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Biomedical subjects

Brian Jolly

Publications and source records attributed to Brian Jolly.

9 recordsLinked to original sources
PubMed2003

Clinical supervision of SpRs: where does it happen, when does it happen and is it effective? Specialist registrars.

OBJECTIVES: To establish what supervisory methods are used in postgraduate medical education and to determine how effective, particularly in relation to patient care, these methods are perceived to be. DESIGN: We carried out a national validated questionnaire survey of medical directors (MDs) of National Health Service (NHS) trusts (both community and hospital), educational supervisors (ESs) and specialist registrars (SpRs). SAMPLE: Seven specialties were selected to represent the potential range of supervisory practices: anaesthesia, general practice, laboratory science, medicine, paediatrics, psychiatry and surgery. These involved 15 ESs and 15 SpRs from each specialty (n = 210) and 100 MDs. MAIN OUTCOME MEASURES: Quantitative data were analysed using the following tests when appropriate: frequency counts, cross tabulations, descriptives, Kruskal-Wallis, Mann-Whitney, chi-square and Fisher exact tests. Qualitative data were also obtained. RESULTS: A total of 91% of SpRs had a formally designated ES. There was evidence of change in perceptions of the roles of supervising consultants. Supervisory practice is highly variable and there are significant differences between ESs and SpRs in perceptions of frequency and effectiveness of supervision. None of the supervisory activities, including ensuring patient safety, were rated as receiving significant or full coverage. CONCLUSIONS: Supervision is considered to be both important and effective but there is inadequate coverage and frequency of supervision activities. At the least this indicates a need for more explicit guidance for ESs and SpRs.

Clinical Competence↗
PubMed2002

Predictive validity and estimated cut score of an objective structured clinical examination (OSCE) used as an assessment of clinical skills at the end of the first clinical year.

BACKGROUND: Assessment plays a key role in the learning process. The validity of any given assessment tool should ideally be established. If an assessment is to act as a guide to future teaching and learning then its predictive validity must be established. AIM: To assess the ability of an objective structured clinical examination (OSCE) taken at the end of the first clinical year of an undergraduate medical degree to predict later performance in clinical examinations. METHODS: Performance of two consecutive cohorts of year 3 medical undergraduates (n=138 and n=128) in a 23 station OSCE were compared with their performance in 5 subsequent clinical examinations in years 4 and 5 of the course. RESULTS: Poor performance in the OSCE was strongly associated with later poor performance in other clinical examinations. Students in the lowest three deciles of OSCE performance were 6 times more likely to fail another clinical examination. Receiver operating characteristic curves were constructed as a method to criterion reference the cut point for future examinations. CONCLUSION: Performance in an OSCE taken early in the clinical course strongly predicts later clinical performance. Assessing subsequent student performance is a powerful tool for assessing examination validity. The use of ROC curves represents a novel method for determining future criterion referenced examination cut points.

Clinical Competence↗
PubMed2002

Assessing health professionals.

BACKGROUND: Good professional regulation depends on high quality procedures for assessing professional performance. Professional assessment can also have a powerful educational impact by providing transparent performance criteria and returning structured formative feedback. AIM: This paper sets out to define some of the fundamental principles of good assessment design. CONCLUSIONS: It is essential to clarify the purpose of the assessment in question because this drives every aspect of its design. The intended focus for the assessment should be defined as specifically as possible. The scope of situations over which the result is intended to generalize should be established. Blueprinting may help the test designer to select a representative sample of practice across all the relevant aspects of performance and may also be used to inform the selection of appropriate assessment methods. An appropriately designed pilot study enables the test designer to evaluate feasibility, acceptability, validity (with respect to the intended focus) and reliability (with respect to the intended scope of generalization).

Clinical Competence↗
PubMed2002

Generalisability: a key to unlock professional assessment.

CONTEXT: Reliability is defined as the extent to which a result reflects all possible measurements of the same construct. It is an essential measurement characteristic. Unfortunately, there are few objective tests for the most important aspects of the professional role because they are complex and intangible. In addition, professional performance varies markedly from setting to setting and case to case. Both these factors threaten reliability. AIM: This paper describes the classical approach to evaluating reliability and points out the limitations of this approach. It goes on to describe how generalisability theory solves many of these limitations. CONDITIONS: A G-study uses variance component analysis to measure the contributions that all relevant factors make to the result (observer, situation, case, assessee and their interactions). This information can be combined to reflect the reliability of a single observation as a reflection of all possible measurements - a true reflection of reliability. It can also be used to estimate the reliability of a combined sample of several different observations, or to predict how many observations are required with different test formats to achieve a given level of reliability. Worked examples are used to illustrate the concepts.

Analysis of Variance↗
PubMed2002

What is effective supervision and how does it happen? A critical incident study.

OBJECTIVES: To identify the key features of supervision from the perspectives of educational supervisors and specialist registrars. DESIGN: Critical incident study. Telephone interviews were conducted with selected informants representing a range of specialties. The sample comprised educational supervisors with an identified interest in supervision, specialist registrars and GP trainees in the Yorkshire region. RESULTS: Educational supervisors and specialist registrars were generally agreed on what constitutes effective supervision: direct supervision was seen as very important. Educational supervisors and specialist registrars had very different concerns in relation to ineffective supervision: specialist registrars were concerned with inadequate supervision whilst educational supervisors were concerned with failures in direct supervision and poorly performing trainees. Supervision practices varied between specialties; in this study there seemed to be particular problems in anaesthesia, medicine and paediatrics. CONCLUSIONS: Direct supervision and the quality of the supervisory relationship are key to effective supervision. There is a need for clear guidance on supervision and the establishment of appropriate procedures and mechanisms to resolve difficulties relating to inadequate supervision for trainees and performing trainees. Insufficient numbers of supervisors have received training in supervision.

Attitude of Health Personnel↗
PubMed2002

A framework for effective training for supervisors.

The purpose of this paper is to identify the key theoretical and empirical considerations that should underpin effective training for supervisors. Decisions about the content of training courses are complex because there is no appropriate model of supervision in medicine. This paper argues that, in the absence of an explanatory model, effective training for supervisors should be based on existing relevant understandings about learning processes and models of supervision, together with relevant empirical data. It explores some useful models of supervision, considers helpful aspects of theories about learning from experience and identifies some relevant empirical findings to identify some key theoretical and empirical considerations that should underpin effective training for supervisors. This paper offers a framework, derived from both empirical and theoretical work, to guide the content of effective supervision training courses. It does not prescribe structure or organization of training but suggests a basis for devising specific courses for response to local needs.

Education, Medical, Continuing↗