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Biomedical subjects

M Hojat

Publications and source records attributed to M Hojat.

At least 55 records · Page 3Linked to original sources
PubMed1996

Perception of maternal availability in childhood and selected psychosocial characteristics in adulthood.

The associations between reported perception of maternal availability in childhood and a set of psychosocial measures in adulthood were examined. Participants were 362 medical students who were divided into three groups based on their retrospective report of maternal availability before their 5th birthday: Mothers mostly available (n = 260), partly available (n = 70), and mostly unavailable (n = 32). Those with mostly unavailable mothers scored significantly higher on the intensity and chronicity of loneliness scales, reported more depression, scored lower on self-esteem, perceived themselves as less healthy, evaluated the same stressful events more negatively, and perceived both of their parents more negatively than those with mostly available mothers.

Adult↗
PubMed1995

Primary care and non-primary care physicians: a longitudinal study of their similarities, differences, and correlates before, during, and after medical school.

PURPOSE--To investigate similarities and differences between physicians in primary care and non-primary care specialties on performance measures prior to, during, and after medical school, and on demographic characteristics, professional plans and preferences in medical school, professional activities, career satisfaction, perceived problems and research activities, and to predict primary--non-primary care career choices from information obtained in medical school. A questionnaire was mailed to 1,076 physicians who graduated from Jefferson Medical College between 1982 and 1986. Of those who responded (62%), 232 were primary care and 406 were non-primary care physicians (29 physicians in mixed specialties were excluded). Data from the questionnaire concerning professional activities, satisfaction, problems, and research productivities were merged with the college's longitudinal study database. RESULTS--Comparisons of primary care--non-primary care physicians indicated no significant difference between them on performance measures before, during, and after medical school, with the exception that non-primary care physicians had higher scores on quantitative tests before medical school, and primary care physicians scored higher on a licensing examination of general clinical skills and patient management taken during residency training. Also, compared with non-primary care physicians, those in primary care were less likely to be employed full-time, were less likely to locate in metropolitan areas, had a lower rate of academic appointment, and had a higher rate of board certification. Other results showed differences between the groups in terms of age at entrance to medical school, proportion of women, estimates during medical school of anticipated income, career plans during medical school, satisfaction with career and income, and research and scientific activities. A logistic regression model could predict primary care--non-primary care status from specialty interest, professional plans and interests expressed in medical school.

Attitude of Health Personnel↗
PubMed1995

Gender comparisons of young physicians' perceptions of their medical education, professional life, and practice: a follow-up study of Jefferson Medical College graduates.

PURPOSE: To obtain information from a group of young physicians and compare men and women on their evaluations of selected areas of the medical school curriculum, their perceptions of issues related to medical practice and professional life, and their specialty choices, professional activities, and research productivity. METHOD: In 1992, a questionnaire was mailed to 1,076 physicians who had graduated from Jefferson Medical College between 1982 and 1986. The responses of men and women were compared using multivariate and univariate analyses of variance, t-tests, chi-square, and median test. RESULTS: Completed questionnaires were returned by 667 graduates (530 men and 137 women). The curriculum areas of interpersonal skills, disease prevention, medical ethics, and economics of health care were rated by both men and women as being the most important in medical training. Conversely, research methodology and statistics received the lowest ratings. Women, in general, valued psychosocial aspects of medical care higher than did men. Among the areas of perceived problems related to practice, lack of leisure time received the highest ratings (as being the greatest problem) and interpersonal interactions received the lowest ratings (as being the least problem) from both men and women. The men were more concerned than the women about the areas of patient chart and documentation, malpractice litigation, physician oversupply, peer review, and interaction with patients. These differences remained when specialties and numbers of hours worked per week were held constant. Generally, the physicians reported satisfaction with their professional lives, but the men tended to be more satisfied than the women about their decisions to become physicians and in their perceptions of medicine as a rewarding career. The proportion of men employed full-time (99.4%) was significantly higher than that for women (84%). Women were more likely to practice general pediatrics, while men were more likely to practice surgery and surgical subspecialties. Full-time--employed women worked fewer hours per week (57) than men (63), and men reported more research productivity than women. CONCLUSION: The implications of the findings of numerous gender differences are discussed regarding the issues of physician workforce, types of care rendered by men and women, and possible changes in the national health care system.

