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Evaluation of the noncognitive professional traits of medical students.

BACKGROUND: Professional attributes such as honesty, integrity, and reliability are critical to success in medical school and postgraduate practice, yet such noncognitive attributes have traditionally been poorly evaluated. METHOD: A program of evaluating students' noncognitive professional attributes at the University of New Mexico School of Medicine was reviewed over a four-year period, from 1987-88 through 1990-91, involving the approximately 525 students enrolled at the school at that time. The evaluation program enabled faculty and staff to quantify their impressions of problem students in a uniform manner, by using an evaluation form that listed and described seven basic professional traits. RESULTS: Over the study years the program identified ten students with difficulties in the basic science and clinical years regarding their character and professionalism. For these ten students, interventions ranged from nothing being done, in one case, to such significant remediations as recommendations of extensive counseling and a leave of absence. One student was dismissed, on the basis of poor academic performance, and the other nine have graduated. In some cases, students noticeably improved their professional behaviors, but whether their behaviors changed as a result of the interventions can't be determined. CONCLUSION: By identifying and tracking students with difficulties, the program offers the opportunity for intervention and, ideally, remediation. This program can complement systems that evaluate academic performance. Such a program can help an institution assure not only the cognitive competence of its graduates, but the competence of their professional behaviors as well.

Character↗

Lack of impact of undergraduate genetic courses on the teaching of medical genetics.

The impact of undergraduate genetic courses on the academic performance of first-year medical students in the medical genetics course at the University of Pittsburgh School of Medicine was evaluated over a period of 9 years. Comparisons were made between medical students who had taken a formal undergraduate course in genetics and those who had not. Little if any differences were found in the academic performance in the medical genetics course between these two groups of students. Perhaps the design of undergraduate courses in genetics should be re-evaluated to give more depth to the medical student's preparation for appreciating the significance of genetics in normal and abnormal human variation.

Education, Medical, Undergraduate↗

The impact of gender on high-stakes dental evaluations.

The purpose of this study was to determine whether gender affects high-stakestest performance among dental students. Our sample consisted of 128 women and 323 men from six consecutive dental classes for which we recorded AADSAS overall and science predental GPAs; Dental Admission Test (DAT) scores; National Board Dental Examination (NBDE) I and II scores and pass/fail status; North East Regional Board of Dental Examiners (NERB) pass/fail status; and cumulative GPAs following the spring quarter of year two and summer quarter of year four of dental school. DAT scores, when controlled for previous academic performance, revealed that men significantly outperformed women in all areas except reading comprehension and biology, where the women's scores significantly exceeded the men's and were comparable, respectively. NBDE I results favored men and approached significance (p = 0.066), while for Part II men significantly outscored women. NBDE I and II and NERB pass rates showed no significant differences. These board results were also controlled for previous academic performance. Although we found that differences existed between genders, which appear to be the ramification of the classic high-stakes dilemma (women do as well as men in the classroom and on course-related tests, but less well on gatekeeper board exams), the context mitigates their operational effects. DAT differences are likely reduced by most admissions processes, but may be problematic when selected predictive algorithms are used. Practically, the NBDE I and II results are unlikely to meaningfully influence women's academic progress in dental school or postgraduate education admissions due to their magnitude and timing.

Biology↗

[Study of the introduction of the European Credit Transfer System (ECTS) in pediatrics and modification of the teaching methodology].

INTRODUCTION: Spanish medical faculties have initiated the new curriculum reform process within the framework of the European Higher Education Area and are required to incorporate the European Credit Transfer System (ECTS) to new syllabi before 2010. OBJECTIVES: To test the introduction of the ECTS in pediatrics and modify the teaching methodology. STUDY DESIGN: The theoretical and practical programs were adapted; academic objectives and a student evaluation system were established. Students were surveyed on starting the second term of the 2004-05 academic year before the theory examination and again on terminating the academic year: a 5-point Likert-type scale was used for responses. Priorities for generic and specific competencies selected by students were compared with those selected by the National Deans Conference (NDC). The results were analyzed using non-parametric tests. RESULTS: Fifteen credits became 11 ECTS, with 297 student working hours. The theory program was reduced from 80 to 52 lessons. The students prepared 14 tutor-supervised case presentations. The teaching staff considered that learning of theory was similar to previous years (66 %) and that practical learning improved (73.3 %). The students thought the program should continue (73.2 %) but 98.8 % considered the workload excessive. The students believed that their practical training and their ability to prepare and make case presentations significantly improved during the semester. Academic performance was significantly higher than that in students of the previous year. Students agreed with NDC priorities for 9/9 general and 4/17 specific competencies. Estimation of workload by students was significantly higher than that by staff, and 73.3 % of the students believed that workload should be reduced and the examination system improved. CONCLUSIONS: Introducing the ECTS improved academic performance, practical training, and self-directed learning. The project was satisfactory for staff and students. Student workload was underestimated.

