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W K Davis

Publications and source records attributed to W K Davis.

At least 19 recordsLinked to original sources
PubMed1998

The reliability of the Diabetes Care Profile for African Americans.

The Diabetes Care Profile (DCP) is an instrument used to assess social and psychological factors related to diabetes and its treatment. The reliability of the DCP was established in populations consisting primarily of Caucasians with type 2 diabetes. This study tests whether the DCP is a reliable instrument for African Americans with type 2 diabetes. Both African American (n = 511) and Caucasian (n = 235) patients with type 2 diabetes were recruited at six sites located in the metropolitan Detroit area. Scale reliability was calculated by Cronbach's coefficient alpha. The scale reliabilities ranged from .70 to .97 for African Americans. These reliabilities were similar to those of Caucasians, whose scale reliabilities ranged from .68 to .96. The Feldt test was used to determine differences between the reliabilities of the two patient populations. No significant differences were found. The DCP is a reliable survey instrument for African American and Caucasian patients with type 2 diabetes.

Black or African American↗
PubMed1998

The reliability and validity of a brief diabetes knowledge test.

OBJECTIVE: To examine the reliability and validity of a brief diabetes knowledge test. The diabetes knowledge test has two components: a 14-item general test and a 9-item insulin-use subscale. RESEARCH DESIGN AND METHODS: Two populations completed the test. In one population, patients received diabetes care in their community from a variety of providers, while the other population received care from local health departments. Cronbach's coefficient alpha was used to calculate scale reliability for each sample. To determine validity, patient group differences were examined. It was hypothesized that test scores would be higher for patients with type 1 diabetes, for patients with more education, and for patients who had received diabetes education. RESULTS: The coefficient alpha s for the general test and the insulin-use subscale indicate that both are reliable, alpha > or = 0.70. In the community sample, patients with type 1 diabetes scored higher than patients with type 2 diabetes on the general test and the insulin-use subscale. In the health department sample, patients with type 1 scored higher than patients with type 2 on the insulin-use subscale. For both samples, scores increased as the years of formal education completed increased, and patients who received diabetes education scored higher than patients who did not. CONCLUSIONS: Although the samples differed demographically, the reliability and validity of the test were supported in both the community and the health department samples. This suggests that the test is appropriate for a variety of settings and patient populations.

Adult↗
PubMed1997

A predictive model of student satisfaction with the medical school learning environment.

PURPOSE: To examine differences in attitudes toward the medical school learning environment among student subgroups based on gender and race-ethnicity, to identify the most influential predictors of student satisfaction with the learning environment, and to create a model of student satisfaction with the learning environment. METHOD: Three years of survey data (1992-93 to 1994-95) from first-year students at the University of Michigan Medical School were combined. The total sample consisted of 430 respondents, broken into two sets of subgroups: women (n = 171) and men (n = 259), and whites (n = 239) and underrepresented minorities (n = 74). Asian students were removed from analyses when comparisons were made by race-ethnicity, but were included in the analyses for all students and those comparing men and women. Student's t-tests were used to identify differences between gender and racial-ethnic groups in mean responses to seven survey items, and effect sizes were used to characterize the magnitudes and practical significances of the differences. Forward stepwise regression was conducted to determine the best predictive models for each student subgroup and for the total sample; the subgroup models were compared with each other as well as with the total-sample model. RESULTS: Cross-validation of the gender and race-ethnicity models showed that the men's satisfaction and the women's satisfaction were predicted equally well using either subgroup's model, and that the white students' satisfaction and the underrepresented-minority students' satisfaction were predicted equally well using either subgroup's model. Furthermore, the total-sample model, employing a subset of five predictors, was similar in its predictive power to the subgroup models. CONCLUSION: The study's findings suggest that curriculum structure (timely feedback and the promotion of critical thinking) and students' perceptions of the priority faculty place on students' education are prominent predictors of student satisfaction (across all subgroups) with the learning environment. In contrast, students' perceptions of the learning environment as a comfortable place for all gender and racial-ethnic groups, although less prominent predictors of satisfaction, will discriminate among the subgroups.

Consumer Behavior↗
PubMed1997

A comparison of global versus disease-specific quality-of-life measures in patients with NIDDM.