Analysis of Variance↗
PubMed1995

A national study of the factors influencing men and women physicians' choices of primary care specialties.

BACKGROUND: Despite a recent increase in the percentage of graduating U.S. medical students planning to pursue generalist careers, interest in primary care among students is still far below what it was in the early 1980s and falls well short of the stated goal of the Association of American Medical Colleges that half of all graduates should choose generalist careers. Also during the past decade, the number of women students and physicians has increased. Given the importance of concerns regarding the primary care work force, it is timely to examine the relationship between gender and other factors that influence the decision to enter primary care. METHOD: Totals of 1,038 (65%) men and 558 (35%) women primary care physicians selected from the 1983 and 1984 graduates of all allopathic U.S. medical schools were surveyed in early 1993. Gender comparisons were made on the 19 variables that influenced the physicians' decisions to enter primary care specialties and on the six factor scores derived from a factor analysis of these 19 variables. Also included in the gender comparisons were characteristics of practice, populations served, timing of making the decision to enter primary care, and personal demographic information. RESULTS: Men, more than women, were influenced to become primary care physicians by early role models. Women, more than men, were influenced by personal and family factors. Overall, medical school experience and personal values are two important factors that explained the largest variances of the 19 predictor variables influencing the physicians' choices of primary care disciplines. There was no gender difference in place of origin, family income as a child, timing of the decision to become a primary care physician, or the amount of debt upon graduation. CONCLUSION: This nationwide study of primary care physicians indicates that men and women physicians differ in their perceptions of the relative importances of factors influencing the choice of a primary care specialty. Gender-specific factors should receive more attention in the development of successful strategies to attract more medical students into primary care specialties.

Career Choice↗
PubMed1995

Physicians' intention to stay in or leave primary care specialties and variables associated with such intention.

A national mail survey of primary care physicians was conducted in 1993 to examine the differences between those who planned to leave and those who planned to stay in primary care disciplines. The physicians who planned to stay in primary care were those who, at the time of choosing primary care specialties, were more influenced by factors such as personal social values, religion, and the presence of a role model prior to medical school. Physicians' race, sex, workload, debt, place where they grew up, family income as a child, and timing when they made the decision to enter primary care disciplines are not associated with their plans to stay in or leave primary care disciplines. Findings indicated that personal social values, religious beliefs, and the presence of a role model prior to medical school not only influenced physicians' choice of primary care, but had a lasting effect on their commitment to such choice.

Career Mobility↗
PubMed1995

Should half of all medical school graduates enter primary care? Perceptions of faculty members at Jefferson Medical College.

PURPOSE: This study was undertaken to promote communication among faculty regarding the impact of a proposed goal that 50% of the graduates of Jefferson Medical College enter generalist careers. Since the opinions and attitudes of faculty regarding career decisions may directly or indirectly influence students, the authors investigated faculty's views of the optimal ratio of primary care to non-primary care physicians in the workforce and their perceptions of the effect on medical education, research, and health care delivery if the 50% goal were to be mandated. METHOD: A questionnaire was mailed in January 1994 to all 684 salaried faculty of Jefferson Medical College. Respondents' opinions about the optimal primary care to non-primary care ratio and their perceptions of the effects of implementing the 50% goal on 21 areas related to medical education, research, and health care delivery were examined using a Likert-type scale. Obstacles perceived by non-primary care physicians as preventing their practice of primary care were also among the outcome measures. RESULTS: A total of 275 completed questionnaires were received (40% response rate; 72 primary care physicians, 141 non-primary care physicians, and 62 non-physicians). The median and mode of an optimal primary care to non-primary care ratio were both 50/50. Faculty, in general, perceived that implementing the 50% goal would enhance public access to primary care, physician-patient relationships, utilization of non-physicians, and the career satisfaction of generalists. They predicted decreases in costs of care, freedom of career choice, funding, and interest in research. The primary care physicians perceived greater enhancements of the image of physicians, quality of care, and satisfaction of generalists and subspecialists than did the non-primary care physicians. Gender and age did not affect the perceptions. A lack of appropriate training was identified by 45% and a lack of interest by 28% of the non-primary care physicians as major obstacles to their practice of primary care medicine. CONCLUSION: The faculty members' positive and negative views of the proposed reform can provide useful information to the institution in understanding the potential impediments to increasing the numbers of generalist graduates. The generalists had significantly different views from the subspecialists about the impact of increasing the proportion of primary care physicians on health care delivery and research. In general the primary care physicians were more likely to view the proposed changes as beneficial than were the non-primary care physicians.

