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Biomedical subjects

J P Cunnington

Publications and source records attributed to J P Cunnington.

9 recordsLinked to original sources
PubMed2000

Assessing the measurement properties of a clinical reasoning exercise.

BACKGROUND: A challenge for Problem-Based Learning (PBL) schools is to introduce reliable, valid, and cost-effective testing methods into the curriculum in such a way as to maximize the potential benefits of PBL while avoiding problems associated with assessment techniques like multiple-choice question, or MCQ, tests. PURPOSE: We document the continued development of an exam that was designed to satisfy the demands of both PBL and the scientific principles of measurement. METHODS: A total of 102 medical students wrote a clinical reasoning exercise (CRE) as a requirement for two consecutive units of instruction. Each CRE consisted of a series of 18 short clinical problems designed to assess a student's knowledge of the mechanism of diseases that were covered in three subunits located within each unit. Responses were scored by a student's tutor and a 2nd crossover tutor. RESULTS: Generalizability coefficients for raters, subunits, and individual problems were low, but the reliability of the overall test scores and the reliability of the scores across 2 units of instruction were high. Subsequent analyses found that the crossover tutor's ratings were lower than the ratings provided by one's own tutor, and the CRE correlated with the biology component of a progress test. CONCLUSION: The magnitude of the generalizability coefficients demonstrates that the CRE is capable of detecting differences in reasoning across knowledge domains and is therefore a useful evaluation tool.

Education, Medical, Undergraduate↗
PubMed1997

Defensible assessment of the competency of the practicing physician.

When a physician's license to practice is at stake, professional acceptance and legal challenge are concerns for an organization undertaking competency assessments for practicing physicians. In 1995 the Physician Review and Enhancement Program (PREP), a program of McMaster University sponsored by the College of Physicians and Surgeons of Ontario, underwent an external review by evaluation experts. As a result, one of the four assessment tools, the Structured Office Oral, was dropped, as it was insufficiently structured to be reliable and because it did not add significantly to the other tools. The content of all assessment tools was revised based on a PREP-developed blueprint for family practice. The multiple-choice questions (MCQs) were upgraded through collaboration with Canada's physician-accrediting body, the Medical Council of Canada (MCC), by the physician assessors, who chose MCQs according to the blueprint from the MCC question bank. The standardized-patient assessment was also refined by these physicians, who developed scenarios of standardized clinical cases with predefined performance criteria. Finally, through collaboration with the American Board of Emergency Medicine, a chart-stimulated recall test, in which the physician's own patient records are used to assess the physician's practice behavior, was restructured to ensure objectivity in standardization and interpretation. The result of these changes in the assessment tools is a more standardized and structured program of assessing physicians' competencies.

Canada↗
PubMed1995

Error in medicine.

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Decision Making↗