high levels of internal consistency, convergent and divergent validity, and the ability to predict both cue-elicited craving and alcohol dependence status. Specific strengths and weaknesses of each model are examined and the theoretical, clinical, and research utility of the current findings are discussed. PMID:19423243
Moksnes, Unni K; Espnes, Geir A
In spite of the potential significance of stressors, the past decades have yielded only limited and incremental progress in the field of the development of valid and reliable stress inventories for adolescents. The Adolescent Stress Questionnaire (ASQ-N) was developed to address the domain of stressors specific to adolescent experience. The present study reports an evaluation of factorial validity, as well as the construct validity of the Norwegian version of the Adolescent Stress Questionnaire (ASQ-N) across two samples, with the use of confirmatory factor analysis (CFA). Gender and age differences on the ASQ-N sub-dimensions are also evaluated. The CFA supported a seven-factor structure, where all sub-dimensions showed adequate internal consistency. The sub-dimensions were correlated positively with measures of depression and anxiety, and were correlated negatively with self-esteem, supporting the construct validity of the ASQ-N. Significant gender differences in self-reported adolescent stress were found in five of the seven scales, where girls had higher mean scores than boys. The correlation between each stress scale and age was weak, with significant correlations found in four of the seven scales. It is suggested that the ASQ-N is a measure of adolescent stress that is adequate for the research context, as well as for clinical investigation. PMID:21883256
We are revising the criteria in the Listing of Impairments (listings) that we use to evaluate cases involving hematological disorders in adults and children under titles II and XVI of the Social Security Act (Act). These revisions reflect our adjudicative experience, advances in medical knowledge, diagnosis, and treatment, and public comments we received in response to a Notice of Proposed Rulemaking (NPRM). PMID:25898435
Grainne Conole; Mike Hall; Susan Smith
This paper describes the evaluation of an online training course in Neonatal Medicine, which involved medical practitioners from across Europe. The paper focuses on the findings from an analysis of the online discussion groups. The project aimed to develop an online course for practitioners and included the development of four modules. Delivery was achieved using hybrid technology via distribution of
Wiggers, T. Thorne; And Others
A Sex Content Scale was developed to evaluate a series of simulated interviews conducted with 24 second year medical students and an actress who was carefully coached to reveal a specific sexual problem as she felt comfortable with the student and as he/she asked her appropriate questions. A patient response form was also developed to quantify the…
Booth, Jerry; Collins, Sarah; Hammond, Anna
This article suggests that quality assessment in the UK has been largely set apart from learning and teaching and reports on a pilot project at the Hull York Medical School which attempted to integrate students' evaluation of their clinical placements into the curriculum. It outlines the operational demands of this integrated method and compares…
Casebeer, Linda; Andolsek, Kathryn; Abdolrasulnia, Maziar; Green, Joseph; Weissman, Norman; Pryor, Erica; Zheng, Shimin; Terndrup, Thomas
Introduction: Much of the international community has an increased awareness of potential biologic, chemical, and nuclear threats and the need for physicians to rapidly acquire new knowledge and skills in order to protect the public's health. The present study evaluated the educational effectiveness of an online bioterrorism continuing medical…
Hersh, William R.; Junium, Katherine; Mailhot, Mark; Tidmarsh, Patricia
Objective: Given the need for continuing education in medical informatics for mid-career professionals, the authors aimed to implement and evaluate distance learning courses in this area. Design: The authors performed a needs assessment, content and technology planning, implementation, and student evaluation. Measurements: The needs assessment and student evaluations were assessed using a combination of Likert scale and free-form questions. Results: The needs assessment indicated much interest in a medical informatics distance learning program, with electronic medical records and outcome research the subject areas of most interest. The courses were implemented by means of streaming audio plus slides for lectures and threaded discussion boards for student interaction. Students were assessed by multiple-choice tests, a term paper, and a take-home final examination. In their course evaluations, student expressed strong satisfaction with the teaching modalities, course content, and system performance. Although not assessed experimentally, the performance of distance learning students was superior to that of on-campus students. Conclusion: Medical informatics education can be successfully implemented by means of distance learning technologies, with favorable student satisfaction and demonstrated learning. A graduate certificate program is now being implemented. PMID:11687564
Silk, Larry; Watt, Jackie; Pilon, Nancy; Draper, Chad
This article describes a psychotropic PRN Evaluative Tool developed by interprofessional clinicians to address inconsistent reporting and assessment of the effectiveness of PRN medications used for people who are developmentally disabled. Fifty-nine participants (37 males, 22 females), ages 16 to 60 years, were included in the review, all…
Bodenreider, Oliver; Burgun, Anita; Botti, Geneviève; Fieschi, Marius; Beux, Pierre Le; Kohler, François
Abstract Objective: The authors evaluated the use of the Unified Medical Language System (UMLS) as a medical knowledge source for the representation of medical procedures in the MAOUSSC system. Design: MAOUSSC, a multiaxial coding system, was used for the representation of 1500 procedures from 15 clinical specialties, using UMLS concepts (augmented by full sources for three new vocabularies being added to the UMLS) and relationships whenever possible. Evaluation criteria for the UMLS included (1) completeness of representation of concepts and of inter-concept relationships, (2) consistency in the categorization of both concepts and inter-concept relationships, and (3) usability, including adaptability of the UMLS to a foreign language (French), its suitability to a geographic region with different medical practices than the USA, and issues relative to the annual update changes in the test vocabularies. Results: During the MAOUSSC trial, the number of missing concepts or relationships identified in the augmented UMLS sources was deemed to be inconsequential relative to overall project goals. “Missing” UMLS inter-concept relationships were identified, although they were small in number. Some inconsistencies in the UMLS were noted, especially in the area of hierarchic relationships. Conclusion: After UMLS was used for five years as a knowledge source for representing 1500 complex medical procedures in MAOUSSC, its value is considered significant. Future editions of the UMLS are expected to improve representation of inter-concept relationships and global consistency. PMID:9452987
Wagner, Kay Cimpl; Byrd, Gary D.
Objective: This study was undertaken to determine if a systematic review of the evidence from thirty years of literature evaluating clinical medical librarian (CML) programs could help clarify the effectiveness of this outreach service model. Methods: A descriptive review of the CML literature describes the general characteristics of these services as they have been implemented, primarily in teaching-hospital settings. Comprehensive searches for CML studies using quantitative or qualitative evaluation methods were conducted in the medical, allied health, librarianship, and social sciences literature. Findings: Thirty-five studies published between 1974 and 2001 met the review criteria. Most (30) evaluated single, active programs and used descriptive research methods (e.g., use statistics or surveys/questionnaires). A weighted average of 89% of users in twelve studies found CML services useful and of high quality, and 65% of users in another overlapping, but not identical, twelve studies said these services contributed to improved patient care. Conclusions: The total amount of research evidence for CML program effectiveness is not great and most of it is descriptive rather than comparative or analytically qualitative. Standards are needed to consistently evaluate CML or informationist programs in the future. A carefully structured multiprogram study including three to five of the best current programs is needed to define the true value of these services. PMID:14762460
...for medical care evaluation studies. 456.242 Section 456...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...Plan: Medical Care Evaluation Studies § 456.242 UR plan requirements...for medical care evaluation studies. (a) The UR plan...
...for medical care evaluation studies. 456.242 Section 456...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...Plan: Medical Care Evaluation Studies § 456.242 UR plan requirements...for medical care evaluation studies. (a) The UR plan...
...for medical care evaluation studies. 456.242 Section 456...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...Plan: Medical Care Evaluation Studies § 456.242 UR plan requirements...for medical care evaluation studies. (a) The UR plan...
Background Despite the benefits of mother-newborn skin-to-skin contact immediately after birth, it has not been universally implemented as routine care for healthy term neonates. Midwifes are the first person to contact the neonate after birth. However, there is evidence that many midwives do not perform mother-newborn skin-to-skin contact. The aim of this study was to develop and psychometrically evaluate an instrument for measuring factors associated with mother-newborn skin-to-skin contact (MSSCQ) based on the PRECEDE-PROCEED model. Methods This was a two-phase qualitative and quantitative study. It was conducted during 2010 to 2012 in Tehran, Iran. In the qualitative part, 150 midwives working in labor room participated in 19 focus group discussions in order to generate a preliminary item pool. Then, content and face validity were performed to provide a pre-final version of the questionnaire. In the quantitative phase, reliability (internal consistency and test-retest analysis), validity and factor analysis (both exploratory and confirmatory) were performed to assess psychometric properties of the instrument. Results A 120-item questionnaire was developed through the qualitative phase. It was reduced to an 83-item after content validity. The exploratory factor analysis loaded fifteen-factors and three constructs (predisposing, enabling and reinforcing) containing 82 items (38, 18, and 26 statements, respectively) that jointly accounted for 60.61% of observed variance. The Confirmatory factors analysis determined a model with appropriate fitness for the data. The Cronbach’s alpha coefficient showed excellent internal consistency (alpha?=?0.92), and test-retest of the scale with 2-week intervals indicated an appropriate stability for the MSSCQ (ICC?=?0.94). Conclusion The Mother-Newborn Skin-to-Skin Contact Questionnaire (MSSCQ) is a reliable and valid theory-based measurement and now can be used in clinical practice, midwifery and nursing studies. PMID:24564830
La Vignera, S
The study was aimed at evaluating a new diagnostic interview, arbitrarily named Structured Interview about male accessory gland infections (SI-MAGI), administered to three different groups of patients with MAGI according to ultrasound evaluation [prostatitis (P) or prostato-vesciculitis (PV) or prostato-vesciculo-epididymitis (PVE)]. We evaluated 110 consecutively selected infertile patients, with diagnosis of MAGI and underwent to transrectal and scrotal ultrasound (US) examination. After ultrasound evaluation, they were divided into three well-characterised, aged-matched groups: prostatitis (P; n = 45), prostato-vesciculitis (PV; n = 30) and prostato-vesciculo-epididymitis (PVE; n = 35). Then, all patients were submitted to active clinical history oriented by SI-MAGI questionnaire elucidated by the operator. The SI-MAGI was structured in four domains (urinary symptoms, ejaculatory pain or discomfort, sexual dysfunction and quality-of-life impact) for a total of 30 questions with four possible answers. Infertile patients of PVE and PV groups showed scores significantly higher than P group in all domains (anovaP < 0.005). PVE showed scores significantly higher than PV group in domain 2 and 3. Our study demonstrates the MAGI's symptoms worsen with major extension of inflammation and ultrasound can evaluate the true extent of MAGI and symptoms can help to suggest the severity of MAGI. PMID:22211812
Nathanson, Andrew T; Young, Justin Mark J; Young, Craig
A request for a preparticipation medical evaluation for wilderness watersports may be made by guiding agencies, instructional camps, or by patients presenting for an annual visit. Although guidelines have been published regarding preparticipation physical evaluation for traditional competitive high school and collegiate sports, little has been written about medical evaluations for those wishing to engage in wilderness and adventure watersports. In this article, we offer guidance based on literature review and expert opinion. Watersports are among the most common recreational activities in the United States and are generally safe. Drowning, however, is a significant risk, particularly in small, self-propelled craft, and among children. Medical counseling before participation in watersports should include screening for medical conditions which may impair swimming ability, including a history of seizures, heart disease, and lung disease. Physicians should also promote preventive health measures such as use of lifejackets and sun protection, as well as alcohol avoidance. Swim testing tailored to specific activities should be strongly considered for children and those with questionable swimming ability. PMID:26340735
Daniel R. Zalles
This module provides a strategy for determining whether a written questionnaire is an appropriate means of gathering data to meet the goals of an evaluation. The authors define which conditions are suitable for using questionnaires.
Crosskey, Liz; Vance, Maggie
Many children with speech, language and communication needs are educated in mainstream schools. Current policy and practice includes training for school staff in facilitating the development of speaking and listening skills. This study evaluates one such training package that focuses on supporting pupils' listening skills, delivered in a…
Objective criteria for evaluating the Eysenck Personality Inventory's internal structure are discussed. An approach based on targeted rotations and the test's scoring key is proposed as a means of providing common criteria. Data from earlier structure and test results for 195 undergraduates support the utility of 3 criteria developed. (SLD)
Lopes, Anália R.; Trelha, Celita S.
Objective This study aimed to translate and culturally adapt the Falls Risk Awareness Questionnaire (FRAQ) for the elderly Brazilian population as well as to evaluate the internal consistency and reliability of this instrument. Method The study used internationally accepted guidelines for the cross-cultural adaptation process. The questionnaire in its final Portuguese version was then applied to 120 elderly people to assess the measurement properties. The participants were interviewed twice in the first assessment (examiners 1 and 2 at an interval of 30to60minutes) and again after 2 to 7 days by examiner 1. The internal consistency was assessed with Cronbach' s alpha coefficient. To evaluate the reliability of the intra- and inter-evaluators, the Kappa coefficient for categorical variables was used; for numeric variables, the intra-class correlation coefficient (2-way mixed model) and the respective 95% confidence intervals were used in addition to the concordance test of Bland and Altman. Results The Brazilian version of the FRAQ was obtained while maintaining a semantic, idiomatic, cultural and conceptual equivalence. The internal consistency was ?=0.95, while for intra-examiner reliability, an intrarater correlation coefficient (ICC-3,1) of 0.91 was obtained with an intra-class correlation Kappa coefficient of 0.89 and a Bland and Altman mean difference (bias) of -0.52. Regarding the inter-examiner reliability, the ICC=0.78, Kappa=0.76 and bias=0.12. Conclusions The translation and cultural adaptation of the FRAQ for the elderly Brazilian population was successfully performed. The instrument demonstrated excellent reliability and internal consistency, thus making it useful for assessing the perception of the risk of a fall among elderly Brazilians. PMID:24346294
Shirai, Kyoko; Kawano, Atsushi; Nishiyama, Nobuhiro; Hagiwara, Akira; Kawaguchi, Sachie; Saito, Yusuke; Tomizawa, Ayako; Keshino, Yumiko; Nonami, Naoko; Suzuki, Mamoru
The satisfaction level is one of the important parameters to evaluate the effectiveness of cochlear implant (CI) in adult CI users. The purpose of this study is to investigate what factor improves the satisfaction level in adult CI users. Questionnaires were used to evaluate the items concerning the satisfaction level. One hundred patients who underwent cochlear implant placement at or over the age of 20 years were enrolled in this study. All patients had an experience of at least 5 years of CI use. To evaluate the effect of CI, questionnaire items were answered about the common communicative methods, listening under various situations, points of dissatisfaction, useful level, anxiety level without CI, satisfaction level, and the duration of CI usage. Sixty two percent of the patients were satisfied with the effect of CI and 80% felt that their CI was useful. Their listening results tended to be better in quieter environments or conversation in small groups. Furthermore, listening was related to the useful and satisfaction levels. Therefore, the better they could hear, the more they were satisfied with their CI, and appreciated its usefulness. The frequency of using CI as a communicative method (application level of CI) was statistically related to useful level, but no statistical relationship was seen between the application level of CI and anxiety level or satisfaction levels. These results suggest that other factors such as psychological status might affect the satisfaction level in addition to the CI application level. We concluded that it was necessary for us to understand the listening level before CI surgery in order to predict the postoperative course and to give an appropriate explanation to the patients. PMID:25731014
Kleinke, Chris L.
College students (N=396), chronic pain patients (N=319), and schizophrenic veterans (N=43) completed the Depression Coping Questionnaire (DCQ) and the Beck Depression Inventory (BDI). Factor analysis of the DCQ identified eleven coping responses: social support, problem solving, self-blame/escape, aggression, indulgence, activities, medication,…
) for your blood pressure or heart condition? 7. Do you know of any other reason why you should not do in the last 3 months 2. Taking medication for high blood pressure 3. Hernia or other condition that may THURSDAY FRIDAY SATURDAY SUNDAY #12;Physical Activity Readiness Questionnaire (American College of Sports
Hill, Ryan M; Rey, Yasmin; Marin, Carla E; Sharp, Carla; Green, Kelly L; Pettit, Jeremy W
Five versions of the Interpersonal Needs Questionnaire (INQ), a self-report measure of perceived burdensomeness and thwarted belongingness, have been used in recent studies (including 10-, 12-, 15-, 18-, and 25-items). Findings regarding the associations between perceived burdensomeness, thwarted belongingness, and suicidal ideation using different versions have been mixed, potentially due to differences in measurement scales. This study evaluated factor structure, internal consistency, and concurrent predictive validity of these five versions in three samples. Samples 1 and 2 were comprised of 449 and 218 undergraduates, respectively; Sample 3 included 114 adolescent psychiatric inpatients. All versions demonstrated acceptable internal consistency. The 10-item version and 15-item version demonstrated the best, most consistent model fit in confirmatory factor analyses. Both perceived burdensomeness and thwarted belongingness consistently predicted concurrent suicidal ideation on the 10-item INQ only. Future research should consider using the 15-item or 10-item versions. PMID:25308815
Wild, Katharina; Scholz, Michael; Ropohl, Axel; Bräuer, Lars; Paulsen, Friedrich; Burger, Pascal H M
Burnout and stress-related mental disorders (depression, anxiety) occur in medical students and physicians with a significantly higher prevalence than in the general population. At the same time, the learning of coping mechanisms against stress is still not an integral part of medical education. In this pilot study we developed an elective course for learning relaxation techniques and examined the condition of the students before and after the course. 42 students participated in the semester courses in 2012 and 2013 as well as in a survey at the start and end of each course. The students were instructed in autogenic training (AT) and progressive muscle relaxation according to Jacobsen (PMR) with the goal of independent and regular exercising. At the beginning and the end of the semester/course the students were interviewed using standardized, validated questionnaires on burnout (BOSS-II) and anxiety (STAI-G), depression (BDI), quality of life (SF-12) and sense of coherence (SOC-L9). We compared the results of our students participating in Relacs with results from eight semester medical students (n?=?88), assessed with the same questionnaires at similar points of time within their semester. Participating students showed a significant decline in cognitive and emotional burnout stress and in trait anxiety. Furthermore, they showed a reduction in state anxiety and a conspicuous decrease in mean depression. The sense of coherence increased at the same time. A comparative cohort of medical students of 8th semester students, showed lower values for the specified measurement parameters at the beginning, but showed no progressive changes. Our course introducing AT and PMR led to a significant reduction of burnout and anxiety within the participating group of medical students. Even the course attendance for just one semester resulted in significant improvements in the evaluated parameters in contrast to those students who did not attend the course. PMID:25517399
Weker, H; Rudzka-Ka?toch, Z; Dylag, H; Struci?ska, M; Klemarczyk, W
The subjects were 120 breast-feeding mothers whose children were admitted for outpatient or inpatient treatment at the Institute of Mother and Child in Warsaw, between March, 1998 and July, 1999. A special nutritional questionnaire was elaborated with the aim to evaluate subjects' nutritional status as well as their diet. All subjects completed the questionnaire and then selected parameters of their nutritional status and diet were evaluated. For 43 of the women under study it was the first month of lactation, for 33--the fourth month, for 23--the sixth and 21 women had been breast-feeding for more then six months. The subjects were of different age, coming from both urban and rural areas. In the studied group the nutritional status, i.e. body mass indices (BMI) before pregnancy, at the end of pregnancy and during lactation were within the normal range. 65 of the subjects had changed their diet due to pregnancy and 52 due to lactation. Women declared to be used to eating 3-4 meals per day. Having additional snacks was declared by 62.5%. Liquids' intake was on average about 2.5 l/24 hr, range 2-31. Average daily energy intake--2938 kcal/12,980 kJ, the lowest--in a diet of a mother with diabetes, the highest--in a diet of a vegetarian mother. The proportion of protein in energy intake was 15.1%, whereas fat--36.3%. Dietary practices of women under study in the period of lactation were well adjusted to nutritional recommendations for this group, as evidenced by indices of nutritional status (i.e. BMI). Among 120 women, 71 were taking supplementary preparations of vitamins and minerals. It turned out that a level of some vitamins in a daily food intake together with supplementation was definitely too high. PMID:10789215
In the proper use of medicine, the quality of medical supplies is an important factor. Use of generic products not only reduces drug costs for the patient, but also offers substantial advantages for governments in reducing medical expenses. When evaluation of the quality of generic products is centered on tablets, products with qualities that are unstable over time may be encountered. Some dosage forms require suitable pharmaceutical tests, processes, and apparatuses, such as those for evaluating orally disintegrating tablets or cutaneous preparations. For example, although simple test equipment has been proposed for patches, a unified method is required. The pharmacist plays an important role in choosing high-quality generic products; however, a substantial amount of information needs to be made available to the public in order to achieve that goal. PMID:25088318
Mache, Stefanie; Scutaru, Cristian; Vitzthum, Karin; Gerber, Alexander; Quarcoo, David; Welte, Tobias; Bauer, Torsten T; Spallek, Michael; Seidler, Andreas; Nienhaus, Albert; Klapp, Burghard F; Groneberg, David A
Background There are several ways to conduct a job task analysis in medical work environments including pencil-paper observations, interviews and questionnaires. However these methods implicate bias problems such as high inter-individual deviations and risks of misjudgement. Computer-based observation helps to reduce these problems. The aim of this paper is to give an overview of the development process of a computer-based job task analysis instrument for real-time observations to quantify the job tasks performed by physicians working in different medical settings. In addition reliability and validity data of this instrument will be demonstrated. Methods This instrument was developed in consequential steps. First, lists comprising tasks performed by physicians in different care settings were classified. Afterwards content validity of task lists was proved. After establishing the final task categories, computer software was programmed and implemented in a mobile personal computer. At least inter-observer reliability was evaluated. Two trained observers recorded simultaneously tasks of the same physician. Results Content validity of the task lists was confirmed by observations and experienced specialists of each medical area. Development process of the job task analysis instrument was completed successfully. Simultaneous records showed adequate interrater reliability. Conclusion Initial results of this analysis supported the validity and reliability of this developed method for assessing physicians' working routines as well as organizational context factors. Based on results using this method, possible improvements for health professionals' work organisation can be identified. PMID:19094213
Afolabi, Muhammed O; Bojang, Kalifa; D'Alessandro, Umberto; Ota, Martin O C; Imoukhuede, Egeruan B; Ravinetto, Raffaella; Larson, Heidi J; McGrath, Nuala; Chandramohan, Daniel
Objective To develop and psychometrically evaluate an audio digitised tool for assessment of comprehension of informed consent among low-literacy Gambian research participants. Setting We conducted this study in the Gambia where a high illiteracy rate and absence of standardised writing formats of local languages pose major challenges for research participants to comprehend consent information. We developed a 34-item questionnaire to assess participants’ comprehension of key elements of informed consent. The questionnaire was face validated and content validated by experienced researchers. To bypass the challenge of a lack of standardised writing formats, we audiorecorded the questionnaire in three major Gambian languages: Mandinka, Wolof and Fula. The questionnaire was further developed into an audio computer-assisted interview format. Participants The digitised questionnaire was administered to 250 participants enrolled in two clinical trials in the urban and rural areas of the Gambia. One week after first administration, the questionnaire was readministered to half of the participants who were randomly selected. Participants were eligible if enrolled in the parent trials and could speak any of the three major Gambian languages. Outcome measure The primary outcome measure was reliability and validity of the questionnaire. Results Item reduction by factor analysis showed that 21 of the question items have strong factor loadings. These were retained along with five other items which were fundamental components of informed consent. The 26-item questionnaire has high internal consistency with a Cronbach's ? of 0.73–0.79 and an intraclass correlation coefficient of 0.94 (95% CI 0.923 to 0.954). Hypotheses testing also showed that the questionnaire has a positive correlation with a similar questionnaire and discriminates between participants with and without education. Conclusions We have developed a reliable and valid measure of comprehension of informed consent information for the Gambian context, which might be easily adapted to similar settings. This is a major step towards engendering comprehension of informed consent information among low-literacy participants. PMID:24961716
Szilagyi, Peter G.; Shone, Laura P.; Dozier, Ann M.; Newton, Ms. Gail L.; Green, Theresa; Bennett, Nancy M.
From the perspective of academic medical centers (AMCs), community engagement is a collaborative process of working toward mutually defined goals to improve the community’s health, and involves partnerships between AMCs, individuals, and entities representing the surrounding community. AMCs increasingly recognize the importance of community engagement, and recent programs such as Prevention Research Centers and Clinical and Translational Science Awards (CTSAs) have highlighted community engagement activities. However, there is no standard or accepted metric for evaluating AMCs’ performance and impact of community engagement activities. In this article, the authors present a framework for evaluating AMCs’ community engagement activities. The framework includes broad goals and specific activities within each goal, wherein goals and activities are evaluated using a health services research framework consisting of structure, process, and outcome criteria. To illustrate how to use this community engagement evaluation framework, the authors present specific community engagement goals and activities of the University of Rochester Medical Center to: 1) improve the health of the community served by the AMC; 2) increase the AMC’s capacity for community engagement, and 3) increase generalizable knowledge and practices in community engagement and public health. Using a structure-process-outcomes framework, a multi-disciplinary team should regularly evaluate an AMC’s community engagement program with the purpose of measurably improving the performance of the AMC and the health of its surrounding community. PMID:24556768
The use of questionnaires to evaluate educational initiatives is widespread, but often problematic. This paper examines four aspects of an evaluation survey carried out with very able pupils attending out-of-school classes: ethics, design, bias and interpretation. There is a particular focus on the interpretation and analysis of pupils' answers to…
Background Changes in self-concept are an important potential outcome for many interventions for people with long-term conditions. This study sought to identify and evaluate outcome questionnaires suitable for quantifying changes in self-concept in people with long-term conditions, in the context of treatment with acupuncture and Chinese medicine. Methods A literature search was followed by an evaluation of three questionnaires: The Wellbeing Questionnaire W-BQ12, the Patient Enablement Instrument (PEI), and the Arizona Integrative Outcome Scale (AIOS). A convenience sample of 23 people completed the questionnaires on two occasions and were interviewed about their experience and their questionnaire responses. All acupuncturists were interviewed. Results Changes in self-concept were common and emerged over time. The three questionnaires had different strengths and weaknesses in relation to measuring changes in self-concept. The generic AIOS had face validity and was sensitive to changes in self-concept over time, but it lacked specificity. The PEI was sensitive and specific in measuring these changes but had lower acceptability. The sensitivity of the W-BQ12 was affected by initial high scores (ceiling effect) and a shorter timescale but was acceptable and is suitable for repeated administration. The PEI and W-BQ12 questionnaires worked well in combination. Conclusion Changes in self-concept are important outcomes of complex interventions for people with long-term illness and their measurement requires carefully evaluated tools and long-term follow-up. The literature review and the analysis of the strengths and weaknesses of the questionnaires is a resource for other researchers. The W-BQ12 and the PEI both proved useful for this population and a larger quantitative study is planned. PMID:16539737
SHAHIDI, FATEMEH; SAQEB, MOHAMMAD MEHDI; AMINI, MITRA; AVAND, ABOLGHASEM; DOWLATKHAH, HAMID REZA
Introduction The majority of countries have brought the quality of higher education into focus in the past few years. They have tried to improve the quality of their own higher education. The studies show that Iranian Universities are not at an accepted level in terms of quality. They have encountered several problems which have diminished their quality level. This study aimed at assessing the quality of medical education program as viewed by general practitioners graduated from Shiraz, Fasa and Jahrom Medical Universities. Methods This is a cross-sectional study. 215 subjects were selected based on a census of all the general practitioners graduated from Shiraz, Fasa and Jahrom Universities during 2011-2013. The questionnaire used for collecting the data was that of the Association of Graduates from American Medical Colleges. The collected data were then analyzed using SPSS 14 through which such descriptive and bivariate statistics as percentage, means, Standard Deviation and ANOVA were used. The level of significance was set to 0.05. Results The questionnaire return rate was 97%. As to the graduates' preclinical experiences, five indices were studied which were assessed as "average" in graduates' views. However, with respect to their clinical experiences five indices were equally studied, among which such indices as "Communication skills" and "The quality of medical apprenticeship" were evaluated as "desirable" in view of the graduates from the very three universities. On the contrary, the quality of clinical experiences and technological skills was evaluated as "almost weak"; furthermore, the integration of basic science with required clinical experience was also considered "weak". Conclusion It seems essential to set up an annual assessment of general practitioner education program and a review of the medical education program in Iran based on the global medical advancement and international standards. PMID:26269791
Jones, E.D. [Lawrence Livermore National Lab., CA (United States); Cunningham, R.E.; Rathbun, P.A. [Nuclear Regulatory Commission, Washington, DC (United States). Office of Nuclear Material Safety and Safeguards
In 1991, the NRC, Division of Industrial and Medical Nuclear Safety, began a program to evaluate the use of probabilistic risk assessment (PRA) in regulating medical devices. This program represents an initial step in an overall plant to evaluate the use of PRA in regulating the use of nuclear by-product materials. The NRC envisioned that the use of risk analysis techniques could assist staff in ensuring that the regulatory approach was standardized, understandable, and effective. Traditional methods of assessing risk in nuclear power plants may be inappropriate to use in assessing the use of by-product devices. The approaches used in assessing nuclear reactor risks are equipment-oriented. Secondary attention is paid to the human component, for the most part after critical system failure events have been identified. This paper describes the risk methodology developed by Lawrence Livermore National Laboratory (LLNL), initially intended to assess risks associated with the use of the Gamma Knife, a gamma stereotactic radiosurgical device. For relatively new medical devices such as the Gamma Knife, the challenge is to perform a risk analysis with very little quantitative data but with an important human factor component. The method described below provides a basic approach for identifying the most likely risk contributors and evaluating their relative importance. The risk analysis approach developed for the Gamma Knife and described in this paper should be applicable to a broader class of devices in which the human interaction with the device is a prominent factor. In this sense, the method could be a prototypical model of nuclear medical or industrial device risk analysis.
MOATTARI, MARZIEH; YADGARI, DAVOOD; HOSEINI, SEYED JALIL
Introduction: The execution of composed educational programs for general practitioners is one of the most common methods of continuing medical education. This research project aims to evaluate one of these programs. Methods: For this purpose, a pre- and post-test design was developed. The subjects consisted of 45 participants. They were tested in two stages: before and after the program. A questionnaire was also used to gather the participants’ views on four variables including teachers' behavior, the degree of achieving the objective of the program, objective of the learner, and satisfaction with the program. Results: Based on the results of this study, the mean scores of the participants’ knowledge increased from 10.05 (pre test) to 12.61 (post test), (p<0.0001). In addition, the results showed that the teachers’ behavior and satisfaction with the program were rated by participants as the highest and least, respectively. Conclusion: The results of this research are indicative of the effectiveness of the composed educational program in continuing medical education. Nevertheless, such programs are recommended to be further evaluated with more rigorous design. PMID:25512932
Campana, Angela Nogueira Neves Betanho; Swami, Viren; Onodera, Carolina Mie Kawagosi; da Silva, Dirceu; Tavares, Maria da Consolação Gomes Cunha Fernandes
Body checking is considered an expression of an excessive preoccupation with appearance. The first aim of this study was to evaluate the psychometric properties of a Brazilian Portuguese version of the Body Checking Questionnaire (BCQ). Additionally, we wanted to examine the questionnaire's associations with body avoidance behaviour, body mass index, dietary habits, and the intensity, frequency, and length of physical exercise. Finally, we also examined the differences between the total BCQ score and the individual BCQ factor scores. Differences between active and sedentary persons and between non-dieters and those on weight-loss diets were also analyzed. For the psychometric study, 546 female public university students from four different courses were surveyed. Two minor samples of university students and eating disorders women were also recruited. In the second part of the study, 403 women were recruited from weight-loss programs, gyms, and a university. All participants were verbally invited to participate in the research and voluntarily took part. Confirmatory factor analysis showed a good fit to the original model of the Brazilian BCQ that retained all 23 items. Satisfactory evidence of construct validity and internal consistency were also generated through analysis of factor loadings, t-values, Cronbach's alpha, and construct reliability tests. The results also showed associations among body checking and body avoidance, body satisfaction, social anxiety, body mass index, and the frequency and intensity of physical exercise. Significant differences were found between non-dieters and weight-loss dieters for all BCQ factors and the total BCQ score. For physically active and sedentary persons, a significant difference was only observed for idiosyncratic checking behaviour. In conclusion, the BCQ appears to be a valid and reliable scale for Brazilian research, and the associations and differences found in this study suggest that women at gyms and especially in weight-loss programs should be targeted for future body checking studies. PMID:24040304
... Non-Prescription -- include all over-the-counter medications; herbal supplements; complementary or alternative medicines)______________________________________________________ _______________________________________________________________ Prior Operations _________________________________________________ _______________________________________________________________ Pre-Anesthesia ...
