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Biomedical subjects

P Richards

Publications and source records attributed to P Richards.

At least 37 records · Page 2Linked to original sources
PubMed1998

Clinical experience, performance in final examinations, and learning style in medical students: prospective study.

OBJECTIVE: To assess whether the clinical experience of undergraduate medical students relates to their performance in final examinations and whether learning styles relate either to final examination performance or to the extent of clinical experience. DESIGN: Prospective, longitudinal study of two cohorts of medical students assessed by questionnaire at time of application to medical school and by questionnaire and university examination at the end of their final clinical year. SUBJECTS: Two cohorts of students who had applied to St Mary's Hospital Medical School during 1980 (n = 1478) and 1985 (n = 2399) for admission in 1981 and 1986 respectively. Students in these cohorts who entered any medical school in the United Kingdom were followed up in their final clinical year in 1986-7 and 1991-2. MAIN OUTCOME MEASURES: Student's clinical experience of a range of acute medical conditions, surgical operations, and practical procedures as assessed by questionnaire in the final year, and final examination results for the students taking their examinations at the University of London. RESULTS: Success in the final examination was not related to a student's clinical experiences. The amount of knowledge gained from clinical experience was, however, related to strategic and deep learning styles both in the final year and also at the time of application, five or six years earlier. Grades in A level examinations did not relate either to study habits or to clinical experience. Success in the final examination was also related to a strategic or deep learning style in the final year (although not at time of entry to medical school). CONCLUSIONS: The lack of correlation between examination performance and clinical experience calls into question the validity of final examinations. How much knowledge is gained from clinical experience as a student is able to be predicted from measures of study habits made at the time of application to medical school, some six years earlier, although not from results of A level examinations. Medical schools wishing to select students who will gain the most knowledge from clinical experience cannot use the results of A level examinations alone but could assess a student's learning style.

Clinical Competence↗
PubMed1997

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Financial Management↗
PubMed1997

The incidence of coronary artery calcification on standard thoracic CT scans.

Coronary artery calcification indicates the presence of atheromatous disease and can represent an area of severe stenosis. The absence of calcification does not correlate with the absence of coronary artery disease, but an incidental finding of calcification has important prognostic implications. The best method available at present is electron beam computed tomography (EBCT) but these are often dedicated units in specialist centres and currently this modality is not widely available in the UK. This is the first study to establish the age/sex frequency with which incidental coronary artery calcification is detected using standard CT scanning in a large population. The methods used are simple, reproducible and based on standard thoracic protocols. The presence of calcification is easily detected using readily available equipment. The reported incidence of calcification using EBCT, the most sensitive method available, was compared with standard CT detection rates. While standard CT underestimates the presence of calcification, the age/sex trends are very similar. Standard CT probably detects the most dense lesions, missing areas of mild calcification, recent studies having shown that these lesions are most likely to represent areas of stenosis. This study shows that, with very little change in current practice and on readily available equipment, it is possible to obtain important diagnostic information suggesting the presence of severe coronary artery disease.

Adult↗
PubMed1996

Shingles in one family practice.

One hundred twenty-four patients presented with herpes zoster in a small-town, solo practice between 1983 and 1992. This article reviews the clinical features and natural history of herpes zoster, followed by a description of the cases seen in the study practice. This common disease, easily diagnosed and treated by the family physician, usually responds well to treatment with acyclovir.

Adolescent↗
PubMed1996

Final examination performance of medical students from ethnic minorities.

It has recently been claimed that UK medical students from ethnic minorities perform less well than White students in final undergraduate examinations and that this results from discrimination in clinical examinations. In this paper the authors examine the performance of students in two prospective studies of 1981 and 1986 entrants to London medical schools taking finals in 1986, 1987, 1991 and 1992. Overall, 18.2% of students in the survey failed one or more examinations at finals. UK ethnic minority students were 2.09 times more likely to fail one or more examinations than were UK White students. Male students were also 1.65 times more likely to fail an examination than female students. More detailed analysis of individual marks confirmed that UK ethnic minority students performed less well than UK White students, although non-UK ethnic minority students performed better than UK White students. The difference between UK White and ethnic minority students could not be explained by differences in educational achievement, study habits or clinical experience. The poorer performance of UK ethnic minority students extended across multiple-choice questions (MCQ), essay, clinical and oral examinations. Ethnic minority students performed particularly poorly on examinations in medicine and surgery as compared with pathology and clinical pharmacology. Although UK-born ethnic minority students perform less well in final examinations than UK White students, this is unlikely to be explained by racial discrimination as the difference is present in MCQ examinations marked by machine and as non-UK ethnic minority students perform better than UK White students. The cause of the difference in performance is therefore not clear and requires further study.

Educational Measurement↗
PubMed1995

Medical school applicants from ethnic minority groups: identifying if and when they are disadvantaged.

