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Biomedical subjects

D E Simpson

Publications and source records attributed to D E Simpson.

At least 37 records · Page 2Linked to original sources
PubMed1998

The costs versus the perceived benefits of an LCME institutional self-study.

PURPOSE: To calculate the costs versus the perceived benefits of an institutional self-study done to satisfy the requirements of the Liaison Committee on Medical Education's (LCME's) accreditation process. METHOD: From postcard questionnaires, the authors determined the hours spent over 18 months from 1994 to 1996 on the institutional self-study by 131 self-study committee members and 64 database compilers at the Medical College of Wisconsin. The committee members also rated the potential utility of the self-study process and the probability that the concerns identified by their subcommittees would be addressed. Administrative costs (self-study coordinating team's hours, supplies, and other expenses) were tracked using calendars and budget subaccount numbers. Personnel costs were calculated using salary data from the Association of American Medical Colleges and the College and Universities Personnel Administrators' survey. RESULTS: Supplies and equipment for the self-study cost $12,158, and the personnel costs, based on an 81% response rate, were estimated at $207,384, for a total of $219,542. The participants in the self-study rated the process as moderately useful, but believed that there was only a medium degree of probability that concerns they had identified would be addressed. CONCLUSION: Considering the costs of self-study, the process might be more useful if attention were focused less on identifying concerns and more on an institution's demonstrated ability to successfully respond to problems.

Computer-Assisted Instruction↗
PubMed1997

The effects of standardization and reference values on patient classification for spine and femur dual-energy X-ray absorptiometry.

The effect of two methods for standardizing dual-energy X-ray absorptiometry (DXA) measurements on patient classification by the T-score has been determined for a group of over 2000 patients. The methods proposed by the International DXA Standardization Committee and the European Community's COMAC-BME group were used in conjunction with young reference data from the major DXA manufacturers, the COMAC-BME group and the third US National Health and Nutrition Examination Survey (NHANES III). The two standardization techniques produced dissimilar classifications as measured by the kappa statistic (kappa = 0.34-0.90), especially for the femoral neck, with up to 24.3% of patients reclassified from osteopenic to normal and 18.6% reclassified from osteoporotic to osteopenic when the standardization method was changed. Considering the effects of both reference data and standardization techniques together, there was a wide variation of patient classification, with the number of patients classified as osteoporotic varying from 9.6% to 21.1% for the postero-anterior spine L2-4 region and from 2.3% to 27.6% for the femoral neck. The agreement between different classifications ranged widely, from very poor to excellent (kappa = 0.02-0.98). The creation of standardized reference data must be an important priority in order to harmonize patient management using standardized BMD measurements. The choice of standardization technique, however, must be addressed in light of the results presented here.

Absorptiometry, Photon↗
PubMed1997

Ambulatory teaching "lite": less clinic time, more educationally fulfilling.

Typically, the primary instructional method for ambulatory care education is direct interaction between a preceptor and a learner during a patient encounter. This paper describes instructional strategies teachers and learners can use in ambulatory care training that can occur before or after scheduled clinic hours, thus providing instruction without disrupting a preceptor's busy clinic. First, they describe how preceptors and clerkship or residency-program directors can orient learners prior to their arrival at assigned sites, so that learners are better prepared to assume their patient-care responsibilities. Then they discuss strategies for making use of various types of conferences and independent learning activities to enhance learners' clinical experiences. Conferences and independent study projects that occur before clinic hours can help learners bring a higher level of thinking and clinical sophistication to their role in the ambulatory care site; conferences and independent study activities that occur after clinic hours give learners an opportunity to reinforce and expand on what they have learned during clinic. In this way, learners' educational experiences are enhanced, the best use is made of preceptors' time and expertise, and clinic efficiency is not disrupted.

Ambulatory Care↗
PubMed1996

A descriptive, cross-sectional study of formal mentoring for faculty.

BACKGROUND AND OBJECTIVES: Professional academic skills (PAS) encompass the values, collegial relations, and career management skills essential for faculty success. Mentoring has been proposed as a way for junior faculty to acquire these skills. In this paper, we present a summary of literature on formal mentoring and report an evaluation of a formal mentoring program (FMP) on the PAS development of junior family medicine faculty. METHODS: A descriptive, cross-sectional study was used to examine FMP impact on two groups of junior faculty with 18 months (n = 8) and 6 months (n = 10) of program exposure. We developed a Likert-type questionnaire to assess PAS development and used semistructured interviews to identify unintended outcomes of program participation. A qualitative, template analysis helped surface themes from the descriptive data. RESULTS: The FMP had an overall positive impact on junior faculty PAS development, with greatest improvements in their understanding of academic values. Proteges with longer program experience had greater gains. Unintended benefits included improved preparation to mentor others and increased perceptions of a supportive academic environment. CONCLUSIONS: Formal mentoring programs can improve the PAS of junior faculty and positively impact an organizational culture that supports faculty development.

Cross-Sectional Studies↗
PubMed1995

Analysis of an international emergency medical service train-the-trainer program.