Rotter, Jason S; Foerster, Douglas; Bridges, John Fp
Economic evaluation is established within health-technology assessment but is challenged by those wanting to use economic evaluation to inform pricing and/or incorporate nontraditional sources of value and the views of diverse stakeholders. The changing role of economic evaluation in (formally or informally) assessing prices/values in four jurisdictions (UK, Australia, Germany and USA) is detailed and the authors propose a taxonomy of factors impacting the value of medical technology spanning clinical utility (effectiveness, safety/tolerability and quality of evidence), consumer demand (consumer preferences, process utility and unmet need), economic incentives (innovation, option value and market competition) and the societal perspective (social justice, social values and national interest). The authors suggest that multicriteria decision analysis methods grounded in hedonic-pricing theory can facilitate the valuing/pricing of medical technologies. The use of such an approach is hindered by a paucity of relevant educational opportunities, vested interests and aversion to placing prices/values on health. PMID:23252354
Koohpayehzadeh, Jalil; Haji Ahmadi, Maryam; Dehnad, Afsaneh; Soltani Arabshahi, Seyed kamran; Bigdeli, Shoaleh; Yadollahi, Sohrab
Background: Learning in a clinical environment is an inseparable part of a training program in medical education. To evaluate the quality of training in a clinical environment, a comprehensive questionnaire which is adjusted for local purposes is essential. This study was conducted to determine the validity and reliability of Activities Coaching Context (ACC)-questionnaire from the perspective of residents and students in a clinical learning environment. Methods: This was a cross-sectional study conducted with 65 residents and students of Semnan University of Medical Sciences. The Content Validity of the questionnaire was confirmed by the judgment of a panel of ten experts in medical education. The construct validity of the questionnaire was determined by factor analysis. Data were collected and analyzed by SPSS16. Results: The ratio and index of content validity calculated by experts’ view were quite acceptable (0.31 and 0.7, respectively). Construct validity was examined by factor analysis which confirmed seven first order factors. Cronbach’s Alfa coefficient revealed a high degree of internal consistency (0.932). The reliability of the questionnaire was measured by test - retest (0.9). Conclusions: The ACC questionnaire appeared to be a valid, reliable and also appropriate tool to evaluate the educational quality of a clinical learning environment. PMID:25405107
K Gray-Donald; J OLoughlin; L Richard; G Paradis
OBJECTIVE: To validate an adaptation of a short questionnaire measuring behaviour related to selecting low fat diets. The questionnaire was adapted for telephone use in a low income, low education population. DESIGN: The factorial structure of the 38 item adaptation was studied in a population based random sample of 1432 adults. Seven day test-retest reliability was measured in a convenience
Batista, Almária Mariz; Carvalho, Maria Cleide Ribeiro Dantas de
The scope of this paper was to evaluate advertising for medication broadcast on radio stations in Natal, State of Rio Grande do Norte, Brazil, from April to September 2008 and from April to September 2010. The advertising was recorded and transcribed in order to conduct legal analysis and content analysis based on the precepts of Laurence Bardin. Both the advertising recorded during the first stage (regulated by RDC 102/00) and the second stage (regulated by RDC 96/08) contained some form of legal violation. Content analysis detected practically the same violations in both stages, namely the lack of information regarding adverse effects of the medication, appeal to consumption, exaggeration of efficiency/effectiveness and abusive exploitation of illness. Despite the inclusion of more modern and restrictive legislation, radio advertising continues to violate the law blatantly, committing abuse and disrespecting the population's entitlement to good health. The study reveals the need for medication advertising to be dealt with in a broader context, in other words to be treated as a public health concern. It must take into consideration the socio-historical scenario in which it evolved, since the legislation alone is insufficient to combat abuse committed to the detriment of public health. PMID:23358781
Boleira, Manuela; Lupi, Omar; Pires, Gisele Vianna; Dias, Gabriela; Seba, Amanda Jaccobson; Guimarães, Daniel Boleira Sieiro
BACKGROUND atopic dermatitis is directly related to psychological stress, reduced quality of life and psychosomatic symptoms. The Psychosomatic Scale for Atopic Dermatitis is the only questionnaire developed specifically for assessment of psychosomatization in atopic dermatitis. OBJECTIVES the objective of this study was to cross-culturally adapt and validate a Brazilian-Portuguese version of the Psychosomatic Scale for Atopic Dermatitis. METHODS adaptation consisted of independent translation and backtranslation by three bilingual translators, followed by a pre-test. The Psychosomatic Scale for Atopic Dermatitis and the Dermatology Life Quality Index were self-administered to 47 patients with atopic dermatitis. Disease severity was evaluated using the Eczema Area and Severity Index. Factor analysis was used to identify the dimensions of the Brazilian Portuguese version of the Psychosomatic Scale for Atopic Dermatitis. Internal consistency and convergence validity were also analyzed. Reproducibility was assessed using the Kappa coefficient. RESULTS factor analysis revealed a two-dimensional structure: stress/laziness/insecurity (I) and maladjustment/social relationships (II), explaining 54.4% of total variance. All dimensions revealed excellent internal consistency. External construct validity was confirmed by positive correlations between the Psychosomatic Scale for Atopic Dermatitis and the Dermatology Life Quality Index. Test-retest reliability was excellent, with k>0.7 for all questions. CONCLUSIONS the Brazilian Portuguese version of the Psychosomatic Scale for Atopic Dermatitis demonstrated acceptable psychometric properties and can be used for the evaluation of psychosomatic symptoms in patients with atopic dermatitis and as a tool in clinical and epidemiological research. PMID:25184916
There is not a perfect agree in the definition of medical image quality from the physician and physicist point of view. The present conference analyzes the standard techniques used to grade image quality. In the first place, an analysis about how viewing conditions related to environment, monitor used or physician experience determines the subjective evaluation is done. After that, the physics point of view is analyzed including the advantage and disadvantage of the main published methods like: Quality Control Tests, Mathematical metrics, Modulation Transfer Function, Noise Power Spectrum, System Response Curve and Mathematical observers. Each method is exemplified with the results of updated papers. We concluded that the most successful methods up to the present have been those which include simulations of the Human Visual System. They have good correlation between the results of the objective metrics and the subjective evaluation made by the observers.
Williams, Sara E.; Smith, Craig A.; Bruehl, Stephen P.; Gigante, Joseph; Walker, Lynn S.
This study examined the effects of diagnosis (functional versus organic), physician practice orientation (biomedical versus biopsychosocial), and maternal trait anxiety (high versus low) on mothers’ responses to a child’s medical evaluation for chronic abdominal pain. Mothers selected for high (n = 80) and low (n = 80) trait anxiety imagined that they were the mother of a child with chronic abdominal pain described in a vignette. They completed questionnaires assessing their negative affect and pain catastrophizing. Next, mothers were randomly assigned to view one of four video vignettes of a physician actor reporting results of the child’s medical evaluation. Vignettes varied by diagnosis (functional versus organic) and physician practice orientation (biomedical versus biopsychosocial). Following presentation of the vignettes, baseline questionnaires were re-administered and mothers rated their satisfaction with the physician. Results indicated that mothers in all conditions reported reduced distress pre- to post-vignette; however, the degree of the reduction differed as a function of diagnosis, presentation, and anxiety. Mothers reported more post-vignette negative affect, pain catastrophizing, and dissatisfaction with the physician when the physician presented a functional rather than an organic diagnosis. These effects were significantly greater for mothers with high trait anxiety who received a functional diagnosis presented by a physician with a biomedical orientation than for mothers in any other condition. Anxious mothers of children evaluated for chronic abdominal pain may be less distressed and more satisfied when a functional diagnosis is delivered by a physician with a biopsychosocial rather than a biomedical orientation. PMID:19767148
Rees, Gwyneth; Lamoureux, Ecosse L; Xie, Jing; Sturrock, Bonnie A; Fenwick, Eva K
This study used Rasch analysis to examine the psychometric validity of the Illness Perception Questionnaire-Revised to assess beliefs about diabetes in 470 participants with Type 2 diabetes and 71 participants with Type 1 diabetes. All Illness Perception Questionnaire-Revised scales had psychometric issues, which included poorly utilised response categories, poor scale precision and multidimensionality. Following re-engineering, only four of the eight scales (Consequences, Illness coherence, Timeline cyclical and Emotional representations) were psychometrically adequate according to the Rasch model. The diabetes-specific version of the Illness Perception Questionnaire-Revised provides suboptimal assessment of beliefs held by patients with diabetes. PMID:24296741
Smith, Ashlea R.; Davenport, Becky R.
The authors evaluated the utility of the Multidimensional Body-Self Relations Questionnaire (MBSRQ; Brown, Cash, & Mikulka, 1990) and the Appearance Schemas Inventory-Revised (ASI-R; Cash, Melnyk, & Hrabosky, 2004) by administering the instruments to Hispanic female college students. Results indicated that the means of the MBSRQ and the ASI-R…
Igoe, Deirdre; Peralta, Christopher; Jean, Lindsey; Vo, Sandra; Yep, Linda Ngan; Zabjek, Karl; Wright, F. Virginia
Preschool-aged children continually learn new skills and perfect existing ones. "Mastery motivation" is theorized to be a personality trait linked to skill learning. The Dimensions of Mastery Questionnaire (DMQ) quantifies mastery motivation. This pilot study evaluated DMQ test-retest score reliability (preschool-version) and included exploratory…
The paper covers the performed evaluation of frequency with which the statistical methods were applied in analyzed works having been published in six selected, national medical journals in the years 1988-1992. For analysis the following journals were chosen, namely: Klinika Oczna, Medycyna Pracy, Pediatria Polska, Polski Tygodnik Lekarski, Roczniki Pa?stwowego Zak?adu Higieny, Zdrowie Publiczne. Appropriate number of works up to the average in the remaining medical journals was randomly selected from respective volumes of Pol. Tyg. Lek. The studies did not include works wherein the statistical analysis was not implemented, which referred both to national and international publications. That exemption was also extended to review papers, casuistic ones, reviews of books, handbooks, monographies, reports from scientific congresses, as well as papers on historical topics. The number of works was defined in each volume. Next, analysis was performed to establish the mode of finding out a suitable sample in respective studies, differentiating two categories: random and target selections. Attention was also paid to the presence of control sample in the individual works. In the analysis attention was also focussed on the existence of sample characteristics, setting up three categories: complete, partial and lacking. In evaluating the analyzed works an effort was made to present the results of studies in tables and figures (Tab. 1, 3). Analysis was accomplished with regard to the rate of employing statistical methods in analyzed works in relevant volumes of six selected, national medical journals for the years 1988-1992, simultaneously determining the number of works, in which no statistical methods were used. Concurrently the frequency of applying the individual statistical methods was analyzed in the scrutinized works. Prominence was given to fundamental statistical methods in the field of descriptive statistics (measures of position, measures of dispersion) as well as most important methods of mathematical statistics such as parametric tests of significance, analysis of variance (in single and dual classifications). non-parametric tests of significance, correlation and regression. The works, in which use was made of either multiple correlation or multiple regression or else more complex methods of studying the relationship for two or more numbers of variables, were incorporated into the works whose statistical methods were constituted by correlation and regression as well as other methods, e.g. statistical methods being used in epidemiology (coefficients of incidence and morbidity, standardization of coefficients, survival tables) factor analysis conducted by Jacobi-Hotellng's method, taxonomic methods and others. On the basis of the performed studies it has been established that the frequency of employing statistical methods in the six selected national, medical journals in the years 1988-1992 was 61.1-66.0% of the analyzed works (Tab. 3), and they generally were almost similar to the frequency provided in English language medical journals. On a whole, no significant differences were disclosed in the frequency of applied statistical methods (Tab. 4) as well as in frequency of random tests (Tab. 3) in the analyzed works, appearing in the medical journals in respective years 1988-1992. The most frequently used statistical methods in analyzed works for 1988-1992 were the measures of position 44.2-55.6% and measures of dispersion 32.5-38.5% as well as parametric tests of significance 26.3-33.1% of the works analyzed (Tab. 4). For the purpose of increasing the frequency and reliability of the used statistical methods, the didactics should be widened in the field of biostatistics at medical studies and postgraduation training designed for physicians and scientific-didactic workers. PMID:9199127
Przybyszowski, Marek; Bochenek, Gra?yna
The achievement and the maintenance of asthma control is currently considered the main goal of asthma treatment. Recent guidelines recommend regular assessment of asthma control and indicate questionnaires as important tools that can facilitate its evaluation. Questionnaires relate to GINA or NAEPP guidelines. Questionnaires constitute complex numerical or categorical scales and consist of several to over a dozen questions relating to the patient's symptoms of asthma, limitations in daily activities and usage of rescue medications within a period of time. Each questionnaire is characterized by the features that affect its reliability and usefulness. In the following paper we discuss most of the questionnaires which assess asthma control. We focus on the items they include and present the results of studies that prove the effectiveness of individual questionnaires in assessment of asthma control. Attention was drawn to the patient groups to which the questionnaires are addressed. We list the features of the questionnaire which should be considered before choosing a test, so that it satisfies both the doctor's and the patient's needs. The role of questionnaires as the easy-to-use tools is growing steadily. Unfortunately, not all are available in Polish language. Conducting appropriate validation studies may allow to use many of them in Polish conditions. PMID:26050984
Lin, Dan; Liu, Jialin; Zhang, Rui; Li, Yong; Huang, Tingting
In order to provide a reference and theoretical guidance of the evaluation of electronic medical record (EMR) and establishment of evaluation system in China, we applied a bibliometric analysis to assess the application of methodologies used at home and abroad, as well as to summarize the advantages and disadvantages of them. We systematically searched international medical databases of Ovid-MEDLINE, EBSCOhost, EI, EMBASE, PubMed, IEEE, and China's medical databases of CBM and CNKI between Jan. 1997 and Dec. 2012. We also reviewed the reference lists of articles for relevant articles. We selected some qualified papers according to the pre-established inclusion and exclusion criteria, and did information extraction and analysis to the papers. Eventually, 1 736 papers were obtained from online database and other 16 articles from manual retrieval. Thirty-five articles met the inclusion and exclusion criteria and were retrieved and assessed. In the evaluation of EMR, US counted for 54.28% in the leading place, and Canada and Japan stood side by side and ranked second with 8.58%, respectively. For the application of evaluation methodology, Information System Success Model, Technology Acceptance Model (TAM), Innovation Diffusion Model and Cost-Benefit Access Model were widely applied with 25%, 20%, 12.5% and 10%, respectively. In this paper, we summarize our study on the application of methodologies of EMR evaluation, which can provide a reference to EMR evaluation in China. PMID:26211253
von Lengerke, Thomas; Kursch, Angelika; Lange, Karin
In the model medical curriculum HannibaL at Hannover Medical School (MHH, Hannover, Germany), communication skills in taking case histories and disclosing diagnoses (breaking bad news) are assessed through an objective structured clinical examination (OSCE). This is part of the examinations which at the MHH represent the equivalent to the First Part of the Medical Examinations. The second year doctor-patient communication course preparing for these examinations was evaluated during the 2009/10 academic year. Using questionnaires specific to the learning objectives, learning needs were assessed, pre-post comparisons of self-assessed competencies were performed and key teaching methods were evaluated (5-point Likert scales, “5”=fully agree). At T0 (start of the course) 267 students participated (response rate: 93.7%), of which 180 filled out the T1 questionnaire during the last session of the course (67.4%). Within-subject analyses of variance and paired t-tests were conducted. The highest learning needs were found for the “to show how”-items regarding history taking and disclosing diagnoses (M=4.4). The T1-T0 comparisons showed the greatest improvements for history taking (“to know how”: mean difference = +1.7, “to show how”: +1.8, p<.0001 as with all tests) and the “to know how”-item regarding the disclosure of diagnoses (+1.6), followed by the “to show how”-items on disclosing a diagnosis (+1.4), shared decision making (+1.2), self-assessing one’s own strengths/weaknesses (+1.0) and confidently approaching new patients (+0.7). Students with T0 values of 1 or 2 on the respective scales improved on average by 2.2 points across all items, students with the value of 3 by 1.1, and from 4 or 5 by 0.1. Methodically, the use of simulated patients was rated the most helpful (M=4.8, 87% with the scale value 5). This doctor-patient communication course is associated with substantial improvements regarding all key learning objectives. Regarding methods, the deployed simulated patients (2-4 per 10-student-course group in 3 of the 7 course sessions, respectively) were rated the most helpful. The present evaluation calls for both further development of the doctor-patient communication curriculum at the MHH and joint activities across medical schools, which are discussed at the end of the paper. PMID:22205912
Garnier, Sophie; Gaubert, Isabelle; Joffroy, Sandra; Auneau, Gérard; Mauriège, Pascale
OBJECTIVE: The first objective of this study was to evaluate the impact of brisk walking on moderately obese (body mass index, 29-35 kg/m) postmenopausal women's perceived health, assessed through a novel short perceived health questionnaire (SPHQ), and to verify whether improvements in six items examined were related to cardiorespiratory fitness (CRF) and/or fat mass changes (study 1). The second objective of this study was to test the SPHQ against validated generic instruments (study 2). METHODS: From the 270 women included in study 1, 181 participants were subjected to three 45-minute walking sessions per week at 60% of their heart rate reserve, whereas 58 women remained inactive for 4 months. Perceived health assessed through the SPHQ, body composition, and CRF were determined before and after the 4-month study period. Another sample of 20 women was selected to validate the SPHQ (study 2). RESULTS: Despite a lack of between-group differences in the amelioration of four perceived health items, ideal weight and stress level were improved in women subjected to our walking program exclusively (P < 0.0001). Improved perceived healthy balanced diet was positively correlated to fat mass reduction in the walking group (r = 0.15; P < 0.05) only (study 1). The SPHQ shows good reproducibility for five of six items (intraclass correlation coefficients ranging from 0.77 to 0.89; P < 0.0001), and three of them were validated against generic tools (0.45 < r < 0.54; P < 0.05; study 2). CONCLUSIONS: Additional studies are needed to more accurately determine the relationships between changes in perceived health and changes in body fatness and/or CRF after endurance training and to continue the validation of the SPHQ. PMID:23385718
Smith, M; Daurat, A; Pariente, P; Sifneos, P E
The concept of alexithymia was first proposed in the 1960's by Sifneos and Nemiah to describe personality traits originally found in psychosomatic patients but which have since been found in other types of patients (alcoholics, drug addicts, traumatic stress disorder patients, sociopaths) as well as in the general population. Etymologically, alexithymia signifies: incapacity to speak one's emotions (from the Greek: a, lack; lexis, word; thymos, sentiments). Alexithymia is not the impossibility of feeling one's emotions, but rather the impossibility of associating them with corresponding mental representations and thus verbalizing them. Such patients tend to act out, to speak circumstantially, and to have difficulty in relationships. A neurophysiological substratum, the absence of connexions between the limbic system and the neo-cortical regions, has been suggested by Sifneos, who has distinguished primary and secondary alexithymia. A "biological" deficit seems to be responsible for primary alexithymia, such as in found in split-brain patients or aprosodias in patients with right hemispheric strokes. Secondary alexithymia, on the other hand, seems to be due to psychodynamic factors such as massive utilisation of defense mechanisms like denial, repression and regression. Appropriate psychotherapy for such patients is debatable, but it seems that in most cases the analytical approach should be replaced by more directive therapies, including relaxation and bio-feedback, to help patients learn to stimulate, master, and verbalize their emotions. The Beth Israel Questionnaire (BIQ) is a rating scale evaluating such traits that is filled out by the rater based on a clinical interview.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1638999
Chastonay, P; Zesiger, V; Klohn, A; Soguel, L; Mpinga, E K; Vu, NV; Bernheim, L
Background Significant changes in medical education have occurred in recent decades because of new challenges in the health sector and new learning theories and practices. This might have contributed to the decision of medical schools throughout the world to adopt community-based learning activities. The community-based learning approach has been promoted and supported by the World Health Organization and has emerged as an efficient learning strategy. The aim of the present paper is to describe the characteristics of a community immersion clerkship for third-year undergraduate medical students, its evolution over 15 years, and an evaluation of its outcomes. Methods A review of the literature and consensus meetings with a multidisciplinary group of health professionals were used to define learning objectives and an educational approach when developing the program. Evaluation of the program addressed students’ perception, achievement of learning objectives, interactions between students and the community, and educational innovations over the years. Results The program and the main learning objectives were defined by consensus meetings among teaching staff and community health workers, which strengthened the community immersion clerkship. Satisfaction, as monitored by a self-administered questionnaire in successive cohorts of students, showed a mean of 4.4 on a five-point scale. Students also mentioned community immersion clerkship as a unique community experience. The learning objectives were reached by a vast majority of students. Behavior evaluation was not assessed per se, but specific testimonies show that students have been marked by their community experience. The evaluation also assessed outcomes such as educational innovations (eg, students teaching other students), new developments in the curriculum (eg, partnership with the University of Applied Health Sciences), and interaction between students and the community (eg, student development of a website for a community health institution). Conclusion The community immersion clerkship trains future doctors to respond to the health problems of individuals in their complexity, and strengthens their ability to work with the community. PMID:23900611
Pirogowicz, Iwona; Szersze?, Ma?gorzata; Gwiazda, Elzbieta; Steciwko, Andrzej
Cigarette smoking is a problem in all environments, including health service workers. It increases the number of ill people and accelerates death. The aim of this study was to diagnose the problem of smoking in medical staff and evaluation of this problem by patients. Research was made in hospitals and out-patient clinics in Opole by using an anonimous questionnaire. Along years there has been a decrease of smoking initiation age: 60-years-old-women had their first cigarette in 70% after them finished 18 years old, while most 30-year-old-women had it before. Every year the level of education in medical staff grows up, but the number of smokers in them does not fall down. It is still common to smoke in non-smokers and pregnant woman presence in spite of knowledge about passive smoking. Also pregnancy is not always strong argument to complete quit smoking, among medical staff as well. Smoking medical personnel has definitely negative evaluation by non-smoking patients (70%), a bit less negative it is seen by smoking patients. As the research showed, promotion of nonsmoking workers by employers could be a motivation to quit smoking. PMID:19189557
...Medical Criteria for Evaluating Language and Speech Disorders AGENCY: Social Security Administration...new rules for evaluating language and speech disorders. The new rules would apply...and methods of evaluating language and speech disorders, along with our program...
Conner, Douglas A; Beck, Arne; Clarke, Christina; Wright, Leslie; Narwaney, Komal; Bermingham, Neysa W
Background: Kaiser Permanente Colorado has been responding to the financial challenges of its members by providing a medical financial assistance (MFA) program since 1992. However, there have been no evaluations of the effect of this program on members’ use of health services or their health outcomes. Methods: A prospective cohort study of 308 MFA program members who were enrolled between May 16, 2008, and May 16, 2009, examined changes in their use of health services, costs, and self-reported physical and mental health after enrollment in the MFA program. Use of services was analyzed with multiple regression, and costs of services with generalized linear models. Results: MFA increased members’ access to health services. There were no changes in physical or mental health status. For each health care visit before the MFA award, patients used the health care system 0.23 visits less. The MFA amount was not associated with an increase or decrease in use. There was no significant difference in total overall cost. Hospital costs were lower, but costs for clinic visits, pharmacy services, phone calls, and radiology services were significantly higher, resulting in service cost neutrality, possibly because financial barriers before MFA award led to accumulated demand for services. Conclusions: Use of services decreased after MFA was received. There was no significant change in total service cost. MFA improved members’ ability to pay for medical services and increased their satisfaction with health services. PMID:23596366
Patterson, Sophie; Cescon, Angela; Samji, Hasina; Cui, Zishan; Yip, Benita; Lepik, Katherine J; Moore, David; Lima, Viviane D; Nosyk, Bohdan; Harrigan, P Richard; Montaner, Julio S G; Shannon, Kate; Wood, Evan; Hogg, Robert S
Since 1986, antiretroviral therapy (ART) has been available free of charge to individuals living with HIV in British Columbia (BC), Canada, through the BC Centre of Excellence in HIV/AIDS (BC-CfE) Drug Treatment Program (DTP). The Highly Active Antiretroviral Therapy (HAART) Observational Medical Evaluation and Research (HOMER) cohort was established in 1996 to maintain a prospective record of clinical measurements and medication profiles of a subset of DTP participants initiating HAART in BC. This unique cohort provides a comprehensive data source to investigate mortality, prognostic factors and treatment response among people living with HIV in BC from the inception of HAART. Currently over 5000 individuals are enrolled in the HOMER cohort. Data captured include socio-demographic characteristics (e.g. sex, age, ethnicity, health authority), clinical variables (e.g. CD4 cell count, plasma HIV viral load, AIDS-defining illness, hepatitis C co-infection, mortality) and treatment variables (e.g. HAART regimens, date of treatment initiation, treatment interruptions, adherence data, resistance testing). Research findings from the HOMER cohort have featured in numerous high-impact peer-reviewed journals. The HOMER cohort collaborates with other HIV cohorts on both national and international scales to answer complex HIV-specific research questions, and welcomes input from external investigators regarding potential research proposals or future collaborations. For further information please contact the principal investigator, Dr Robert Hogg (firstname.lastname@example.org). PMID:24639444
Freimuth, Robert R; Wix, Kelly; Zhu, Qian; Siska, Mark; Chute, Christopher G
We evaluated the potential use of RxNorm to provide standardized representations of generic drug name and route of administration to facilitate management of drug lists for clinical decision support (CDS) rules. We found a clear representation of generic drug name but not route of administration. We identified several issues related to data quality, including erroneous or missing defined relationships, and the use of different concept hierarchies to represent the same drug. More importantly, we found extensive semantic precoordination of orthogonal concepts related to route and dose form, which would complicate the use of RxNorm for drug-based CDS. This study demonstrated that while RxNorm is a valuable resource for the standardization of medications used in clinical practice, additional work is required to enhance the terminology so that it can support expanded use cases, such as managing drug lists for CDS. PMID:25954360
Freimuth, Robert R.; Wix, Kelly; Zhu, Qian; Siska, Mark; Chute, Christopher G.
We evaluated the potential use of RxNorm to provide standardized representations of generic drug name and route of administration to facilitate management of drug lists for clinical decision support (CDS) rules. We found a clear representation of generic drug name but not route of administration. We identified several issues related to data quality, including erroneous or missing defined relationships, and the use of different concept hierarchies to represent the same drug. More importantly, we found extensive semantic precoordination of orthogonal concepts related to route and dose form, which would complicate the use of RxNorm for drug-based CDS. This study demonstrated that while RxNorm is a valuable resource for the standardization of medications used in clinical practice, additional work is required to enhance the terminology so that it can support expanded use cases, such as managing drug lists for CDS. PMID:25954360
Khalil, Mohammed K; Kirkley, Debbie L; Kibble, Jonathan D
This article describes the development of an interactive computer-based laboratory manual, created to facilitate the teaching and learning of medical histology. The overarching goal of developing the manual is to facilitate self-directed group interactivities that actively engage students during laboratory sessions. The design of the manual includes guided instruction for students to navigate virtual slides, exercises for students to monitor learning, and cases to provide clinical relevance. At the end of the laboratory activities, student groups can generate a laboratory report that may be used to provide formative feedback. The instructional value of the manual was evaluated by a questionnaire containing both closed-ended and open-ended items. Closed-ended items using a five-point Likert-scale assessed the format and navigation, instructional contents, group process, and learning process. Open-ended items assessed student's perception on the effectiveness of the manual in facilitating their learning. After implementation for two consecutive years, student evaluation of the manual was highly positive and indicated that it facilitated their learning by reinforcing and clarifying classroom sessions, improved their understanding, facilitated active and cooperative learning, and supported self-monitoring of their learning. PMID:23408507
Ilgner, Justus F. R.; Kawai, Takashi; Shibata, Takashi; Yamazoe, Takashi; Westhofen, Martin
Introduction: An increasing number of surgical procedures are performed in a microsurgical and minimally-invasive fashion. However, the performance of surgery, its possibilities and limitations become difficult to teach. Stereoscopic video has evolved from a complex production process and expensive hardware towards rapid editing of video streams with standard and HDTV resolution which can be displayed on portable equipment. This study evaluates the usefulness of stereoscopic video in teaching undergraduate medical students. Material and methods: From an earlier study we chose two clips each of three different microsurgical operations (tympanoplasty type III of the ear, endonasal operation of the paranasal sinuses and laser chordectomy for carcinoma of the larynx). This material was added by 23 clips of a cochlear implantation, which was specifically edited for a portable computer with an autostereoscopic display (PC-RD1-3D, SHARP Corp., Japan). The recording and synchronization of left and right image was performed at the University Hospital Aachen. The footage was edited stereoscopically at the Waseda University by means of our original software for non-linear editing of stereoscopic 3-D movies. Then the material was converted into the streaming 3-D video format. The purpose of the conversion was to present the video clips by a file type that does not depend on a television signal such as PAL or NTSC. 25 4th year medical students who participated in the general ENT course at Aachen University Hospital were asked to estimate depth clues within the six video clips plus cochlear implantation clips. Another 25 4th year students who were shown the material monoscopically on a conventional laptop served as control. Results: All participants noted that the additional depth information helped with understanding the relation of anatomical structures, even though none had hands-on experience with Ear, Nose and Throat operations before or during the course. The monoscopic group generally estimated resection depth to much lesser values than in reality. Although this was the case with some participants in the stereoscopic group, too, the estimation of depth features reflected the enhanced depth impression provided by stereoscopy. Conclusion: Following first implementation of stereoscopic video teaching, medical students who are inexperienced with ENT surgical procedures are able to reproduce depth information and therefore anatomically complex structures to a greater extent following stereoscopic video teaching. Besides extending video teaching to junior doctors, the next evaluation step will address its effect on the learning curve during the surgical training program.
Lenore B. Behar
In summary, the Preschool Behavior Questionnaire was developed as a screening instrument for use by preschool teachers, providing norms for children, ages 3–6. During the 34-month period since its publication in late 1974, the scale has been used to a considerable extent in the screening of young children. Those who have used the scale evaluate it highly. However, the variations
Bru, Juan; Berger, Christopher A
Background Point-of-care electronic medical records (EMRs) are a key tool to manage chronic illness. Several EMRs have been developed for use in treating HIV and tuberculosis, but their applicability to primary care, technical requirements and clinical functionalities are largely unknown. Objectives This study aimed to address the needs of clinicians from resource-limited settings without reliable internet access who are considering adopting an open-source EMR. Study eligibility criteria Open-source point-of-care EMRs suitable for use in areas without reliable internet access. Study appraisal and synthesis methods The authors conducted a comprehensive search of all open-source EMRs suitable for sites without reliable internet access. The authors surveyed clinician users and technical implementers from a single site and technical developers of each software product. The authors evaluated availability, cost and technical requirements. Results The hardware and software for all six systems is easily available, but they vary considerably in proprietary components, installation requirements and customisability. Limitations This study relied solely on self-report from informants who developed and who actively use the included products. Conclusions and implications of key findings Clinical functionalities vary greatly among the systems, and none of the systems yet meet minimum requirements for effective implementation in a primary care resource-limited setting. The safe prescribing of medications is a particular concern with current tools. The dearth of fully functional EMR systems indicates a need for a greater emphasis by global funding agencies to move beyond disease-specific EMR systems and develop a universal open-source health informatics platform. PMID:22763661
Yarmohammadian, Mohammad Hossein; Mohebbi, Nooshin
Background: Sensitivity of teaching and learning processes in universities emphasizes the necessity of assessment of the quality of education which improves the efficiency and effectiveness of the country. This study was conducted with an aim to review and develop the evaluation criteria of health information technology course at Master of Science level in Tehran, Shahid Beheshti, Isfahan, Shiraz, and Kashan medical universities in 2012 by using CIPP model. Materials and Methods: This was an applied and descriptive research with statistical population of faculty members (23), students (97), directorates (5), and library staff (5), with a total of 130 people, and sampling was done as a census. In order to collect data, four questionnaires were used based on Likert scale with scores ranging from 1 to 5. Questionnaires’ validity was confirmed by consulting with health information technology and educational evaluation experts, and questionnaires’ reliability of directorates, faculty, students, and library staff was tested using the Cronbach's alpha coefficient formula, which gave r = 0.74, r = 0.93, r = 0.98, and r = 0.80, respectively. SPSS software for data analysis and both descriptive and inferential statistics containing mean, frequency percentage, standard deviation, Pearson correlation, and Spearman correlation were used. Results: With studies from various sources, commentary of experts, and based on the CIPP evaluation model, 139 indicators were determined and then evaluated, which were associated with this course based on the three factors of context, input, and process in the areas of human resources professional, academic services, students, directors, faculty, curriculum, budget, facilities, teaching–learning activities, and scientific research activities of students and faculty, and the activities of the library staff. Conclusion: This study showed that in total, the health information technology course at the Master of Science level is relatively good, but trying to improve and correct it in some areas and continuing the evaluation process seems necessary. PMID:25883998
Watling, Christopher J.; Lingard, Lorelei
An essential goal of evaluation is to foster learning. Across the medical education spectrum, evaluation of clinical performance is dominated by subjective feedback to learners based on observation by expert supervisors. Research in non-medical settings has suggested that participants' perceptions of evaluation processes exert considerable…
Chen, Bojiang; Wang, Youjuan; Cao, Huibi; Liu, Dan; Zhang, Shangfu; Gao, Jun; Yu, Jianqun; Huang, Yan; Li, Weimin
The standard definition of high-risk individuals for lung cancer was not uniform and the value of chest digital radiography (DR) in lung cancer screening was still unproven. The aim of this study was to assess whether the original questionnaire named as "Self-evaluation Scoring Questionnaire for High-risk Individuals of Lung Cancer" combined with DR examinations could detect early stage of lung cancer effectively. The Self-evaluation Scoring Questionnaire for High-risk Individuals of Lung Cancer had been designed in previous studies. Subjects with scores over 116 points were regarded as high-risk individuals and underwent the current DR scans at least once a year from 2007 to 2009. Noncalcified nodules with a diameter over 30 mm, along with enlarged pulmonary hilus and atelectasis, were considered to be positive and subjected to further special examinations. Efficacy of the scoring questionnaire combined with DR scans was estimated by 3-year results. Among 1,537 subjects, 13, 11, and 7 were diagnosed with lung cancer in the first, second, and third year, respectively, indicating the detection rate of 2.02 % (31/1,537). In addition, 77.42 % (24/31) of the patients were in stage I and 51.61 % (16/31) were adenocarcinomas. For the 31 cases, 28 were defined as detected cancers, while the other three were interval ones, only accounting for 0.20 % (3/1,504) of individuals with negative judgments. The protocol of Self-evaluation Scoring Questionnaire for High-risk Individuals of Lung Cancer combined with DR scans is a cost-effective and safe approach to detect early stage of lung cancer. PMID:22411060
Ghahrani, Nassim; Balaghafari, Azita; Aligolbandi, Kobra; Vahedi, Mohammad; Siamian, Hasan
Background and purpose: One of the most common ways used in most of the countries and Iran to determine the status of teacher training is the evaluation by students. The most common method of evaluation is the survey questionnaire, the content of a number of questions about educational activities provided to the students. The researchers plan to evaluate the students’ and experts’ performances at Mazandaran University of Medical Sciences on the process of evaluating the performance of teachers, they examined in 2014. Materials and methods: This study surveys the students and experts in the evaluation of faculty members’ performance process. The study subjects were 3904 students and 37 evaluation expert of Mazandaran University of Medical Sciences. Using Cochran sampling formula of 350 students through proportional stratified random sampling were selected. The experts’ viewpoint, method was used. Data collection tools consisted of 14 questions with answers Yes, or, I don’t know. Descriptive Statistical analysis of the data and chi-square test was performed. Results: From total of 350 students, 346 and the entire 37 evaluations expert participated in this study. Most of the students, 80 (23.12%) and the largest number of experts, 8 (21.62%) were from Sari Allied Medical Sciences Faculty. Most of the demographic information about gender were, 255 female students (74.56%) and 29 female experts (78.37%). In most age groups of students, 188 (55.62 percent) were in the category of 18 to 20 years, and the experts, 19 (51.35%) were in the category of 22 and 31 years. Most students, 232 of them (70.95%) were in semester 2 and 4. Most experts, 20 (54.05 percent) were under 10 years of work experience. The comparison between the views of students and experts in the evaluation process between the schools of Mazandaran University of Medical Sciences, Sari School of Nursing and Midwifery, there was difference between the opinions of experts and students (p-value=0.01. It showed 86.7% student and 33.3% of experts is satisfied with the evaluation process. Conclusion: on comparison of students and experts viewpoints on the implementation of the evaluation process, it is noteworthy that among students of different opinions on how the evaluation process. It worth to mention that there is insignificant difference between their viewpoints and majority of students and evaluation experts with the evaluation the process. In addition, the experts evaluated at different schools, most of them are satisfied the process. PMID:26236169
Heydarpour, Pouria; Hafezi-Nejad, Nima; Khodabakhsh, Ali; Khosravi, Mohsen; Khoshkis, Shayan; Sadeghian, Majid; Samavat, Bijan; Faturechi, Ali; Pasalar, Parvin; Dehpour, Ahmad Reza
Podcasting has become a popular means of transferring knowledge in higher education through making lecture contents available to students at their convenience. Accessing courses on media players provides students with enhanced learning opportunities. Development of teaching methods able to cope with ever-changing nature of medicine is crucial to train the millennium students. Pharmacology education in Tehran University of Medical Sciences has been based on lectures so far; our aim was to implement a pilot study to evaluate the advantages and disadvantages of offering the course contents as podcasts as well as evaluating whether such program can be feasible in our educational program. 46% of students downloaded the podcast according to our download center. 48% favored usage of both internet and DVD-ROM concurrently. Overall 96% of students perceived that podcasting had a positive impact on their learning in pharmacology course. Our results indicate that most of attendants proposed the positive yields of podcasting despite low usage of it, mainly as a pre-class preparing tool. PMID:23456586
...applied by the Coast Guard in making medical fitness determinations for issuance of merchant...applied by the Coast Guard in making medical fitness determinations for issuance of merchant...the ultimate determination of medical fitness rests with the Coast Guard,...
