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Biomedical subjects

L O Langdon

Publications and source records attributed to L O Langdon.

14 recordsLinked to original sources
PubMed1996

Future roles and training of internal medicine subspecialists. American Board of Internal Medicine Task Force on Subspecialty Internal Medicine.

While fellowship training programs are being reduced in size to better conform to societal needs, the training of subspecialist basic scientists and clinical investigators must be protected to ensure continued discovery and the scholarly application of knowledge to patient care. Fewer subspecialist clinicians must be appropriately trained to serve as consultants, as principal care providers, and as scholarly leaders and educators in their subspecialties. This article describes the recommendations of the American Board of Internal Medicine for subspecialty training. To encourage physicians to choose careers as investigators, overlapping but different training paths are delineated for subspecialist clinicians and investigators. More didactic coursework is recommended for both paths. To maximize the contribution of fewer subspecialists, it is essential to provide rigorous training that is appropriately relevant and realistically matched with career opportunities.

Certification↗
PubMed1993

The relevance to clinical practice of the certifying examination in internal medicine.

OBJECTIVE: To determine the relevance of the initial certifying examination to the practice of internal medicine and the suitability of items used in initial certification for recertification. DESIGN: Using a matrix-sampling approach, items from the 1991 Certifying Examination were assigned to two sets of judges: directors of the American Board of Internal Medicine (ABIM) and practicing general internists. Each judge rated the relevance of items on a five-point scale. PARTICIPANTS: 54 current or former directors of the ABIM and 72 practicing general internists; practitioners were nominated by directors and their ratings were included if they spent > 80% of their time in direct patient care. RESULTS: The directors' mean rating of all 576 items was 3.98 (SD = 0.62); the practitioners' mean rating was 4.11 (SD = 0.82). The directors assigned to 27 items ratings of less than 3 and the practitioners assigned to 42 items ratings of less than 3; seven of these items received low ratings from both groups. There were differences in the two groups' ratings of the relevance of various medical content categories, but the mean rating of core items was higher than that of noncore items and the mean rating of items testing clinical judgment was higher than that of items testing knowledge or synthesis. CONCLUSIONS: These findings suggest that the initial certifying examination is relevant to clinical practice and that many of the examination items are suitable for use in recertification. Differences in perception appear to exist between practitioners and directors, and the use of practitioner ratings is likely to be a routine part of judging the suitability of items for Board examinations in the future.

Certification↗
PubMed1993

A core component of the certification examination in internal medicine.

OBJECTIVE: To develop and test the psychometric characteristics of an examination of core content in internal medicine. DESIGN: A cross-sectional pilot test comparing the core examination with the 1988 certifying examination and two pretest examinations. SETTING: The 1988 certifying examination of the American Board of Internal Medicine. PARTICIPANTS: A random sample of 2,975 candidates from 8,968 candidates who took the 1988 certifying examination were given the core examination; similarly drawn samples were each given one of two pretests of traditional questions. INTERVENTIONS: A framework for developing an examination of core internal medicine questions was designed and used to develop a 92-question core test with an absolute pass/fail standard. RESULTS: Candidates answered 74% of core internal medicine questions, compared with 64%, 52%, and 53% of traditional questions on the 1988 certifying examination and the two pretests. The discriminating ability of the core internal medicine examination was lower than that of the certifying examination (r-values were 0.28 and 0.34, respectively). The pass rate was 83% for the core internal medicine examination and 57% for the certifying examination; 27% passed the core examination and failed the certifying examination; 1% passed the certifying examination and failed the core examination. CONCLUSION: Core internal medicine questions were easier than but almost as discriminating as traditional questions of the certifying examination. A small percentage of candidates passed the certifying examination but failed the core examination.

Certification↗
PubMed1989

First American Board of Internal Medicine critical care examination: process and results.

On November 10, 1987, 2,712 diplomates of the American Board of Internal Medicine (ABIM) took the initial examination recognizing added qualifications in critical care medicine (CCM). The 1-day examination, made up of one-best-answer and multiple true/false questions, covered a broad range of topics from the internal medicine domain of CCM. Diplomates were admitted to the examination through four pathways requiring formal training in CCM and two practice pathways; 89% of the diplomates entered through the practice pathways. The absolute standard for the examination resulted in a total group pass rate of 64% (n = 1,725); the pass rate for diplomates with training in CCM was 84%. Examination performance was positively associated with months of critical care training, earlier ABIM examination scores, certification in pulmonary medicine, program directors' ratings of overall clinical competence, and several factors associated with the critical care work environment.

Certification↗
PubMed1988

The validity of an experimental video examination.

This study investigated the validity of an experimental video examination that had previously been shown to be feasible and have reproducible scores for a sample of candidates taking the 1987 ABIM Cardiovascular Disease examination. Correlations of the three video formats of echocardiograms, ventriculograms, and arteriograms with traditional item formats, similar content multiple choice question scores, experience, and external measures suggest that the video formats could be a worthwhile addition to the examination.

Audiovisual Aids↗
PubMed1988

The reproducibility of scores from three video formats.

The purpose of this paper was to assess the reproducibility of three simulations presented on videotape: echocardiograms, ventriculograms, and arteriograms. The results indicate that roughly comparable numbers of cases, but different amounts of testing time, are required to achieve specified levels of reproducibility; score interpretation affected reproducibility in the expected ways.

Audiovisual Aids↗