OBJECTIVE: To assess whether people from ethnic minority groups are less likely to be accepted at British medical schools, and to explore the mechanisms of disadvantage. DESIGN: Prospective study of a national cohort of medical school applicants. SETTING: All 28 medical schools in the United Kingdom. SUBJECTS: 6901 subjects who had applied through the Universities' Central Council on Admissions in 1990 to study medicine. MAIN OUTCOME MEASURES: Offers and acceptance at medical school by ethnic group. RESULTS: Applicants from ethnic minority groups constituted 26.3% of those applying to medical school. They were less likely to be accepted, partly because they were less well qualified and applied later. Nevertheless, taking educational and some other predictors into account, applicants from ethnic minority groups were 1.46 times (95% confidence interval 1.19 to 1.74) less likely to be accepted. Having a European surname predicted acceptance better than ethnic origin itself, implying direct discrimination rather than disadvantage secondary to other possible differences between white and non-white applicants. Applicants from ethnic minority groups fared significantly less well in 12 of the 28 British medical schools. Analysis of the selection process suggests that medical schools make fewer offers to such applicants than to others with equivalent estimated A level grades. CONCLUSIONS: People from ethnic minority groups applying to medical school are disadvantaged, principally because ethnic origin is assessed from a candidate's surname; the disadvantage has diminished since 1986. For subjects applying before A level the mechanism is that less credit is given to referees' estimates of A level grades. Selection would be fairer if (a) application forms were anonymous; (b) forms did not include estimates of A level grades; and (c) selection took place after A level results are known.

Black or African American↗
PubMed1994

Health research.

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Research Support as Topic↗
PubMed1994

Are cerebral aneurysms atherosclerotic?

BACKGROUND AND PURPOSE: The aim of our study was to investigate plasma and genetic risk factors for rupture of cerebral aneurysms. METHODS: In London, a case-control study was made of 56 consecutive patients admitted to a regional neurosurgical service for treatment of ruptured cerebral aneurysm and of 93 control subjects. A further 40 consecutive patients admitted in Arhus with ruptured cerebral aneurysm also were studied. RESULTS: The British case-control study showed that smoking was associated with an increased risk of ruptured cerebral aneurysm (odds ratio, 9.1; 95% confidence interval [CI], 3.4 to 23.8; P < .001 for a history of > 10 pack years). After age and sex adjustment, factors associated with ruptured cerebral aneurysm included a cholesterol concentration in the highest tertile (> or = 6.3 mmol/L; odds ratio, 10.2; 95% CI, 3.9 to 26.7; P < .001), an apolipoprotein B concentration in the highest tertile (> or = 0.84 g/L; odds ratio, 6.4; 95% CI, 2.5 to 16.3; P < .001), and concentrations of HDL cholesterol in the lowest tertile (< 1.1 mmol/L; odds ratio, 3.6; 95% CI, 1.4 to 8.2; P < .01). History of hypertension was of less importance (odds ratio, 4.0; 95% CI, 1.41 to 11.7; P < .01). Smoking history (P < .001) and increased concentrations of cholesterol (P < .0001) were the most important independent risk factors associated with ruptured cerebral aneurysm on multivariate analysis. The histories of hypertension and smoking, together with apolipoprotein B levels, in the Danish patients were similar to those in the British patients. In the entire patient group, the frequencies of two polymorphic variations in the type III collagen gene and polymorphisms at the apolipoprotein B, apolipoprotein C-III, and haptoglobin gene loci were not different from control subjects or the normal population; allele frequencies in British and Danish patients were similar. CONCLUSIONS: An atherosclerotic profile including increased total cholesterol concentration and a long smoking history may contribute to the rupture of cerebral aneurysms. This study provides no support for the hypothesis that inherited abnormalities of type III collagen are a common cause of cerebral aneurysms.

Adult↗
PubMed1994

Foot agility and social anxiety in older children (9-15 years).

According to Paul MacLean's phylogenetic model of the brain, the anterior cingulate should be associated with interpersonal emotional bonding. If this assumption is correct, then foot agility (primarily affected by the dorsal medical surface of the cerebrum) should be associated with attenuated bonding and enhanced social anxiety. It would not be associated with finger agility, finger agnosia, or toe agnosia because their integrity involves more distal portions of the cortex. Strong age-dependent and linear increases in agility but not agnosia were shown for the fingers and the feet for normal children (28 girls, 28 boys) between 9 and 15 years of age. As predicted, a correlation of -0.50, not confounded by age or other measures, was noted between foot agility and social anxiety, but was statistically significant for the girls, not for the boys.

Adolescent↗
PubMed1993

Preliminary results from the third flight of the Millimeter Anisotropy Experiment (MAX).

Preliminary results from the June 1991 flight of MAX are presented. Simultaneous observations were made in bands centered at 6, 9, and 12 cm-1 with a bolometric receiver operating at 300 mK. The experimental sensitivities are the highest reported at angular scales of 0.3 degrees to 1.0 degrees. Interstellar dust is observed to have an emissivity [symbol, see text] nu 1.4+/-0.3 and to correlate with the Infrared Astronomical Satellite (IRAS) 100- map. After removal of emission from interstellar dust, 1.3 hr of integration on a 6 degrees scan yields an upper limit of temperature difference Delta T/T < 2.6 x 10(-5) at a Gaussian autocorrelation function centered at 0.5 degrees. The experiment and data analysis are described.

Journal Article↗