Alepis, Efthymios; Virvou, Maria
Mobile computing facilities may provide many assets to the educational process. Mobile technology provides software access from anywhere and at any time, as well as computer equipment independence. The need for time and place independence is even greater for medical instructors and medical students. Medical instructors are usually doctors that…
Allan, Nicholas P.; Lonigan, Christopher J.; Wilson, Shauna B.
Temperament is a developmentally important construct, hierarchically comprised of several lower-order dimensions subsumed under effortful control, negative affectivity, and surgency. The Children's Behavior Questionnaire-Very Short Form (CBQ-VSF) was developed as a brief measure of the higher-order factors of temperament to aid researchers in…
Ottmar, Erin R.; Konold, Timothy R.; Berry, Robert Q.; Grissmer, David W.; Cameron, Claire E.
Psychometric properties of 24 items from the fifth grade Early Childhood Longitudinal Study-Kindergarten Cohort Mathematics Teacher Questionnaire were investigated in a sample of 5,181 participants. These items asked teachers to report how often they had their classroom students engage in different mathematics content, skills and instructional…
Sarafino, Edward P.; Graham, James A.
The Preferred Items and Experiences Questionnaire (PIEQ) is a new instrument to assess reinforcer preferences in adolescents and adults. Research was conducted with college and high school students to develop the PIEQ, to examine its reliability with test-retest and internal consistency methods, and to test its validity. This research provides…
Greco, Laurie A.; Lambert, Warren; Baer, Ruth A.
The authors describe the development and validation of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y), a child-report measure of psychological inflexibility engendered by high levels of cognitive fusion and experiential avoidance. Consistent with the theory underlying acceptance and commitment therapy (ACT), items converged into a…
Ntoumanis, Nikos; Aggelonidis, Yannis
The purpose of this study was to examine the psychometric properties of the Group Environment Questionnaire (GEQ) adapted to the Greek language. The sample consisted of 586 male and female volleyball players of elite and regional level status. Data were analysed from three time points of a competitive season. For each time point, seven competing…
Doralp, Samantha; Bartlett, Doreen
This paper highlights the development and testing of the Infant Movement Motivation Questionnaire (IMMQ), an instrument designed to evaluate qualities of infant characteristics that relate specifically to early motor development. The measurement development process included three phases: item generation, pilot testing and evaluation of acceptability and feasibility for parents and exploratory factor analysis. The resultant 27-item questionnaire is designed for completion by parents and contains four factors including Activity, Exploration, Motivation and Adaptability. Overall, the internal consistency of the IMMQ is 0.89 (Cronbach's alpha), with test-retest reliability measured at 0.92 (ICC, with 95% CI 0.83-0.96). Further work could be done to strengthen the individual factors; however it is adequate for use in its full form. The IMMQ can be used for clinical or research purposes, as well as an educational tool for parents. PMID:24861943
F. Asghari; A. Fotouhi; A. Jafarian
BackgroundThis study aims at evaluating doctors' attitudes towards handling medical errors made by their peers.MaterialsThis cross-sectional questionnaire survey was conducted between April and July 2006 and targeted general practitioners attending continuing medical education programmes in Tehran. A total of 474 doctors were approached, 400 of whom completed the questionnaire. The questionnaire contained a clinical vignette with three hypothetical patient outcomes:
Avrunin, George S.
A Benchmark for Evaluating Software Engineering Techniques for Improving Medical Processes Stefan C@nursing.umass.edu ABSTRACT The software engineering and medical informatics communi- ties have been developing a range data-driven process improvement. To address such concerns, the software engineering and medical
Siobhan Gallanagh; Davide Castagno; Ben Wilson; Erland Erdmann; Faiez Zannad; Willem J. Remme; José L. Lopez-Sendon; Philippe Lechat; Ferenc Follath; Christer Höglund; Viacheslav Mareev; Zygmunt Sadowski; Ricardo J. Seabra-Gomes; Henry J. Dargie; John J. V. McMurray
Aims We evaluated a generic quality of life (QoL) Functional Status Questionnaire (FSQ), in patients with chronic heart failure\\u000a (CHF). The FSQ assesses the 3 main dimensions of QoL: physical functioning, mental health and social role. It also includes\\u000a 6 single item questions about: work status, frequency of social interactions, satisfaction with sexual relationships, days\\u000a in bed, days with restricted activity
Nagata, Satoko; Gregg, Misuzu F; Miki, Yuko; Arimoto, Azusa; Murashima, Sachiyo; Kim, Mi Ja
Evaluation of doctoral education in nursing is needed with the rapid increase in doctoral nursing programs in Japan. This study aimed to compare the evaluations of doctoral nursing education by students, graduates, and faculty. All 46 doctoral nursing programs in Japan were target settings. 127 students who had been in the doctoral program, 24 graduates and 87 faculty members had responded to the survey. A questionnaire with 17 items for program evaluation, 12 items for faculty evaluation, 9 items for resource evaluation, and 3 for overall evaluations was distributed in November and December 2008. Responses to 1 program evaluation item, 2 faculty evaluation items and 4 resource evaluation items indicated significant differences among evaluators. While 79.2% of graduates responded positively that the number of faculty members was sufficient to facilitate learning, only 36.1% of faculty members and 49.6% of students responded affirmatively. Graduates' ratings were the most positive and faculty members were the least positive, especially for infrastructure or equipment such as libraries, computers, and the number of technical and support staff. The significant differences among the evaluators suggested that having evaluators in various roles is important to evaluate the quality of doctoral nursing education. PMID:21665333
Schmidmaier, Ralf; Holzer, Matthias; Angstwurm, Matthias; Nouns, Zineb; Reincke, Martin; Fischer, Martin R.
Aims: The Medical Curriculum Munich (MeCuM) has been implemented since 2004 and was completely established in 2007. In this study the clinical part of MeCuM was evaluated with respect to retention of the knowledge in internal medicine (learning objectives of the 6th/7th semester). Methods: In summer of 2009 and winter of 2009/2010 1065 students participated in the Progress Test Medizin (PTM) from Charité Medical School Berlin. Additionally the students answered a questionnaire regarding the acceptance and rating of the progress test and basic demographic data. Results: The knowledge of internal medicine continuously increases during the clinical part of the medical curriculum in Munich. However, significant differences between the sub-disciplines of internal medicine could be observed. The overall acceptance of the PTM was high and increased further with the study progress. Interestingly, practical experiences like clinical clerkships positively influenced the test score. Conclusions: The PTM is a useful tool for the evaluation of knowledge retention in a specific curriculum. PMID:21818215
Sivan, Atara; Chan, Dennis W K; Kwan, Yee Wan
This study validated the Chinese version of the Questionnaire on Teacher Interaction (C-QTI) with two samples (ns = 370 and 369) of primary school students in Hong Kong. The 48-item measure had acceptable internal consistency reliability, but the reliability coefficients of four of the scales were too low. The findings supported the validity of the circumplex model underlying the instrument and verified the ability of the measure to differentiate between students' perceptions in different classes. With the refinement of the measure based on reliability analysis and Principal Components Analysis, Confirmatory Factor Analysis was conducted on the 35-item instrument to test its hypothesized factor structure. Findings on model fit indices were mixed, lending some support to the eight-factor structure of the questionnaire. PMID:25074304
Mitchell, J B; Pozen, M W; D'Agostino, R B; Berezin, M M
Evaluations of emergency medical service (EMS) programs have been ambiguous, due in part, to problems of sample definition. Four different sampling strategies were studied: 1) all patients in cardiac arrest; 2) patients with a final diagnosis of myocardial infarction (MI); 3) patients with an emergency room diagnosis of "rule out MI"; and 4) patients identified by the ambulance team as a possible MI. Using a regional data base of all ambulance runs, we created study samples based on each of these strategies and measured the error that may be introduced as a result of sample selection. Bias was measured along three parameters of EMS system performance: 1) observed incidence of MI in the ambulance system; 2) condition recognition--the ability of the ambulance team to correctly identify acute cardiac patients; and 3) emergency room and hospital mortality rates. The emergency room diagnosis strategy systematically excludes all false-positives, while samples based on the ambulance team's assessment omit all false-negatives. The final diagnosis strategy yields significant underestimates of cardiac mortality. Samples restricted to cardiac arrests result in biased estimates of both the incidence of MI and the number of deaths. PMID:470472
Lloyd, Charles W.; Martin, William J.; Gosbee, John
The goal was to visually evaluate the effect gravity has on delivery of medications by the use of various aerosol devices. During parabolic flight the same four aerosols were retested as performed in studio ground tests. It appears that the Cetacaine spray and the Ventolin inhaler function without failure during all test. The pump spray (Nostril) appeared to function normally when the container was full, however it appeared to begin to fail to deliver a full mist with larger droplet size when the container was nearly empty. The simple hand spray bottle appeared to work when the container was full and performed progressively worse as the container was emptied. During Apollo flights, it was reported that standard spray bottles did not work well, however, they did not indicate why. It appears that we would also conclude that standard spray bottles do not function as well in zero gravity by failing to produce a normal mist spray. The standard spray bottle allowed the fluid to come out in a narrow fluid stream when held with the nozzle either level or slightly tilted upward.
Sagi, Sreedhar; Wendt-Nordahl, Gunnar; Alken, Peter; Knoll, Thomas
Medical treatment for cystinuria aims to decrease the concentration of cystine in the urine, increase its solubility and therefore prevent stone formation. Ascorbic acid and captopril have been recommended as alternatives to thiol drugs, though conflicting data undermining their efficacy has been widely reported, too. The aim of this study was to verify the effects of ascorbic acid and captopril on cystine stone formation in the cystinuria mouse model. A total of 28 male homozygous pebbles mice were used for characterizing the mice on normal diet, ascorbic acid and captopril supplemented diets. The baseline physiological parameters of the mice were determined initially. The normal diet was then replaced with the supplemented diet (ascorbic acid/captopril) for the next 48 weeks and various biochemical parameters in urine and plasma were analyzed. All homozygous mice developed urinary cystine stones during the first year of life. No reduction in the urinary cystine concentration was seen with either of the supplemented diets. The stone mass varied widely in the study and a beneficial effect of ascorbic acid in some of the animals was possible though an overall statistical significance was not seen. Conclusions: The cystinuria mouse model provides an ideal tool for evaluation of stone preventive measures in a standardized environment. This study confirms that ascorbic acid and captopril are not effective in cystinuria.
Khak, Mohammad; Hassanijirdehi, Marzieh; Afshari-Mirak, Sohrab; Holakouie-Naieni, Kourosh; Saadat, Soheil; Taheri, Taher; Rahimi-Movaghar, Vafa
Sexual activity is an important aspect of life in patients with spinal cord injury (SCI), rated as one of the top priorities for recovery of function. This study was conducted to establish an understanding of the severity of erectile dysfunction (ED), a major component of male sexual activity, and its correlates in patients with SCI in our community. In a cross-sectional study, 37 male veterans with SCI admitted for regular follow-up at our center were recruited. Demographic and SCI-related descriptive information was gathered through a self-administered questionnaire. Sexual Health Inventory for Men was used to assess the presence and severity of ED. Euro Quality of Life questionnaire and General Health Questionnaire (GHQ-12) were also administered. The mean age of the participants was 45.7 ± 6.5 years with injury duration of 24.7 ± 6.2 years. Mean GHQ-12 score of 3.65 ± 3.38 and mean Sexual Health Inventory for Men score of 11.57 ± 5.28 were measured. All participants had ED, and 27% were suffering from severe ED. Sleep deprivation, worse GHQ-12 score, and hypertension were significantly associated with higher risk of much severe ED (p < .05). In conclusion, ED is a common problem in veterans with SCI and is inversely associated with their general health status. PMID:25432464
Menakaya, C U; Khan, A S; Nunn, T; Pennington, N; Ward, M; Malhotra, R; Muthukumar, N; Mohsen, A
This paper explores patients' perceptions of a new service and protocol for managing outpatient venous thromboembolism (VTE) prophylaxis, using either subcutaneous Dalteparin or oral off-license Dabigatran in patients with lower limb injury requiring immobilisation. Establishing a patient's perspective is part of good practice as, when this is positive, it aids patient compliance and protocol dissemination. A questionnaire consisting of fifty questions was given at random to one hundred patients over a six month period when they attended the trauma clinic. Each question was scored on a five point Likert scale (1 = poor, 5 = excellent) by the patient. The internal consistency of the questionnaire (Cronbach's alpha reliability coefficient) was more than 0.9 in all domains. Qualitative analysis was done for open-ended questions. One hundred respondents completed the questionnaire, two were void due to significant amounts of incomplete data. The gender split was 54 females, 43 males, and one did not answer the question. The average age was 43 (range 18-72). Sixty seven respondents were first-time attenders, 22 were follow-up patients and nine did not complete this section. The overall average score was 4.26 (range 1-5), with 90% of the patients recommending the service. The overall patient satisfaction for a VTE prophylaxis service is high although there is room for improvement as demonstrated by the range of the scores. PMID:26012185
Papanikolaou, Dimitrios; Papanikolaou, Ioannis; Diakakis, Michalis; Deligiannakis, Georgios
In the face of a growing number of natural disasters and the increasing costs associated with them, Europe and Greece in particular, have devoted significant efforts and resources in natural hazards mitigation during the last decades. Despite the significant legislative efforts (e.g. 1998/22/EC, 2001/792/EC, 2007/60/EC Directives, 3013/2002 Act) and even though a number of steps has been taken towards improving civil protection, recent catastrophic events have illustrated the weaknesses of current approaches. In particular, in Greece, events such as the 1999 Athens earthquake, the 2007 and 2009 wildfires have shown the inadequacy of prevention and mitigation practices. Given the enhanced civil protection responsibilities, given by the Greek national law (Acts 3013/2002, 3852/2010) to local authorities in Greece, this work analyses and evaluates the existing structure and current management framework under which local authorities function and examines their risk mitigation practices. We conducted the largest questionnaire survey regarding Civil Protections issues, among the municipalities of Greece. To this aim, this work used a innovative online tool to assess current framework. Therefore, a network connecting civil protection departments of municipalities was developed, based on an Internet platform that acted also as a communication tool. Overall, we had feedback either online or offline from 125 municipalities across the country (representing more than one/third of the total municipalities of Greece). Through this network, municipal civil protection officials completed surveys designed to obtain and quantify information on several aspects of civil protection practices and infrastructure. In particular, the examined factors included: (i) personnel and equipment, (ii) inter-agency cooperation, (iii) training, (iv) compliance with existing regulations and (v) persistent problems encountered by civil protection departments, that prevent the effectiveness of current practices. Responses showed that civil protection personnel lack adequate training and expertise, many are overstretched with several duties, while several prevention actions are carried out by seasonal or voluntary staff. Approximately half of the heads of civil protection offices do not hold a university degree, only 27% have a relevant scientific background (geoscientists or engineers) and more than half of them are elected members and not permanent staff, implying that no continuity is secured. Inter-agency cooperation is shown to be poor and organizational learning from international practices not adequate. Half of the municipalities report that the authorization processes are too slow so that prevention actions particularly regarding forest fires are severely delayed. Existing regulations are not followed by a significant portion of municipalities since 19% have not established a civil protection office and 23% have not compiled an action plan yet. Existing action plans lack important information, present no spatial data and are predominantly catalogues and tables of information regarding authorised personnel and equipment. Overall, underfunding, poor coordination of the different actors involved, lack of training and understaffing, lack of proper equipment and several other issues are held responsible by officials for preventing effectiveness of current practices. Finally, the EU emergency number 112 is widely unknown (87%). This work was held under the LIFE+ project "Local Authorities Alliance for Forest Fire Prevention - LIFE08/ENV/GR/000553" which is implemented with the contribution of the LIFE financial instrument of the European Community.
Hordinsky, J. R.
The Skylab program established the opportunity for the first time to perform extensive medical experimentation on man in a long-term zero-g environment. This experimentation involved metabolic studies, cardiovascular systems, nutrition and mineral balance, hematology, vestibular function, and many other related investigations. This report presents an overview of the significant results of the medical experiments performed during the program and a summary of the medical observations gathered by the team of life scientists.
Skipper, James K., Jr.; And Others
An evaluation of an experimental problem-based medical education curriculum used with 18 first-year students at the Bowman Gray Medical School of Wake Forest University is discussed. The study, which included a matched group of students experiencing a traditional curriculum, provides insights into design problems in such evaluations. (TJH)
Newton, Alice Whittier; Vandeven, Andrea Marie
It was only 30 years ago that the medical community began to develop an increased awareness of child sexual abuse, and the role of the medical provider in the evaluation of sexually abused children has evolved significantly. As clinicians worldwide develop a greater understanding of the impact of the sexual abuse evaluation on the child, the roles…
...and Research Report of Scientific and Medical Literature...Biologics Evaluation and Research (CBER), Food and...Biologics Evaluation and Research (HFM-17), Food...comments on its report of scientific and medical literature...extract(s) studied and method of preparation;...
Carr, Sandra; Iredell, Helena; Newton-Smith, Carol; Clark, Catherine
Medical practitioners need the skills to find relevant information and evaluate its authenticity, validity, and reliability. The learning of information literacy has been embedded in the University of Western Australia (UWA) medical course since 2000. The purpose of this study was to evaluate the effectiveness of the enhanced information literacy…
Anyaehie, U. S. B.; Nwobodo, E.; Oze, G.; Nwagha, U. I.; Orizu, I.; Okeke, T.; Anyanwu, G. E.
The expansion of biomedical knowledge and the pursuit of more meaningful learning have led to world-wide evidence-based innovative changes in medical education and curricula. The recent emphasis on problem-based learning (PBL) and student-centred learning environments are, however, not being implemented in Nigerian medical schools. Traditional…
Bastian, Mauresa; Eggett, Dennis L; Jefferies, Laura K
Question placement and usage of pre-evaluation instructions (PEI) in questionnaires for food sensory analysis may bias consumers' scores via carry-over effects. Data from consumer sensory panels previously conducted at a central location, spanning 11 years and covering a broad range of food product categories, were compiled. Overall acceptance (OA) question placement was studied with categories designated as first (the first evaluation question following demographic questions), after nongustation questions (immediately following questions that do not require panelists to taste the product), and later (following all other hedonic and just-about-right [JAR] questions, but occasionally before ranking, open-ended comments, and/or intent to purchase questions). Each panel was categorized as having or not having PEI in the questionnaire; PEI are instructions that appear immediately before the first evaluation question and show panelists all attributes they will evaluate before receiving test samples. Postpanel surveys were administered regarding the self-reported effect of PEI on panelists' evaluation experience. OA scores were analyzed and compared (1) between OA question placement categories and (2) between panels with and without PEI. For most product categories, OA scores tended to be lower when asked later in the questionnaire, suggesting evidence of a carry-over effect. Usage of PEI increased OA scores by 0.10 of a 9-point hedonic scale point, which is not practically significant. Postpanel survey data showed that presence of PEI typically improved the panelists' experience. Using PEI does not appear to introduce a meaningful carry-over effect. PMID:25604650
Thompson, C L; Schulz, Wade L; Terrence, Adam
The University of Minnesota medical student wiki (UMMedWiki) allows students to collaboratively edit classroom notes to support medical education. Since 2007, UMMedWiki has grown to include 1,591 articles that have collectively received 1.2 million pageviews. Although small-scale wikis have become increasingly important, little is known about their dynamics compared to large wikis, such as Wikipedia. To better understand UMMedWiki's management and its potential reproducibility at other medical schools, we used an edit log with 28,000 entries to evaluate the behavior of its student editors. The development of tools to survey UMMedwiki allows for quality comparisons that improve both the wiki and the curriculum itself. We completed a content survey by comparing the UMMedWiki with two types of rubric data: TIME, a medical education taxonomy consisting of 1500 terms and national epidemiological data on 2,100 diseases. PMID:22195202
Thompson, CL; Schulz1, Wade L.; Terrence, Adam
The University of Minnesota medical student wiki (UMMedWiki) allows students to collaboratively edit classroom notes to support medical education. Since 2007, UMMedWiki has grown to include 1,591 articles that have collectively received 1.2 million pageviews. Although small-scale wikis have become increasingly important, little is known about their dynamics compared to large wikis, such as Wikipedia. To better understand UMMedWiki’s management and its potential reproducibility at other medical schools, we used an edit log with 28,000 entries to evaluate the behavior of its student editors. The development of tools to survey UMMedwiki allows for quality comparisons that improve both the wiki and the curriculum itself. We completed a content survey by comparing the UMMedWiki with two types of rubric data: TIME, a medical education taxonomy consisting of 1500 terms and national epidemiological data on 2,100 diseases. PMID:22195202
Barsky, A J; Wyshak, G; Klerman, G L
We attempted to integrate the DSM-III criteria for hypochondriasis with the clinical literature and derived six positive and two negative diagnostic criteria. Seven of these were assessed in a random sample of 92 medical outpatients by means of a self-report questionnaire, structured interview, and medical record audit. The results are in accord with previous work: there appears to be considerable internal validity and consistency in the syndrome in that disease conviction, disease fear, bodily preoccupation, and somatic symptoms are significantly intercorrelated. The three hypochondriacal attitudes (conviction, fear, and preoccupation) were not statistically related to the number of medical diagnoses in the patients' medical records. Depressive symptoms, as measured by the Beck Depression Inventory, were highly correlated with the other hypochondriacal symptoms. The hypochondriacal syndrome in these patients appears to be consistent with the clinical disorder described in DSM-III. PMID:3964028
Harris, Ilene B.; And Others
Use of the Helping Relationship Inventory (HRI) to assess the impact of an introductory medical interviewing course on beginning medical students' preference for interview response modes was studied at the University of Minnesota. The HRI, a brief paper-and-pencil instrument, was administered as a pre-test and post-test for five consecutive years…
A partnership was formed to address the crisis that rural health care facilities in rural Nebraska face in attracting and hiring trained health care workers. The Rural Allied Medical Business Occupations (RAMBO) project trained economically disadvantaged individuals in high technology medical fields. Five objectives were outlined in the project:…
Jones, Bonnie J.; Borges, Nicole J.
Medical school admissions committees are expected to select physicians with specific attributes such as intelligence, altruism, dutifulness, and compassion. Besides basing these attributes on the best professional judgment of the physicians and medical school faculty, there has been little quantitative research to determine the psychological…
Lively, B T
Medication history taking is a commonly discussed factor in the role of the pharmacist. Effective and efficient interviewing skills are important since they can be influential in affecting the quality of the medication history. Level of risk taking has been related to many factors which affect personal interaction. The objective of this study was to relate level of risk taking to the successful outcome of the medication history interview. Outcome dimensions of the medication interview were defined as successful completion and unsuccessful completion. Senior pharmacy students were observed and rated relative to the performance criteria of effectiveness and efficiency in acquiring patient medication histories over an eight-week period in an ambulatory medicine clinic. A significant Kendall Coefficient of Concordance indicated that the judges involved applied essentially the same standards in ranking the subjects. Subjects were administered a six-item questionnaire, the Choice Dilemmas Questionnaire (CDQ), which measured their risk taking propensity. There were significant differences in mean levels of risk taking between the groups rated as high and low in terms of effectiveness and efficiency. Effective and efficient interviewers, who successfully completed interviews, were significantly higher in risk taking propensity. Tetrachoric r indicated the CDQ was efficient in distinguishing the criterion groups. PMID:10263626
Welch, Wayne W.; And Others
This was developed in collaboration with the White Bear Lake Senior High School Evaluation Committee to evaluate the school's flexible module scheduling program. It includes a questionnaire about the school and its program and a questionnaire form for interviews in the community. Part I of the high school questionnaire has 25 questions about the…
Forrest, David V
Techniques developed for teaching more empathic affect recognition and reflection to medical students during their introduction to psychiatric interviewing begin with a concrete grounding in facial muscular movements and facial affect recognition, and proceed to the use of countertransferential affective experience to aid in ascertaining personality types. Observations about the temper of today's medical students by psychoanalysts may be of help in avoiding increasing their already substantial characterological resistance to affective learning and empathy that has recently been reported in the medical education literature. PMID:21699350
Anyaehie, U S B; Nwobodo, E; Oze, G; Nwagha, U I; Orizu, I; Okeke, T; Anyanwu, G E
The expansion of biomedical knowledge and the pursuit of more meaningful learning have led to world-wide evidence-based innovative changes in medical education and curricula. The recent emphasis on problem-based learning (PBL) and student-centred learning environments are, however, not being implemented in Nigerian medical schools. Traditional didactic lectures thus predominate, and learning is further constrained by funding gaps, poor infrastructure, and increasing class sizes. We reviewed medical students' perceptions of their exposed learning environment to determine preferences, shortcomings, and prescriptions for improvements. The results confirm declining interest in didactic lectures and practical sessions with preferences for peer-tutored discussion classes, which were considered more interactive and interesting. This study recommends more emphasis on student-centered learning with alternatives to passive lecture formats and repetitive cookbook practical sessions. The institutionalization of student feedback processes in Nigerian medical schools is also highly recommended. PMID:21652499
Ohashi, Kumiko; Dykes, Patricia; McIntosh, Kathleen; Buckley, Elizabeth; Wien, Matt; Bates, David W.
While some published research indicates a fairly high frequency of Intravenous (IV) medication errors associated with the use of smart infusion pumps, the generalizability of these results are uncertain. Additionally, the lack of a standardized methodology for measuring these errors is an issue. In this study we iteratively developed a web-based data collection tool to capture IV medication errors using a participatory design approach with interdisciplinary experts. Using the developed tool, a prevalence study was then conducted in an academic medical center. The results showed that the tool was easy to use and effectively captured all IV medication errors. Through the prevalence study, violation errors of hospital policy were found that could potentially place patients at risk, but no critical errors known to contribute to patient harm were noted. PMID:24551395
Hofmann, Mareike; Hagemeier, Ina; Altenhain, Karsten; Kruse, Johannes
The quality of medical and psychological certificates and expert opinions in asylum and residence legislation was analyzed using judicial requirements as well as standards of the German Bundesärztekammer (SBPM). A sample of 53 cases of asylum seekers including 86 medical certificates and 15 expert opinions was evaluated qualitative and quantitative. The quality varies strongly from exemplary to insufficient. Predominantly, the medical certificates did not comply with judicial requirements. Two thirds of the expert opinions met the standards formulated by SBPM. Experts should write medical/psychological opinions being familiar with both traumatized individuals and refugees. The minimum requirements and standards should be better communicated to involved medical and psychological practitioners. PMID:23784797
Eisenstein, Eric L.; Ortiz, Maqui; Anstrom, Kevin J.; Crosslin, David R.; Lobach, David F.
Medical information systems are being recognized for their ability to improve patient outcomes. While standards for the economic evaluation of medical technologies were instituted in the mid-1990s, little is known about their application in medical information technology studies. In a review of medical information technology evaluation studies published between 1982 and 2002, we found that the volume and variety of economic evaluations had increased; however, investigators routinely omitted key cost or effectiveness elements in their designs, resulting in publications with incomplete, and potentially biased, economic findings. Of the studies that made economic claims, 23% did not report any economic data, 40% failed to include any effectiveness measures, and more than 50% used a case study or pre- post- test design. Thus, during a time when health economic study methods in general have experienced significant development, there is little evidence of similar progress in medical information technology economic evaluations. PMID:17238338
Sweeney, M P; Bagg, J; Kirkland, G; Farmer, T A
A resource pack has been devised for training medical and nursing staff and other carers in order that they may recognize oral disease and carry out routine oral care and treat common oral disorders. The custom-designed folding pack contains a videotape, a CD-ROM disc, and an A5-sized spiral-bound booklet, together with wall posters and a list of useful addresses. One hundred of the packs were distributed across Scotland to medical, nursing, and dental staff involved in postgraduate medical and nursing education. The packs were independently evaluated by an external organization through a questionnaire and also by telephone interviews. The pack received very positive responses, and 35% of the respondents reported making changes to their current practice. A long-term measure of success, beyond the scope of this paper, will depend on the measurement of improved quality of oral health care of the patients in those institutions where the pack has been used in training. PMID:11203895
Bhrolchain, C; Shribman, S J
There is an ongoing debate about the relative value of selective vs routine entrant medicals. This paper describes a districtwide study of entrant medicals using the tracer method to assess the prevalence and detection rates of problems at school entry. Overall 57% of school entrants were selected for a medical but there was a significant difference in selection rates in urban and rural schools. This selection rate is higher than that reported by other authors. There was a trend for tracer conditions to be more prevalent in urban areas although this was not statistically significant. Prevalence rates suggest that the method of selection successfully detected children with problems. The tracer methodology provided useful information for service planning without the collection of large amounts of data and has not, to our knowledge, been used before in community child health. We recommended this methodology to other districts as a simple and effective method of assessing selective entrant medicals. PMID:7716252
Eisenstein, Eric L.; Ortiz, Maqui; Anstrom, Kevin J.; Crosslin, David R.; Lobach, David F.
Standards for the economic evaluation of medical technologies were instituted in the mid-1990s, yet little is known about their application in medical information technology studies. In a review of evaluation studies published between 1982 and 2002, we found that the volume and variety of economic evaluations had increased. However, investigators routinely omitted key cost or effectiveness elements in their designs, resulting in publications with incomplete, and potentially biased, economic findings. PMID:17238533
Irby, David M; Wilkerson, Luann
As one of the first generation medical education pioneers, Charles W. Dohner, PhD established the ninth office of medical education at the University of Washington (UW) where he served as chairman from 1967-1996. With a background in education and measurement, he focused his work on evaluation of educational programs and faculty development. The Department of Medical Education went through three distinct stages of development: pathfinding 1967-1972 focused on developing working relationships with the faculty and clarifying identity, integration into academic affairs 1972-1980, and direct leadership by department faculty 1980-1996. Dohner helped to create and evaluate the WAMI program, a regional medical education program for the states of Washington, Alaska, Montana, and Idaho. He served as a consultant to a specialty board, the founding president of the Society of Directors of Research in Medical Education, and a frequent consultant in international medical education. Dohner identified three important innovations in medical education: educators in academic medicine, simulations and performance assessment, and community-based medical education. Success factors for professional education include technical competence in education, interpersonal communication and collaboration skills, a plan for personal growth, and use of mentors. Future trends in medical education will involve information technology, professionalism, wellness and complementary medicine, and performance assessment. He has been a passionate spokesman for excellence in medical education and most noted for his roles as an evaluator, program developer, and mentor of academic leaders. PMID:12652169
Watmough, Simon; O'Sullivan, Helen; Taylor, David
Background In 1996 The University of Liverpool reformed its medical course from a traditional lecture-based course to an integrated PBL curriculum. A project has been underway since 2000 to evaluate this change. Part of this project has involved gathering retrospective views on the relevance of both types of undergraduate education according to graduates. This paper focuses on the views of traditional Liverpool graduates approximately 6 years after graduation. Methods From February 2006 to June 2006 interviews took place with 46 graduates from the last 2 cohorts to graduate from the traditional Liverpool curriculum. Results The graduates were generally happy with their undergraduate education although they did feel there were some flaws in their curriculum. They felt they had picked up good history and examination skills and were content with their exposure to different specialties on clinical attachments. They were also pleased with their basic science teaching as preparation for postgraduate exams, however many complained about the overload and irrelevance of many lectures in the early years of their course, particular in biochemistry. There were many different views about how they integrated this science teaching into understanding disease processes and many didn't feel it was made relevant to them at the time they learned it. Retrospectively, they felt that they hadn't been clinically well prepared for the role of working as junior doctor, particularly the practical aspects of the job nor had enough exposure to research skills. Although there was little communication skills training in their course they didn't feel they would have benefited from this training as they managed to pick up had the required skills on clinical attachments. Conclusion These interviews offer a historical snapshot of the views of graduates from a traditional course before many courses were reformed. There was some conflict in the interviews about the doctors enjoying their undergraduate education but then saying that they didn't feel they received good preparation for working as a junior doctor. Although the graduates were happy with their undergraduate education these interviews do highlight some of the reasons why the traditional curriculum was reformed at Liverpool. PMID:19857252
This paper researched on course of registration and administrative licensing for medical device product specification, analyzed the existing demands of review and pre-evaluation, discussed about how to improve and manage pre-evaluation results for testing laboratory and manufacturer in China, based on "Provision of Medical Device Product Specification Standardization", "Provision on Medical Device Registration" and relative documents of States Food & Drug Administration. It suggested that set up and maintain a professional team of review and approval staff, further strengthen standardization of medical device specification, arming at current situations of non-compatibility between documents and inconformity of performance in different provinces. It paid attention to control the quality of medical device to ensure the core of safety and effectiveness for using medical device. PMID:24195397
Nakagawa, Yoshiaki; Tomita, Naoko; Irisa, Kaoru; Yoshihara, Hiroyuki; Nakagawa, Yoshinobu
Introduction of Electronic Medical Record (EMR) into a hospital was started from 1999 in Japan. Then, most of all EMR company said that EMR improved efficacy of the management of the hospital. National Hospital Organization (NHO) has been promoting the project and introduced EMR since 2004. NHO has 143 hospitals, 51 hospitals offer acute-phase medical care services, the other 92 hospitals offer medical services mainly for chronic patients. We conducted three kinds of investigations, questionnaire survey, checking the homepage information of the hospitals and analyzing the financial statements of each NHO hospital. In this financial analysis, we applied new indicators which have been developed based on personnel costs. In 2011, there are 44 hospitals which have introduced EMR. In our result, the hospital with EMR performed more investment of equipment/capital than personnel expenses. So, there is no advantage of EMR on the financial efficacy. PMID:23920774
Wiecha, John M; Markuns, Jeffrey F
To provide patient-centered care, physicians must be well trained in the concepts and methods of humanistic practice. Educational efforts to promote humanism may help to overcome the counter-training of the hidden medical school curriculum, responsible for a decline in empathy and idealism over the course of medical training. The online component of the clerkship in family medicine at Boston University introduced activities founded on reflection, self-awareness, collaborative learning, and applied practice to successfully promote student confidence in three key areas of humanistic practice. PMID:18830833
Krantz-Girod, Catherine; Bonvin, Raphael; Lanares, Jacques; Cueanot, Seagoleine; Feihl, Francois; Bosman, Fred; Waeber, Bernard
The second preclinical year of the medical curriculum at the Medical Faculty of the University of Lausanne in Switzerland includes nine multidisciplinary organ-system-oriented modules consisting of lectures and problem-based-learning tutorials. This study reports the experience accumulated with the evaluation of lectures during the academic years…
EmSe: Initial Evaluation of a Child-friendly Medical Search System Carsten Eickhoff, Leif Azzopardi://www.puppyir.eu) ABSTRACT When undergoing medical treatment in combination with extended stays in hospitals, children have been frequently found to develop an interest in their condition and the course of treatment. A natural
Daniels, W.J.; Orris, P.