OBJECTIVE: This study was conducted to compare the Short Form 36 (SF-36) (a global measure of health-related quality of life) and the Diabetes Care Profile (DCP) (a diabetes-specific measure of self-care and diabetes-related quality of life) in patients with NIDDM. RESEARCH DESIGN AND METHODS: This study was conducted as part of a larger study initiated in 1991 using a randomly selected sample of communities, physicians, and patients with diabetes located throughout Michigan. A total of 255 patients with NIDDM participated. The study examined the relationship between the two measures and diabetes variables, such as glycosylated hemoglobin level and number of complications. RESULTS: The SF-36 and the DCP have both common and discrete measurement domains. Both instruments have acceptable subscale reliability. The DCP has predictive validity regarding glycemic control, whereas the SF-36 does not. Both measures correlate with the number of complications for patients who have NIDDM treated with insulin. CONCLUSIONS: This study suggests that for examining relationships within diabetes, e.g., the impact of acute complications and/or regimen on quality of life, the DCP is the appropriate measure. Conversely, when examining relationships between the patient's experience of living with diabetes and quality of life and other chronic diseases, the SF-36 would be an appropriate measure. Both instruments can be used to illuminate the experience and behavior of patients living with and caring for NIDDM.

Adult↗
PubMed1996

Performance on the radiology component of a critical clinical skills examination.

RATIONALE AND OBJECTIVES: Clinical competence certification is now required in some specialties in medicine. A Comprehensive Clinical Assessment (CCA) was created to test mastery of critical skills by students at the end of the 3rd year of medical school. METHODS: The CCA is a series of stations that test skills the faculty consider important for all medical students (eg, breast examination, electrocardiogram reading, chest pain assessment, ophthalmology photographs). The radiology station was designed to evaluate imaging skills believed to be taught and learned in the core 3rd-year rotations. RESULTS: External measures (National Board Examinations, grade point average, and overall score) of clinical performance of the 608 medical students who completed the CCA examination between 1991 and 1993 were found to be correlated with the radiology station scores. CONCLUSION: The radiology station in the CCA examination is a reproducible measure of clinical performance.

Certification↗
PubMed1996

Content analysis of research in undergraduate medical education.

The authors describe research in undergraduate medical education as reported in journal articles. A sample of 773 articles was randomly selected from 3,689 articles published from 1975 through 1994. Content analysis was used to quantitatively assess subject interests and methods over the past 20 years. The most frequent topics related to curriculum, teaching, and student assessment. Over 45% (353) of the sample articles were reports of research activity (i.e., they used specific methods to ascertain new facts, concepts, or ideas). The research reported was overwhelmingly conducted in a naturalistic environment; was evaluative or comparative in design; used observation, testing, or questionnaires to collect data; and included inferential statistical analyses. The research described by the authors confirms the close relationship between medical education and clinical or laboratory environments. The literature on undergraduate medical education reflects a lack of theory-based research and little evidence of work built on prior research, which may be partially due to the scattered nature of the literature. The increased numbers of authors per article over the study period may be indicative of increased interdisciplinary collaboration. The lack of reported external funding may be a problem of underreporting or it may be related to the large number of single-institution-based studies.

Education, Medical, Undergraduate↗
PubMed1996

Development and validation of the Diabetes Care Profile.

To determine the reliability and the validity of the Diabetes Care Profile (DCP), an instrument that assesses the social and psychological factors related to diabetes and its treatment, two studies with separate populations and methodologies were conducted. In the first study, the DCP was administered to, and physiologic measures collected from, individuals with diabetes being cared for in a community setting (n = 440). In the second study, the DCP and several previously validated scales were administered to individuals with diabetes receiving care at a university medical center (n = 352). Cronbach's alphas of individual DCP scales ranged from .60 to .95 (Study 1) and from .66 to .94 (Study 2). Glycohemoglobin levels correlated with three DCP scales (Study 1). Several DCP scales discriminated among patients with different levels of disease severity. The results of the studies indicate that the DCP is a reliable and valid instrument for measuring the psychosocial factors related to diabetes and its treatment.

Adult↗
PubMed1995

The effect of pass/fail grading and weekly quizzes on first-year students' performances and satisfaction.

