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Biomedical subjects

K I Hoffman

Publications and source records attributed to K I Hoffman.

15 recordsLinked to original sources
PubMed1993

The USMLE, the NBME subject examinations, and assessment of individual academic achievement.

This second of the four-part set of articles published in this issue examines the appropriateness of using scores on the Step 1 and Step 2 examinations of the United States Medical Licensing Examination (USMLE) to make individual academic achievement decisions (e.g., for promotion or graduation) and the appropriateness of determining course grades by using scores on the National Board of Medical Examiners (NBME) Subject Examinations. The article attempts to make explicit the underlying philosophical and psychometric assumptions involved in using these examinations for such purposes. Specifically, in using the USMLE examinations for promotion and/or graduation, one assumes (1) that the competencies measured by the examinations are essential requirements for graduation or promotion, and (2) that these competencies are not effectively measured by current in-school assessment or that they need an external verification. In using the NBME subject examinations for in-course grading, one assumes (1) that grades should reflect the student's current (end-of-course) knowledge in a subject area; (2) that grades should reflect global content knowledge versus knowledge of content presented during the course; and (3) that grades should be assigned in a normative versus a criterion- or content-referenced manner unless percent-correct scores are specifically requested and properly used. The author argues for and against the viability of the various assumptions stated in the article and concludes that there are dangers and limitations in using the USMLE examinations and the NBME subject examinations for internal academic decision making.(ABSTRACT TRUNCATED AT 250 WORDS)

Educational Measurement↗
PubMed1988

Medical students' attitudes towards cancer: influence of the type of clerkship experience.

Attitudes of third-year medical students relative to patients with cancer were assessed prior to and following three different 6-week pediatric clerkships. Clerkship I (N = 139) was conducted in a public hospital where student contact with all patients occurred in wards, supervised by pediatricians in all subspecialties. Clerkship II (N = 146) was in a pediatric hospital which is a cancer center. Contact with patients with cancer was directed by oncologists and nononcologists. Clerkship III (N = 31) was similar to II, with an exposure to an oncology ward. A 51-item instrument, employing a visual analog scale, which included general, adult, and pediatric items, was used (pre- & postclerkship) to evaluate attitudes in all 316 students and 49 faculty instructors associated with the clerkships. Factor analysis of student responses to pediatric items resulted in four factors: a) early diagnosis, b) aggressive therapy, c) long-range surveillance, and d) psychosocial support in reference to patients with cancer. Post-test differences between clerkship groups in items a and b were noted, with increasing positivity correlated with increased exposure to oncology and oncologists. Attitudes of faculty nononcologists differed significantly from those of oncologists irrespective of institutional affiliation.

Attitude of Health Personnel↗
PubMed1986

The development and validation of a standardized in-training examination for pediatric surgery.

This paper reports on the development and validation of a standardized in-training examination for approved graduate program in pediatric surgery. The major purpose of the examination was to provide an external source of data for program and/or educational evaluation. The method used for equating the examination across years, ensuring content relevance are detailed. Given the emphasis on program evaluation, validation procedures concentrated on determining if differences in training would be reflected in performance differences on the examination. The performance of four groups differing in levels of training was compared. Three of the groups represented increasing levels of training within pediatric surgery. The fourth group consisted of trainees in general surgery with an average of 2.5 postgraduate years. Analysis of variance revealed a significant difference in mean performance across and between all four groups. Trend analysis showed the greatest difference to be between trainees in general surgery and trainees just beginning their pediatric surgical training. The smallest difference is noted between the first and second year trainees in pediatric surgery. Performance gains within the second year of training seem to be more specialized and concentrated in certain subject areas. The impact of the above findings and the examination in general for residency program development and evaluation are discussed.

Education, Medical, Graduate↗
PubMed1985

Effects of intensive clinical exposure on attitudes of medical students toward cancer-related problems.

The attitudes of third-year medical students toward cancer and patients with cancer was examined before and after a 6-week clerkship that included contact with pediatric patients with cancer and their families. A 51-item testing instrument was employed, which included pediatric, adult, and general oncology questions. Beginning with positive attitudes toward the importance of early diagnosis, aggressive therapy, and the complete disclosure of prognosis, the clinical exposure appeared to strengthen the two former attitudes and somewhat diminish the latter. Approval of aggressive cancer therapy was stronger for children than for adults; but approval of both aggressive therapy and intensive surveillance of patients in remission was increased in regard to adults as well as children after the clerkship. A comparison with responses of second-year medical students from another institution suggests that third-year students recognize greater personal limitations in respect to management and adopt a more "defensive" position regarding the patient. In general, during the clerkship, the students moved in the direction of attitudes that were previously designated to be appropriate for students by a multidisciplinary committee that was distinct from the instructional staff in oncology.

