Search PubMed⌕ Search

Biomedical subjects

R A DiTomasso

Publications and source records attributed to R A DiTomasso.

7 recordsLinked to original sources

Precept-Assist. a computerized, data-based evaluation system.

BACKGROUND AND OBJECTIVES: Traditional methods of resident evaluation have several limitations, including recall bias and memory decay. We developed a real-time, computerized, data-based evaluation system and determined 1) the feasibility of using such a system in an ambulatory care teaching center and 2) the types of evaluation data such a computer-based evaluation system provides to residency directors, faculty, and residents. METHODS: We developed Precept-Assist, a computerized, data-based evaluation system. Reports from the system provide quantitative data, summative reports, and qualitative comments regarding specific competencies of residents. Following each precepting encounter between a faculty member and a resident, the faculty member entered into the system an array of coded information on the resident's level of performance, competencies achieved, and procedural skills. RESULTS: We have entered more than 15,000 pieces of evaluative data on 4,504 precepting encounters. The average time to enter data was about 40 seconds per encounter. Reports were generated to monitor each resident's progress through the program. The information was used to generate learning plans tailored to each resident's needs. CONCLUSIONS: Precept-Assist was useful for evaluating the performance of residents in this study.

Computers↗

The development of a patient satisfaction questionnaire in the ambulatory setting.

Patient satisfaction is of critical interest to medical care providers. The main objective of this study was to evaluate the psychometric properties of a patient satisfaction questionnaire. A preliminary 80-item questionnaire was created, and a random sample of 268 family practice patients participated. Subjects rated items on a 4-point Likert scale (strongly disagree, disagree, agree, strongly agree). Items were subjected to a principal components varimax rotated factor analysis and five factors (60 items) were extracted, accounting for 47.5% of the variance. These factors were: satisfaction with physician, dissatisfaction with practice management, physician availability, receptionist behavior, and wait time. Alpha reliability coefficients for factors 1-5 were: .96, .93, .89, .84, and .78, respectively. All items correlated highly with total scores on the respective factors. Factor intercorrelations were all significant (P less than .001) and in the expected direction. Patients with a higher level of education were significantly less satisfied about physician availability than patients without a high school education (P less than .05). Implications of the findings are discussed.

Adult↗

Factors influencing program selection among family practice residents.

Factors on which family practice residents base their judgments about ranking programs are identified. Questionnaires were mailed to 1,810 first-year family practice residents who participated in the 1981 matching program; 830 (46 percent) responded. The questionnaire items were factor analyzed, and nine factors accounting for 59.4 percent of the variance emerged. Reliability for the questionnaire was estimated to be .82 using coefficient alpha. Factor scores for the nine subscales were computed and employed as dependent variables in several multivariate analyses of variance. Significant differences for sex, age, race, and geographical region were found on various factors; these findings indicated differences in what those groups considered important when selecting a residency.

Decision Making↗

Patient self-monitoring of behavior.

Family physicians often rely solely upon patients' recollections of events in the assessment and treatment of psychological complaints. One important method that is likely to enhance the quality and quantity of relevant clinical data is patient self-monitoring. Self-monitoring involves utilizing patients as self-observers and systematic recorders of information concerning their target complaint(s). Self-monitoring affords several advantages to both the patient and physician. It is especially useful as a basis for performing a functional analysis of behavior. The most valuable aspect of patient self-monitoring lies in the systematic collection and summarization of clinical information that is crucial for the assessment and treatment of psychosocial complaints.

Adult↗