STUDY OBJECTIVE: To assess the effectiveness of an international emergency medical services (EMS) train-the-trainer program. PARTICIPANTS: Seven bilingual Polish physicians attended a 350-hour US-based EMS training program. The physicians returned to Poland to train Polish-speaking EMS personnel. INTERVENTIONS: The Polish training was assessed by means of a pretest, a final examination, a series of skill stations, and a retrospective self-assessment instrument created by the authors. The retrospective self-assessment instrument, using a six-point Likert scale, measured the degree of self-reported competence before and after training in three areas: basic trauma, advanced medical, and basic medical. RESULTS: One hundred seventy-nine Polish students were assessed. Pretest scores ranged from 17% to 100% (mean, 74% +/- 11%). Ninety-one percent passed the final examination (mean, 91% +/- 4.0%; range, 74% to 99%). All students passed all skill stations. The before-and-after instrument indicated that the Polish students' prior competence ranged from not competent (Likert score 1) to fully competent (Likert score 6). Mean scores were: basic trauma, 2.6 +/- 4; advanced medical, 2.5 +/- 7; and basic medical, 2.8 +/- 7. After-course scores demonstrated improved competence. Before-and-after instrument score differences were significant for each area (P < .0001). CONCLUSION: Despite differences in language, culture, technology, and resources, an international train-the-trainer program can be evaluated. In addition to standard testing, a retrospective before-and-after self-assessment instrument provides corroborative evidence of program success.

Clinical Competence↗
PubMed1995

Deconvolution of planar scintigrams by maximum entropy.

Planar scintigrams are deconvolved with a point spread function using the maximum entropy method with the aim of improving image quality. The technique requires the specification of several parameters. These are related to the level of noise present in the data and our a priori knowledge of the object imaged. The performance of the technique is tested for a wide range of these parameters using images of a Williams phantom in scattering material and a figure of merit, derived from the detectability of the smallest cold spot, is calculated. For close to optimal values of the parameters a factor of two improvement in the figure is found. A processed bone image shows improved contrast and resolution. Maximum entropy processing could be used to increase image quality or allow comparable image quality with reduced imaging time or patient dose.

Bone and Bones↗
PubMed1995

Translating family medicine's educational expertise into academic success.

BACKGROUND: Today's family medicine educator occupies a position of increasing stature in medical education. The recognition of education as scholarship creates a framework for the evaluation of clinician-educators for promotion. A system is needed to document educational excellence, peer review, and public dissemination. METHODS: The Educator's Portfolio, a 10-category system for organizing educational expertise, was developed in a family medicine department for use as a promotion document. The effectiveness of the Educator's Portfolio in documenting faculty candidates' educational activities was assessed in two ways. Members of the department rank and tenure committee were surveyed to assess their ability to evaluate faculty teaching contributions using the portfolio, and faculty promotion results were tracked for the first 2 years of portfolio use at the Medical College of Wisconsin. RESULTS: The ability to judge candidates' educational activities via a portfolio was rated to be excellent or very good by 100% of respondents, as compared with using a traditional curriculum vitae alone. Promotion results indicate successful promotion of faculty using the Educator's Portfolio. CONCLUSIONS: As a method for evaluating scholarship in education, the Educator's Portfolio is an important addition to a candidate's promotion packet.

Educational Measurement↗
PubMed1994

A technique for simulation of the point spread function of a gamma camera.

A technique for simulating the point spread function (PSF) of gamma-camera images which treats primary photons and detected scattered photons separately is described. The primary photon PSF was measured at different distances in air from the camera. The scatter PSF was also assessed with different thicknesses of water between the point and the camera, and fitted to a circularly symmetric bi-exponential function. An analysis of the variation of detected scattered radiation based on the results is presented. Simulation of the PSF at a given distance from the camera and thickness of attenuating medium was then possible from the sum of the appropriate primary photon PSF corrected for attenuation and the appropriate scatter PSF. The accuracy of the technique has been studied with variation in depth, density and uniformity of thickness of the attenuating medium.

Algorithms↗
PubMed1994

An alternative approach to defining the role of the clinical teacher.

BACKGROUND: A number of studies have attempted to identify the components of the clinical teacher role by examining learners' numerical ratings of items on researcher-generated lists. Some of these studies have also compared different groups' perceptions of clinical teaching, but have not directly compared the perceptions of first- and third-year residents. This study addressed two questions: (1) What do residents consider important components of the clinical teacher role? (2) Do first- and third-year residents perceive this role similarly? METHOD: A content analysis was performed on the comments written on evaluation forms by 268 residents about 490 clinical teachers over a five-year period (1980-81 through 1984-85) at a large family practice residency. Of 5,664 forms completed by the residents, 2,388 (42%) contained written comments; comments were on 1,024 (46%) of the first-year resident's forms, 701 (41%) of the second-year residents' forms, and 663 (39%) of the third-year residents' forms. Themes in these comments were coded into a coding dictionary of 157 categories, within 37 clusters, within four roles. RESULTS: The ten highest-ranked categories (Global; Teaching: General; Knowledgeable; Gives Resident Responsibility; Supportive; Miscellaneous; Interested in Teaching; Clinical Competence; Makes Effort to Teach; and Gives Resident Opportunity to Do Procedures) accounted for 41% of the themes coded. The first- and third-year residents differed in the clusters they used to describe their clinical teachers on evaluation forms (chi 2 = 149.86, df = 36, p < .0001). CONCLUSION: The results suggest that content analysis can be used to validly and reliably study residents' written evaluative comments about their teachers. This study contributes to the definition of the clinical teacher role, showing the relative importances of its components, and also supports Stritter's Learning Vector theory, finding the anticipated differences between the comments made by first- and third-year residents.

Clinical Competence↗