Personal and area air samples were analyzed for ethylene oxide and waste anesthetic gases at Hennepin County Medical Center, Minneapolis, Minnesota in February, April, and July, 1984. The survey was requested by the center to evaluate health problems among employees. Medical questionnaires were administered and interviews were conducted with 59 employees in the instrument and operating room areas of the ear, nose, and throat, and surgery clinics. Ethylene-oxide was not detected during operation of the sterilizer. Nitrous-oxide concentrations of 66 to 138ppm were detected during surgical procedures. The authors conclude that a health hazard due to exposure to waste anesthetic gases exists at the center. Recommendations include evaluating the ventilation system and conducting additional monitoring for waste anesthetic gases.
Berg, Kelly C.; Peterson, Carol B.; Frazier, Patricia; Crow, Scott J.
Objective The purpose of this study was to systematically review the reliability of scores on the Eating Disorder Examination (EDE) and the Eating Disorder Examination-Questionnaire (EDE-Q) and to examine the validity of their use as measures of eating disorder symptoms. Method Articles describing the psychometric properties of the EDE and EDE-Q were identified in a systematic search of major computer databases and a review of reference lists. Articles were selected based on a priori inclusion and exclusion criteria. Results Fifteen studies were identified that examined the psychometrics of the EDE, whereas 10 studies were found that examined the psychometrics of the EDE-Q. Discussion Both instruments demonstrated reliability of scores. There is evidence that scores on the EDE and EDE-Q correlate with scores on measures of similar constructs and support for using the instruments to distinguish between cases and non-cases. Additional research is needed to broaden the generalizability of the findings. PMID:21744375
Shatenstein, Bryna; Payette, Hélène
A 36-item Short Diet Questionnaire (SDQ) was developed to assess usual consumption frequencies of foods providing fats, fibre, calcium, vitamin D, in addition to fruits and vegetables. It was pretested among 30 community-dwelling participants from the Québec Longitudinal Study on Nutrition and Successful Aging, “NuAge” (n = 1793, 52.4% women), recruited in three age groups (70 ± 2 years; 75 ± 2 years; 80 ± 2 years). Following revision, the SDQ was administered to 527 NuAge participants (55% female), distributed among the three age groups, both sexes and languages (French, English) prior to the second of three non-consecutive 24 h diet recalls (24HR) and validated relative to the mean of three 24HR. Full data were available for 396 participants. Most SDQ nutrients and fruit and vegetable servings were lower than 24HR estimates (p < 0.05) except calcium, vitamin D, and saturated and trans fats. Spearman correlations between the SDQ and 24HR were modest and significant (p < 0.01), ranging from 0.19 (cholesterol) to 0.45 (fruits and vegetables). Cross-classification into quartiles showed 33% of items were jointly classified into identical quartiles of the distribution, 73% into identical and contiguous quartiles, and only 7% were frankly misclassified. The SDQ is a reasonably accurate, rapid approach for ranking usual frequencies of selected nutrients and foods. Further testing is needed in a broader age range. PMID:26247965
Vazan, Peter; Mateu-Gelabert, Pedro; Cleland, Charles M; Sandoval, Milagros; Friedman, Samuel R
We report on psychometric properties of a new questionnaire to study long-term strategies, practices and tactics that may help injection drug users (IDUs) avoid infection with HIV and hepatitis C. Sixty-two long-term IDUs were interviewed in New York City in 2009. Five scales based on a total of 47 items were formed covering the following domains: stigma avoidance, withdrawal prevention, homeless safety, embedding safety within a network of users, and access to resources/social support. All scales (? ? .79) except one (? = .61) were highly internally consistent. Seven single-item measures related to drug use reduction and injection practices were also analyzed. All variables were classified as either belonging to a group of symbiotic processes that are not directly focused upon disease prevention but nonetheless lead to risk reduction indirectly or as variables describing prevention tactics in risky situations. Symbiotic processes can be conceived of as unintentional facilitators of safe behaviors. Associations among variables offer suggestions for potential interventions. These Staying Safe variables can be used as predictors of risk behaviors and/or biological outcomes. PMID:22038081
Shatenstein, Bryna; Payette, Hélène
A 36-item Short Diet Questionnaire (SDQ) was developed to assess usual consumption frequencies of foods providing fats, fibre, calcium, vitamin D, in addition to fruits and vegetables. It was pretested among 30 community-dwelling participants from the Québec Longitudinal Study on Nutrition and Successful Aging, "NuAge" (n = 1793, 52.4% women), recruited in three age groups (70 ± 2 years; 75 ± 2 years; 80 ± 2 years). Following revision, the SDQ was administered to 527 NuAge participants (55% female), distributed among the three age groups, both sexes and languages (French, English) prior to the second of three non-consecutive 24 h diet recalls (24HR) and validated relative to the mean of three 24HR. Full data were available for 396 participants. Most SDQ nutrients and fruit and vegetable servings were lower than 24HR estimates (p < 0.05) except calcium, vitamin D, and saturated and trans fats. Spearman correlations between the SDQ and 24HR were modest and significant (p < 0.01), ranging from 0.19 (cholesterol) to 0.45 (fruits and vegetables). Cross-classification into quartiles showed 33% of items were jointly classified into identical quartiles of the distribution, 73% into identical and contiguous quartiles, and only 7% were frankly misclassified. The SDQ is a reasonably accurate, rapid approach for ranking usual frequencies of selected nutrients and foods. Further testing is needed in a broader age range. PMID:26247965
Siegal, Harvey A.; And Others
The Week-end Intervention Program (WIP) used by Wright State University School of Medicine, which assesses the alcohol problems of those convicted of offenses such as drunk driving and then assists in finding treatment, is described. The impact of the program in educating medical students about alcoholism is discussed. (MLW)
Bacro, Thierry R. H.; Gebregziabher, Mulugeta; Fitzharris, Timothy P.
Recently, the Medical University of South Carolina adopted a lecture recording system (LRS). A retrospective study of LRS was implemented to document the students' perceptions, pattern of usage, and impact on the students' grades in three basic sciences courses (Cell Biology/Histology, Physiology, and Neurosciences). The number of accesses and…
Raddatz, Mikaela M.; Royal, Kenneth D.; Pennington, Jessica
The purpose of this study is to determine if the construct of a medical subspecialty examination, as defined by the hierarchy of item difficulties, is stable across physicians who completed a fellowship and recertifiers as compared to non-fellows. Three comparisons of groups are made: 1) Practice pathway board candidates compared to members of all…
Tishuk, E A
The medical-and-demographic processes as a starting point for the planning of means and resources for the short- and average-term future are forecasted in the paper on the basis of long-term peculiarities of the natural-science data and with respect for the social-and-economic crisis now underway in the country. PMID:14661406
International Association for Cryptologic Research (IACR)
personalized online self-service, medical error reduction, consumer data mining and more (e.g., [Goo09.sadeghi,email@example.com Abstract. Diagnostic and classification algorithms play an important role in data analysis, with ap- plications in areas such as health care, fault diagnostics, or benchmarking. Branching programs (BP
.g., diabetes, high blood pressure) or prior medical treatment or incident (e.g., prior bypass or myocardial.g., in the doc- tor's oÆce or the operation room). Searching databases of published results is a major activity students, residents, and interns), and an activity in which even experienced doctors have to engage
Murphy, Lucy P.; McNair, E. Wesley
Describes a program established in 1969 by Meharry Medical College for undergraduate minority students interested in careers in medicine and dentistry. Reviews the results of an evaluation of the program's outcomes. (GC)
Jha, Vikram; Duffy, Sean
Reports the results of an evaluation of Distance Interactive Learning in Obstetrics and Gynecology (DIALOG) which is an electronic program for continuing education. Presents 10 golden rules for designing software for medical practitioners. (Contains 26 references.) (Author/YDS)
This work introduces the design and exploratory evaluation of a home reminder system for medication and healthcare that situates the timing and location of reminders based on contextual information about the user. The ...
Background Though several questionnaires on self-care and regimen adherence have been introduced, the evaluations do not always report consistent and substantial correlations with measures of glycaemic control. Small ability to explain variance in HbA1c constitutes a significant limitation of an instrument’s use for scientific purposes as well as clinical practice. In order to assess self-care activities which can predict glycaemic control, the Diabetes Self-Management Questionnaire (DSMQ) was designed. Methods A 16 item questionnaire to assess self-care activities associated with glycaemic control was developed, based on theoretical considerations and a process of empirical improvements. Four subscales, ‘Glucose Management’ (GM), ‘Dietary Control’ (DC), ‘Physical Activity’ (PA), and ‘Health-Care Use’ (HU), as well as a ‘Sum Scale’ (SS) as a global measure of self-care were derived. To evaluate its psychometric quality, 261 patients with type 1 or 2 diabetes were assessed with the DSMQ and an established analogous scale, the Summary of Diabetes Self-Care Activities Measure (SDSCA). The DSMQ’s item and scale characteristics as well as factorial and convergent validity were analysed, and its convergence with HbA1c was compared to the SDSCA. Results The items showed appropriate characteristics (mean item-total-correlation: 0.46 ± 0.12; mean correlation with HbA1c: -0.23 ± 0.09). Overall internal consistency (Cronbach’s alpha) was good (0.84), consistencies of the subscales were acceptable (GM: 0.77; DC: 0.77; PA: 0.76; HU: 0.60). Principal component analysis indicated a four factor structure and confirmed the designed scale structure. Confirmatory factor analysis indicated appropriate fit of the four factor model. The DSMQ scales showed significant convergent correlations with their parallel SDSCA scales (GM: 0.57; DC: 0.52; PA: 0.58; HU: n/a; SS: 0.57) and HbA1c (GM: -0.39; DC: -0.30; PA: -0.15; HU: -0.22; SS: -0.40). All correlations with HbA1c were significantly stronger than those obtained with the SDSCA. Conclusions This study provides preliminary evidence that the DSMQ is a reliable and valid instrument and enables an efficient assessment of self-care behaviours associated with glycaemic control. The questionnaire should be valuable for scientific analyses as well as clinical use in both type 1 and type 2 diabetes patients. PMID:23937988
Watling, Christopher J; Lingard, Lorelei
An essential goal of evaluation is to foster learning. Across the medical education spectrum, evaluation of clinical performance is dominated by subjective feedback to learners based on observation by expert supervisors. Research in non-medical settings has suggested that participants' perceptions of evaluation processes exert considerable influence over whether the feedback they receive actually facilitates learning, but similar research on perceptions of feedback in the medical setting has been limited. In this review, we examine the literature on recipient perceptions of feedback and how those perceptions influence the contribution that feedback makes to their learning. A focused exploration of relevant work on this subject in higher education and industrial psychology settings is followed by a detailed examination of available research on perceptions of evaluation processes in medical settings, encompassing both trainee and evaluator perspectives. We conclude that recipients' and evaluators' perceptions of an evaluation process profoundly affect the usefulness of the evaluation and the extent to which it achieves its goals. Attempts to improve evaluation processes cannot, therefore, be limited to assessment tool modification driven by reliability and validity concerns, but must also take account of the critical issue of feedback reception and the factors that influence it. Given the unique context of clinical performance evaluation in medicine, a research agenda is required that seeks to more fully understand the complexity of the processes of giving, receiving, interpreting, and using feedback as a basis for real progress toward meaningful evaluation. PMID:20143260
This comprehensive guide leads the user step-by-step through questionnaire creation. Topics include preliminary considerations, writing the questionnaire items, issues that may come up when giving the questionnaire, statistical considerations, and references for further reading. This resource is intended for novice and professional evaluators.
Wack, Maxime; Georgin-Lavialle, Sophie; Pierre, Isabelle; Tanguy, Aurelia; Ackermann, Felix; Mallet, Celine; Pavie, Juliette; Boultache, Hakima; Durieux, Pierre; Avillach, Paul
Objective To evaluate the impact of computerized provider order entry (CPOE) at the bedside on medical students training. Materials and Methods We conducted a randomized cross-controlled educational trial on medical students during two clerkship rotations in three departments, assessing the impact of the use of CPOE on their ability to place adequate monitoring and therapeutic orders using a written test before and after each rotation. Students’ satisfaction with their practice and the order placement system was surveyed. A multivariate mixed model was used to take individual students and chief resident (CR) effects into account. Factorial analysis was applied on the satisfaction questionnaire to identify dimensions, and scores were compared on these dimensions. Results Thirty-six students show no better progress (beginning and final test means = 69.87 and 80.98 points out of 176 for the control group, 64.60 and 78.11 for the CPOE group, p = 0.556) during their rotation in either group, even after adjusting for each student and CR, but show a better satisfaction with patient care and greater involvement in the medical team in the CPOE group (p = 0.035*). Both groups have a favorable opinion regarding CPOE as an educational tool, especially because of the order reviewing by the supervisor. Conclusion This is the first randomized controlled trial assessing the performance of CPOE in both the progress in prescriptions ability and satisfaction of the students. The absence of effect on the medical skills must be weighted by the small time scale and low sample size. However, students are more satisfied when using CPOE rather than usual training. PMID:26367388
Chapman, A M; Taylor, C A; Girling, A J
The economic evaluation of medical products and services is increasingly prioritised by healthcare decision makers and plays a key role in informing funding allocation decisions. It is well known that there are a number of methodological difficulties in the health technology assessment of medical devices, particularly in the provision of efficacy evidence. By contrasting devices with pharmaceuticals, the way in which the differing systems of innovation mould the UK's industry landscape is described and substantiated with market statistics. In recognition of the challenges faced by industry, as well as the growing need for cost-effective allocation of National Health Service (NHS) resources, the National Institute for Health and Care Excellence (NICE) led the development of the Medical Technologies Evaluation Programme (MTEP), which launched in 2009/2010. The review of the UK's medical devices market supports the programme's three principal aims: to simplify access to evaluation, speed up the process, and increase evaluative capacity for devices within NICE. However, an analysis of the output of MTEP's first 3 years suggests that it has some way to go to meet each of these aims. PMID:24934924
Ahmad, A; Patel, I; Mohanta, GP; Balkrishnan, R
Background: Many of the studies have investigated the prevalence and nature of self-medication. It is a common type of self-care behavior among the populace of various countries. World Health Organization promotes the practice of self-medication for effective and quick relief of symptoms without medical consultations to reduce the burden on health-care services, which are often understaffed and inaccessible in rural and remote areas. Aim: The aim of the study was to determine the extent and pattern of self-medication among the population (patients) attending pharmacies at study sites and to note the association of self-medication variables with demographic factors. Subjects and Methods: The present study was a community based cross sectional study aimed to gather information about the prevalence of self-medication in the rural town of Sahaswan, Uttar Pradesh from June 2012 to July 2012. The sample size comprised of 600 respondents. Data were collected through a prepared questionnaire. All descriptive data were coded, entered and analyzed using the statistical package for Social sciences program version 17.0 (Chicago, IL, USA). Descriptive data analysis was conducted and reported as frequencies and percentage. Results: The percentage of patients who were seeking self-medication was approximately 50% (300/600). Most of the patients were seeking self-medication for headache and other pain (23.3% [140/600]), fever (14.5% [87/600]), urinary tract infections (9.7% [58/600]) and respiratory tract infections (11.7% [70/600]). The drugs most commonly purchased for practicing self-medication were non-steroidal anti-inflammatory drugs (25.3% [152/600]), medications used for gastro intestinal problems (20.8% [125/600]) and antibiotics (16.7% [100/600]). Conclusion: Prevalence of self-medication was high primarily among illiterate males aged above 15 years with a low income. Patient health awareness programs, assistance by community pharmacists and pharmacist continuing education are necessary for controlling self-medication. There is a need for planning interventions to promote rational self-medication through mass medias such as newspaper, magazine and TV. PMID:25184092
Lustig, Stuart L; Kureshi, Sarah; Delucchi, Kevin L; Iacopino, Vincent; Morse, Samantha C
Although many individuals applying for political asylum allege maltreatment and sometimes torture in their countries of origin, the utility of medical evaluations in asylum adjudication has not been documented. This study compares the asylum grant rate among US asylum seekers who received medical evaluations from Physicians for Human Rights (PHR), with rates among asylum seekers who did not receive PHR evaluations. Retrospective analysis was carried out on all asylum cases referred to PHR between 2000 and 2004 for medical evaluations for which adjudication outcome was available. Basic demographic information was obtained: age, sex, country of origin, English language ability, US region where adjudication occurred, whether legal representation was pro bono, type of evaluation, provision of oral court testimony, and whether asylum seekers were in detention. Cases were analyzed descriptively and with chi square tests. Between 2000 and 2004, 1663 asylum seekers received medical evaluations from PHR; the adjudication status (either granted or denied) was determined in 746 cases at the time of the study. Of these cases, 89% were granted asylum, compared to the national average of 37.5% among US asylum seekers who did not receive PHR evaluations. Medical evaluations may be critical in the adjudications of asylum cases when maltreatment is alleged. PMID:17492260
Ho, Chao Chung
Ever since Taiwan's National Health Insurance implemented the diagnosis-related groups payment system in January 2010, hospital income has declined. Therefore, to meet their medical waste disposal needs, hospitals seek suppliers that provide high-quality services at a low cost. The enactment of the Waste Disposal Act in 1974 had facilitated some improvement in the management of waste disposal. However, since the implementation of the National Health Insurance program, the amount of medical waste from disposable medical products has been increasing. Further, of all the hazardous waste types, the amount of infectious medical waste has increased at the fastest rate. This is because of the increase in the number of items considered as infectious waste by the Environmental Protection Administration. The present study used two important findings from previous studies to determine the critical evaluation criteria for selecting infectious medical waste disposal firms. It employed the fuzzy analytic hierarchy process to set the objective weights of the evaluation criteria and select the optimal infectious medical waste disposal firm through calculation and sorting. The aim was to propose a method of evaluation with which medical and health care institutions could objectively and systematically choose appropriate infectious medical waste disposal firms. PMID:21419613
Ho, Chao Chung, E-mail: firstname.lastname@example.org [Department of Industrial Management, National Taiwan University of Science and Technology, Taipei, Taiwan (China)
Ever since Taiwan's National Health Insurance implemented the diagnosis-related groups payment system in January 2010, hospital income has declined. Therefore, to meet their medical waste disposal needs, hospitals seek suppliers that provide high-quality services at a low cost. The enactment of the Waste Disposal Act in 1974 had facilitated some improvement in the management of waste disposal. However, since the implementation of the National Health Insurance program, the amount of medical waste from disposable medical products has been increasing. Further, of all the hazardous waste types, the amount of infectious medical waste has increased at the fastest rate. This is because of the increase in the number of items considered as infectious waste by the Environmental Protection Administration. The present study used two important findings from previous studies to determine the critical evaluation criteria for selecting infectious medical waste disposal firms. It employed the fuzzy analytic hierarchy process to set the objective weights of the evaluation criteria and select the optimal infectious medical waste disposal firm through calculation and sorting. The aim was to propose a method of evaluation with which medical and health care institutions could objectively and systematically choose appropriate infectious medical waste disposal firms.
Pande, Sushma; Pande, Santosh; Parate, Vrushali; Pande, Sanket; Sukhsohale, Neelam
Poor awareness among medical graduates about basic life support (BLS) is a matter of great concern. The presence of a trained rescuer is the key determinant of ultimate survival from life-threatening emergencies. To achieve this goal, early exposure to such life-saving skills is the right decision to foster these skills for medical students, which can be reenforced in succeeding years. Forty-two first-year medical students participated in this study. The entire procedure consisted of faculty training, assessment of knowledge of students by a pretest questionnaire, a lecture, a demonstration, and hands-on training using a mannequin (with special emphasis on the site, depth, rate, and sustainment of uninterrupted chest compressions). Posttest 1 was conducted to assess the knowledge gained. The retention of knowledge and skills in the second year was evaluated by posttest 2 and directly observed procedural skills, respectively. Student feedback was collected on five-point Likert scale. Analysis using a Freidman test indicated the mean rank for posttest 1 (2.81) to be significantly higher than the pretest (1.26), indicating a gain in knowledge. The mean rank for posttest 2 (1.93) was lower than for posttest 1 (2.81) but was significantly higher compared with the pretest (1.26), indicating a significant retention of knowledge during the second year. Directly observed procedural skill evaluation showed that 7% students could perform all the seven steps correctly and that 74% students could perform three or more steps correctly, signifying a good retention of skill. Two students taught BLS skills to their family members as well. The results of this study suggest that the program provides students with sound basic knowledge and adequate practical skills in BLS. PMID:24585468
Simone, Charles B. Vapiwala, Neha; Hampshire, Margaret K.; Metz, James M.
Purpose: Pain is a common symptom among cancer patients, yet many patients do not receive adequate pain management. Few data exist quantifying analgesic use by radiation oncology patients. This study evaluated the causes of pain in cancer patients and investigated the reasons patients fail to receive optimal analgesic therapy. Methods and Materials: An institutional review board-approved, Internet-based questionnaire assessing analgesic use and pain control was posted on the OncoLink (available at (www.oncolink.org)) Website. Between November 2005 and April 2006, 243 patients responded. They were predominantly women (73%), white (71%), and educated beyond high school (67%) and had breast (38%), lung (6%), or ovarian (6%) cancer. This analysis evaluated the 106 patients (44%) who underwent radiotherapy. Results: Of the 106 patients, 58% reported pain from their cancer treatment, and 46% reported pain directly from their cancer. The pain was chronic in 51% and intermittent in 33%. Most (80%) did not use medication to manage their pain. Analgesic use was significantly less in patients with greater education levels (11% vs. 36%, p = 0.002), with a trend toward lower use by whites (16% vs. 32%, p 0.082) and women (17% vs. 29%, p = 0.178). The reasons for not taking analgesics included healthcare provider not recommending medication (87%), fear of addiction or dependence (79%), and inability to pay (79%). Participants experiencing pain, but not taking analgesics, pursued alternative therapies for relief. Conclusions: Many radiation oncology patients experience pain from their disease and cancer treatment. Most study participants did not use analgesics because of concerns of addiction, cost, or failure of the radiation oncologist to recommend medication. Healthcare providers should have open discussions with their patients regarding pain symptoms and treatment.
Purpose: The aim of this paper is to provide evidence for the validity and reliability of a questionnaire for assessing the implementation of problem-based learning (PBL). This questionnaire was developed to assess the quality of PBL implementation from the perspective of medical school graduates. Methods: A confirmatory factor analysis was conducted to assess the validity of the questionnaire. The analysis was based on a survey of 225 graduates of a problem-based medical school in Indonesia. Results: The results showed that the confirmatory factor analysis model had a good fit to the data. Further, the values of the standardized loading estimates, the squared inter-construct correlations, the average variances extracted, and the composite reliabilities all provided evidence of construct validity. Conclusion: The PBL implementation questionnaire was found to be valid and reliable, making it suitable for evaluation purposes. PMID:26072901
Ismail, Salwani; Salam, Abdus; Alattraqchi, Ahmed G; Annamalai, Lakshmi; Chockalingam, Annamalai; Elena, Wan Putri; Rahman, Nor Iza A; Abubakar, Abdullahi Rabiu; Haque, Mainul
Background Didactic lecture is the oldest and most commonly used method of teaching. In addition, it is considered one of the most efficient ways to disseminate theories, ideas, and facts. Many critics feel that lectures are an obsolete method to use when students need to perform hands-on activities, which is an everyday need in the study of medicine. This study evaluates students’ perceptions regarding lecture quality in a new medical school. Methods This was a cross-sectional study conducted of the medical students of Universiti Sultan Zainal Abidin. The study population was 468 preclinical medical students from years 1 and 2 of academic year 2012–2013. Data were collected using a validated instrument. There were six different sections of questions using a 5-point Likert scale. The data were then compiled and analyzed, using SPSS version 20. Results The response rate was 73%. Among 341 respondents, 30% were male and 70% were female. Eighty-five percent of respondents agree or strongly agree that the lectures had met the criteria with regard to organization of lecture materials. Similarly, 97% of students agree or strongly agree that lecturers maintained adequate voices and gestures. Conclusion Medical students are quite satisfied with the lecture classes and the lectures. However, further research is required to identify student-centered teaching and learning methods to promote active learning. PMID:25878516
Rintoul, Mark Daniel; Wilson, Andrew T.
Hospitals have always generated and consumed large amounts of data concerning patients, treatment and outcomes. As computers and networks have permeated the hospital environment it has become feasible to collect and organize all of this data. This raises naturally the question of how to deal with the resulting mountain of information. In this report we detail a proof-of-concept test using two commercially available parallel database systems to analyze a set of real, de-identified medical records. We examine database scalability as data sizes increase as well as responsiveness under load from multiple users.
Nagata, Shuya; Yatera, Kazuhiro; Tokuyama, Susumu; Yamasaki, Kei; Nishida, Chinatsu; Kawanami, Yukiko; Kawanami, Toshinori; Ishimoto, Hiroshi; Mukae, Hiroshi
In the present study, we evaluated the antiemetic effect of aprepitant in combination with 5-hydroxytryptophan(5-HT3) receptor antagonist and dexamethasone for chemotherapy-induced emesis and nausea in lung cancer patients treated with carboplatin-based systemic chemotherapy using the Functional Living Index-Emesis, an emesis- and nausea-specific quality of life(QOL)questionnaire. Patients experiencing emesis and/or nausea during and/or after previous courses of carboplatin-based chemotherapy received aprepitant in the following treatment cycle with the same anti-cancer agent. Emesis- and nausea-specific QOL aspects were significantly improved with the addition of aprepitant to the existing regimen containing dexamethasone and 5-HT3 receptor antagonist. Our result suggests that combined antiemetic treatment with aprepitant, dexamethasone, and 5-HT3 receptor antagonist is more effective in lung cancer patients receiving carboplatin-based systemic chemotherapy than dexamethasone and 5-HT3 receptor antagonist alone. PMID:24743279
Salehi, Hadi; Khadivar, Zahra; Mehrabi, Mahmood
Evaluation is basically a matching process, which concerns matching learners' needs to available solutions. Through analysis and assessment of ESP textbooks, a much more promising and desirable approach to a theory of ESP takes place. To this aim, the purpose of the present study was to evaluate the ESP medical textbook. To gather the necessary…
Lim, Russell F.; Wegelin, Jacob; Hua, Lisa L.; Kramer, Elizabeth J.; Servis, Mark E.
Objective: The authors aim to evaluate the effectiveness of a presentation designed to increase cultural competence. Methods: A measure was developed to evaluate the attainment of knowledge and attitude objectives by first-year medical students who watched a presentation on the effect of culture on the doctor-patient relationship and effective…
Dorpema, J. W.
Safety assessment of medical devices includes sterilization and biological evaluation or biocompatibility testing. Sterilization by ETO gas is critised for their carcinogenic potency or even banned. Mutual acceptance of biological evaluation test results is promoted by a laboratory accreditation and qualification program.
Siegel, John H.
This report summarizes the work done on the contract NAG9-567, which was activated at the New Jersey Medical School-UMDNJ in April 1992 and carried on during the 1992-93 year to the present 1993-94 year which was terminated in May 1994. The initial examination stage was completed of an interactive program for the recording of physical and physiologic injury information obtained from examination of an injured person, who might be an astronaut sustaining traumatic injury, due to a burn or physical trauma, either in space or in an earth bound training environment. In this report three aspects will be discussed: 1) a description of the system of diagnostic examination graphics, 2) a description of the organization of the therapeutic advisory systems with a demonstration of two specific modules, and 3) a brief technical description of the organization of the programming system carried out on a UNIX based work station using a WINDOWS environment.
Ali, Mohammad A; Ali, Adam M; Patel, Ishita; MacGregor, Thomas; Shankar, Sushma; Cahill, Thomas J; Finlayson, Alexander ET; Mahmud, Imran
Objectives To (1) evaluate educational needs of clinical students at Al-Quds University Medical School in the West Bank; (2) address these needs where possible using synchronous distance learning, with clinicians in Oxford providing case-based tutorials to undergraduates in the West Bank via an online platform (WizIQ) and (3) assess the impact of this education. Design Review of online OxPal Medlink database for tutorials held between March 2012 and April 2013. Needs assessment and evaluation of student and tutor experiences through online questionnaires, focus groups and semi-structured interviews. Setting Oxford University Hospitals, Oxford, UK, and Al-Quds University Medical School, Abu Dies, Palestine. Participants Doctors at Oxford University Hospitals and fourth-, fifth- and sixth-year medical students and faculty members at Al-Quds Medical School. Main outcome measures Number of tutorials, student participation, student-rated satisfaction and qualitative feedback from tutors and students. Results Students demonstrated strong theoretical knowledge but struggled to apply this in presentation-based scenarios. Between March 2012 and April 2013, 90 tutorials were delivered to 60 students. Feedback: >95% respondents rated tutorials as ‘Excellent’ or ‘Good’ and ‘Very’ or ‘Fairly’ relevant to their future practice in Palestine. Students reported the programme had modified their approach to patients but requested better synchronization with concurrent attachments and clarification of learning outcomes. Conclusions OxPal Medlink is a novel, web-based distance-learning partnership designed to overcome some of the challenges to local medical education in the occupied Palestinian territories. Evaluation of the first year indicates teaching is relevant to local practice and of high quality. This approach may have the potential to strengthen local capacity for medical education. PMID:25057373
Bucci, David J.
Controller. Sincerely, Dartmouth Emergency Medical Services and Participating Agencies #12;Homeland Security Exercise and Evaluation Program (HSEEP) Public Announcement, Dartmouth Emergency Medical Services NNE Collegiate Drill Day Dartmouth EMS Collegiate Day Drill, 2013 PUBLIC ANNOUNCEMENT
We are revising the criteria in parts A and B of the Listing of Impairments (listings) that we use to evaluate claims involving cancer (malignant neoplastic diseases) under titles II and XVI of the Social Security Act (Act). These revisions reflect our adjudicative experience, advances in medical knowledge, recommendations from medical experts we consulted, and public comments we received in response to a Notice of Proposed Rulemaking (NPRM). PMID:26003962
Patterson, J. E.
The pre-travel medical evaluation of elderly patients and patients with chronic illness requires special assessment and advice. Screening and special precautions are reviewed for traveling patients with respiratory disease, cardiac disease, sinusitis, diabetes mellitus, HIV infection, and other chronic medical conditions. Current guidelines for empiric therapy and prophylaxis of travelers' diarrhea are reviewed, with emphasis on concerns in geriatric or chronically ill travelers. Special considerations such as potential drug-drug interactions and insurance coverage are also discussed. PMID:1290273
...Section 456.370 Public Health CENTERS FOR MEDICARE...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...interdisciplinary team of health professionals must...family history; (4) Mental and physical functional...Evaluation by an agency worker of the resources...
...fingers (CF) or no light perception (NLP), to evaluate your vision loss. This...perception or light perception only), or NLP (no light perception) indicates that no...is recorded as CF, HM, LP or LPO, or NLP, we will determine that...