BACKGROUND: In 1992-93 the University of Michigan Medical School revised its first-year curriculum. An evaluation system using honors, high-pass, pass, and fail grading and only two examinations (a midterm and a final) was replaced with a system using pass/fail grading and weekly quizzes in addition to the two examinations. The objective was to increase students' satisfaction while maintaining a high level of achievement. METHOD: Students' performance scores and survey data from the final year of the former system (1991-92, 222 students) and the first year of the new system (1992-93, 195 students) were used to investigate whether overall performance decreased and whether the students liked the new approach to grading. Statistical methods used were one-sample t-tests, Student's t-test, and Fisher's Z-test. RESULTS: Under the new system, the average scores for courses remained well above passing, and no evidence was found that the students achieved at lower levels than had their predecessors with the former, more traditional grading system. Also, higher cumulative pre-final scores (i.e., scores on the weekly quizzes as well as the midterm) did not predict lower, "just passing" achievement on final examinations. The students' responses to the surveys included comments that pass/fail grading eased anxiety and reduced competition while encouraging the students' co-operation. CONCLUSION: Despite concerns that implementing pass/fail grading for all first-year courses would result in lower overall performance and decreased motivation among students, during the first year of implementation these fears proved to be unfounded as the students continued to perform well and reported greater satisfaction with the new system.

Attitude↗
PubMed1994

Impact of social support, social cognitive variables, and perceived threat on depression among adults with diabetes.

Tested was a model of social support and cognitive appraisal of self-efficacy, outcome expectancies, and illness threat on depression. Study participants were community-dwelling adults with diabetes who completed a mailed questionnaire (N = 362). Results of structural equation modeling indicated that 52% of the variance in depression was explained by the model--largely by the direct effects of physical functioning, the perceived availability of social support, and the perceived threat of diabetes as well as the indirect paths from perceived support to perceived threat and from physical functioning to perceived support and perceived threat of diabetes. Diabetes-specific social support, self-efficacy, and outcome expectancies were not significant predictors of depression.

Adaptation, Psychological↗
PubMed1994

Influence of a highly focused case on the effect of small-group facilitators' content expertise on students' learning and satisfaction.

BACKGROUND: There has been considerable debate over the need for content expertise to lead a successful small-group discussion for medical students. Some authors feel process expertise related to the conduct of a small group is of more value than content expertise related to the case. At least one study has presented data that suggest content expertise can lead to teacher domination of the learning environment. In an earlier study, the present authors found that students learned more and were more satisfied with small-group instruction when the instruction was facilitated by a faculty member who was an expert in the content of the case. That study also identified no tendency for content experts to dominate the sessions (e.g., through lecturing or otherwise controlling the learning environment). The purpose of the present study was to explore the efficacy of a carefully designed and highly focused case problem to remove the influence of group facilitators' content expertise on students' learning outcomes. METHOD: The 211 students in the University of Michigan Medical School class of 1994 were randomly assigned to 28 groups in a microbiology and immunology course in the fall of 1991; each small group was led by a faculty facilitator. Complete data were available from 27 groups: 13 groups led by experts and 14 groups led by non-experts. Data collection included observers' codings of interactions between the students and the facilitators (interactional analysis), test scores, and students' ratings of the experience. RESULTS: Unlike in the previous study, group leaders who were content experts devoted significantly more time to teacher-directed activities than did non-content-expert leaders. However, overall, 62% of the time was devoted to student-initiated activity. The results of the multiple-choice tests that were related specifically to the goals of the case indicated there was no significant difference between the students' performances in the groups led by experts and those led by non-experts. With respect to students' satisfaction, all students gave consistently high ratings to the experience and there was no difference between groups led by expert and non-expert facilitators. CONCLUSION: The data from this study suggest that a facilitator's content expertise alone does not determine the amount of teacher-directed behavior in a group, the amount of students' learning, or students' satisfaction. The focus built into the case and the amount of facilitator's training directly related to the content of the case are also significant variables related to students' learning, teacher's behavior, and students' satisfaction.

Curriculum↗
PubMed1994

Community diabetes care. A 10-year perspective.

OBJECTIVE: To compare diabetes care and education at the community level in 1981 and 1991 in order to record progress achieved in the decade of the 1980s, determine if there is a gap that must be closed to reach diabetes-related objectives for 2000, and establish a baseline to which changes stimulated by the Diabetes Control and Complications Trial can be compared. RESEARCH DESIGN AND METHODS: In eight Michigan communities, representative primary-care physicians (61 in 1981; 68 in 1991) and their diabetic patients (428 and 440) were identified. Communities, physicians, and patients were randomly selected. Participating patients were interviewed and examined in their community or home to assess the kind and extent of diabetes care they had been receiving; their metabolic, nutritional, educational, and psychosocial status; their diabetic history and current status; and other related factors. The diabetic status, care, and education of the 1981 community patients were compared with those of patients studied in 1991. RESULTS: Positive changes in diabetes care and education at the community level from 1981 to 1991 were seen in the areas of patient glucose monitoring, insulin administration practices, hypertension control, exercise recommendations in diabetic management; and smoking rates. Negative changes occurred in the percentage of non-insulin-dependent diabetes mellitus (NIDDM) patients receiving diabetes education and frequency of office visits to the patient's primary-care physician. Changes of indeterminate value included a sharp decline in primary diabetes admissions to the hospital and a decrease in the proportion of NIDDM patients managed with insulin. Many other hoped-for changes from 1981 status, such as screening for retinopathy, foot-care practices, and overall metabolic control of diabetes, did not occur. CONCLUSIONS: The decade of the 1980s produced modest, but not impressive, improvements in diabetes care and education at the community level. Progress must be accelerated if the diabetes-related objectives included in the national targets for health promotion and disease prevention for 2000 are to be met.