Attitude of Health Personnel↗
PubMed1994

Primary care and nonprimary care physicians' concerns in practice and perceptions of medical school curriculum.

The purpose of the present study is to address the issue of physicians' concerns in practice and their perception of a medical school's curriculum with an emphasis on comparisons between primary and nonprimary care physicians. The sample consisted of 663 physicians who graduated from Jefferson Medical College (JMC) between 1982 and 1986, and also responded to a mailed questionnaire. Comparisons were made between physicians in primary care (n=234) and in nonprimary care (n=429) specialties on their responses regarding concerns in medical practice and evaluation of the medical school curriculum. Primary care physicians were more concerned about the time for their professional development whereas nonprimary care physicians were more concerned about an oversupply of physicians in their specialties, prospective hospital payment, and malpractice litigation. Regardless of the specialties, the physicians overall seemed very concerned about their personal time. Interpersonal skills were regarded by all respondents as an important aspect of the medical school's curriculum. The importance of psychological, social, and cultural factors in the curriculum was strongly supported by these physicians' responses, particularly among primary care and women physicians.

Attitude of Health Personnel↗
PubMed1993

Longitudinal comparison of the academic performances of Asian-American and white medical students.

PURPOSE: To compare the academic performances of Asian-American medical students--before, during, and after medical school--with those of white students. METHOD: The 140 Asian-American graduates and 2,269 white graduates from the classes of 1981-1992 at Jefferson Medical College were studied prospectively: data on academic performance, indebtedness, and delayed graduation were analyzed and compared for all the graduates. F-tests, chi-square tests, and regression models were used. RESULTS: The Asian-Americans had statistically significantly higher scores on the SAT (Scholastic Aptitude Test) quantitative subtest and on the MCAT (Medical College Admission Test) chemistry, physics, and science problems subtests; the whites had significantly higher scores on the MCAT reading subtest; third-year grade-point averages for required clerkships; and scores on National Board of Medical Examiners Part I, II, and III examinations (NBME I, II, and III). No significant difference was found in the other performance measures, including ratings in the first year of residency. Regression analysis showed that the MCAT reading score was the major predictor of Asian-Americans' performances on the NBME I and II. CONCLUSION: Because the MCAT reading score is the major predictor of later performance for Asian-American students, schools should consider employing different criteria in predicting and monitoring these students' performances.

Achievement↗
PubMed1993

A case of mistaken identity: signal and noise in connecting performance assessments before and after graduation from medical school.

The authors examine the assumption that there is continuity from one level of training to another in structured and purposeful professional education. Thus, more advanced levels of training are built upon the foundations laid in the preceding levels. While the connection between performance before and performance after graduation from medical school is theoretically rational, such a connection has not been well documented in empirical studies. The issue has been debated but has not been settled because relevant findings are inconsistent. It is argued that these inconsistencies can stem from contaminating factors and the conceptual and methodologic limitations of empirical studies. Such limitations are described in terms of "noise" that obscures the maximal value of a true relationship (the "signal"). Contaminating factors such as the time interval between testings; institutional factors; specialty choices; conceptual dissimilarities between performance measures in medical school and in practice; methodologic limitations such as the shapes of rating distributions, nonlinearity, heteroscedasticity, restriction of range, multicollinearity, voluntary participation, psychometrics of assessment instruments and differing methods of assessments; and a lack of assessments of personal qualities can produce "noise" that inhibits the strength of the "signal." While suggesting solutions for extricating some of the tangled web of methodologic and conceptual issues, the authors feel that solutions do not exist for all of the problems. They conclude that researchers should be aware of the limitations if they are to avoid underestimating the "signal," which may fade because of background "noise."

