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Biomedical subjects

D B Swanson

Publications and source records attributed to D B Swanson.

60 records · Page 4Linked to original sources
PubMed1984

A comparison of knowledge, synthesis, and clinical judgment. Multiple-choice questions in the assessment of physician competence.

This study compares the reliability, validity, and efficiency of three multiple-choice question (MCQs) ability scales with patient management problems (PMPs). Data are from the 1980, 1981, and 1982 American Board of Internal Medicine Certifying Examinations. The MCQ ability scales were constructed by classifying the one best answer and multiple-true/false questions in each examination as measuring predominantly clinical judgment, synthesis, or knowledge. Clinical judgment items require prioritizing or weighing management decisions; synthesis items require the integration of findings into a diagnostic decision; and knowledge items stress recall of factual information. Analyses indicate that the MCQ ability scales are more reliable and valid per unit of testing time than are PMPs and that clinical judgment and synthesis scales are slightly more correlated with PMPs than is the knowledge scale. Additionally, all MCQ ability scales seem to be measuring the same aspects of competence as PMPs.

Clinical Competence↗
PubMedDate not supplied

Residents' perception of evaluation procedures used by their training program.

OBJECTIVE: To determine the methods of evaluation used routinely by training programs and to obtain information concerning the frequencies with which various evaluation methods were used. DESIGN: Survey of residents who had recently completed internal medicine training. PARTICIPANTS: 5,693 respondents who completed residencies in 1987 and 1988 and were registered as first-time takers for the 1988 Certifying Examination in Internal Medicine. This constituted a 76% response rate. MAIN RESULTS: Virtually all residents were aware that routine evaluations were submitted on inpatient rotations, but were more uncertain about the evaluation process in the outpatient setting and the methods used to assess their humanistic qualities. Most residents had undergone a Clinical Evaluation Exercise (CEX); residents' clinical skills were less likely to be evaluated by direct observation of history or physical examination skills. Resident responses were aggregated within training programs to determine the pattern of evaluation across programs. The majority of programs used Advanced Cardiac Life Support (ACLS) certification, medical record audit, and the national In-Training Examination to assess most of their residents. Performance-based tests were used selectively by a third or more of the programs. Breast and pelvic examination skills and ability to perform sigmoidoscopy were thought not to be adequately assessed by the majority of residents in almost half of the programs. CONCLUSIONS: While most residents are receiving routine evaluation, including a CEX, increased efforts to educate residents about their evaluation system, to strengthen evaluation in the outpatient setting, and to evaluate certain procedural skills are recommended.

Attitude of Health Personnel↗