In an effort to better align item development to goals of assessing higher-order tasks and decision making, complex decision trees were developed to follow clinical reasoning scripts and used as models on which multiple-choice questions could be built. This approach is compatible with best-practice assessment frameworks like Evidence Centered…

It is the responsibility of the athletic trainer to diagnose the nature and extent of an injury to an athlete, administer prompt first aid treatment, prevent any exacerbation of the injury, and hospitalize the patient quickly if it is necessary. The importance of these responsibilities is emphasized when an athlete suffers an injury to the abdomen…

Medical records of older outpatients treated at 15 university teaching hospitals were reviewed to evaluate how their medical problems were managed in university-based internal medicine practices. The finding suggests either that these patients were extremely atypical or that their geriatric problems were unrecognized. (Author/MLW)

An innovative internal medicine clerkship provides a one-month ambulatory care component followed by two months of traditional inpatient experience. Assessment of the changes in student ability to diagnose in a variety of brief cases found knowledge gains in the shorter ambulatory care segment were double those in the longer segment. (MSE)

Surveys were mailed to a sample of Michigan internists and family practitioners (N=2060). This study examined influences on (1) how confident physicians feel about treating a particular problem, (2) where they look for assistance and advice, and (3) what level of continued involvement in the patient's care they prefer. (MLW)

This study retrospectively applies aggregate scoring to the cardiology questions from a recertifying examination in general internal medicine. Three groups of experts were identified among the examinees and the remainder of the examinees were the participants (N=1887) of the study. Generalizability theory is applied to these data. (MLW)

This study compared the analytic scores on an essay test of clinical judgment generated by nonphysician readers with those of physician readers. Generalizability theory was applied to determine the number of essays and scorers required to reach specified levels of reproducibility. Results suggested that with training nonphysicians could…

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)

A study assessed the effectiveness of medical resident training programs during 1983-88 by evaluating students' certification scores and comparing them to the program's evaluation of students' clinical competence. Results are reported and analyzed for top-rated, university-affiliated, and non-university-affiliated programs, focusing on trends over…

In an attempt to replicate an earlier study by H. G. Schmidt, H. P. A. Boshuizen, and P. P. M. Hobus (1988), 96 students and physicians at the University of Limburg (Netherlands) studied 4 clinical cases, produced a diagnosis, and recalled each case. Subjects were 24 second-year, 24 fourth-year, and 24 sixth-year medical students and 24 internists…

In the present study, task instruction and lab data format were manipulated to explain the discrepancy between the positive linear recall function with expertise (reported by van de Wiel and others, 1993), and the generally found intermediate effect in clinical case recall. Sixteen second-year medical students, 16 fourth-year students, and 16…

This study attempted to establish the validity of an essay test of clinical judgment by defining the domain of clinical judgment and operationalizing this definition in a 12-item essay examination administered to 98 residents in internal medicine. The relationship between essay scores and other measures of competence was then examined and the…

Information seeking strategies that primary care physicians use to supplement their knowledge in problem solving were studied to help tailor continuing medical education (CME) courses for various groups of physicians. Of interest were: the sequences physicians use to access different sources, variability among physicians in information search…

Over a 4-year period moral reasoning and performance data were studied on 350 resident pediatricians, internists, and practitioners of family medicine from seven different institutions. Clinical performance was measured by faculty ratings, and integrity (moral reasoning) was measured by Kohlberg's Standard of Moral Judgement Interview and Rest's…

A study investigated possible differences in standardized patient examination scores for three groups of undergraduate (n=176) and graduate (n=221) medical students assessed at different sites over two years. Results show no systematic change in scores over testing dates, suggesting no problems with breach of test security. (MSE)