The third year clerkship is one of the most exciting and challenging times for medical students (Cooke, Irby, & O'Brien, 2010) when students spend significant time in clinical settings (e.g., hospitals) assisting in the care of patients on a daily basis. Getting information and resources just-in-time and at point-of-care (Author, 2009) is one…

A theory is discussed in which observed performance ratings are derived from the distance between a rater reference point and subject performance point located on a postulated equal-interval scale and a postulated s-shaped rater characteristic curve, operationalized as the normal ogive. Least-squares estimates of rater (nR=47, 31, and 29) and…

The effects of experience with a series of similar cases on the knowledge restructuring and learning from text were studied in a longitudinal design. Two groups of fourth-year medical students were confronted with a series of cases, part of them having the same underlying disease. The cases were interspersed with fillers, and each set of cases had…

In standardized patient-based tests of clinical competence, patients are used to present the clinical problem and to rate the actions taken by the student. This approach is evaluated by a microanalysis of 1 case used in a fourth year clinical examination of 98 medical students at the University of Manitoba. (MLW)

A multi-faceted Rasch measurement (MFRM) approach was used to analyze clinical performance ratings of 24 first-year residents in one surgery residency program in Thailand to investigate three types of rater effects: leniency, rater inconsistency, and restriction of range. Faculty from 14 surgical services rated the clinical performance of…

A multi-faceted Rasch measurement (MFRM) model was used to analyze a clinical skills assessment of 173 fourth-year medical students in a Midwestern medical school to investigate four types of rater errors: leniency, inconsistency, halo, and restriction of range. Each student performed six clinical tasks with six standardized patients (SPs), who…

The Vanderbilt Summer Research Program in diabetes, which was designed to interest medical students in research careers and diabetes care, was evaluated. The program provides stipends to 20 sophomore and junior medical students for 12 weeks of preceptor-supervised laboratory research work, clinical experience, and classroom instruction. The…

Teaching hospitals are caught between two modi operandi of the 1980s--cost containment and competition. The major area of conflict faced by medical school faculty are the demands of clinical practice and research. Medical students originally motivated by idealistic concerns are seduced by the specialties and subspecialties. (MLW)

The social and economic changes of Medicare and Medicaid broadened the patient base for teaching, universalized student involvement in the teaching hospital, and improved the care of both the poor and the well-to-do. (MLW)

Previous research has shown that expert physicians' diagnostic performance improves when contextual information about a patient is available, while the performance of novices is not influenced by this source of information. These results are explained by supposing that experts' knowledge is organized in illness-scripts. This study examined this…

Prescriptive, decision-analysis of medical problem-solving has been based on decision theory that involves calculation and manipulation of complex probability and utility values to arrive at optimal decisions that will maximize patient benefits. The studies offer a methodology for improving clinical judgment. (Author/MLW)

Medical students' (N=18) were interviewed as part of the evaluation of an innovative Longitudinal Introduction of Clinical Medicine program. Three themes emerged: the importance of experiences with patients; the differences in the effect of patient contact in the first versus the second year; and the educational structure that makes patient…

The purpose of the present investigation was to address several critical issues relating to setting a performance standard on a nationally administered standardized patient examination (SPX). The specific goals of the study were to: (1) compare pass/fail rates from this exercise to those of past studies undertaken with the same examination; (2)…

In August and September of 1989, 76 fourth year students at the University of Arizona College of Medicine took the objective structured clinical examinations. Analyses were conducted looking at the relationship of sequence to see whether scores showed a decrease in the afternoon. No significant effect of examinee fatigue was seen. (MLW)

A summary of what is generally thought to be taught well in internal medicine and what is taught less effectively is presented. The roles of medical students are considered in that context. Teaching contributions, evaluation of teaching, problems on clerkships, and opportunities for change are discussed. (MLW)