Adult↗
PubMed1993

Medical student use of history and physical information in diagnostic reasoning.

Clinical data gathering is central to clinical competence. Although research has demonstrated the value to experienced clinicians of information obtained from the history, little is known of how medical students use this information. In the present study, two case simulations (in rheumatoid arthritis and systemic lupus erythematosis) were developed to assess medical student information gathering and utilization. The results indicate that most of the students were already considering the correct diagnosis as a possibility after the presenting complaint and patient description. However, the medical history exerted the strongest influence on transforming the correct diagnosis from just another diagnostic possibility into the favored diagnostic candidate. Students who failed to list the correct diagnosis in the differential diagnosis after obtaining the history were significantly less likely to reach the correct diagnosis at the end of the case. These results confirm the critical importance of the history in medical problem solving.

Arthritis, Rheumatoid↗
PubMed1992

Effects of expert and non-expert facilitators on the small-group process and on student performance.

At the University of Michigan Medical School in 1990, the authors investigated the effects of faculty facilitators' levels of content expertise on the educational process and learning outcomes of small-group teaching sessions. The study was conducted in a microbiology course for second-year students in which four small-group sessions were used to replace 38 hours of lecture and laboratory time. The interactions between 11 expert and ten non-expert faculty facilitators and 156 students were observed and coded. The students' levels of knowledge and satisfaction were measured. The results indicate that, although significant differences in faculty-student interactions were not observed, the students in the 11 groups led by the content experts had higher levels of satisfaction and higher examination scores.

Attitude↗
PubMed1992

Controversial beliefs about diabetes and its care.

OBJECTIVE: The purpose of this study was to identify specific beliefs that differentiate health-care professionals whose attitudes toward diabetes agreed most strongly with a group of national diabetes experts from those whose attitudes disagreed most strongly. RESEARCH DESIGN AND METHODS: The sample for this study included 271 physicians, 834 nurses, and 546 dietitians who completed a Diabetes Attitudes Survey. The sample included specialists in diabetes care and nonspecialists. Controversial beliefs about diabetes and its care were determined by comparing the beliefs of the 10% of the sample whose attitudes were most concordant (with the national panel) with the beliefs of the 10% of the sample whose attitudes were the most discordant. Ten beliefs met the criteria for being defined as controversial. RESULTS: The most controversial beliefs concerned whether the patient or the physician should be the primary decision maker in diabetes care, the meaning of patient noncompliance, and the seriousness of non-insulin-dependent diabetes mellitus. The 10% of the sample with the most discordant attitudes contained a disproportionately large number of physicians, nonspecialists in diabetes, and health-care professionals who had been in practice longer than the other members of the sample. CONCLUSIONS: This study identifies some important differences in beliefs between younger health-care professionals who specialize in diabetes and older nonspecialists. Such beliefs should be addressed in continuing education programs with the aim being to foster the widespread adoption of a contemporary approach to diabetes care.

Attitude of Health Personnel↗
PubMed1991

Learning to empower patients. Results of professional education program for diabetes educators.

The patient empowerment approach to diabetes education is intended to enable patients to make informed decisions about their own diabetes care and to be fully responsible members of the health-care team. Facilitating patient empowerment requires a specific set of skills and attitudes on the part of diabetes educators. A professional education program designed to facilitate the acquisition and enhancement of the requisite skills and attitudes was designed, implemented, and evaluated. The program involved adhering to a simulated diabetes care regimen for 3 days followed by a 3-day intensive skills-based workshop. The 23 educators who participated in the first two offerings of this program made significant gains in their counseling skills and demonstrated a positive change in attitude.

Attitude↗