Adult↗
PubMed1985

Medical students' concepts of childhood cancer and its management.

Medical student's attitudes toward cancer and patients with cancer were studied prior to and following a required pediatric clerkship which included contact with children on an oncology service. Emphasis in the study was placed on the students' reactions to the child with cancer, and these were compared with the same students' attitudes in the context of the adult with cancer or general oncology. Early diagnosis is regarded as of more significance, and an aggressive therapeutic response following diagnosis of more urgency when the patient is a child. These attitudes, recognizing the importance of early diagnosis and expressing strong approval of aggressive therapy for the pediatric patient, increased during the clerkship. The students strongly supported a program aimed at return of the child to his normal activities with the least delay; recognized the special significance of long-range surveillance for secondary effects in the pediatric patient; and recommended the "center" as opposed to the community hospital as the site for care of the child with cancer. In other areas of cancer management, including (a) the importance of psychosocial support, (b) the problems of emotional involvement of the physician with the patient, and (c) care of the dying patient, attitudes toward patients in the two age groups was not significantly different.

Attitude of Health Personnel↗
PubMed1985

The role of the student ward in the medical clerkships.

The authors describe the structure and the development of an internal medicine clerkship designed to promote proficiency in the process of clinical reasoning. The clerkship is centered around a "student ward" in which the student assumes the role of primary physician. The environment provides not only close supervision and counsel but also allows a great deal of autonomy as students embark on their first clinical medicine rotation. The student ward offers a structured environment where the emphasis is on in-depth clinical exposure and the acquisition of clinical knowledge in a manner consistent with the principles of problem-based learning. Breadth of clinical exposure is accomplished through a variety of educational approaches.

Clinical Clerkship↗
PubMed1981

Objective measure of incidental learning in oncology.

The learning experience of 150 third-year medical students in the specific area of paediatric oncology during a 6-week required paediatric clerkship, was assessed. The clerkship, during which emphasis is placed on patient contact, was based at each of two institutions (A and B). Institution A, with a large relevant patient population and more teaching staff in the field of paediatric oncology, relies primarily on incidental learning relative to this area during the clerkship. Institution B, with smaller related patient groups and teaching staff, employs didactic instruction in this field. Results of pre- and ost-testing at both institutions revealed comparable and significant gain in information relative to paediatric oncology in both student groups. Pre-test scores did not increase during the course of the school year, suggesting that the influence of specific prior clerkships was negligible. Differences in the amount learned between individual student rotational groups were less marked in institution A, where opportunities to contact patients and teaching staff concerned with this specific area, was more consistent.

California↗
PubMed1979

Medical student attitude toward seeking professional psychological help.

To explore the antecedents of emotional distress among physicians, the authors investigated the relationship between year in medical school and student attitude toward seeking professional psychological help. The sample consisted of 489 students at the University of Southern California School of Medicine. Since a cross-sectional approach was employed a classical regression analysis was used to control for possible differences in the variables of sex, age, contact with psychotherapy, and specialty choice. Differences in male and female responses prompted separate analyses. For women, no attitudinal changes were noted during medical school. For men, a significant positive change in attitude was noted between the students of years one and two, as compared with students of years three and four. Results were contrary to findings in the literature. Several possible explanations are discussed.

Adult↗
PubMed1978

Student-constructed examination items.

Student-written items were compared with teacher-written items on an objective examination given to first year medical students. While student scores were higher on the student-written items than on teacher-written items, there was a positive correlation between the scores. Student items did not differ from teacher items in the course, according to student ratings of emphasis. As a by-product of this study, correlations were found which suggest that student scores on an item often reflect the degree of teaching emphasis given the content area of the item rather than the inherent difficulty of the content. It is suggested that further research is needed to determine whether students learn through the process of writing examination items. Therefore, if the process proves to be educational, this study indicates that it will be feasible to incorporate the student-constructed items in examinations.

California↗