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Biomedical subjects

K Doig

Publications and source records attributed to K Doig.

6 recordsLinked to original sources

Referrals for movement disorder surgery: under-representation of females and reasons for refusal.

OBJECTIVE: Referral of movement disorder patients for deep brain stimulation surgery was examined to determine whether referred patients were representative of gender proportions in our population, and reasons why patients do not proceed to surgery. METHODS: Demographic information on referrals to the surgical program was retrospectively reviewed from our database and from a detailed chart review. RESULTS: Although almost equal numbers of movement disorder patients are male and female, of the 91 patients referred for surgery, only 31% were female. Sixty-one percent of referred patients did not undergo surgery. Of these, the majority were denied for medical reasons, including cognitive decline (21%), psychiatric concerns (5%) and neurological reasons (42%). CONCLUSIONS: Almost one-third of patients referred for movement disorder surgery were denied for medical reasons. This underscores the importance of evaluation of all potential patients by a multidisiplinary team to fully assess suitablity for stereotactic surgery. Interestingly, women were under-represented in those referred. In order that all appropriate patients have the opportunity to consider surgery, education of both physicians and patients, and different strategies to approach females regarding surgery may allow more patients to benefit from this treatment.

Deep Brain Stimulation↗

CLT and CLS job responsibilities: current distinctions and updates.

OBJECTIVE: This study was undertaken to address the following questions: 1. What tasks distinguish the job of a clinical laboratory scientist (CLS) from that of a clinical laboratory technician (CLT)? 2. What changes in role distinctions, have occurred for entry-level CLS and CLT practitioners over the five-year period 1993-98? 3. What tasks have been deleted from the CLT and CLS content outlines because they were not frequently performed or not considered entry-level? 4. What changes in practice are reflected in the current job analyses? DESIGN: A national job analysis of tasks constituting the job of clinical laboratory scientists (CLSs) and clinical laboratory technicians (CLTs) was conducted in 1998-99 as part of a standard setting process for the certifying examinations of the National Credentialing Agency for Laboratory Personnel (NCA). The job analyses relied upon mail surveys to 1200 individuals for each job level asking respondents to identify tasks significant to effective practice at job entry. The task lists resulting from statistical analysis of those surveys were examined to answer the study questions. PARTICIPANTS: The sample for each survey included 1200 practitioners, educators and laboratory managers selected at random from membership in professional organizations or from NCA certificant lists. Sampling was stratified to insure adequate practitioner representation. MAIN OUTCOME MEASURES: The mean rating on a four point scale for each item on the surveys was evaluated for overall significance as well as significance across geographic regions. The tasks meeting specified criteria were retained in the final task lists. Tasks were counted and their content evaluated to compare CLS and CLT job tasks. RESULTS: The response rates to the surveys were 33% for CLT and 21% for CLS. Reliability was judged based on average intraclass correlation coefficients of .86 and .82 for the CLT and CLS surveys, respectively. There were 952 tasks retained on the CLS content outline and 725 retained on the CLT content outline of the 1151 tasks on the original survey. Seven hundred and twenty two tasks were found on content outlines of both job levels, representing a 76% overlap. Tasks found only on the CLS outline included advanced technical tasks, a few management tasks, and more communication tasks. CONCLUSIONS: The jobs of CLS and CLT practitioners are distinct at job entry level with CLSs performing a broader array of technical and communication tasks as well as some management tasks. Though CLS staff uses few management skills at job entry, those tasks are performed by CLS staff in the laboratory and curricula must help prepare graduates for these tasks expected of experienced staff. CLTs perform tasks requiring problem solving and high level reasoning. CLT curricula must address the need for CLTs to perform these tasks.

Data Collection↗

Teaching of pathology in United States medical schools, 1996/1997 survey.

A variety of pressures to change curriculum have resulted in revision of pathology teaching in most medical schools in the United States. Responses obtained from 71% of schools on a recent survey of pathology teaching indicate the following: There are wide variations in the extent of use of various teaching modalities with resulting emergence of different teaching formats which can be categorized as "traditional," "enhanced traditional," predominantly "problem based" or "case oriented," entirely "problem based," or some form of "hybrid" of traditional and problem based. The traditional lecture and laboratory continue to be the primary modes of teaching in the vast majority (74%) of schools, however, 53% also use other approaches, eg, small group discussion, case studies, or conferences to enhance instruction. The lecture remains an important component of instruction in all major models. The form and extent of the laboratory use varies remarkably from minimal to large number of hours of instruction. The laboratory material is incorporated into small group discussion or conferences in many schools. The use of small group discussions (presently, by 79% of schools) has increased since the last survey conducted in 1986. The mean curricular time (presently 188 hours) has dropped, however, it is not easy to quantify pathology teaching in many schools with increasing integration. Instruction is entirely integrated, multidisciplinary in 28% of schools. Computer-aided instruction is used in some form to varying extents in 66% of schools, with the majority using it as a supplementary tool. There are persistent concerns about faculty time, and high student-faculty ratio.

Autopsy↗

The value of noncognitive factors in predicting students' first-year academic probation.

PURPOSE: To test the value of Sedlacek's Noncognitive Questionnaire (NQ) in predicting the risk of academic probation for first-year students at the College of Human Medicine at Michigan State University. METHOD: Ninety-six of 106 students completed the NQ during their first week of medical school. The NQ assesses the students in eight noncognitive domains such as academic positive self-concept and realistic self-appraisal. Using a previously derived grade-point average (GPA) and Medical College Admission Test (MCAT)-based risk-prediction equation, students were classified as high- or low-risk for first-year academic probation. At the end of their first year, students actually on probation were identified. RESULTS: High-risk students scored significantly higher than did low-risk students in both academic positive self-concept and realistic self-appraisal. The NQ factors alone predicted risk at a 70% accuracy rate, slightly lower than when the previously derived risk equation was used (74%). CONCLUSION: Sedlacek's noncognitive factors did not improve upon a prediction of academic probation based on GPA and MCAT scores. Sedlacek's NQ may lack the sensitivity required for use with medical students. Further research may identify more appropriate noncognitive factors.

Adult↗