These final rules revise the criteria in the Listing of Impairments (listings) that we use to evaluate cases involving genitourinary disorders in adults and children under titles II and XVI of the Social Security Act (Act). The revisions reflect our program experience and address adjudicator questions we have received since we last comprehensively revised this body system in 2005. PMID:25341262
J. B. Antoine Maintz; Petra A. Van Den Elsen; Max A. Viergever
Ridge-like structures in digital images may be extracted by convolving the images with deriva- tives of Gaussians. The choice of the convolution operator and of the parameters involved defines a specific ridge image. In this paper, various ridge measures related to isophote curvature are con- structed, reviewed, and evaluated with respect to their usability in CT\\/MRI matching of human brain
Background Patients with limited English proficiency (LEP) represent a growing proportion of the US population and are at risk of receiving suboptimal care due to difficulty communicating with healthcare providers who do not speak their language. Medical school curricula are required to prepare students to care for all patients, including those with LEP, but little is known about how well they achieve this goal. We used data from a survey of medical students' cross-cultural preparedness, skills, and training to specifically explore their self-rated preparedness to care for LEP patients. Methods We electronically surveyed students at one northeastern US medical school. We used bivariate analyses to identify factors associated with student self-rated preparedness to care for LEP patients including gender, training year, first language, race/ethnicity, percent LEP and minority patients seen, and skill with interpreters. We used multivariate logistic regression to examine the independent effect of each factor on LEP preparedness. In a secondary analysis, we explored the association between year in medical school and self-perceived skill level in working with an interpreter. Results Of 651 students, 416 completed questionnaires (63.9% response rate). Twenty percent of medical students reported being very well or well-prepared to care for LEP patients. Of these, 40% were in their fourth year of training. Skill level working with interpreters, prevalence of LEP patients seen, and training year were correlated (p < 0.001) with LEP preparedness. Using multivariate logistic regression, only student race/ethnicity and self-rated skill with interpreters remained statistically significant. Students in third and fourth years were more likely to feel skilled with interpreters (p < 0.001). Conclusions Increasingly, medical students will need to be prepared to care for LEP patients. Our study supports two strategies to improve student preparedness: training students to work effectively with interpreters and increasing student diversity to better reflect the changing US demographics. PMID:21631943
Schiekirka, Sarah; Feufel, Markus A.; Herrmann-Lingen, Christoph; Raupach, Tobias
Background and objective: Evaluation is an integral part of education in German medical schools. According to the quality standards set by the German Society for Evaluation, evaluation tools must provide an accurate and fair appraisal of teaching quality. Thus, data collection tools must be highly reliable and valid. This review summarises the current literature on evaluation of medical education with regard to the possible dimensions of teaching quality, the psychometric properties of survey instruments and potential confounding factors. Methods: We searched Pubmed, PsycINFO and PSYNDEX for literature on evaluation in medical education and included studies published up until June 30, 2011 as well as articles identified in the “grey literature”. Results are presented as a narrative review. Results: We identified four dimensions of teaching quality: structure, process, teacher characteristics, and outcome. Student ratings are predominantly used to address the first three dimensions, and a number of reliable tools are available for this purpose. However, potential confounders of student ratings pose a threat to the validity of these instruments. Outcome is usually operationalised in terms of student performance on examinations, but methodological problems may limit the usability of these data for evaluation purposes. In addition, not all examinations at German medical schools meet current quality standards. Conclusion: The choice of tools for evaluating medical education should be guided by the dimension that is targeted by the evaluation. Likewise, evaluation results can only be interpreted within the context of the construct addressed by the data collection tool that was used as well as its specific confounding factors. PMID:26421003
Liddle, Stephanie; Grover, Lata; Zhang, Rachel; Khitrov, Maxim; Brown, Joan C; Cobb, J Perren; Goldman, Julian; Chou, Joseph; Yagoda, Daniel; Westover, Brandon; Reisner, Andrew T
Our hospital became interested in the extraction of electronic data from our bedside monitor network to enrich clinical care, and enable various quality improvement projects, research projects, and future applications involving advanced decision-support. We conducted a range of tests to confirm the safety of deploying BedMaster (Excel Medical Electronics, Jupiter FL, USA), which is third-party software sold expressly to provide electronic data extraction and storage from networked General Electric Healthcare bedside patient monitors. We conducted a series of tests examining the changes in network performance when the BedMaster system was on our isolated patient monitor network. We found that use of BedMaster led to measurable, but trivial increases in network traffic and latency. We did not identify any failure scenarios in our analysis and testing. The major value of this report is to highlight potential challenges inherent in data and electronic device integration within the healthcare setting. In describing our strategy for testing the BedMaster system, it is our intention to present one testing protocol and to generate thought and discussion in the broader community about what types of problems can arise with inter-operability, and what types of testing are necessary to mitigate against these risks. Standards for inter-operability would surely reduce the inherent risks. PMID:23367271
Diamond, Edward; French, Kim; Gronkiewicz, Cynthia; Borkgren, Marilyn
This article describes the initial and ongoing efforts of our pulmonary medicine practice to deploy an electronic medical records (EMR) system. Key factors in the vendor selection and implementation process included (1) identification and commitment to long-term goals for EMR; (2) dedicated resources, including both physician and nonphysician champions to lead the design and implementation teams; and (3) ample patience and time allotted to achieve the desired results: a fully functional system that enhances quality, improves operational efficiency, and reduces costs. An EMR scorecard including multiple system attributes was designed to facilitate vendor comparisons. Perseverance, patience, and compromise were necessary to overcome the challenge of changing the behavior of providers and support staff. We have accomplished improvements in workflow automation and reductions in staff hours, office supplies, file space, and transcription costs. Our system lacks pulmonary-specific templates and prompts for work flow and clinical decision making. We have directed internal resources and outsourced professional support to design these features as our practice strives to enhance our quality of care with pulmonary disease management that conforms to national guidelines. PMID:20822993
Maggi, Lauretta; Conte, Ubaldo; Nhamias, Alain; Grenier, Pascal; Vergnault, Guy
The overall stability of medicated chewing gums is investigated under different storage conditions. Active substances with different chemical stabilities in solid state are chosen as model drugs. The dosage form is a three layer tablet obtained by direct compression. The gum core contains the active ingredient while the external layers are formulated to prevent gum adhesion to the punches of the tableting machine. Two accelerated test conditions (40°C/75% RH and 30°C/65% RH) are performed for 6 months. Furthermore, a long-term stability test at room conditions is conducted to verify the predictability of the results obtained from the stress tests. Some drugs are stable in all the conditions tested, but other drugs, generally considered stable in solid dosage forms, have shown relevant stability problems particularly when stress test conditions are applied to this particular semi-solid dosage forms. For less stable drugs, the stress conditions of 40°C/75% RH are not always predictable of chewing gum stability at room temperature and may produce false negative; intermediate conditions, 30°C/65% RH, are more predictive for this purpose, the results of drug content found after 6 months at intermediate stress conditions and 12 months at room conditions are generally comparable. But the results obtained show that only long-term conditions stability tests gave consistent results. During aging, the semi solid nature of the gum base itself, may also influence the drug delivery rate during chewing and great attention should be given also to the dissolution stability. PMID:22794248
Background The use of anonymous audience response technology (ART) to actively engage students in classroom learning has been evaluated positively across multiple settings. To date, however, there has been no empirical evaluation of the use of individualised ART handsets and formative feedback of ART scores. The present study investigates student perceptions of such a system and the relationship between formative feedback results and exam performance. Methods Four successive cohorts of Non-Medical Prescribing students (n=107) had access to the individualised ART system and three of these groups (n=72) completed a questionnaire about their perceptions of using ART. Semi-structured interviews were carried out with a purposive sample of seven students who achieved a range of scores on the formative feedback. Using data from all four cohorts of students, the relationship between mean ART scores and summative pharmacology exam score was examined using a non-parametric correlation. Results Questionnaire and interview data suggested that the use of ART enhanced the classroom environment, motivated students and promoted learning. Questionnaire data demonstrated that students found the formative feedback helpful for identifying their learning needs (95.6%), guiding their independent study (86.8%), and as a revision tool (88.3%). Interviewees particularly valued the objectivity of the individualised feedback which helped them to self-manage their learning. Interviewees’ initial anxiety about revealing their level of pharmacology knowledge to the lecturer and to themselves reduced over time as students focused on the learning benefits associated with the feedback. A significant positive correlation was found between students’ formative feedback scores and their summative pharmacology exam scores (Spearman’s rho = 0.71, N=107, p<.01). Conclusions Despite initial anxiety about the use of individualised ART units, students rated the helpfulness of the individualised handsets and personalised formative feedback highly. The significant correlation between ART response scores and student exam scores suggests that formative feedback can provide students with a useful reference point in terms of their level of exam-readiness. PMID:23148762
Eagan, G.D.; Grier, R.S.
The Medical Information System (MIS) at the Los Alamos Scientific Laboratory automates the acquisition, storage, and retrieval of medical information concerning the nine thousand project-connected personnel. The MIS incorporates an on-line, interactive medical history questionnaire, mark sense form processing, and automated coronary risk assesment in the medical evaluation process. Also, MIS has created the ability for long-term study and comparison of employee health as well as made the physician's time more effective.
Wilby, K J; Hazi, H M; Ashour, M A
The objectives of this study were to assess the needs of schoolchildren relating to medication safety and to develop and implement a health promotion programme in Qatar. Semi-structured interviews were completed with teachers, nurses and school administrators at 2 primary schools in Doha. Two main themes were identified from these interviews, namely medication basics and medication safety. Subsequently, a 25-minute health promotion programme was developed and delivered to 11 groups of schoolchildren aged 6-10 years. The student groups contained both expatriate and local Qatari students. The programme was evaluated based on perceptions of site representatives, investigators and peer reviewers using a standardized evaluation form. All the evaluators agreed that the programme was beneficial and should be recommended to other schools in Qatar. This study can serve as a prototype for future programmes in the Eastern Mediterranean Region and elsewhere. PMID:25907194
Janzek-Hawlat, Stefan; Ammenwerth, Elske; Dorda, Wolfgang; Duftschmid, Georg; Hackl, Werner; Hörbst, Alexander; Jung, Martin; Woertz, Klemens; Gall, Walter
The objective of this paper is to present results and recommendations from the Austrian e-Medikation pilot project. e-Medikation comprises a national medication list of all prescribed and dispensed medications as well as central medication checks. Evaluation was based on log-file analysis and survey of all participants (physicians, pharmacists, patients). During the evaluation period, 97 physicians, 58 pharmacies and more than 5.000 patients, participated. All user groups found that e-Medikation has the potential to improve patient safety, but that software quality and system architecture is not yet suitable for routine use. The evaluation resulted in 34 recommendations for further development and roll out of e-Medikation in Austria. Most of these recommendations have already been included in the recently passed law concerning the upcoming Austrian electronic health record system called "ELGA". PMID:23920574
Mione, Sylvia; Valcke, Martin; Cornelissen, Maria
Histology stands as a major discipline in the life science curricula, and the practice of teaching it is based on theoretical didactic strategies along with practical training. Traditionally, students achieve practical competence in this subject by learning optical microscopy. Today, students can use newer information and communication technologies in the study of digital microscopic images. A virtual microscopy program was recently introduced at Ghent University. Since little empirical evidence is available concerning the impact of virtual microscopy (VM) versus optical microscopy (OM) on the acquisition of histology knowledge, this study was set up in the Faculty of Medicine and Health Sciences. A pretest-post test and cross-over design was adopted. In the first phase, the experiment yielded two groups in a total population of 199 students, Group 1 performing the practical sessions with OM versus Group 2 performing the same sessions with VM. In the second phase, the research subjects switched conditions. The prior knowledge level of all research subjects was assessed with a pretest. Knowledge acquisition was measured with a post test after each phase (T1 and T2). Analysis of covariance was carried out to study the differential gain in knowledge at T1 and T2, considering the possible differences in prior knowledge at the start of the study. The results pointed to non-significant differences at T1 and at T2. This supports the assumption that the acquisition of the histology knowledge is independent of the microscopy representation mode (VM versus OM) of the learning material. The conclusion that VM is equivalent to OM offers new directions in view of ongoing innovations in medical education technology. PMID:23463716
Reynolds, Paul M; MacLaren, Robert; Mueller, Scott W; Fish, Douglas N; Kiser, Tyree H
Extravasations are common manifestations of iatrogenic injury that occur in patients requiring intravenous delivery of known vesicants. These injuries can contribute substantially to patient morbidity, cost of therapy, and length of stay. Many different mechanisms are behind the tissue damage during extravasation injuries. In general, extravasations consist of four different subtypes of tissue injury: vasoconstriction, osmotic, pH related, and cytotoxic. Recognition of high-risk patients, appropriate cannulation technique, and monitoring of higher risk materials remain the standard of care for the prevention of extravasation injury. Prompt interdisciplinary action is often necessary for the treatment of extravasation injuries. Knowledge of the mechanism of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. The best therapeutic agent for treatment of vasopressor extravasation is intradermal phentolamine. Topical vasodilators and intradermal terbutaline may provide relief. Intradermal hyaluronidase has been effective for hyperosmotic extravasations, although its use largely depends on the risk of tissue injury and the severity of extravasation. Among the hyperosmotic agents, calcium extravasation is distinctive because it may present as an acute tissue injury or may possess delayed clinical manifestations. Extravasation of acidic or basic materials can produce significant tissue damage. Phenytoin is the prototypical basic drug that causes a clinical manifestation known as purple glove syndrome (PGS). This syndrome is largely managed through preventive and conservative treatment measures. Promethazine is acidic and can cause a devastating extravasation, particularly if administered inadvertently through the arteriolar route. Systemic heparin therapy remains the accepted treatment option for intraarteriolar administration of promethazine. Overall, the evidence for managing extravasations due to noncytotoxic medications is nonexistent or limited to case reports. More research is needed to improve knowledge of patient risk, prompt recognition of the extravasation, and time course for tissue injury, and to develop prevention and treatment strategies for extravasation injuries. PMID:24420913
Powell, Danny H [ORNL] [ORNL; Elwood Jr, Robert H [ORNL] [ORNL
The questionnaire is the instrument used for recording performance data on the nuclear material protection, control, and accountability (MPC&A) system at a nuclear facility. The performance information provides a basis for evaluating the effectiveness of the MPC&A system. The goal for the questionnaire is to provide an accurate representation of the performance of the MPC&A system as it currently exists in the facility. Performance grades for all basic MPC&A functions should realistically reflect the actual level of performance at the time the survey is conducted. The questionnaire was developed after testing and benchmarking the material control and accountability (MC&A) system effectiveness tool (MSET) in the United States. The benchmarking exercise at the Idaho National Laboratory (INL) proved extremely valuable for improving the content and quality of the early versions of the questionnaire. Members of the INL benchmark team identified many areas of the questionnaire where questions should be clarified and areas where additional questions should be incorporated. The questionnaire addresses all elements of the MC&A system. Specific parts pertain to the foundation for the facility's overall MPC&A system, and other parts pertain to the specific functions of the operational MPC&A system. The questionnaire includes performance metrics for each of the basic functions or tasks performed in the operational MPC&A system. All of those basic functions or tasks are represented as basic events in the MPC&A fault tree. Performance metrics are to be used during completion of the questionnaire to report what is actually being done in relation to what should be done in the performance of MPC&A functions.
Hillen, Jodie B; Vitry, Agnes; Caughey, Gillian E
Given the growing aged care population, the complexity of their medication-related needs and increased risk of adverse drug events, there is a necessity to systematically monitor and manage medication-related quality of care. The aim of this systematic review was to identify and synthesise medication-related quality of care indicators with respect to application to residential aged care. MEDLINE (Ovid), Psychinfo, CINAHL, Embase and Google® were searched from 2001 to 2013 for studies that were in English, focused on older people aged 65+ years and discussed the development, application or validation of original medication-related quality of care indicators. The quality of selected articles was appraised using the Critical Appraisal Skills Program and psychometric qualities extracted and synthesised using content analysis. Indicators were mapped to six medication-related quality of care attributes and a minimum indicator set derived. Thirty three articles describing 25 indicator sets met the inclusion criteria. Thirteen (52%) contained prescribing quality indicators only. Eight (32%) were developed specifically for aged care. Twenty three (92%) were validated and seven (28%) assessed for reliability. The most common attribute addressed was medication appropriateness (n?=?24). There were no indicators for evaluating medication use in those with limited life expectancy, which resulted in only five of the six attributes being addressed. The developed minimum indicator set contains 28 indicators representing 22 of 25 identified indicator sets. Whilst a wide variety of validated indicator sets exist, none addressed all aspects of medication-related quality of care pertinent to residential aged care. The minimum indicator set is intended as a foundation for comprehensively evaluating medication-related quality of care in this setting. Future work should focus on bridging identified gaps. PMID:26069870
Sanchez-Reilly, Sandra; Ross, Jeanette S
Major efforts have been pursued to improve palliative care education for physicians at all levels of their training. Such changes include the incorporation of palliative care curriculum and guidelines, an established process for competency-based evaluation and certification, faculty development, innovative educational experiences, the improvement of textbooks, and the establishment of accredited palliative medicine fellowships. Hospice and palliative medicine (HPM) has been clearly defined as a subspecialty and a crucial area of medical education. As innovative curricular approaches have become available to educate medical and other interprofessional trainees, this article aims to describe different models and methods applied in curriculum evaluation, tailoring such approaches to the field of palliative medicine. A stepwise process of curriculum development and evaluation is described, focusing on available curriculum evaluation competency-based tools for each level of learners. As HPM evolves and its educational programs grow, curriculum evaluation will provides invaluable feedback to institutions and programs in many ways. PMID:22268408
Measuring the improvement in health-related quality of life using King’s health questionnaire in non-obese and obese patients with lower urinary tract symptoms after alpha-adrenergic medication: a preliminary study
Background The efficacy of medical treatment among obese men with lower urinary tract symptoms (LUTS) has been less clear, especially regarding the improvement of QoL. We aimed to investigate the difference in efficacy and consequent satisfaction of life quality after medical treatment of male LUTS according to obesity. Methods An 8-week prospective study was performed for a total of 140 patients >50?years old with International Prostate Symptom Scores (IPSS) > 12 points and prostate volume > 20?mL. Obesity was determined by either body mass index (BMI) or waist circumference (WC). Patients were divided into 2 groups according to BMI or WC. Patients received tamsulosin at a dose of 0.4?mg daily for 8?weeks. The changes from baseline in the IPSS, maximal urinary flow rate (Qmax), post-void residual volume, questionnaire of quality of life (QoL), and King’s Health Questionnaire (KHQ) were analyzed. Results Of the 150 enrolled patients, 96 completed the study. Seventy-five patients (78.1%) had BMI ? 23?kg/m2, and 24 (25.0%) had WC > 90?cm. Overall, the IPSS, IPSS QoL, and total KHQ showed significant improvement. Obese (BMI ? 23?kg/m2) and non-obese (BMI < 23?kg/m2) both showed improvement of the IPSS and IPSS QoL scores, but only the obese (BMI ? 23?kg/m2) group showed improvement of the total KHQ score (P < 0.001 vs. P = 0.55). Only the obese (WC > 90?cm) group showed improvement of the IPSS and total KHQ scores (P < 0.001). Conclusions Our preliminary study showed the different efficacy of an alpha-blocker for improvement of LUTS and life quality according to obesity. Obese patients, defined by BMI or WC, showed the tendency toward a more favorable improvement of LUTS and life quality. Trial registration Current Controlled Trials 2010–058. Registered 2 September 2010 in Soonchunhyang Univeristy Hospital PMID:25099073
Husain, Salina; Gendeh, Balwant Singh
Nasal polyposis (NP) has a great impact on quality of life (QOL) and its management involves a combination of medical therapy and surgery. To the authors' knowledge, no publication has extensively examined NP after optimal medical treatment based on subjective evaluations. The aim of this prospective study was designed to evaluate the QOL in NP patients after (1) a short course of oral steroids, (2) initial 3-month course of macrolide, and (3) long-term treatment with intranasal steroids. A total of 55 patients with grades I and II NP were consecutively treated with oral prednisolone at 25 mg in a single dose for 2 weeks, macrolide at 250 mg daily for the first 3 months, and long-term intranasal steroids. Patients were followed up and evaluated at baseline and 3, 6, and 12 months for QOL measure. At baseline, patients with grade I and grade II NP showed significantly worse QOL scores on all Rhinosinusitis Disability Index domains, particularly for physical function (4.59 ± 1.41) and were significantly higher in social function (3.16 ± 1.17). At 3, 6, and 12 months of treatment, patients showed a significant improvement in all impaired QOL domains compared with baseline after optimal medical therapy (p < 0.05). These results suggest that the optimal medical treatment to improve QOL incorporates medical polypectomy with a short course of oral steroids in addition to macrolide and this can be maintained by long-term intranasal steroid therapy. PMID:24612853
Jünger, Jana; Fischer, Martin R; Duelli, Roman; Putz, Reinhard; Resch, Franz
The implementation of new medical licensing regulations (AAppO 2003) was the starting point for radical curricular changes in all German medical schools. In 2004, the postgraduate and interfaculty Master of Medical Education (MME) degree programme was established at the University of Heidelberg under the auspices of the Medical Faculty Association (Medizinischer Fakultätentag, MFT) and supported by the Association for the Promotion of Science and Humanities in Germany (Stifterverband für die Deutsche Wissenschaft). This new degree programme is intended to train multipliers and leaders in medical education, to build a German-speaking network and to strengthen educational research. The eight one-week MME modules are organised by seven locations in Germany (Munich, Tuebingen, Muenster/Essen, Berlin, Heidelberg, Cologne, Dresden) and an annually changing international faculty. The instructor teams are composed of national and international experts. Major focal points include: curriculum development, education theory, teaching and exam methods, evaluations, team building and group dynamics, project management, leadership, and faculty development, as well as educational research. The modules are connected with each other longitudinally: each participant conducts a project to improve teaching in his or her own faculty and writes a master's thesis about an educational research project. Overall, the participants earn 60 ECTS (European Credit Transfer System) in the course of two years while working. So far 100 participants (25 per year) from 33 of 34 medical faculties have started the program and 19 participants (50% of the participants from Cohort 1, 29% of the participants from Cohort 2) completed the program. The evaluation of the individual modules showed a very high level of participant satisfaction. In two modules, the evaluation results demonstrated a need for change. In 2006, an external evaluation conducted by international experts positively highlighted the MME Programme structure as a leading example emphasizing all aspects of modern medical education, including relevant managerial skills. The MME Programme as a contribution to the professionalization of medical education in the German-speaking area has become firmly established. The impact of the MME Programme on the career development of its participants and the institutional development of the medical faculties still remains to be evaluated. PMID:19402348
Huesman, Ronald H.; Reutter, Bryan W.; Marshall, Robert C.
Kinetic analysis of dynamic tracer data is performed with the goal of evaluating myocardial radiotracers for cardiac nuclear medicine imaging. Data from experiments utilizing the isolated rabbit heart model are acquired by sampling the venous blood after introduction of a tracer of interest and a reference tracer. We have taken the approach that the kinetics are properly characterized by an impulse response function which describes the difference between the reference molecule (which does not leave the vasculature) and the molecule of interest which is transported across the capillary boundary and is made available to the cell. Using this formalism we can model the appearance of the tracer of interest in the venous output of the heart as a convolution of the appearance of the reference tracer with the impulse response. In this work we parameterize the impulse response function as the sum of a large number of exponential functions whose predetermined decay constants form a spectrum, and each is required only to have a nonnegative coefficient. This approach, called spectral analysis, has the advantage that it allows conventional compartmental analysis without prior knowledge of the number of compartments which the physiology may require or which the data will support.
The need for effective treatments for pediatric overweight is well known. We evaluated the applicability of an evidence-based treatment in an applied clinic setting that includes children with severe obesity and comorbid medical or psychiatric conditions. Forty-eight overweight children and their fa...
Besdine, Richard W.; Shield, Renee R.; McNicoll, Lynn; Campbell, Susan E.; Wetle, Terrie
Brown Medical School developed a comprehensive curriculum in which enriched aging content increased from 22 to 80 hours in preclerkship courses and was also added for clerkships, residencies, and nongeriatrician physicians. Innovative evaluation strategies are also described. Highlights include "treasure hunts" in the anatomy laboratory, a…
Clinical problem solving exercises for preclinical medical education that were developed at Michigan State University School of Osteopathic Medicine are described. Two types of outcomes were set as priorities in the design and implementation of the problem solving sessions: small group peer interactions as instructional and evaluative resources;…
Decker, Jesse; Ronay, Ashley; Telfer, Megan; Becker, Craig M.; Cremeens, Jennifer; Swinker, Marian
A medical school at a Southeastern university implemented a tobacco free policy to promote a healthy environment for its employees, patients, and visitors. Eighteen months post policy implementation, undergraduate students in the Department of Health Education and Promotion evaluated the satisfaction, awareness, and perceived…
Stevens, Ronald H.; And Others
A study to determine the feasibility of creating and administering computer-based problem-solving examinations for evaluating second-year medical students in immunology and to determine how students would perform on these tests relative to their performances on concurrently administered objective and essay examinations is described. (Author/MLW)
This monograph describes the basic physical/neurological examination of children with special needs and how such an exam fits into the multidisciplinary evaluation and development of individualized programming for such children. The first section addresses the importance of the medical history. Next, the basic exam is described, followed by…
Bray, James H.; Kowalchuk, Alicia; Waters, Vicki; Laufman, Larry; Shilling, Elizabeth H.
The Baylor College of Medicine SBIRT Medical Residency Training Program is a multilevel project that trains residents and faculty in evidenced-based screening, brief intervention, and referral to treatment (SBIRT) methods for alcohol and substance use problems. This paper describes the training program and provides initial evaluation after the…
Cimino, James J.
, Ph.D.,2 and Andre W. Kushniruk, Ph.D.,2 1 Department of Medical Informatics, Columbia University, New security functions and records user activities, relieving application developers from concerns about safeCIS architecture supports application integration while providing adequate security and evaluation functions
Aguirre-Gas, Héctor Gerardo
Evaluation of the quality of medical care began in Mexico in 1956. This was done by reviewing the clinical files of patients. In 1984, Donabedian introduced the Theory of Systems that evaluates structure, process and results, adopted as a base in the IMSS to develop the System of Integral Evaluation and Continuous Improvement of the Quality of the Medical Care, through the identification and solution of the problems that affect quality in medical care as well as the improvements of the inefficient processes or those with low quality. The Joint Commission on Accreditation of Health Care, European Foundation for Quality Management (ETQM) and International Society for Quality in Health Care (ISQua) use a similar methodology in its evaluations. The ISO System (International Organization for Standardization) was created in 1947 to assure and to certify the quality of the production processes and to guarantee the quality of the products that were fabricated. In health institutions the ISO system is useful to certify the structure and organization, and it indicates that they are under conditions to assure the quality of medical care, but it does not guarantee that this must happen. On the other hand, faults in structure and organization may result in poor quality of care. We conclude that both systems are complementary, rather than exclusionary. PMID:18492443
The Headroom Method of early economic evaluation of medical devices: A useful tool for device Life Year] Headroom Determines the maximum reimbursable price of the new device Can the manufacturer opportunity... £ £ £ £ Stops manufacturers wasting resources on devices that will never be cost effective
Azer, Samy A.
The aim of the present study was to critically evaluate the accuracy and readability of English Wikipedia articles on the respiratory system and its disorders and whether they can be a suitable resource for medical students. On April 27, 2014, English Wikipedia was searched for articles on respiratory topics. Using a modified DISCERN instrument,…
Marsh, Herbert W; Martin, Andrew J; Jackson, Susan
Based on the Physical Self Description Questionnaire (PSDQ) normative archive (n = 1,607 Australian adolescents), 40 of 70 items were selected to construct a new short form (PSDQ-S). The PSDQ-S was evaluated in a new cross-validation sample of 708 Australian adolescents and four additional samples: 349 Australian elite-athlete adolescents, 986 Spanish adolescents, 395 Israeli university students, 760 Australian older adults. Across these six groups, the 11 PSDQ-S factors had consistently high reliabilities and invariant factor structures. Study 1, using a missing-by-design variation of multigroup invariance tests, showed invariance across 40 PSDQ-S items and 70 PSDQ items. Study 2 demonstrated factorial invariance over a 1-year interval (test-retest correlations .57-.90; Mdn = .77), and good convergent and discriminant validity in relation to time. Study 3 showed good and nearly identical support for convergent and discriminant validity of PSDQ and PSDQ-S responses in relation to two other physical self-concept instruments. PMID:20733208
Yarmohammadian, Mohammad H.; Tavakoli, Nahid; Shams, Assadollah; Hatampour, Farzaneh
Context: People capacity maturity model (PCMM) is one of the models which focus on improving organizational human capabilities. Aims: The aim of this model's application is to increase people ability to attract, develop, motivate, organize and retain the talents needed to organizational continuous improvement. Settings and Design: In this study, we used the PCMM for investigation of organizational maturity level in medical record departments of governmental hospitals and determination strengths and weaknesses of their staff capabilities. Materials and Methods: This is an applied research and cross sectional study in which data were collected by questionnaires to investigation of PCMM model needs in medical record staff of governmental hospitals at Isfahan, Iran. We used the questionnaire which has been extracted from PCMM model and approved its reliability with Cronbach's Alpha 0.96. Statistical Analysis Used: Data collected by the questionnaire was analyzed based on the research objectives using SPSS software and in accordance with research questions descriptive statistics were used. Results: Our findings showed that the mean score of medical record practitioners, skill and capability in governmental hospitals was 35 (62.5%) from maximum 56 (100%). There is no significant relevance between organizational maturity and medical record practitioners, attributes. Conclusions: Applying PCMM model is caused increasing staff and manager attention in identifying the weaknesses in the current activities and practices, so it will result in improvement and developing processes. PMID:25077147
Huwendiek, Sören; De Leng, Bas A; Kononowicz, Andrzej A; Kunzmann, Romy; Muijtjens, Arno M M; Van Der Vleuten, Cees P M; Hoffmann, Georg Friedrich; Tönshoff, Burkhard; Dolmans, Diana H J M
Abstract Background: Virtual patients (VPs) are increasingly used to train clinical reasoning. So far, no validated evaluation instruments for VP design are available. Aims: We examined the validity of an instrument for assessing the perception of VP design by learners. Methods: Three sources of validity evidence were examined: (i) Content was examined based on theory of clinical reasoning and an international VP expert team. (ii) The response process was explored in think-aloud pilot studies with medical students and in content analyses of free text questions accompanying each item of the instrument. (iii) Internal structure was assessed by exploratory factor analysis (EFA) and inter-rater reliability by generalizability analysis. Results: Content analysis was reasonably supported by the theoretical foundation and the VP expert team. The think-aloud studies and analysis of free text comments supported the validity of the instrument. In the EFA, using 2547 student evaluations of a total of 78 VPs, a three-factor model showed a reasonable fit with the data. At least 200 student responses are needed to obtain a reliable evaluation of a VP on all three factors. Conclusion: The instrument has the potential to provide valid information about VP design, provided that many responses per VP are available. PMID:25313931
Ameh, Nkeiruka; Abdul, Mohammed A.; Adesiyun, Gbadebo A.; Avidime, Solomon
Background: Method of testing clinical competence of medical students in this setting has been controversial. This report evaluates the perceptions and preferences of 5th and 6th year medical students about traditional clinical examination (TCE) and objective structured clinical examination (OSCE). Materials and Methods: A cross-sectional study using a structured questionnaire, administered to 156 students, who had been previously exposed to TCE and OSCE. Results: There were 110 (70.5%) males and 46 (29.5%) females, with median age group of 26–30 years. One hundred and thirty-one respondents (84%) felt TCE is more difficult and 20 (12.8%) felt OSCE was more difficult. One hundred and forty-two (91%) felt OSCE was easier to pass, 8 (5.1%) felt TCE was easier to pass and 6 (3.8%) were undecided. Majority of the 5th and 6th year students (95.5% and 100%, respectively) preferred OSCE for assessment. In relation to validity and reliability of OSCE, 124 (79.5%) of all the students felt it provides a true measure of essential clinical skills, 130 (83.3%) felt its scores are standardised, 143 (91.7%) felt it is a practical and useful experience and 135 (86.5%) felt students’ personality, ethnicity and gender will not affect OSCE scores. Overall, there were no significant differences in preference and perceptions between 5th and 6th year students and between males and females. Conclusion: Students preferred OSCE as method of assessing clinical competence and considered it a more valid and reliable method of examination. PMID:25114366
Kumarswami, Shweta; Tiwari, Anish; Parmar, Mayank; Shukla, Manisha; Bhatt, Amit; Patel, Mittal
Background: The best way to handle an emergency is to be prepared in advance. The purpose of this study was to assess the availability of medical emergency drugs at dental offices and to determine the level of knowledge and preparedness of dentists to manage medical emergencies at their dental offices. Materials and Methods: A descriptive cross-sectional study was conducted from January to June 2014 with 250 dental graduates to determine their knowledge and ability in the management of medical emergencies and assess availability of emergency drugs and equipments in dental offices in the Ahmedabad and Udaipur areas of India. The questionnaire consisted of mainly objective questions, requiring a simple yes or no reply. Mann–Whitney test was used for the analysis. A 95% confidence level was used and a P value of less than or equal to 0.05 was considered statistically significant. Results: The results of our study showed that almost all the surveyed dentists (98%) enquired about medical history, but only 12% obtained filled health history proforma from patients regarding the above. Only 38.4% participants recorded the vital signs of patients before commencing any treatment. Also, 7.6% reported about having attended any workshops on emergency training or management programs. Emergency kits were available with only 24% participants and the available kits were assessed for the availability of emergency drugs. Also, 34% were confident about giving intramuscular injection and only 6.6% were sure about giving intravenous injections. The P value was found to be highly statistically significant. Conclusion: The results of our study reflect an alarming situation about the capability of dentists to deal with such conditions. PMID:25767767
...precandidate packet, including USAFA Form 149, Precandidate Questionnaire, with a request for the applicant to provide academic, athletic, leadership, and medical information. (b) The Academy evaluates the precandidate information and provides an...
Tourancheau, Sylvain; Sjöström, Mårten; Olsson, Roger; Persson, Anders; Ericson, Thomas; Rudling, Johan; Norén, Bengt
New display technologies enable the usage of 3D-visualization in a medical context. Even though user performance seems to be enhanced with respect to 2D thanks to the addition of recreated depth cues, human factors, and more particularly visual comfort and visual fatigue can still be a bridle to the widespread use of these systems. This study aimed at evaluating and comparing two different 3D visualization systems (a market stereoscopic display, and a state-of-the-art multi-view display) in terms of quality of experience (QoE), in the context of interactive medical visualization. An adapted methodology was designed in order to subjectively evaluate the experience of users. 14 medical doctors and 15 medical students took part in the experiment. After solving different tasks using the 3D reconstruction of a phantom object, they were asked to judge their quality of the experience, according to specific features. They were also asked to give their opinion about the influence of 3D-systems on their work conditions. Results suggest that medical doctors are opened to 3D-visualization techniques and are confident concerning their beneficial influence on their work. However, visual comfort and visual fatigue are still an issue of 3D-displays. Results obtained with the multi-view display suggest that the use of continuous horizontal parallax might be the future response to these current limitations.
Objective To describe: a) a self-report questionnaire of 34 item, developed by a Family Association of Psychiatric Patients in collaboration with two psychiatrists to evaluate by key-relative in a clinical practice the perceived quality of mental health services, the needs and family burden; b) the methodology of validation. Methods It has been studied (a) the Face Validity by two focus groups of 10 relatives for each group, (b) the concurrent validity of family burden items comparing the ABC with QPF, a widely used questionnaire, in 6 Italian mental health centres on a sample of key-relatives, (c) the discriminant validity comparing three different samples of key-relatives of patients with psychiatric illness, Alzheimer or cancer. The internal consistency of items for assessing relatives' opinions on the quality of care has been evaluated by Chronbach' s ?. The test-retest has been evaluated on a sample of 20 key-relatives. Results The results indicate a fairly good performance of the questionnaire in this preliminary but almost complete phase of validation. The time to fill in it has been estimated in a 7 minutes average. Conclusion It is possible by this self-report questionnaire to evaluate in a clinical routine setting and in a very short time three important problems for relatives and professionals: opinions and needs of relatives, and objective and subjective family burden of severe mental illness. PMID:17877813
... 2010-04-01 false How will the FAB evaluate new medical evidence submitted...of Impairment § 30.908 How will the FAB evaluate new medical evidence submitted...relied upon by the district office, the FAB will not consider the additional...