Clinical Competence↗
PubMed1993

Is the glass half full or half empty? A reexamination of the associations between assessment measures during medical school and clinical competence after graduation.

The purpose of this study was to investigate the associations between performances during medical school and in the first year of residency. It was hypothesized that the strength of such associations is a function of several variables, including similarities of the measured concepts, the formats of the assessments, the time interval between the assessments, performance levels, and specialty areas. The total sample consisted of 2,368 graduates of Jefferson Medical College between 1980 through 1990. The performance measures in medical school were grades on objective examinations in basic and clinical sciences, global ratings of clinical competence in junior core clerkships, and scores on the Part I and Part II examinations of the National Board of Medical Examiners (NBME). The postgraduate performance measures were scores on the Part III NBME examination, postgraduate competence ratings, and board certification. The ratings of postgraduate clinical competence (available for 73% of graduates) were made by residency directors at the end of the first year of residency in the areas of data-gathering and processing skills, interpersonal skills and attitudes, and socioeconomic aspects of patient care. Results supported the research hypotheses. It was found that the associations varied for different measures, at different levels of performance, and in different specialties. The authors conclude that the glass is "half full" regarding the associations between assessment measures before and after graduation from medical school.

Achievement↗
PubMed1993

Further psychometric evaluations of a class-ranking model as a predictor of graduates' clinical competence in the first year of residency.

PURPOSE: To investigate further the psychometrics of a class-ranking model in which a weight of one-third was assigned to performance measures in basic sciences and a weight of two-thirds to ratings on six core clerkships. METHOD: The first part of the study involved 215 graduates of Jefferson Medical College who--based on the ranking model--had been in the top and bottom quarters of the classes of 1991 and 1992. Six faculty, who did not know the graduates' ranks but were familiar with their performances and characteristics, were asked to judge the graduates' potential to become competent physicians. The graduates' ranks according to the model were then compared with the ratings they received from the faculty. The second part of the study investigated whether there was a linear relationship between class ranks and ratings of postgraduate competence, by using directors' ratings of the data-gathering skills of 598 graduates (1986-1990) at the end of their first year of residency. RESULTS: A concordance rate of 85% was obtained between the graduates' ranks and the ratings they received from the medical school faculty, which supports the criterion-related validity of the ranking model. In addition, class ranks were linearly related to ratings of postgraduate competence. However, women and graduates who had been low achievers in medical school were less likely to have given permission for collecting postgraduate ratings, which led to range restriction and a possible underestimation of the validity of the model. CONCLUSION: The psychometric evidence supports the class-ranking model, but other schools should exercise caution in employing the model until they accumulate evidence from data obtained from their own students.

Clinical Competence↗
PubMed1993

Students' psychosocial characteristics as predictors of academic performance in medical school.

PURPOSE: To investigate the incremental effects of selected psychosocial measures--beyond the effects of conventional admission measures--in predicting students' academic performances in medical school. METHODS: In 1989-90, 210 second-year students at Jefferson Medical College were each asked to complete 11 psychosocial questionnaires that were then used as predictors of performance measures in medical school. The students' scores on three subtests of the Medical College Admission Test (MCAT) were also used as predictors. Three composite measures of performance were used as the criterion measures: basic science examination grades, clinical examination grades, and ratings of clinical competence. A multiple regression algorithm (general linear model) was used for statistical analysis. RESULTS: The response rate was 83% (175 students). When the psychosocial measures were added to the statistical models in which the common variances of the MCAT scores were already determined, significant increments in the common variances were observed for two of the three performance measures: basic science grades and clinical examination grades. Whereas only 4% of the common variance in the ratings of clinical competence could be accounted for by the MCAT scores, 14% could be accounted for by the psychosocial measures. CONCLUSION: The "noncognitive," or psychosocial, measures increased the magnitude of the relationships between the predictive and criterion measures of the students' academic performances, beyond the magnitude attained when only the conventional admission measures were used. Therefore, psychosocial measures should be considered as significant and unique predictors of performance in medical school.

Algorithms↗