Constantinou, Riana; Marangos, Charis; Kyriacou, Efthyvoulos; Bamidis, Panagiotis; Dafli, Eleni; Pattichis, Constantinos S
Background Serious games involving virtual patients in medical education can provide a controlled setting within which players can learn in an engaging way, while avoiding the risks associated with real patients. Moreover, serious games align with medical students’ preferred learning styles. The Virtual Emergency TeleMedicine (VETM) game is a simulation-based game that was developed in collaboration with the mEducator Best Practice network in response to calls to integrate serious games in medical education and training. The VETM game makes use of data from an electrocardiogram to train practicing doctors, nurses, or medical students for problem-solving in real-life clinical scenarios through a telemedicine system and virtual patients. The study responds to two gaps: the limited number of games in emergency cardiology and the lack of evaluations by professionals. Objective The objective of this study is a quantitative, professional feedback-informed evaluation of one scenario of VETM, involving cardiovascular complications. The study has the following research question: “What are professionals’ perceptions of the potential of the Virtual Emergency Telemedicine game for training people involved in the assessment and management of emergency cases?” Methods The evaluation of the VETM game was conducted with 90 professional ambulance crew nursing personnel specializing in the assessment and management of emergency cases. After collaboratively trying out one VETM scenario, participants individually completed an evaluation of the game (36 questions on a 5-point Likert scale) and provided written and verbal comments. The instrument assessed six dimensions of the game: (1) user interface, (2) difficulty level, (3) feedback, (4) educational value, (5) user engagement, and (6) terminology. Data sources of the study were 90 questionnaires, including written comments from 51 participants, 24 interviews with 55 participants, and 379 log files of their interaction with the game. Results Overall, the results were positive in all dimensions of the game that were assessed as means ranged from 3.2 to 3.99 out of 5, with user engagement receiving the highest score (mean 3.99, SD 0.87). Users’ perceived difficulty level received the lowest score (mean 3.20, SD 0.65), a finding which agrees with the analysis of log files that showed a rather low success rate (20.6%). Even though professionals saw the educational value and usefulness of the tool for pre-hospital emergency training (mean 3.83, SD 1.05), they identified confusing features and provided input for improving them. Conclusions Overall, the results of the professional feedback-informed evaluation of the game provide a strong indication of its potential as an educational tool for emergency training. Professionals’ input will serve to improve the game. Further research will aim to validate VETM, in a randomized pre-test, post-test control group study to examine possible learning gains in participants’ problem-solving skills in treating a patient’s symptoms in an emergency situation. PMID:26084866
Matsumoto, Takehiro; Honda, Masayuki
The Community Medical ICT Network service at the Nagasaki, Japan was established in 2009. Medical information network for sharing patients data was investigated focused on the access log data from April of 2009 and October of 2010. The total number of the access to the medical information was 30,914 of 2,213 patients. And the total number of access of the image including diagnostic imaging report, medical examination, treatment and medical documents was 10,278(33.2%), 8,949(28.9%), 6,896(22.3%) and 4,791(15.5%) respectively. These results showed that these medical information had enough valued for sharing in the regional medicine. In conclusion, many types of medical information should be required for sharing in the community medical ICT network in Japan. PMID:23920791
Miller, Sharon; Kimball, Olive M.
Criteria related to merit evaluations of medical technology faculty were evaluated, based on a survey of members of the American Society for Medical Technology's scientific section on education. Questionnaire responses were obtained from 27 academic institutions. Criteria included publications, institutional committee activity, research, clinical…
Olney, Cynthia A.; Chumley, Heidi; Parra, Juan M.
A team designing a Web-enhanced third-year medical education didactic curriculum based their course planning and evaluation activities on the Institute for Higher Education Policy's (2000) 24 benchmarks for online distance learning. The authors present the team's blueprint for planning and evaluating the Web-enhanced curriculum, which incorporates…
Purdue Univ., Lafayette, IN. Educational Research Center.
The 116-item parent questionnaire is designed for parents of elementary school children. It is intended to be used with the child's mother, or the person acting as the child's mother. The questionnaire consists of a section devoted to demographic variables and scales measuring 14 parent variables: (1) parent's achievement aspirations for the…
Abramowitz, Joelle; O'Hara, Brett
This article uses the 2013 Current Population Survey Annual Social and Economic Supplement to estimate the financial burden of medical out-of-pocket costs by comparing medical out-of-pocket expenditures to income. This measure is important for evaluating the magnitude of burden, better understanding who bears it, and establishing a baseline to assess the impact of the Patient Protection and Affordable Care Act. We examine the distribution of burden and the incidence of high burden across all families and by individuals' health insurance status and demographic and socioeconomic characteristics. We look more closely at one group vulnerable to having high burden: those younger than age 65 with incomes between 138% and 200% of the federal poverty line. We find that 18.5% of these individuals have incomes below the threshold of expansion Medicaid eligibility after accounting for non-over-the-counter medical expenses and examine the characteristics associated with being classified below this threshold. PMID:25524865
Sunaga, Masayo; Kondo, Keiko; Adachi, Toshiko; Miura, Yoshiko; Kinoshita, Atsuhiro
Dental and dental hygiene students must acquire the skill of measuring periodontal pockets and learn to identify the bottom of a pocket, especially of deep periodontal pockets. A new dental model that would enable students to practice measuring deep periodontal pockets was developed at the Tokyo Medical and Dental University. The purpose of this study was to evaluate the feasibility and effectiveness of this model. Twenty dental hygiene students in their third year at the school and twenty-four instructors or dental hygienists of the University Hospital measured periodontal pockets on the newly designed dental model. Feasibility and effectiveness of the model were evaluated based on periodontal probing by the students and instructors, as well as results of a questionnaire. The results demonstrated an intraexaminer agreement (within ±1 mm) averaging 91 percent. The mean percentages of correct answers of the students and instructors were 82 percent and 80 percent, respectively. More than 90 percent of the instructors and students reported that the new model would be suitable for pocket probing training. In the questionnaire, they responded that this practice using the new model would contribute to students' future and that they wanted to try other dental models with various probing depths. The new dental model designed for periodontal pocket probing training was reported to be feasible and effective for student practice. PMID:24002857
Georgakis, D. Christine; Trace, David A.; Naeymi-Rad, Frank; Evens, Martha
Medical expert systems require comprehensive evaluation of their diagnostic accuracy. The usefulness of these systems is limited without established evaluation methods. We propose a new methodology for evaluating the diagnostic accuracy and the predictive capacity of a medical expert system. We have adapted to the medical domain measures that have been used in the social sciences to examine the performance of human experts in the decision making process. Thus, in addition to the standard summary measures, we use measures of agreement and disagreement, and Goodman and Kruskal's ? and ? measures of predictive association. This methodology is illustrated by a detailed retrospective evaluation of the diagnostic accuracy of the MEDAS system. In a study using 270 patients admitted to the North Chicago Veterans Administration Hospital, diagnoses produced by MEDAS are compared with the discharge diagnoses of the attending physicians. The results of the analysis confirm the high diagnostic accuracy and predictive capacity of the MEDAS system. Overall, the agreement of the MEDAS system with the “gold standard” diagnosis of the attending physician has reached a 90% level.
Aggarwal, Ashutosh N; Agarwal, Ritesh; Gupta, Dheeraj
Background: There is no disease-specific instrument to describe health-related quality of life (HRQoL) in Indian patients with asthma. However, an abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-Bref), a generic Hindi HRQoL measure, has been developed and validated in India. Aims: To evaluate the WHOQOL-Bref in adult patients with asthma and to test possible modifications to the instrument to improve its psychometric adequacy. Methods: Sixty-seven patients with asthma completed the WHOQOL-Bref. Rasch analysis was used to explore the psychometric performance of the four domains (physical, psychological, social relationships and environment) of the scale. Overall fit of data to model expectations, appropriate category ordering, presence of differential item functioning, individual item fit and targeting of item difficulty to patient ability were explored for each domain. Item deletion and rescoring were applied to misfitting items to improve overall performance. Results: The overall fit of the WHOQOL-Bref data was adequate. Item 3 (pain prevents doing work) displayed a large positive fit residual value (indicating violation of unidimensionality), resulting in poor construct validity for the physical domain. No item exhibited differential item functioning. Ten items had disordered thresholds. The WHOQOL-Bref was modified by dropping item 3 and rescoring category structures of 16 items. The modified scale had good construct validity for all domains, ordered thresholds for all items and good targeting of items to persons. Conclusions: The WHOQOL-Bref performed inadequately in describing HRQoL in the asthma patients studied. However, when modified by Rasch analysis, the scale proved better than the original scale. PMID:24921608
Background The SF-36 physical functioning scale (PF-10) and the Health Assessment Questionnaire disability index (HAQ-DI) are the most frequently used instruments for measuring self-reported physical function in rheumatoid arthritis (RA). The objective of this study was to develop a crosswalk between scores on the PF-10 and HAQ-DI in RA. Methods Item response theory (IRT) methods were used to co-calibrate both scales using data from 1791 RA patients. The appropriateness of a Rasch-based crosswalk was evaluated by comparing it with crosswalks based on a two-parameter and a multi-dimensional IRT model. The accuracy of the final crosswalk was cross-validated using baseline (n?=?532) and 6-month follow-up (n?=?276) data from an independent cohort of early RA patients. Results The PF-10 and HAQ-DI adequately fit a unidimensional Rasch model. Both scales measured a wide range of functioning, although the HAQ-DI tended to better target lower levels of functioning. The Rasch-based crosswalk performed similarly to crosswalks based on the two-parameter and multidimensional IRT models. Agreement between predicted and observed scale scores in the cross-validation sample was acceptable for group-level comparisons. The longitudinal validity in discriminating between disease response states was similar between observed and predicted scores. Conclusion The crosswalk developed in this study allows for converting scores from one scale to the other and can be used for group-level analyses in patients with RA. PMID:24229416
Fotiadis, Dimitris A; Astaras, Alexandros; Bamidis, Panagiotis D; Papathanasiou, Kostas; Kalfas, Anestis
This paper presents a novel method for tracking the position of a medical instrument's tip. The system is based on phase locking a high frequency signal transmitted from the medical instrument's tip to a reference signal. Displacement measurement is established having the loop open, in order to get a low frequency voltage representing the medical instrument's movement; therefore, positioning is established by means of conventional measuring techniques. The voltage-controlled oscillator stage of the phase-locked loop (PLL), combined to an appropriate antenna, comprises the associated transmitter located inside the medical instrument tip. All the other low frequency PLL components, low noise amplifier and mixer, are located outside the human body, forming the receiver part of the system. The operating details of the proposed system were coded in Verilog-AMS. Simulation results indicate robust medical instrument tracking in 1-D. Experimental evaluation of the proposed position tracking system is also presented. The experiments described in this paper are based on a transmitter moving opposite a stationary receiver performing either constant velocity or uniformly accelerated movement, and also together with two stationary receivers performing constant velocity movement again. This latter setup is implemented in order to demonstrate the prototype's accuracy for planar (2-D) motion measurements. Error analysis and time-domain analysis are presented for system performance characterization. Furthermore, preliminary experimental assessment using a saline solution container to more closely approximate the human body as a radio frequency wave transmission medium has proved the system's capability of operating underneath the skin. PMID:25265618
Granger, Bradi B.; Staton, Melodie; Peterson, Lindsay; Rusincovitch, Shelley A.
Medication non-adherence is a major public health issue, and measuring non-adherence is a crucial step toward improving it. A paucity of retrievable data prevents researchers from effectively measuring, tracking and sharing outcomes on medication management. High quality data derived from prescribing patterns, including behavioral and technology-based interventions, is necessary to support meaningful use, improve publicly reported quality metrics, and develop strategies to improve medication management. Electronic health records make medication data more numerous and accessible, yet the reliability and utility of electronically available data elements that reflect adherence has not been well established. We sought to explore the types of medication-related data captured over time in a series of patient encounters (n=5500) in a population-based intervention in four U.S. counties in the SouthEastern Diabetes Initiative (SEDI). The purpose was to evaluate data generated through routine healthcare delivery that are repurposed (ie, “secondary use”) for research/QI/population health.
Granger, Bradi B; Staton, Melodie; Peterson, Lindsay; Rusincovitch, Shelley A
Medication non-adherence is a major public health issue, and measuring non-adherence is a crucial step toward improving it. A paucity of retrievable data prevents researchers from effectively measuring, tracking and sharing outcomes on medication management. High quality data derived from prescribing patterns, including behavioral and technology-based interventions, is necessary to support meaningful use, improve publicly reported quality metrics, and develop strategies to improve medication management. Electronic health records make medication data more numerous and accessible, yet the reliability and utility of electronically available data elements that reflect adherence has not been well established. We sought to explore the types of medication-related data captured over time in a series of patient encounters (n=5500) in a population-based intervention in four U.S. counties in the SouthEastern Diabetes Initiative (SEDI). The purpose was to evaluate data generated through routine healthcare delivery that are repurposed (ie, "secondary use") for research/QI/population health. PMID:26306240
Nichol, K L; Korn, J E; Baum, P
As part of an effort to evaluate the effectiveness of a multifaceted, institution-wide influenza vaccination program, we mailed a self-administered postcard questionnaire to 500 randomly selected outpatients following both the 1987-1988 and 1988-1989 immunization seasons. The postcard asked if the patients received influenza vaccine, where they were immunized, whether they had any high-risk medical illnesses, their age at their last birthday, and their name. To assess the validity of the questionnaire, following the 1988 survey, we selected a 25% systematic sample of respondents and compared survey responses with medical record documentation. Response rates for the surveys were 77.6% for the 1988 survey (two mailings) and 86.5% for the 1989 survey (three mailings). Ninety-four percent (n = 89) of charts selected for audit were successfully reviewed. Agreement between questionnaire responses and medical records was excellent, with greater than 90% agreement and kappas of .8 to .9 for classifying patients as high-risk and receipt of vaccine at the Department of Veterans' Affairs Medical Center. For other data, agreement ranged from 84% to 96% with kappas of .6 to .75. Responses to the 1989 survey also demonstrated the importance of sample frame definition and response wave on estimates of risk characteristics and vaccination rates. A self-administered postcard questionnaire is a valid tool for estimating outpatient risk characteristics and influenza vaccination rates. PMID:1756055
The International Medical University has a Community and Family Case Study (CFCS) programme as part of the training for medical students. The aim of the programme is to emphasize the family and community perspective of patient care in the home environment. A cross-sectional descriptive study was done among 66 final year medical students using a questionnaire. The students were in the 10th Semester and had completed their Community and Family Case Studies (CFCS) programme. Majority (54.5%) of the students who were interviewed were Malays, 34.8% Chinese and 9.1% Indians. Majority of the students (87.9%) liked the programme because it was a good opportunity to understand the patient in their home environment; it improved their commination skills and made them understand the patient better in the community setting. The perceived problem in this programme by the students were mainly choosing an index patient initially (32.8%), patient cooperation (19.0%) and transportation to the patients' house (13.8%). They said that this programme was useful because they learnt more about the disease (45%) and understood the patient management better (15%). The programme also provided the students a wider exposure to medicine (37.9%) and the opportunity to practice clinical skills. Overall the CFCS programme in IMU was well liked by the students as it gave them an opportunity to practice some of the clinical skills in the patients' home environment and it provided an opportunity to manage the patient better. The major problem the students faced was in selecting the index patient. PMID:23629554
Masseroli, Marco; Pinciroli, Francesco
To provide easy retrieval, integration and evaluation of multimodal cardiology images and data in a web browser environment, distributed application technologies and java programming were used to implement a client-server architecture based on software agents. The server side manages secure connections and queries to heterogeneous remote databases and file systems containing patient personal and clinical data. The client side is a Java applet running in a web browser and providing a friendly medical user interface to perform queries on patient and medical test dat and integrate and visualize properly the various query results. A set of tools based on Java Advanced Imaging API enables to process and analyze the retrieved cardiology images, and quantify their features in different regions of interest. The platform-independence Java technology makes the developed prototype easy to be managed in a centralized form and provided in each site where an intranet or internet connection can be located. Giving the healthcare providers effective tools for querying, visualizing and evaluating comprehensively cardiology medical images and records in all locations where they can need them- i.e. emergency, operating theaters, ward, or even outpatient clinics- the developed prototype represents an important aid in providing more efficient diagnoses and medical treatments.
Isfahani, Haleh Mousavi; Aryankhesal, Aidin; Haghani, Hamid
Performance of different organizations, such as hospitals is mainly influenced by their managers' performance. Nursing managers have an important role in hospital performance and their managerial skills can improve the quality of the services. Hence, the present study was conducted in order to assess the relationship between the managerial skills and the results of their performance evaluation in Teaching Hospitals of Iran University of Medical Science in 2013. The research used the cross sectional method in 2013. It was done by distributing a managerial skills assessment questionnaire, with close-ended questions in 5 choice Likert scale, among 181 managers and head nurses of hospitals of Iran university of Medical Sciences; among which 131 answered the questions. Another data collection tools was a forms to record evaluation marks from the personnel records. We used Pearson and Spearman correlation tests and SPSS for analysis and description (frequency, mean and standard deviation). Results showed that the managerial skills of the nursing mangers were fair (2.57 out of 5) and the results of the performance evaluation were in a good condition (98.44). The mangers' evaluation results and the managerial skills scores were not in a meaningful correlation (r=0.047 np=0.856). The research showed no correlation between different domains of managerial skills and the performance evaluation marks: decision making skills (r=0.074 and p=0.399), leadership (correlation coefficient 0.028 and p=0.654), motivation (correlation coefficient 0.118 and p=0.163), communication (correlation coefficient 0.116 and p=0.122), systematic thinking (correlation coefficient 0.028 and p=0.828), time management (correlation coefficient 0.077 and p=0.401) and strategic thinking (correlation coefficient 0.041 and p=0.756). Lack of any correlation and relation between managers' managerial skills and their performance evaluation results shows need to a fundamental revision at managers' performance evaluation form. PMID:25716403
ESLAMI, JAMSHID; KHADEMI, MOHSEN
Introduction An evaluation of the curriculum elements can be recognized as a necessity in curriculum dynamic and improvement. This study aimed at evaluating five main elements of a physiopathology curriculum in internal medicine (objectives, content, methods, evaluation, and management). Method The present study is of a descriptive-analytical type, and the studypopulation consisted of a total of 48 faculty members of internal medicine physiopathology departmentat Shiraz University of Medical Sciences. Participants wereselected using Cochran’s sample size formula andthrough simple random sampling.Thedatawere collected using a 58-item questionnaire devised by the researcher, usingcurriculum planning experts. Face and content validity of the scale were obtained throughexpert views and modifications provided by 10 professors and experts in medical curriculum evaluation. Also, research reliability was calculated using Alpha Cronbachto be 0.99. Reliability value and coefficient was acceptable.Moreover, One-sample t-test, Independent t-test and one-way ANOVA were used for data analysis. Results Based on the faculty members’ views, of the five curriculum elements, objectives and content were in relatively good conditions (at an average level) while other elements including method, evaluation and management were in poor conditions (lower than average). According to results oftwo-way ANOVA, there wasa significant relationship between faculty members with various work experiencein terms of curriculum evaluation. Conclusion According to research findings, a comparative examination of the curriculum elements and their characteristics in physiopathology course can be conducted, resulting in identification of curriculum weaknesses and their pitfalls. Also, with regard to teaching, evaluation, management methods, weak and strong pointsof the course,efficiency, and effectiveness of the elements were identified. PMID:25927069
Goldstein, Matthew J; Lunn, Mitchell R; Peng, Lily
Since the publication of the Flexner Report in 1910, the medical education enterprise has undergone many changes to ensure that medical schools meet a minimum standard for the curricula and clinical training they offer students. Although the efforts of the licensing and accrediting bodies have raised the quality of medical education, the educational processes that produce the physicians who provide the best patient care and conduct the best biomedical research have not been identified. Comparative analyses are powerful tools to understand the differences between institutions, but they are challenging to carry out. As a result, the analysis performed by U.S. News & World Report (USN&WR) has become the default tool to compare U.S. medical schools. Medical educators must explore more rigorous and equitable approaches to analyze and understand the performance of medical schools. In particular, a better understanding and more thorough evaluation of the most successful institutions in producing academic physicians with biomedical research careers are needed. In this Perspective, the authors present a new model to evaluate medical schools' production of academic physicians who advance medicine through basic, clinical, translational, and implementation science research. This model is based on relevant and accessible objective criteria that should replace the subjective criteria used in the current USN&WR rankings system. By fostering a national discussion about the most meaningful criteria that should be measured and reported, the authors hope to increase transparency of assessment standards and ultimately improve educational quality. PMID:25607941
La Rochelle, Jeffrey S.; Dezee, Kent J.; Gehlbach, Hunter
In this AMEE Guide, we consider the design and development of self-administered surveys, commonly called questionnaires. Questionnaires are widely employed in medical education research. Unfortunately, the processes used to develop such questionnaires vary in quality and lack consistent, rigorous standards. Consequently, the quality of the questionnaires used in medical education research is highly variable. To address this problem, this AMEE Guide presents a systematic, seven-step process for designing high-quality questionnaires, with particular emphasis on developing survey scales. These seven steps do not address all aspects of survey design, nor do they represent the only way to develop a high-quality questionnaire. Instead, these steps synthesize multiple survey design techniques and organize them into a cohesive process for questionnaire developers of all levels. Addressing each of these steps systematically will improve the probabilities that survey designers will accurately measure what they intend to measure. PMID:24661014
Yu Lifeng; Zu Donglin; Wang Weidong; Bao Shanglian
In this paper we proposed an integrated scheme to fuse medical images from different modalities. At first we register images using SVD-ICP(Iterative Closest Points) method, then fuse them by multiresolution method based on wavelet decomposition. We show examples of the application of this scheme on both CT-MRI and PET-MRI. In particular, we evaluate the different fusion results when applying different
Davis, P O; Biersner, R J; Barnard, R J; Schamadan, J
Aside from the obvious dangers to life and limb associated with the job, fire fighting subjects the body to environmental and physical stressors that can adversely affect various systems. In fact, the effects of these stressors on the cardiovascular system have made coronary heart disease a greater killer among fire fighters than among other occupational groups. The approach to medical evaluation of fire fighters presented here is based on an appreciation of these stressors. PMID:7100014
Guo, Yao-yu; Tan, Cheng; Liu, Bing-kun; Jiang, Shi-zhong
Landing impact is the dynamic factor that manned spaceship will inevitably meet after the mission has been completed, and impact force may cause damages to human tissues [correction of tissuses] and organs, even death. This paper described the characteristics of pathological and dynamic response of human body to landing impact, and discussed various related factors such as impact angle, fetters, design of cushion, harness and terrain condition. Medical evaluation of +Gx, +Gz, +/- Gy impacts were summarized. PMID:12622097
Australia's fabled Royal Flying Doctor Service recently undertook a soul-searching evaluation of its structure, operations and goals. Although there are no plans to stop providing emergency medical services to the residents of the outback, the service may refocus efforts on health promotion and prevention, since 75% of its work involves nonemergency care. Cost efficiency, the key phrase for health care around the globe, will be another goal. Images p746-a p747-a p748-a PMID:7882237
Buri, J R
A questionnaire was developed for the purpose of measuring Baumrind's (1971) permissive, authoritarian, and authoritative parental authority prototypes. It consists of 30 items per parent and yields permissive, authoritarian, and authoritative scores for both the mother and the father; each of these scores is derived from the phenomenological appraisals of the parents' authority by their son or daughter. The results of several studies have supported the Parental Authority Questionnaire as a psychometrically sound and valid measure of Baumrind's parental authority prototypes, and they have suggested that this questionnaire has considerable potential as a valuable tool in the investigation of correlates of parental permissiveness, authoritarianism, and authoritativeness. PMID:16370893
Anselma, Luca; Bottrighi, Alessio; Montani, Stefania; Terenziani, Paolo
The process of keeping up-to-date the medical knowledge stored in relational databases is of paramount importance. Since quality and reliability of medical knowledge are essential, in many cases physicians' proposals of updates must undergo experts' evaluation before possibly becoming effective. However, until now no theoretical framework has been provided in order to cope with this phenomenon in a principled and non-ad hoc way. Indeed, such a framework is important not only in the medical domain, but in all Wikipedia-like contexts in which evaluation of update proposals is required. In this paper we propose GPVM (General Proposal Vetting Model), a general model to cope with update proposal?evaluation in relational databases. GPVM extends the current theory of temporal relational databases and, in particular, BCDM - Bitemporal Conceptual Data Model - "consensus" model, providing a new data model, new operations to propose and accept?reject updates, and new algebraic operators to query proposals. The properties of GPVM are also studied. In particular, GPVM is a consistent extension of BCDM and it is reducible to it. These properties ensure consistency with most relational temporal database frameworks, facilitating implementation on top of current frameworks and interoperability with previous approaches. PMID:23380684
Medical technology assessment in Italy is considered to have had scant impact on policy. Government has played a limited role in financing evaluative research and increased public funding might therefore be expected to have a positive effect on the contribution that this activity makes to policy. The choice of arrangements for such funding, however, must take account of the broader institutional context in which these operate. Intergovernmental relations in any country are inherently difficult due to the fact that the distribution of powers is in general poorly specified and to a tendency for central government to try to impose itself. Budgetary difficulties may exacerbate the problem. Italy has quite a decentralised system of government and there has been significant disagreement over how to interpret the intergovernmental distribution of powers, including those relating to health care. Central government has also had difficulty in that sector making lower governments accountable for how they spend their central grants and for budget deficits. This has created serious problems for the implementation of medical technology policy developed at the centre. This state of affairs counsels against adopting funding arrangements for evaluative research in which central government plays a dominant role. Probably the most appropriate solution is that of a partnership between the centre and the Regions with each party having an equal say on the medical technologies studied, the evaluative methodologies adopted and how the data produced are used in policy development.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8047921
The basic goal of the study is to develop a five dimensional leadership questionnaire for a project leader in an international scientific research laboratory and to verify statistically the independency of the individual questions from each other to ensure low overlap in content and meaning by achieving low correlation coefficients. This leadership questionnaire is designed to examine the behavior, personality, and character attributes of a project or experiment team leader in an international scientific research laboratory as perceived by her/his team members during the planning, design, implementation, and execution of the project itself. The leadership questionnaire is applied to a sample of about 40 participants from different international scientific research laboratories. This sample should represent in age, rank, and profession the whole population of employees and team members currently working in different international scientific research laboratories dealing with physics, informatics, and engineeri...
Carstensen, Ole; Rasmussen, Kurt; Pontén, Ann; Gruvberger, Birgitta; Isaksson, Marléne; Bruze, Magnus
The aim of this study was to evaluate the validity of a questionnaire and medical anamnesis to identify persons with dermatitis in an occupational setting. The design was a clinical epidemiological cross-sectional study. The study was performed between the second and fourth week of January 2001. A questionnaire was followed a week later by a medical occupational interview and a clinical dermatological examination, including a comprehensive patch test with potential workplace chemicals. The anamnesis and the clinical examination were made independently by occupational and dermatological physicians, and the skin examination was performed blinded to anamnestic data. The setting was the mother plants of a Danish-based international company producing wind turbine systems. The study population was a workplace cohort, highly exposed to epoxy resin systems and other chemicals, and totalled 724 production workers at 4 facilities. The rate of participation was 84.7%. Using enquete questions of current skin rash against the clinical presence of dermatitis, we found a sensitivity of 22% and a specificity of 89%, compared to 45% and 87%, respectively, when the anamnestic work history, taken by an occupational physician, was the screening parameter. Using 'workplace periodic prevalence' of dermatitis, we found sensitivities in the range of 63-76% by a questionnaire and 70-83% by medical anamnesis. Questionnaire screening by skin symptoms gave the highest values for redness, a sensitivity of 33% and a specificity of 76%, and decreasing validity parameters as more symptoms were added to the list of screening questions. We found that the use of a questionnaire and medical anamnesis were problematic, when the purpose was screening for contact dermatitis and allergy, in this industrial cohort manufacturing reinforced plastic products. But these instruments might be useful for epidemiological surveillance, when the questionnaire has been validated in the given occupational setting. PMID:17026696
Any employee with an actual or suspected laser-induced injury should be evaluated by a medical professional as soon as possible after the exposure. For laser-induced injury to the eye, the medical evaluation shall be performed
1 Any employee with an actual or suspected laser-induced injury should be evaluated by a medical professional as soon as possible after the exposure. For laser-induced injury to the eye, the medical by a physician. Revised December, 2014 OKLAHOMA STATE UNIVERSITY LASER INCIDENT REPORT Laser Safety Officer
Background Diarrhea-predominant irritable bowel syndrome (IBS-d) significantly diminishes the health-related quality of life (HRQOL) of patients. Psychological and social impacts are common with many IBS-d patients reporting comorbid depression, anxiety, decreased intimacy, and lost working days. The Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire is a 34-item instrument developed and validated for measurement of HRQOL in non-subtyped IBS patients. The current paper assesses this previously-validated instrument employing data collected from 754 patients who participated in a randomized clinical trial of a novel treatment, eluxadoline, for IBS-d. Methods Psychometric methods common to HRQOL research were employed to evaluate the IBS-QOL. Many of the historical analyses of the IBS-QOL validations were used. Other techniques that extended the original methods were applied where more appropriate for the current dataset. In IBS-d patients, we analyzed the items and substructure of the IBS-QOL via item reduction, factor structure, internal consistency, reproducibility, construct validity, and ability to detect change. Results This study supports the IBS-QOL as a psychometrically valid measure. Factor analyses suggested that IBS-specific QOL as measured by the IBS-QOL is a unidimensional construct. Construct validity was further buttressed by significant correlations between IBS-QOL total scores and related measures of IBS-d severity including the historically-relevant Irritable Bowel Syndrome Adequate Relief (IBS-AR) item and the FDA’s Clinical Responder definition. The IBS-QOL also showed a significant ability to detect change as evidenced by analysis of treatment effects. A minority of the items, unrelated to the IBS-d, performed less well by the standards set by the original authors. Conclusions We established that the IBS-QOL total score is a psychometrically valid measure of HRQOL in IBS-d patients enrolled in this study. Our analyses suggest that the IBS-QOL items demonstrate very good construct validity and ability to detect changes due to treatment effects. Furthermore, our analyses suggest that the IBS-QOL items measure a univariate construct and we believe further modeling of the IBS-QOL from an item response theory (IRT) approach under both non-treatment and treatment conditions would greatly further our understanding as item-based methods could be used to develop a short form. PMID:24330412
Freisthler, Bridget; Kepple, Nancy J; Sims, Revel; Martin, Scott E
In 1996, California was the first state to pass a Compassionate Use Act allowing for the legal use of marijuana for medical purposes. Here we review several current policy and land use environmental interventions designed to limit problems related to the influx of medical marijuana dispensaries across California cities. Then we discuss the special challenges, solutions, and techniques used for studying the effects of these place-based policies. Finally, we present some of the advanced spatial analytic techniques that can be used to evaluate the effectiveness of environmental interventions, such as those related to reducing problems associated with the proliferation of medical marijuana dispensaries. Further, using data from a premise survey of all the dispensaries in Sacramento, this study will examine what characteristics and practices of these dispensaries are related to crime within varying distances from the dispensaries (e.g., 100, 250, 500, and 1,000 feet). We find that some security measures, such as security cameras and having a door man outside, implemented by medical marijuana dispensary owners might be effective at reducing crime within the immediate vicinity of the dispensaries. PMID:22821130
Osborn, G G; Meoli, F G; Buser, B R; Clearfield, M B; Bruno, J P; Sumner-Truax, L
Medical licensure in the United States demands a dynamic and current means to evaluate the competency of physicians seeking to practice medicine. A systematic measuring tool is required--one that is based on actual patient encounters and how physicians should apply their knowledge and skills to the clinical setting according to their level of training and professional development. Osteopathic physicians have a distinctive approach to healthcare, applying the biopsychosocial model with emphasis on the neuromusculoskeletal system. A component of this distinctive approach is a high level of knowledge and skill in the application of osteopathic manipulative treatment. Developed by the National Board of Osteopathic Medical Examiners, COMPLEX-USA is the new sequential three-level examination process for osteopathic medical licensure in the United States. The examination process is interdisciplinary and highly clinical, with even basic science components tested within a clinical context. Examination content is based on wide expert consensus and data consistent with osteopathic medical education, training, and practice. Its design is a novel multidimensional structure that emphasizes clinical problem-solving skills and osteopathic principles and practice within the context of life cycle, gender, ethnicity, and points of service. Design schemata and blueprints are included along with descriptions of strategic research and development. COMPLEX-USA represents the most appropriate pathway for initial licensure for a distinctive and unique professional: the osteopathic physician in the United States. PMID:10732394
Freisthler, Bridget; Kepple, Nancy J.; Sims, Revel; Martin, Scott E.
In 1996, California was the first state to pass a Compassionate Use Act allowing for the legal use of marijuana for medical purposes. Here we review several current policy and land use environmental interventions designed to limit problems related to the influx of medical marijuana dispensaries across California cities. Then we discuss the special challenges, solutions, and techniques used for studying the effects of these place-based policies. Finally, we present some of the advanced spatial analytic techniques that can be used to evaluate the effectiveness of environmental interventions, such as those related to reducing problems associated with the proliferation of medical marijuana dispensaries. Further, using data from a premise survey of all the dispensaries in Sacramento, this study will examine what characteristics and practices of these dispensaries are related to crime within varying distances from the dispensaries (e.g., 100, 250, 500, and 1000 feet). We find that some security measures, such as security cameras and having a door man outside, implemented by medical marijuana dispensary owners might be effective at reducing crime within the immediate vicinity of the dispensaries. PMID:22821130
Background Many medical situations necessitate a stressful period of waiting for potentially threatening test results. The medical waiting period is often associated with negative anticipatory anxiety and rumination about the outcome of treatment. Few evidence-based self-help coping interventions are available to assist individuals manage these periods. Theory and research suggest that positive reappraisal coping strategies may be particularly useful for this type of unpredictable and uncontrollable stressful context. The objective of this study is to investigate the effects of a Positive Reappraisal Coping Intervention (PRCI) on psychological well-being of women waiting for the outcome of their fertility treatment cycle. Methods/Design In a three-armed randomized controlled trial, the effectiveness of the PRCI will be tested. Consecutive patients undergoing in vitro fertilisation in a Dutch university hospital and meeting selection criteria will be invited to participate. Those who agree will be randomized to one of three experimental groups (N=372). The PRCI Intervention group will receive the intervention that comprises an explanatory leaflet and the 10 statements designed to promote positive reappraisal coping, to be read at least once in the morning, once in the evening. To capture the general impact of PRCI on psychological wellbeing patients will complete questionnaires before the waiting period (pre-intervention), on day ten of the 14-day waiting period (intervention) and six weeks after the start of the waiting period (post-intervention). To capture the specific effects of the PRCI during the waiting period, patients will also be asked to monitor daily their emotions and reactions during the 14-day waiting period. The primary outcome is general anxiety, measured by the Hospital Anxiety and Depression Scale. Secondary outcomes are positive and negative emotions during the waiting period, depression, quality of life, coping and treatment outcome. During recruitment for the RCT it was decided to add a fourth non-randomized group, a PRCI Control group that received the PRCI and completed the questionnaires but did not complete daily monitoring. Discussion Positive reappraisal is one of the few ways of coping that has been shown to be associated with increased wellbeing during unpredictable and uncontrollable situations like medical waiting periods. A simple evidence based self-help intervention could facilitate coping during this common medical situation. This RCT study will evaluate the value of a self-help coping intervention designed for medical waiting periods in women undergoing fertility treatment. Trial registration The study is registered at the Clinical Tials.gov (NCT01701011). PMID:24004640
Background Medication nonadherence has a significant impact on the health and wellbeing of individuals with chronic disease. Several mobile medication management applications are available to help users track, remember, and read about their medication therapy. Objective The objective of this study was to explore the usability and usefulness of existing medication management applications for older adults. Methods We recruited 35 participants aged 50 and over to participate in a 2-hour usability session. The average age ranged from 52-78 years (mean 67 years) and 71% (25/35) of participants were female. Each participant was provided with an iPad loaded with four medication management applications: MyMedRec, DrugHub, Pillboxie, and PocketPharmacist. These applications were evaluated using the 10 item System Usability Scale (SUS) and visual analog scale. An investigator-moderated 30-minute discussion followed, and was recorded. We used a grounded theory (GT) approach to analyze qualitative data. Results When assessing mobile medication management applications, participants struggled to think of a need for the applications in their own lives. Many were satisfied with their current management system and proposed future use only if cognition and health declined. Most participants felt capable of using the applications after a period of time and training, but were frustrated by their initial experiences with the applications. The early experiences of participants highlighted the benefits of linear navigation and clear wording (eg, “undo” vs “cancel”) when designing for older users. While there was no order effect, participants attributed their poor performance to the order in which they tried the applications. They also described being a part of a technology generation that did not encounter the computer until adulthood. Of the four applications, PocketPharmacist was found to be the least usable with a score of 42/100 (P<.0001) though it offered a drug interaction feature that was among the favorite features of participants. The usability scores for MyMedRec (56/100), DrugHub (57/100), and Pillboxie (52/100) were not significantly different and participants preferred MyMedRec and DrugHub for their simple, linear interfaces. Conclusions With training, adults aged 50 and over can be capable and interested in using mHealth applications for their medication management. However, in order to adopt such technology, they must find a need that their current medication management system cannot fill. Interface diversity and multimodal reminder methods should be considered to increase usability for older adults. Lastly, regulation or the involvement of older adults in development may help to alleviate generation bias and mistrust for applications. PMID:25099993
Thiede, Birgit; Kramer, Axel
Safe reprocessing of medical devices through cleaning, disinfection, and sterilization is essential for the prevention of health care associated infections (HAI) and to guarantee patient safety. Several studies detected residual contamination and even severe infections of patients, despite carrying out reprocessing. To develop appropriate solutions, the existing situation in Germany and selected European countries was analyzed. Additionally, in 27 medical practitioners’ offices and 14 hospitals, the true practice of reprocessing was analyzed using a questionnaire, a checklist, and inspection on site. A structured analysis of potential alternatives to the internal reprocessing was conducted within the German and European context. The results indicate that the conditions for the execution of the reprocessing process in the analyzed health facilities in southern Hesse (Germany) do not satisfy legal requirements. The detected deficiencies were consistent with other reports from Germany and Europe. The analysis gave insight into several reasons for the detected deficiencies. The three main reasons were the high costs for proper implementation, the subjective value assigned to the reprocessing unit in health care facilities, and deficits in monitoring by the health authority. Throughout the European Union, a similar regulatory framework for the performance of the reprocessing process exists, while the environment, structures of the health systems and administrative supervision vary significantly. The German states as well as selected European countries are currently discussing the challenges of increased quality-assured execution of the reprocessing process. For instance, the same supervisory system for hospitals and medical practitioners should be established at an equal standard. Alternatives such as the use of single-use medical devices, outsourcing the decontamination processes, or the cooperation of health facilities may be considered. This paper also discusses economic and ecological aspects. Finally, different options are recommended to ensure the exclusive use of reliable medical devices for surgical procedures that guarantee an adequate standard of patient safety within economic constraints. PMID:24327946
Barber, Susan; Thakkar, Kandarp; Marvin, Vanessa; Franklin, Bryony Dean; Bell, Derek
Objectives A passport-sized booklet, designed by patients for patients to record details about their medicines, has been developed as part of a wider project focusing on improving prescribing in the elderly (‘ImPE’). We undertook an evaluation of ‘My Medication Passport’ to gain an understanding of its value to patients and how it may be used in communications about medicines. Setting The Passport was launched in secondary care with the initial users being older people discharged home after an admission to one of the four North West London participating Trusts. The uptake subsequently spread to other (community) locations and other age groups. Participants We recruited more than 200 patients from a cohort who had been given a passport as part of the improvement projects at one of four sites. Of them, 63% (133) completed the structured telephone questionnaire including 27% for whom English was not their first language. Approximately half of the respondents were male and 40% were over 70?years of age. Results More than half of the respondents had found their medication passport useful or helpful in some way; 42% through sharing details from it with others (most frequently family, carer or doctor) or using it as a platform for conversations with healthcare professionals. One-third of those questioned carried the passport with them at all times. Conclusions My Medication Passport has been positively evaluated; we have a better understanding of how it is used by patients, what they are recording and how it can be an aid to dialogue about medicines with family, carers and healthcare professionals. Further development and spread is underway including an App for smartphones that will be subject to wider evaluation to include feedback from clinicians. PMID:25138809
Nelson, Lewis S; Loh, Meredith; Perrone, Jeanmarie
The decision to approve a drug for clinical use is based on an understanding of its benefits versus the risks. Although efficacy is generally understood at the time of submission to the FDA for approval, the risks are more difficult to assess. Both PubMed (from 2000 to 2012) and the FDA website (www.fda.gov) were searched using the search terms "risk evaluation and mitigation strategy" (REMS). Articles for review were selected by relevance to topic, and their references were searched as well for additional relevant resources. Since the search results were not expected to contain research studies, formal quality assessment and inclusion and exclusion criteria were not utilized resulting in a narrative review. Few directly relevant research studies exist, although supporting documents such as government reports were available. For effective drugs with unclear or concerning safety records, the FDA has the option of requiring a risk evaluation and mitigation strategy, which allows a systematic approach to track and assure safe medication use. Over 100 different medications are currently covered by REMS, and each REMS is developed individually based on the needs of the specific drug or class. Although likely associated with improvements in medication safety, the potential benefit, limitations, and consequences of REMS are not yet fully understood. PMID:24414251
Curry, C J; Stevenson, R E; Aughton, D; Byrne, J; Carey, J C; Cassidy, S; Cunniff, C; Graham, J M; Jones, M C; Kaback, M M; Moeschler, J; Schaefer, G B; Schwartz, S; Tarleton, J; Opitz, J
A Consensus Conference utilizing available literature and expert opinion sponsored by the American College of Medical Genetics in October 1995 evaluated the rational approach to the individual with mental retardation. Although no uniform protocol replaces individual clinician judgement, the consensus recommendations were as follows: 1. The individual with mental retardation, the family, and medical care providers benefit from a focused clinical and laboratory evaluation aimed at establishing causation and in providing counseling, prognosis, recurrence risks, and guidelines for management. 2. Essential elements of the evaluation include a three-generation pedigree: pre-, peri-, and post-natal history, complete physical examination focused on the presence of minor anomalies, neurologic examination, and assessment of the behavioral phenotype. 3. Selective laboratory testing should, in most patients, include a banded karyotype. Fragile X testing should be strongly considered in both males and females with unexplained mental retardation, especially in the presence of a positive family history, a consistent physical and behavioral phenotype and absence of major structural abnormalities. Metabolic testing should be initialed in the presence of suggestive clinical and physical findings. Neuroimaging should be considered in patients without a known diagnosis especially in the presence of neurologic symptoms, cranial contour abnormalities, microcephaly, or macrocephaly. In most situations MRI is the testing modality of choice. 4. Sequential evaluation of the patient, occasionally over several years, is often necessary for diagnosis, allowing for delineation of the physical and behavioral phenotype, a logical approach to ancillary testing and appropriate prognostic and reproductive counseling. PMID:9375733
Bair, C W
A unique case study approach to training medical students in community diagnosis techniques was initiated at the Medical College of Ohio at Toledo. This paper describes the five elements of this teaching method: preliminary specification of target community and data base; group problem-solving requirement; specification of desired output; defined performance objectives; and regularly scheduled time for analysis. Experience with the case study method over two years was evaluated to identify specific strengths and weaknesses. The identified strengths include use of limited educational time to introduce community health problems, development of experience in a collegial team work setting, and specific awareness of the types of data useful to the analysis of community health service problems. Negative evaluations suggested that the method was not conducive to the development of skills in three areas: ability to establish the relative importance of health problems in communities; ability to identify an appropriate health system response to a community health problem from feasible alternatives; and ability to anticipate the community impact of health program modifications or improvements. Potential explanations for these deficiencies include: need for increased didactic support in the classroom for particular skill areas; need to establish a direct field experience in community diagnosis; inappropriateness of the data base used for evaluation of particular skills; and the probability that quantitative analysis, as used in this evaluation, may not be sufficient in and of itself to measure the outcome of a community diagnosis experience. PMID:7430422
A. S. Melani; W. Verponziani; E. Boccoli; G. L. Trianni; A. Federici; R. Amerini; M. G. Vichi; P. Sestini
In this study we evaluated the smoking habits, beliefs and attitudes of nurse and medical students at the University of Siena and Florence, Italy. Students who entered the 1st year of school in 1998 were asked to complete a self-administered anonymous questionnaire. Two hundred medical students completed the questionnaire; they had a mean age (±SD) of 19.8 ± 1.7 years
Kavan, Michael G.; Malin, Paula Jo; Wilson, Daniel R.
Objectives: This article explores ethical and practical issues associated with the Liaison Committee on Medical Education (LCME) provision that states health professionals who provide psychiatric/psychological care to medical students must have no involvement in the academic evaluation or promotion of students receiving those services. Method: The…
Alfici, C.; And Others
The purpose of this research is to build a test for the evaluation of the knowledge needed by medical students before entering clinical courses in medical school. The criterion for this was provided by teachers in both the pre-clinical and clinical subjects. The Pilot instrument consisted of 335 items that covered 8 sections. Each one of these…
Kuwabara, Cleuza Catsue Takeda; Evora, Yolanda Dora Martinez; de Oliveira, Márcio Mattos Borges
With the continuous incorporation of health technologies, hospital risk management should be implemented to systemize the monitoring of adverse effects, performing actions to control and eliminate their damage. As part of these actions, Technovigilance is active in the procedures of acquisition, use and quality control of health products and equipment. This study aimed to construct and validate an instrument to evaluate medical-hospital products. This is a quantitative, exploratory, longitudinal and methodological development study, based on the Six Sigma quality management model, which has as its principle basis the component stages of the DMAIC Cycle. For data collection and content validation, the Delphi technique was used with professionals from the Brazilian Sentinel Hospital Network. It was concluded that the instrument developed permitted the evaluation of the product, differentiating between the results of the tested brands, in line with the initial study goal of qualifying the evaluations performed. PMID:21120414
Wright, Adam; Laxmisan, Archana; Ottosen, Madelene J; McCoy, Jacob A; Butten, David; Sittig, Dean F
Objective We describe a novel, crowdsourcing method for generating a knowledge base of problem–medication pairs that takes advantage of manually asserted links between medications and problems. Methods Through iterative review, we developed metrics to estimate the appropriateness of manually entered problem–medication links for inclusion in a knowledge base that can be used to infer previously unasserted links between problems and medications. Results Clinicians manually linked 231?223 medications (55.30% of prescribed medications) to problems within the electronic health record, generating 41?203 distinct problem–medication pairs, although not all were accurate. We developed methods to evaluate the accuracy of the pairs, and after limiting the pairs to those meeting an estimated 95% appropriateness threshold, 11?166 pairs remained. The pairs in the knowledge base accounted for 183?127 total links asserted (76.47% of all links). Retrospective application of the knowledge base linked 68?316 medications not previously linked by a clinician to an indicated problem (36.53% of unlinked medications). Expert review of the combined knowledge base, including inferred and manually linked problem–medication pairs, found a sensitivity of 65.8% and a specificity of 97.9%. Conclusion Crowdsourcing is an effective, inexpensive method for generating a knowledge base of problem–medication pairs that is automatically mapped to local terminologies, up-to-date, and reflective of local prescribing practices and trends. PMID:22582202
Wood, Evan; Kerr, Thomas; Lloyd-Smith, Elisa; Buchner, Chris; Marsh, David C; Montaner, Julio SG; Tyndall, Mark W
Many Canadian cities are experiencing ongoing infectious disease and overdose epidemics among injection drug users (IDUs). In particular, Human Immunodeficiency Virus (HIV) and hepatitis C Virus (HCV) have become endemic in many settings and bacterial and viral infections, such as endocarditis and cellulitis, have become extremely common among this population. In an effort to reduce these public health concerns and the public order problems associated with public injection drug use, in September 2003, Vancouver, Canada opened a pilot medically supervised safer injecting facility (SIF), where IDUs can inject pre-obtained illicit drugs under the supervision of medical staff. The SIF was granted a legal exemption to operate on the condition that its impacts be rigorously evaluated. In order to ensure that the evaluation is appropriately open to scrutiny among the public health community, the present article was prepared to outline the methodology for evaluating the SIF and report on some preliminary observations. The evaluation is primarily structured around a prospective cohort of SIF users, that will examine risk behavior, blood-borne infection transmission, overdose, and health service use. These analyses will be augmented with process data from within the SIF, as well as survey's of local residents and qualitative interviews with users, staff, and key stakeholders, and standardised evaluations of public order changes. Preliminary observations suggest that the site has been successful in attracting IDUs into its programs and in turn helped to reduce public drug use. However, each of the indicators described above is the subject of a rigorous scientific evaluation that is attempting to quantify the overall impacts of the site and identify both benefits and potentially harmful consequences and it will take several years before the SIF's impacts can be appropriately examined. PMID:15535885
Johnson-Troop; Pettys, Marianne; Hurst, Victor, IV; Smaka, Todd; Paul, Bonnie; Rosenquist, Kevin; Gast, Karin; Gillis, David; McCulley, Phyllis
International Space Station (ISS) Mission Operations are managed by multiple flight control disciplines located at the lead Mission Control Center (MCC) at NASA-Johnson Space Center (JSC). ISS Medical Operations are supported by the complementary roles of Flight Surgeons (Surgeon) and Biomedical Engineer (BME) flight controllers. The Surgeon, a board certified physician, oversees all medical concerns of the crew and the BME provides operational and engineering support for Medical Operations Crew Health Care System. ISS Medical Operations is currently addressing the coordinated response to a crew call down for an emergent medical event, in particular when the BME is the only Medical Operations representative in MCC. In this case, the console procedure BME Response to Crew Call Down for an Emergency will be used. The procedure instructs the BME to contact a Surgeon as soon as possible, coordinate with other flight disciplines to establish a Private Medical Conference (PMC) for the crew and Surgeon, gather information from the crew if time permits, and provide Surgeon with pertinent console resources. It is paramount that this procedure is clearly written and easily navigated to assist the BME to respond consistently and efficiently. A total of five BME flight controllers participated in the study. Each BME participant sat in a simulated MCC environment at a console configured with resources specific to the BME MCC console and was presented with two scripted emergency call downs from an ISS crew member. Each participant used the procedure while interacting with analog MCC disciplines to respond to the crew call down. Audio and video recordings of the simulations were analyzed and each BME participant's actions were compared to the procedure. Structured debriefs were conducted at the conclusion of both simulations. The procedure was evaluated for its ability to elicit consistent responses from each BME participant. Trials were examined for deviations in procedure task completion and/or navigation, in particular the execution of the Surgeon call sequence. Debrief comments were used to analyze unclear procedural steps and to discern any discrepancies between the procedure and generally accepted BME actions. The sequence followed by BME participants differed considerably from the sequence intended by the procedure. Common deviations included the call sequence used to contact Surgeon, the content of BME and crew interaction and the gathering of pertinent console resources. Differing perceptions of task priority and imprecise language seem to have caused multiple deviations from the procedure s intended sequence. The study generated 40 recommendations for the procedure, of which 34 are being implemented. These recommendations address improving the clarity of the instructions, identifying training considerations, expediting Surgeon contact, improving cues for anticipated flight control team communication and identifying missing console tools.
Background Informed consent is a legal and ethical doctrine derived from the principle of respect for autonomy. Generally two rights derived from autonomy are accorded legal protection. The constitutional right to bodily integrity followed by the right to bodily well-being, protected by professional negligence rules. Therefore healthcare professionals treating patients' without valid consent may be guilty of infringing patients' rights. Many challenges are experienced by doctors obtaining informed consent in complex multicultural societies like South Africa. These include different cultural ethos, multilingualism, poverty, education, unfamiliarity with libertarian rights based autonomy, and power asymmetry between doctors and patients. All of which could impact on the ability of doctors to obtain legally valid informed consent. Methods The objective of this study was to evaluate whether the quality of informed consent obtained by doctors practicing in South Africa is consistent with international ethical standards and local regulations. Responses from 946 participants including doctors, nurses and patients was analyzed, using a semi-structured self-administered questionnaire and person triangulation in selected public hospitals in Durban, KwaZulu-Natal, South Africa. Results The median age of 168 doctors participating was 30 years with 51% females, 28% interns, 16% medical officers, 26% registrars, 30% consultant/specialists. A broad range of clinical specialties were represented. Challenges to informed consent practice include language difficulties, lack of interpreters, workload, and time constraints. Doctors spent 5-10 minutes on consent, disclosed most information required to patients, however knowledge of essential local laws was inadequate. Informed consent aggregate scores (ICAS) showed that interns/registrars scored lower than consultants/specialists. ICAS scores were statistically significant by specialty (p = 0.005), with radiologists and anaesthetists scoring lowest, while internists, GPs and obstetricians/gynaecologists scored highest. Comparative ICAS scores showed that professional nurses scored significantly lower than doctors (p ? 0.001). Conclusions This study shows that though doctors had general knowledge of informed consent requirements, execution in practice was inadequate, with deficiency in knowledge of basic local laws and regulations. Remedying identified deficiencies may require a 'corps' of interpreters in local hospitals to assist doctors in dealing with language difficulties, and continuing education in medical law and ethics to improve informed consent practices and overall quality of healthcare service delivery. PMID:24564932
It was the goal of this review to determine if the MHS of Armenia meets benchmarks for health care quality; to provide military medical officials with relevant information to create an adequate environment for all the quality improvement initiatives being undertaken at the medical care level; to design and implement effective interventions to make informed strategic choices and promote quality and a culture of safety in. Documents addressing the quality of care in the MHS of Armenia were reviewed. PMID:25416224
Gagliardi, K; Walker, S
This paper describes the development and implementation of a new evaluation format for assessing professional attitudes in medical laboratory technology students--the performance appraisal. This tool measures attitudes considered desirable in the ¿ideal technologist¿, and links the presence or absence of these attitudes to behaviors which can be observed in the student. The performance appraisal functions not only as an evaluation instrument for instructors, but as a learning tool for students, who can identify behavioral objectives, assess their own progress, and set goals and strategies for development of professional attitudes. Details regarding the administration of the evaluation instrument, such as rating scales, remedial planning, and responsibilities of faculty, clinical coordinators, and students are presented. In addition, controversies regarding the evaluation of professional attitudes are discussed, including: optimizing instructor objectivity; timing and grading of evaluations; forwarding of evaluations from one instructor to another; identification of mandatory and desirable attitudes; and criterion referencing of objectives. Plans for future development of the system are included. PMID:10145067
Slattery, Martha L; Murtaugh, Maureen A; Schumacher, Mary Catherine; Johnson, Jennifer; Edwards, Sandra; Edwards, Roger; Benson, Joan; Tom-Orme, Lillian; Lanier, Anne P
Collection of dietary intake in epidemiologic studies involves using methods that are comprehensive yet appropriate for the population being studied. Here we describe a diet history questionnaire (DHQ) that was developed using an audio self-administered computer-assisted interview technique. The DHQ was developed for use in a cohort of American Indians and Alaskan Natives with tribal input and area-specific modules to incorporate local food availability. The DHQ includes 54 main food group questions, specific food items within the main food group, and food preparation and general eating practice questions. The questionnaire was programmed to be self-administered using a computer with a touch screen. The average time for the first 6,604 participants to complete the questionnaire was 36 minutes. Almost 100% of participants had complete DHQ data and the average number of food items selected was 70. The methods developed for collection of dietary data appear to be appropriate for the targeted population and may have usefulness for other populations where collecting dietary data in a self-administered format is desirable. PMID:18155994
Schreier, Gunter; Schwarz, Mark; Modre-Osprian, Robert; Kastner, Peter; Scherr, Daniel; Fruhwald, Friedrich
The intake of prescribed medication presents a challenge, in particular for elderly people and in cases where a variety of medications have to be taken in accordance to a complex schedule. To support patients with this task, an mHealth-concept was developed and evaluated in the course of a clinical trial. The system used a multimodal user interface concept, i.e. both RFID tags and barcodes to identify and document the intake of medications. Results of the clinical study with 20 patients indicate that the multimodal mHealth concept utilizing barcode and RFID tags enabled easy-to-use medication management. Although further clinical evaluation is needed to assess whether such a tool can also enhance adherence, the system shows the potential for targeting the problem of medication management with mHealth methods. PMID:24111423
I. Kandarakis; D. Cavouras; P. Prassopoulos; E. Kanellopoulos; C. D. Nomicos; G. S. Panayiotakis
2 SiO4:Mn phosphor was evaluated for use in radiation detectors of medical imaging systems. Zn2SiO4:Mn was used in the form of laboratory-prepared fluorescent layers (screens) with coating weights from 18 to 150 mg\\/cm2. The phosphor was excited to luminescence by low-energy X-raysusing X-raytube voltages ranging from 15 to 50 kVp. The number\\u000a of emitted optical photons per incident X-rayquantum was thus determined for
Lin, Chao-Cheng; Li, Yu-Chuan; Bai, Ya-Mei; Chen, Jen-Yeu; Hsu, Chien-Yeh; Wang, Chih-Hung; Chiu, Hung-Wen; Wan, Hsu-Tien
Game-Based e-learning (GBeL) was a newly designed platform for education of students with higher education, especially for medical students. The purpose of this study was to preliminarily evaluate the attraction of GBeL, the motivation toward GBeL and the learning effect. We found more than 80% of students thought that GBeL was attractive and more interesting than traditional class. However, the percentage of enhancing interest to learn and learning more complete and deep knowledge were less than 50%. PMID:16779319
Goldman, Roberta E.; Parker, Donna R.; Brown, Joanna; Walker, Judith; Eaton, Charles B.; Borkan, Jeffrey M.
PURPOSE There is a strong push in the United States to evaluate whether the patient-centered medical home (PCMH) model produces desired results. The explanatory and contextually based questions of how and why PCMH succeeds in different practice settings are often neglected. We report the development of a comprehensive, mixed qualitative-quantitative evaluation set for researchers, policy makers, and clinician groups. METHODS To develop an evaluation set, the Brown Primary Care Transformation Initiative convened a multidisciplinary group of PCMH experts, reviewed the PCMH literature and evaluation strategies, developed key domains for evaluation, and selected or created methods and measures for inclusion. RESULTS The measures and methods in the evaluation set (survey instruments, PCMH meta-measures, patient outcomes, quality measures, qualitative interviews, participant observation, and process evaluation) are meant to be used together. PCMH evaluation must be sufficiently comprehensive to assess and explain both the context of transformation in different primary care practices and the experiences of diverse stakeholders. In addition to commonly assessed patient outcomes, quality, and cost, it is critical to include PCMH components integral to practice culture transformation: patient and family centeredness, authentic patient activation, mutual trust among practice employees and patients, and transparency, joy, and collaboration in delivering and receiving care in a changing environment. CONCLUSIONS This evaluation set offers a comprehensive methodology to enable understanding of how PCMH transformation occurs in different practice settings. This approach can foster insights about how transformation affects critical outcomes to achieve meaningful, patient-centered, high-quality, and cost-effective sustainable change among diverse primary care practices. PMID:25755039
Brown, Lawrence S.; Kritz, Steven; Lin, Melissa; Zavala, Roberto
Objectives The Addiction Research and Treatment Corporation evaluated the impact of an electronic medical record system. Methods A prospective pre and post-implementation design was utilized that examined the domains of quality, productivity, satisfaction, risk management, and financial performance. Results There were highly statistically significant improvements in timely completion of Annual Medical and 30-Day, 90-Day, and Annual Multidiscipline assessments. There was no statistically significant change in obtaining Hepatitis C viral load for Hepatitis C antibody positive patients. The prevalence of risk management events was too low to detect statistically meaningful changes. Patient satisfaction was unchanged pre and post-implementation, while staff satisfaction trended upward post-implementation. Productivity significantly declined for counseling staff; there was a non-significant productivity decline for medical services staff; and a non-significant productivity increase for case manager staff. Revenue per capita staff increased by 0.6%; while cost per patient visit increased by 5.7%. Conclusions Despite less robust results than expected, had we not implemented the electronic system, recent changes in documentation and reimbursement for services would have paralyzed our agency. PMID:24562402
Sajn, Luka; Kukar, Matjaž
The paper presents results of our long-term study on using image processing and data mining methods in a medical imaging. Since evaluation of modern medical images is becoming increasingly complex, advanced analytical and decision support tools are involved in integration of partial diagnostic results. Such partial results, frequently obtained from tests with substantial imperfections, are integrated into ultimate diagnostic conclusion about the probability of disease for a given patient. We study various topics such as improving the predictive power of clinical tests by utilizing pre-test and post-test probabilities, texture representation, multi-resolution feature extraction, feature construction and data mining algorithms that significantly outperform medical practice. Our long-term study reveals three significant milestones. The first improvement was achieved by significantly increasing post-test diagnostic probabilities with respect to expert physicians. The second, even more significant improvement utilizes multi-resolution image parametrization. Machine learning methods in conjunction with the feature subset selection on these parameters significantly improve diagnostic performance. However, further feature construction with the principle component analysis on these features elevates results to an even higher accuracy level that represents the third milestone. With the proposed approach clinical results are significantly improved throughout the study. The most significant result of our study is improvement in the diagnostic power of the whole diagnostic process. Our compound approach aids, but does not replace, the physician's judgment and may assist in decisions on cost effectiveness of tests. PMID:20846741
Trikalinos, Thomas A; Siebert, Uwe; Lau, Joseph
The clinical utility of medical tests is measured by whether the information they provide affects patient-relevant outcomes. To a large extent, effects of medical tests are indirect in nature. In principle, a test result affects patient outcomes mainly by influencing treatment choices. This indirectness in the link between testing and its downstream effects poses practical challenges to comparing alternate test-and-treat strategies in clinical trials. Keeping in mind the broader audience of researchers who perform comparative effectiveness reviews and technology assessments, the authors summarize the rationale for and pitfalls of decision modeling in the comparative evaluation of medical tests by virtue of specific examples. Modeling facilitates the interpretation of test performance measures by connecting the link between testing and patient outcomes, accounting for uncertainties and explicating assumptions, and allowing the systematic study of tradeoffs and uncertainty. The authors discuss challenges encountered when modeling test-and-treat strategies, including but not limited to scarcity of data on important parameters, transferring estimates of test performance across studies, choosing modeling outcomes, and obtaining summary estimates for test performance data. PMID:19734441
Lodder, Anton; Kamath, Markad V; Upton, Adrian R; Armstrong, David
An implant can be defined, in a medical context, as biological or artificial materials inserted or grafted into the body. Implants may be sensory devices (cochlear, ocular), mechanical devices that are 'passive' (orthopedic joint replacements and fixation plates, dental implants, coronary artery stents and vascular grafts) or 'active' (left ventricular assist devices, heart valves) electrophysiological stimulation devices (cardiac or gastric pacemakers, implantable cardiac defibrillators, functional electrical stimulators for epilepsy or Parkinson's disease) or medication administration devices (insulin or analgesic delivery pumps) or intra-ocular sustained drug release implants. Implantation has had a long history in several subspecialties of medicine. Evaluation of the efficacy of implants is a multifactorial issue. Several variables need to be considered while studying the rejection of the implants such as pathophysiological mechanisms, malfunction, design shortcomings and improper implementation/implantation by a medical team. This paper identifies a variety of modes of failure and how they affect the overall efficacy of the device technologies. Suggestions for improvement, as outlined in the literature, will be examined. PMID:21395517
Berger, Douglas; Williams, Emily C; Bryson, Chris L; Rubinsky, Anna D; Bradley, Katharine A
Improving the quality of alcohol-related care requires practical approaches to assessing alcohol consumption to guide management and monitor outcomes. Given the increasing use of alcohol screening questionnaires to identify alcohol misuse it would be ideal if scores on screening questionnaires were also indicators of average alcohol consumption. However, the questionnaires were not designed for this purpose and include dimensions of drinking that may not reflect average consumption (e.g. heavy episodic drinking, alcohol-related problems). In a general population sample, scores on the AUDIT-C screen correlated with reports of alcohol consumption in detailed interviews, but the relationship is unknown for clinical populations and other questionnaires. Serum high-density lipoprotein cholesterol (HDL) is a biomarker routinely obtained in clinical care and is known to rise with average alcohol consumption. This cross-sectional study of 11,175 male U.S. Veterans Affairs patients enrolled in a primary care study used HDL as an objective biomarker to evaluate whether average alcohol consumption increased as scores increased on 3 brief alcohol screens - the AUDIT-C, AUDIT Question #3 (a single-item screen), and the CAGE questionnaire. Mean HDL progressively increased as screening scores increased for the AUDIT-C and AUDIT Question #3: about 12 mg/dL from the lowest to the highest scores. The association was much weaker for the CAGE questionnaire. Results were minimally affected by adjustment for covariates (e.g. age, race, medical comorbidity, smoking, medication count, and depression) but the association was modified (p = 0.008) and mildly attenuated by adherent use of lipid-lowering medications. This study using HDL as a biomarker of average alcohol consumption adds to evidence that some alcohol screening scores may also serve as scaled markers of average alcohol consumption. PMID:23886863
The Follow-up Questionnaire data set provides information concerning the activities within the household during the sampling week. The information is from 774 Follow-up Questionnaires for 320 households. Medication and supplemental dietary information is provided. The Follow-u...
develop and select cost-effective green building products. The data gathered from this questionnaire-cycle assessment is its comprehensive, multi- dimensional scope. Many green building to develop environmental profiles for building products. The goal is to help manufacturers and designers
California Community Colleges, Sacramento. Office of the Chancellor.
In order to determine the extent to which the California community colleges share and borrow facilities, a questionnaire was sent to each California community college in January 1974. Sixty-six (96 percent) of the 69 districts responded. Analysis of the data revealed that the typical campus shared 7.5 facilities and borrowed 5.6. More than 37…
Sarker, Mohammad Abul Bashar; Harun-Or-Rashid, Md.; Hirosawa, Tomoya; Hai, Md. Shaheen Bin Abdul; Siddique, Md. Ruhul Furkan; Sakamoto, Junichi; Hamajima, Nobuyuki
Background Improper handling of medical wastes, which is common in Bangladesh, could adversely affect the hospital environment and community at large, and poses a serious threat to public health. We aimed to assess the knowledge and practices regarding medical waste management (MWM) among healthcare providers (HCPs) and to identify possible barriers related to it. Material/Methods A cross-sectional study was carried out during June to September, 2012 including 1 tertiary, 3 secondary, and 3 primary level hospitals in Dhaka division, Bangladesh through 2-stage cluster sampling. Data were collected from 625 HCPs, including 245 medical doctors, 220 nurses, 44 technologists, and 116 cleaning staff who were directly involved in MWM using a self-administered (researcher-administered for cleaning staff), semi-structured questionnaire. Results Nearly one-third of medical doctors and nurses and two-thirds of technologists and cleaning staff had inadequate knowledge, and about half of medical doctors (44.0%) and cleaning staff (56.0%) had poor practices. HCPs without prior training on MWM were more likely to have poor practices compared to those who had training. Lack of personal protective equipment, equipment for final disposal, MWM-related staff, proper policy/guideline, and lack of incinerator were identified as the top 5 barriers. Conclusions Strengthening and expansion of ongoing educational programs/training is necessary to improve knowledge and practices regarding MWM. The government should take necessary steps and provide financial support to eliminate the possible barriers related to proper MWM. PMID:25488747
The marketing approval (AMM) is based on criteria of pharmaceutical quality, efficacy and safety of use. Before marketing, the data are collected by means of double-blind, randomized, prospective clinical trials that compare the study product to a reference product. A post-AMM assessment is needed to define the increase of the medical benefit (ASMR) and the therapeutic value of the new drugs. The quantification of the ASMR is essential for registration on the list of drugs reimbursable for those who benefit from Social Security. The evaluation of the therapeutic value and the nature of the affection treated are the criteria upon which the reimbursement ratio is chosen. After marketing, the reevaluation of the medical benefit and the drugs' usefulness may be compared to the treatment's net medical cost (direct + indirect cost--avoided cost) in cost/utility or cost/benefit studies. The Transparency Commission has worked out a scale of assessment of the ASMR which will orient recommendation, or non-recommendation, of registration on the list of reimbursable drugs as well as price fixing proposals. In the future, the Transparency Commission is to strengthen its position regarding the good use of the drug through a better prescriber information system. Thanks to the pharmaco-epidemiology and the pharmaco-vigilance data, the Transparency Commission will be able to guarantee the post-marketing follow-up of the drugs. The examination of the products' conditions of use, the reevaluation of the treatment's advantages based on the utility studies and the epidemiological surveys, and the cost-benefit studies will contribute to a medical control of health spending linked to drug consumption. PMID:1523604
Tallo, Fernando Sabia; de Campos Vieira Abib, Simone; Baitello, André Luciano; Lopes, Renato Delascio
OBJECTIVE: To describe the profile of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil and to evaluate their quality of life. METHODS: Both a semi-structured questionnaire with 57 questions and the SF-36 questionnaire were sent to research departments within SAMU in the Brazilian state capitals, the Federal District and inland towns in Brazil. RESULTS: Of a total of 902 physicians, including 644 (71.4%) males, 533 (59.1%) were between 30 and 45 years of age and 562 (62.4%) worked in a state capital. Regarding education level, 45.1% had graduated less than five years before and only 43% were specialists recognized by the Brazilian Medical Association. Regarding training, 95% did not report any specific training for their work at SAMU. The main weaknesses identified were psychiatric care and surgical emergencies in 57.2 and 42.9% of cases, respectively; traumatic pediatric emergencies, 48.9%; and medical emergencies, 42.9%. As for procedure-related skills, the physicians reported difficulties in pediatric advanced support (62.4%), airway surgical access (45.6%), pericardiocentesis (64.4%) and thoracentesis (29.9%). Difficulties in using an artificial ventilator (43.3%) and in transcutaneous pacing (42.2%) were also reported. Higher percentages of young physicians, aged 25-30 years (26.7 vs 19.0%; p<0.01), worked exclusively in prehospital care (18.0 vs 7.7%; p<0.001), with workloads >48 h per week (12.8 vs 8.6%; p<0.001), and were non-specialists with the shortest length of service (<1 year) at SAMU (30.1 vs 18.2%; p<0.001) who were hired without having to pass public service exams* (i.e., for a temporary job) (61.8 vs 46.2%; p<0.001). Regarding quality of life, the pain domain yielded the worst result among physicians at SAMU. CONCLUSIONS: The doctors in this sample were young and within a few years of graduation, and they had no specific training in prehospital emergencies. Deficiencies were mostly found in pediatrics and psychiatry, with specific deficiencies in the handling of essential equipment and in the skills necessary to adequately attend to prehospital emergencies. A disrespectful labor scenario was also found; the evaluation of quality of life showed a notable presence of pain on the SF-36 among physicians at SAMU and especially among doctors who had worked for a longer length of time at SAMU. PMID:25318091
McNulty, John A; Halama, James; Espiritu, Baltazar
A two-year study was conducted to provide summative evaluations of web-based computer-aided instruction (CAI) specifically designed to supplement the laboratory dissections in the medical human anatomy course. Utilization of CAI was analyzed using server statistics, student surveys and network login tables. There was a significant increase in server requests for CAI over the period of the course in both years of the study. In general, student surveys corresponded with the login data for individual students, although several discrepancies showed limitations of the respective methodologies. When course examination scores were compared to the number of CAI logins for individual students, there were statistically significant direct correlations between exam grades and frequency of CAI use. Our findings illustrate the value of combining server statistics with user surveys for evaluations of CAI as an effective supplement for student learning in the anatomy curriculum. PMID:14695594
Annemarie J Fouwels; Sebastiaan JH Bredie; H. C. H. Wollersheim; Gerard M Schippers
BACKGROUND: To evaluate the vigilance of medical specialists as to the lifestyle of their cardiovascular outpatients by comparing lifestyle screening as registered in medical records versus a lifestyle questionnaire (LSQ), a study was carried out at the cardiovascular outpatient clinic of the university hospital of Nijmegen, The Netherlands, between June 2004 and June 2005. METHODS: For 209 patients information from
Gutzwiller, Roberta; Shawhan, Gerald L.
As an aid in evaluating the present and future benefits given house staff personnel (residents, interns, and clinical fellows) at the University of Cincinnati Medical Center, the Department of Institutional Studies sent out questionnaires concerning benefits extended to house staff personnel to the 46 medical schools using university owned or…
Dib, Hassan H; Pan, Xilong; Zhang, Hong
Background To prove the possibility of implementing the New Rural Cooperative Medical System (NRCMS) at different levels with a premium funding according to their economic level in developed and less developed areas in Guangdong province, and study the insurable inpatients in different types of regions, taking into account limitations of indemnities and loss ratios. Method All data samples were randomly collected from the NRCMS Department, Guangdong Province. Gross domestic product (GDP) at 10000 Yuan per capita was employed to divide Guangdong into two economic levels: (1) economically developed & (2) less economically developed regions. A descriptive analysis about tendency of raising premium and reimbursement ratios of common fund was performed with independent samples and t-test as well as implementing a model to evaluate the differences in premium contribution differences in co-payments, thresholds, and rebates. Also, a qualitative study measured several economic factors to evaluate farmers' financial and social potency in contributing to the NRCMS. Result A higher GDP per capita were found within economically developed regions (p < 0.05) than in less developed areas, with higher tendency for funding capacity and average funding capability in villages and towns within economically developed regions (p < 0.05) than in economically less developed. Maximum benefits between two regions in medical insurance coverage showed significant difference (p < 0.05); differences between basic medical insurance coverage between two regions was insignificant (p > 0.05); nevertheless, economically developed regions showed higher threshold and rebates with less co-payments in the economically developed than less developed. Conclusion Despite some loop holes in the NRCMS, the system is workable, but needs more strengthening by encouraging farmers' participation into NRCMS with a necessity to implement a new reimbursement payment system by health care providers. In addition it is proposed that for maximum benefits another premium funding should be secured. PMID:18590574
Keberlein, Pamela; Sorenson, Gigi; Mohler, Sailor; Tye, Blake; Ramirez, A. Susana; Carroll, Mark
Abstract Background: Remote monitoring for heart failure (HF) has had mixed and heterogeneous effects across studies, necessitating further evaluation of remote monitoring systems within specific healthcare systems and their patient populations. “Care Beyond Walls and Wires,” a wireless remote monitoring program to facilitate patient and care team co-management of HF patients, served by a rural regional medical center, provided the opportunity to evaluate the effects of this program on healthcare utilization. Materials and Methods: Fifty HF patients admitted to Flagstaff Medical Center (Flagstaff, AZ) participated in the project. Many of these patients lived in underserved and rural communities, including Native American reservations. Enrolled patients received mobile, broadband-enabled remote monitoring devices. A matched cohort was identified for comparison. Results: HF patients enrolled in this program showed substantial and statistically significant reductions in healthcare utilization during the 6 months following enrollment, and these reductions were significantly greater compared with those who declined to participate but not when compared with a matched cohort. Conclusions: The findings from this project indicate that a remote HF monitoring program can be successfully implemented in a rural, underserved area. Reductions in healthcare utilization were observed among program participants, but reductions were also observed among a matched cohort, illustrating the need for rigorous assessment of the effects of HF remote monitoring programs in healthcare systems. PMID:25025239
Ersin, Özlem H.; Chen, Yu-Chieh
Objective. To describe and assess student perceptions and performance on a medication use evaluation (MUE) team project. Design. Following a 1-hour MUE lecture in a 62-student patient safety course, student teams (n=14) were assigned a medication safety or quality issue. Teams worked with a mentor to design an MUE to address the issue. The deliverable was a verbal presentation recorded as a webinar. Assessment. Presentations were assessed by 2 reviewers for content and style. Mean score was 45.0 +/- 2.7 of 50 points. Students rated level of agreement that they could perform MUE-related skills pre- and postproject (n=35 and 34, respectively) on a 5-point Likert scale. Students perceived improved ability to design an MUE after project completion (median 3 vs 4; p=0.003). Student comfort with sample determination, data, collaborators, study limitations, and potential project impact also improved. Conclusion. Teams achieved the objective of successfully designing an MUE, and related enabling outcomes (ie, supportive activities that contribute to designing an MUE), as measured by evaluators and student perceptions. PMID:25386020
Matheson, N W; Grefsheim, S F
A comparative study was undertaken to assess the reasons for the low rankings received by George Washington University Medical Center library in the Annual Statistics for Medical School Libraries in the United States and Canada. Although internal studies showed the library was successfully satisfying user needs and meeting its primary objectives, the rankings, which include the traditional measures of quality used by accrediting bodies, indicated the contrary. Three hypotheses were postulated to account for the discrepancy. In a matched group of similar libraries: (1) the rankings of an individual library would differ from the national rankings; (2) clustering the variables would change the rankings; and (3) libraries with similar staff size would tend to rank in the same quartile in service and resource variables. All hypotheses were invalidated. Further tests led to the conclusion that the Annual Statistics and other traditional measures of quality are inappropriate and inaccurate methods for evaluating library programs, since they only measure resource allocations and not the effectiveness of those allocations. Alternative evaluation methods are suggested. PMID:7248592
...Information Collection (Report of Medical Examination for Disability...claimants prior to undergoing a VA medical examination for disability...other forms of information technology. Title: Report of Medical Examination for...
Wolf, Fredric M.; And Others
Results of individaul evaluations of four classes of medical students' (N=213) performance in a communication and interview skills curriculum were synthesized using methods typically used in literary meta-analytic reviews. Results showed a significant positive effect. Implications for program evaluation are discussed. (JAC)
Martinent, Guillaume; Decret, Jean-Claude; Isoard-Gautheur, Sandrine; Filaire, Edith; Ferrand, Claude
This study used confirmatory factor analyses (CFAs) among a sample of young French table tennis players to test: (a) original 19-factor structure, (b) 14-factor structure recently suggested in literature, and (c) hierarchical factor structure of the Recovery-Stress Questionnaire for Athletes (RESTQ-Sport). 148 table tennis players completed the RESTQ-Sport and other self-report questionnaires between one to five occasions with a delay of 1 mo. between each completion. Results of CFAs showed: (a) evidence for relative superiority of the original model in comparison to an alternative model recently proposed in literature, (b) a good fit of the data for the 67-item 17-factor model of the RESTQ-Sport, and (c) an acceptable fit of the data for the hierarchical model of the RESTQ-Sport. Correlations between RESTQ-Sport subscales and burnout and motivation subscales also provided evidence for criterion-related validity of the RESTQ-Sport. This study provided support for reliability and validity of the RESTQ-Sport. PMID:24897893
He, Daojing; Chen, Chun; Chan, Sammy; Bu, Jiajun; Vasilakos, Athanasios V
The development of medical sensor networks (MSNs) is imperative for e-healthcare, but security remains a formidable challenge yet to be resolved. Traditional cryptographic mechanisms do not suffice given the unique characteristics of MSNs, and the fact that MSNs are susceptible to a variety of node misbehaviors. In such situations, the security and performance of MSNs depend on the cooperative and trust nature of the distributed nodes, and it is important for each node to evaluate the trustworthiness of other nodes. In this paper, we identify the unique features of MSNs and introduce relevant node behaviors, such as transmission rate and leaving time, into trust evaluation to detect malicious nodes. We then propose an applicationindependent and distributed trust evaluation model for MSNs. The trust management is carried out through the use of simple cryptographic techniques. Simulation results demonstrate that the proposed model can be used to effectively identify malicious behaviors and thereby exclude malicious nodes. This paper also reports the experimental results of the Collection Tree Protocol with the addition of our proposed model in a network of TelosB motes, which show that the network performance can be significantly improved in practice. Further, some suggestions are given on how to employ such a trust evaluation model in some application scenarios. PMID:22623434
Love, R R; Newcomb, P A; Schiller, J H; Wilding, G; Stone, H L
While both oral and written communication skills are important in the daily work of physicians, medical school evaluation methods focus on content of written essays or often answers to multiple choice questions. To determine the feasibility and value of oral examinations for preclinical medical students, we gave a written short essay examination and an oral examination on the same question to 106 second-year medical students in a required neoplastic diseases course. Examination performance by each method was evaluated according to the same specific content and, separately, based on four communication skills criteria. We found high levels of inter-rater reliability with two oral examiners for both content and skills. Content and skills performance on both written and oral evaluations could be separately determined. Content performance was greater on the written evaluation. PMID:8363938
Pérez Rodrigo, Carmen; Aranceta, Javier; Salvador, Gemma; Varela-Moreiras, Gregorio
Food Frequency Questionnaires are dietary assessment tools widely used in epidemiological studies investigating the relationship between dietary intake and disease or risk factors since the early '90s. The three main components of these questionnaires are the list of foods, frequency of consumption and the portion size consumed. The food list should reflect the food habits of the study population at the time the data is collected. The frequency of consumption may be asked by open ended questions or by presenting frequency categories. Qualitative Food Frequency Questionnaires do not ask about the consumed portions; semi-quantitative include standard portions and quantitative questionnaires ask respondents to estimate the portion size consumed either in household measures or grams. The latter implies a greater participant burden. Some versions include only close-ended questions in a standardized format, while others add an open section with questions about some specific food habits and practices and admit additions to the food list for foods and beverages consumed which are not included. The method can be self-administered, on paper or web-based, or interview administered either face-to-face or by telephone. Due to the standard format, especially closed-ended versions, and method of administration, FFQs are highly cost-effective thus encouraging its widespread use in large scale epidemiological cohort studies and also in other study designs. Coding and processing data collected is also less costly and requires less nutrition expertise compared to other dietary intake assessment methods. However, the main limitations are systematic errors and biases in estimates. Important efforts are being developed to improve the quality of the information. It has been recommended the use of FFQs with other methods thus enabling the adjustments required. PMID:25719771
Chong, Wei Wen; Aslani, Parisa; Chen, Timothy F
Background Recent studies have shown that pharmacists have a role in addressing antidepressant nonadherence. However, few studies have explored community pharmacists’ actual counseling practices in response to antidepressant adherence-related issues at various phases of treatment. The purpose of this study was to evaluate counseling practices of community pharmacists in response to antidepressant adherence-related issues. Methods A simulated patient method was used to evaluate pharmacist counseling practices in Sydney, Australia. Twenty community pharmacists received three simulated patient visits concerning antidepressant adherence-related scenarios at different phases of treatment: 1) patient receiving a first-time antidepressant prescription and hesitant to begin treatment; 2) patient perceiving lack of treatment efficacy for antidepressant after starting treatment for 2 weeks; and 3) patient wanting to discontinue antidepressant treatment after 3 months due to perceived symptom improvement. The interactions were recorded and analyzed to evaluate the content of consultations in terms of information gathering, information provision including key educational messages, and treatment recommendations. Results There was variability among community pharmacists in terms of the extent and content of information gathered and provided. In scenario 1, while some key educational messages such as possible side effects and expected benefits from antidepressants were mentioned frequently, others such as the recommended length of treatment and adherence-related messages were rarely addressed. In all scenarios, about two thirds of pharmacists explored patients’ concerns about antidepressant treatment. In scenarios 2 and 3, only half of all pharmacists’ consultations involved questions to assess the patient’s medication use. The pharmacists’ main recommendation in response to the patient query was to refer the patient back to the prescribing physician. Conclusion The majority of pharmacists provided information about the risks and benefits of antidepressant treatment. However, there remains scope for improvement in community pharmacists’ counseling practice for patients on antidepressant treatment, particularly in providing key educational messages including adherence-related messages, exploring patients’ concerns, and monitoring medication adherence. PMID:23986631
Kortsch, Gabrielle; Kurtines, William M.; Montgomery, Marilyn J.
The study reported in this paper, a Multistage Longitudinal Comparative (MLC) Design Stage II evaluation conducted as a planned preliminary efficacy evaluation (psychometric evaluation of measures, short-term controlled outcome studies, etc.) of the Changing Lives Program (CLP), provided evidence for the reliability and validity of qualitative…
Alfred I. Tauber
The structure, content, and orientation of the contemporary medical record inadequately reflect the appropriate influence of patients' rights and bioethics on health care. Most tellingly, the medical chart reveals a remarkable absence of attention to medical ethics, except in the case of crisis management. But medical ethics informs both crisis decision-making and virtually all clinical interventions. Indeed, clinical care embodies
Edelin, Kenneth C.; Ugbolue, Augustine
Correlated medical school performance of underrepresented minority students participating in Boston University's Early Medical School Selection Program with their Scholastic Aptitude Test and Medical College Admission Test scores. Found that students with higher scores had more success completing their first two years of medical school and passing…
Palmsten, Kristin; Huybrechts, Krista F.; Mogun, Helen; Kowal, Mary K.; Williams, Paige L.; Michels, Karin B.; Setoguchi, Soko; Hernández-Díaz, Sonia
Background In the absence of clinical trial data, large post-marketing observational studies are essential to evaluate the safety and effectiveness of medications during pregnancy. We identified a cohort of pregnancies ending in live birth within the 2000–2007 Medicaid Analytic eXtract (MAX). Herein, we provide a blueprint to guide investigators who wish to create similar cohorts from healthcare utilization data and we describe the limitations in detail. Methods Among females ages 12–55, we identified pregnancies using delivery-related codes from healthcare utilization claims. We linked women with pregnancies to their offspring by state, Medicaid Case Number (family identifier) and delivery/birth dates. Then we removed inaccurate linkages and duplicate records and implemented cohort eligibility criteria (i.e., continuous and appropriate enrollment type, no private insurance, no restricted benefits) for claim information completeness. Results From 13,460,273 deliveries and 22,408,810 child observations, 6,107,572 pregnancies ending in live birth were available after linkage, cleaning, and removal of duplicate records. The percentage of linked deliveries varied greatly by state, from 0 to 96%. The cohort size was reduced to 1,248,875 pregnancies after requiring maternal eligibility criteria throughout pregnancy and to 1,173,280 pregnancies after further applying infant eligibility criteria. Ninety-one percent of women were dispensed at least one medication during pregnancy. Conclusions Mother-infant linkage is feasible and yields a large pregnancy cohort, although the size decreases with increasing eligibility requirements. MAX is a useful resource for studying medications in pregnancy and a spectrum of maternal and infant outcomes within the indigent population of women and their infants enrolled in Medicaid. It may also be used to study maternal characteristics, the impact of Medicaid policy, and healthcare utilization during pregnancy. However, careful attention to the limitations of these data is necessary to reduce biases. PMID:23840692
McGrail, Kimberlyn; Sobolev, Boris
Background Adverse drug events are unintended and harmful events related to medication use. They are a leading cause of visits to the emergency department, unplanned admissions to hospital and death. Adverse drug events can be misdiagnosed in the emergency department, resulting in treatment delays. Our objective was to describe a process to evaluate the effect of pharmacist-led medication review in high-risk patients in the emergency department on the number of days these patients subsequently spent in hospital within 30 days of their index visit. Methods We describe the evaluation of a prospective multicentre quality improvement program. During the evaluation period, triage nurses will flag incoming patients to the emergency department at high risk for adverse drug events by applying a clinical decision rule consisting of 4 variables (comorbid conditions, antibiotic use within 7 days, medication changes within 28 days and age). Consecutive eligible patients will be enrolled in the study and systematically allocated to either a pharmacist-led medication review group or a control group. In the intervention group, pharmacists will collect best-possible medication histories, review the patient’s medications for appropriateness and adverse drug events, and communicate the results of their medication review to patients, caregivers and physicians. In the control group, nurses will start medication reconciliation by collecting best-possible medication histories, and physicians will refer patients to onsite pharmacists for specific medication management questions as needed. Health outcomes will be assessed using anonymized data linkage to administrative health databases. The primary outcome will be the percent days spent in hospital over a 30-day period. Interpretation This protocol describes the methods for evaluating the effect of pharmacist-led medication review in high-risk patients in the emergency department on use of health services, and highlights the methodological challenges that will be encountered. We plan to disseminate the results of this evaluation through articles published in peer-reviewed journals, presentations at scientific meetings and briefing notes to institutional, provincial and national stakeholders. PMID:25844362
He, Yu; Hu, Zhiwei; Ren, Mengda; Ding, Changkun; Chen, Peng; Gu, Qun; Wu, Qiong
Two types of fibers were prepared by using bio-based materials: a mono-filament made from poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) and a multi-filament made from poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) and polylactic acid (PLA) blend. The two fibers were evaluated for mechanical properties, biocompatibility and degradability for the potential application as medical sutures. The PHBHHx fiber showed remarkable biocompatibility by H.E. Stainning, with very little impact to the surrounding tissues. The degradation of the fiber was observed by SEM after implantation for 36 weeks, and the major degradation product was detected after 96 weeks. Consistently, the PHBHHx fiber maintained more than half of the mechanical properties after 96 weeks. The other fiber was prepared by twisting PHBV/PLA blend strands to a bunch, and showed high biocompatibility and relatively high degradability. The bunched structure loosed after 36 weeks of implantation. These low-cost and easily prepared fibers have great potential in medical applications, since they could avoid the formation of fibrous capsule, reduce the size of scar, and degrade into non-toxic and even beneficial products. PMID:24178983
Shelley, AM; Brunton, P; Horner, K
Objectives Survey by questionnaire is a widely used research method in dental radiology. A major concern in reviews of questionnaires is non-response. The objectives of this study were to review questionnaire studies in dental radiology with regard to potential survey errors and to develop recommendations to assist future researchers. Methods A literature search with the software search package PubMed was used to obtain internet-based access to Medline through the website www.ncbi.nlm.nih.gov/pubmed. A search of the English language peer-reviewed literature was conducted of all published studies, with no restriction on date. The search strategy found articles with dates from 1983 to 2010. The medical subject heading terms used were “questionnaire”, “dental radiology” and “dental radiography”. The reference sections of articles retrieved by this method were hand-searched in order to identify further relevant papers. Reviews, commentaries and relevant studies from the wider literature were also included. Results 53 questionnaire studies were identified in the dental literature that concerned dental radiography and included a report of response rate. These were all published between 1983 and 2010. In total, 87 articles are referred to in this review, including the 53 dental radiology studies. Other cited articles include reviews, commentaries and examples of studies outside dental radiology where they are germane to the arguments presented. Conclusions Non-response is only one of four broad areas of error to which questionnaire surveys are subject. This review considers coverage, sampling and measurement, as well as non-response. Recommendations are made to assist future research that uses questionnaire surveys. PMID:22517994
Zain, Jasni M; Fauzi, Abdul R M
This paper will study and evaluate watermarking technique by Zain and Fauzi . Recommendations will then be made to enhance the technique especially in the aspect of recovery or reconstruction rate for medical images. A proposal will also be made for a better distribution of watermark to minimize the distortion of the Region of Interest (ROI). The final proposal will enhance AW-TDR in three aspects; firstly the image quality in the ROI will be improved as the maximum change is only 2 bits in every 4 pixels, or embedding rate of 0.5 bits/pixel. Secondly the recovery rate will also be better since the recovery bits are located outside the region of interest. The disadvantage in this is that, only manipulation done in the ROI will be detected. Thirdly the quality of the reconstructed image will be enhanced since the average of 2 x 2 pixels would be used to reconstruct the tampered image. PMID:18003297
Marks, Stefan; Windsor, John A; Wünsche, Burkhard
Virtual environments (VE) are increasingly used for teamwork training purposes, e.g., for medical teams. One shortcoming is lack of support for nonverbal communication channels, essential for teamwork. We address this issue by using an inexpensive webcam to track the user's head and using that data for controlling avatar head movement, thereby conveying head gestures and adding a nonverbal communication channel. In addition, navigation and orientation within the virtual environment is simplified. We present the design and evaluation of a simulation framework based on a game engine and consumer-level hardware and the results of two user studies showing, among other results, an improvement in the usability of the VE and in the perceived quality of realism and communication within the VE by using head tracking avatar and view control. PMID:22357001
Sun, Bo; McKenzie, Frederic D; Garcia, Hector M; Hubbard, Thomas W; Ullian, John A; Gliva, Gayle A
Standardized patients (SPs), individuals who realistically portray patients, are widely used in medical education to teach and assess communication skills, eliciting a history, performing a physical exam, and other important clinical skills. They are typically healthy individuals with few or no abnormal physical findings. One limitation is that each SP can only portray a limited set of physical symptoms. We have developed a functioning prototype that uses sound-based augmented reality (AR) to expand the capabilities of an SP to exhibit physically-manifested abnormalities. The previous research and evaluation of this prototype have been published in medicine meets virtual reality conference in January 2006. Current research has combined a virtual crackle sound with a healthy SP's real breath sound at end of inspiration in real time. The technology used is intended to correlate the inspiration timing of SP's. A learner will hear this simulated sound through an electronic-stethoscope wirelessly. PMID:17377324
Alyusuf, Raja H.; Prasad, Kameshwar; Abdel Satir, Ali M.; Abalkhail, Ali A.; Arora, Roopa K.
Background: The exponential use of the internet as a learning resource coupled with varied quality of many websites, lead to a need to identify suitable websites for teaching purposes. Aim: The aim of this study is to develop and to validate a tool, which evaluates the quality of undergraduate medical educational websites; and apply it to the field of pathology. Methods: A tool was devised through several steps of item generation, reduction, weightage, pilot testing, post-pilot modification of the tool and validating the tool. Tool validation included measurement of inter-observer reliability; and generation of criterion related, construct related and content related validity. The validated tool was subsequently tested by applying it to a population of pathology websites. Results and Discussion: Reliability testing showed a high internal consistency reliability (Cronbach's alpha = 0.92), high inter-observer reliability (Pearson's correlation r = 0.88), intraclass correlation coefficient = 0.85 and ? =0.75. It showed high criterion related, construct related and content related validity. The tool showed moderately high concordance with the gold standard (? =0.61); 92.2% sensitivity, 67.8% specificity, 75.6% positive predictive value and 88.9% negative predictive value. The validated tool was applied to 278 websites; 29.9% were rated as recommended, 41.0% as recommended with caution and 29.1% as not recommended. Conclusion: A systematic tool was devised to evaluate the quality of websites for medical educational purposes. The tool was shown to yield reliable and valid inferences through its application to pathology websites. PMID:24392243
Saffor, A; bin Ramli, A R; Ng, K H
Wavelet-based image coding algorithms (lossy and lossless) use a fixed perfect reconstruction filter-bank built into the algorithm for coding and decoding of images. However, no systematic study has been performed to evaluate the coding performance of wavelet filters on medical images. We evaluated the best types of filters suitable for medical images in providing low bit rate and low computational complexity. In this study a variety of wavelet filters are used to compress and decompress computed tomography (CT) brain and abdomen images. We applied two-dimensional wavelet decomposition, quantization and reconstruction using several families of filter banks to a set of CT images. Discreet Wavelet Transform (DWT), which provides efficient framework of multi-resolution frequency was used. Compression was accomplished by applying threshold values to the wavelet coefficients. The statistical indices such as mean square error (MSE), maximum absolute error (MAE) and peak signal-to-noise ratio (PSNR) were used to quantify the effect of wavelet compression of selected images. The code was written using the wavelet and image processing toolbox of the MATLAB (version 6.1). This results show that no specific wavelet filter performs uniformly better than others except for the case of Daubechies and bi-orthogonal filters which are the best among all. MAE values achieved by these filters were 5 x 10(-14) to 12 x 10(-14) for both CT brain and abdomen images at different decomposition levels. This indicated that using these filters a very small error (approximately 7 x 10(-14)) can be achieved between original and the filtered image. The PSNR values obtained were higher for the brain than the abdomen images. For both the lossy and lossless compression, the 'most appropriate' wavelet filter should be chosen adaptively depending on the statistical properties of the image being coded to achieve higher compression ratio. PMID:12956184
Spreng, R. Nathan; McKinnon, Margaret C.; Mar, Raymond A.; Levine, Brian
In order to formulate a parsimonious tool to assess empathy, we used factor analysis on a combination of self-report measures to examine consensus and developed a brief self-report measure of this common factor. The Toronto Empathy Questionnaire (TEQ) represents empathy as a primarily emotional process. In three studies, the TEQ demonstrated strong convergent validity, correlating positively with behavioral measures of social decoding, self-report measures of empathy, and negatively with a measure of Autism symptomatology. Moreover, it exhibited good internal consistency and high test-retest reliability. The TEQ is a brief, reliable, and valid instrument for the assessment of empathy. PMID:19085285
Background Professionalism is a difficult construct to define in medical students but aspects of this concept may be important in predicting the risk of postgraduate misconduct. For this reason attempts are being made to evaluate medical students' professionalism. This study investigated the psychometric properties of Selected Response Questions (SRQs) relating to the theme of professional conduct and ethics comparing them with two sets of control items: those testing pure knowledge of anatomy, and; items evaluating the ability to integrate and apply knowledge ("skills"). The performance of students on the SRQs was also compared with two external measures estimating aspects of professionalism in students; peer ratings of professionalism and their Conscientiousness Index, an objective measure of behaviours at medical school. Methods Item Response Theory (IRT) was used to analyse both question and student performance for SRQs relating to knowledge of professionalism, pure anatomy and skills. The relative difficulties, discrimination and 'guessabilities' of each theme of question were compared with each other using Analysis of Variance (ANOVA). Student performance on each topic was compared with the measures of conscientiousness and professionalism using parametric and non-parametric tests as appropriate. A post-hoc analysis of power for the IRT modelling was conducted using a Monte Carlo simulation. Results Professionalism items were less difficult compared to the anatomy and skills SRQs, poorer at discriminating between candidates and more erratically answered when compared to anatomy questions. Moreover professionalism item performance was uncorrelated with the standardised Conscientiousness Index scores (rho = 0.009, p = 0.90). In contrast there were modest but significant correlations between standardised Conscientiousness Index scores and performance at anatomy items (rho = 0.20, p = 0.006) though not skills (rho = .11, p = .1). Likewise, students with high peer ratings for professionalism had superior performance on anatomy SRQs but not professionalism themed questions. A trend of borderline significance (p = .07) was observed for performance on skills SRQs and professionalism nomination status. Conclusions SRQs related to professionalism are likely to have relatively poor psychometric properties and lack associations with other constructs associated with undergraduate professional behaviour. The findings suggest that such questions should not be included in undergraduate examinations and may raise issues with the introduction of Situational Judgement Tests into Foundation Years selection. PMID:21714870
Hussain, M M; Talukder, H K; Moazzem, N; Rashid, A; Hanif, A; Nargis, T
This study was conducted for evaluation of existing MBBS curriculum (2002) of undergraduate medical education in Bangladesh. The specific objectives of this study were: i) to assess the subject wise course content coverage in the new MBBS curriculum, ii) to assess different examination system for evaluation of MBBS students, iii) to evaluate the effectiveness of teaching and learning activities under the curriculum, iv) to explore students opinions regarding improvement of new curriculum. This was a descriptive cross-sectional study. The study was conducted among the students of Dhaka medical colleges of Bangladesh in 2008. Data was collected by self administered structured questioner adopting convenient sampling method. About ninety percent students opined that the coverage of course content of subjects in the curriculum in Phase I was enough. In case of the subjects in phase II except community medicine more than four fifth of the students expressed their opinion about coverage of course content in the curriculum as enough. In case of phase III it was mentioned by most of the students that coverage of course content was enough. Study revealed that teaching methods were perceived suitable by about three fourth of the respondents, to achieve learning objectives. Most of the students expressed their positive views regarding practice of block posting teaching. More than three fourth of the students perceived that formative assessment was encouraging for students to become time bound learner and Structured Oral Examination (SOE) was fair on an average. Only 31(8.6%) of the respondents had opinion that Objective Structured Practical Examination (OSPE)/Objective Structured Clinical Examination (OSCE) was not well organized. About half of the students opined that 20% marks in written test should be allocated for Multiple Choice Question (MCQ). Students' suggestions regarding teaching were: there should be smaller group sessions; more interactive sessions; more clinical and practical sessions; more problem oriented sessions; more sessions with senior and experienced teachers; teachers should follow the curriculum properly; and should be well prepared for class. Regarding assessment suggestions were: written script of the formative examination should be returned to students with feedback; teachers should not be biased. Study recommended that training of the teachers on teaching methodology and assessment system is needed; teachers should provide feedback to the students according to the performance of the formative assessment at the individual level; to maintain the standards of assessment proper planning, designing, conduction and evaluation of assessment should be taken into consideration; subject wise review and updating is essential to make the curriculum more need based, user friendly and applicable considering context of Bangladesh. PMID:21522092
Raeisi, Ahmad Reza; Yarmohammadian, Mohammad Hossein; Bakhsh, Roghayeh Mohammadi; Gangi, Hamid
Background: Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. Materials and Methods: This is a combination (quantitative–qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Results: Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and three indicators were agreed upon, with a mean score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%. Conclusion: One way to create demand for hospital services is performance evaluation by paying close attention to all BSC perspectives, especially the non-financial perspectives such as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the hospital managers improve their performance indicators. The learning and growth perspective obtained the highest score, and the financial perspective obtained the least score. Since the learning and growth perspective acts as a base for all other perspectives and they depend on it, hospitals must continuously improve the service processes and the quality of services by educating staff and updating their policies and procedures. This can increase customer satisfaction and productivity and finally improve the BSC in financial perspective. PMID:23555104
Busari, Jamiu O; Stammen, Lorette A; Gennissen, Lokke M; Moonen, Rob M
Introduction The increasing demands for effective and efficient health care delivery systems worldwide have resulted in an expansion of the desired competencies that physicians need to possess upon graduation. Presently, medical residents require additional professional competencies that can prepare them to practice adequately in a continuously changing health care environment. Recent studies show that despite the importance of competency-based training, the development and evaluation of management competencies in residents during residency training is inadequate. The aim of this literature review was to find out which assessment methods are currently being used to evaluate trainees’ management competencies and which, if any, of these methods make use of valid and reliable instruments. Methods In September 2012, a thorough search of the literature was performed using the PubMed, Cochrane, Embase®, MEDLINE®, and ERIC databases. Additional searches included scanning the references of relevant articles and sifting through the “related topics” displayed by the databases. Results A total of 25 out of 178 articles were selected for final review. Four broad categories emerged after analysis that best reflected their content: 1) measurement tools used to evaluate the effect of implemented curricular interventions; 2) measurement tools based on recommendations from consensus surveys or conventions; 3) measurement tools for assessing general competencies, which included care-management; and 4) measurement tools focusing exclusively on care-management competencies. Conclusion Little information was found about (validated) assessment tools being used to measure care-management competence in practice. Our findings suggest that a combination of assessment tools should be used when evaluating residents’ care-management competencies. PMID:24600299
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The Michigan Questionnaire Documentation System (MQDS) is a powerful tool used to help create questionnaire documentation, with or without summary statistics, and other documentation based on the Blaise data model for a study. MQDS works by: 1...
McKenzie, Karen; Murray, Aja Louise
In situations where completing a full intellectual assessment is not possible or desirable the clinician or researcher may require an alternative means of accurately estimating intellectual functioning. There has been limited research in the use of proxy IQ measures in children with an intellectual disability or low IQ. The present study aimed to provide a means of converting total scores from a screening tool (the Child and Adolescent Intellectual Disability Screening Questionnaire: CAIDS-Q) to an estimated IQ. A series of linear regression analyses were conducted on data from 428 children and young people referred to clinical services, where FSIQ was predicted from CAIDS-Q total scores. Analyses were conducted for three age groups between ages 6 and 18 years. The study presents a conversion table for converting CAIDS-Q total scores to estimates of FSIQ, with corresponding 95% prediction intervals to allow the clinician or researcher to estimate FSIQ scores from CAIDS-Q total scores. It is emphasised that, while this conversion may offer a quick means of estimating intellectual functioning in children with a below average IQ, it should be used with caution, especially in children aged between 6 and 8 years old. PMID:25460217
Gabridge, Michael G.
Microbiology is a typical medical science in which basic information can have direct application. Yet, surveys and questionnaires of recent medical school graduates indicate a serious lack of retentiion in regard to basic biological science. (Author)