Achievement↗

THE PREMEDICAL STUDENT: HIS PROGRESS. A STUDY OF A COHORT OF PREMEDICAL STUDENTS AT THE UNIVERSITY OF BRITISH COLUMBIA.

Since September 1961, a prospective study of premedical and science students has been conducted at the University of British Columbia. On completion of their sophomore year, after a year of changes from one group to another or withdrawal from either group, only 82 students existed in the diminished Premedical cohort while 137 students existed in the augmented Science cohort. These two groups have now become similar demographically, and their academic potential, as indicated by achievement and ability tests, has also become similar in terms of their mean test scores. In academic performance the present Premedical cohort has displayed some superiority over the Science cohort in high school, freshman and sophomore years. The sophomore premedical mean grade was 66.0% compared with 63.7% for the Science cohort. The hypothesis is developed that these findings reflect a difference in motivation, and therefore that perception of ultimate career goals will motivate and affect academic performance of students in their undergraduate years.

Achievement↗

Differential effects of methylphenidate and self-reinforcement on attention-deficit hyperactivity disorder.

Six boys aged 9 to 12 years attended a tutoring class focusing on reading for 30 minutes each morning. The investigators employed a modified Latin-square design in which each child began with a 5-day baseline phase followed by six 10-day treatment phases that used drug placebo, noncontingent reinforcers, 0.3 mg/kg methylphenidate, 0.7 mg/kg methylphenidate, and self-reinforcement in various combinations. Amount of academic performance was the major measure of outcome and the target behavior of self-reinforcement. Drug placebo and noncontingent reinforcers had no systematic impact. Methylphenidate had differential effects across the recorded behaviors. Self-reinforcement improved the target behavior; the mean effect size for self-reinforcement was 2.66. The combined effects of methylphenidate and self-reinforcement on academic performance were greater than either of the treatments given alone (mean effect size = 2.89).

Attention Deficit Disorder with Hyperactivity↗

A preliminary study on the association between ventilation rates in classrooms and student performance.

Poor conditions leading to substandard indoor air quality (IAQ) in classrooms have been frequently cited in the literature over the past two decades. However, there is limited data linking poor IAQ in the classrooms to student performance. Whereas, it is assumed that poor IAQ results in reduced attendance and learning potential, and subsequent poor student performance, validating this hypothesis presents a challenge in today's school environment. This study explores the association between student performance on standardized aptitude tests that are administered to students on a yearly basis, to classroom carbon dioxide (CO2) concentrations, which provide a surrogate of ventilation being provided to each room. Data on classroom CO2 concentrations (over a 4-5 h time span within a typical school day) were recorded in fifth grade classrooms in 54 elementary schools within a school district in the USA. Results from this preliminary study yield a significant (P < 0.10) association between classroom-level ventilation rate and test results in math. They also indicate that non-linear effects may need to be considered for better representation of the association. A larger sample size is required in order to draw more definitive conclusions. Practical Implications Future studies could focus on (1) gathering more evidence on the possible association between classroom ventilation rates and students' academic performance; (2) the linear/non-linear nature of the association; and (3) whether it is possible to detect 'no observed adverse effect level' for adequate ventilation with respect to academic performance in schools. All of this information could be used to improve guidance and take regulatory actions to ensure adequate ventilation in schools. The high prevalence of low ventilation rates, combined with the growing evidence of the positive impact that sufficient ventilation has on human performance, suggests an opportunity for improving design and management of school facilities.

Air Pollution, Indoor↗

Evaluating the performance of academic medical education administrators.

Educators have devoted little attention to formal evaluation of educational administrative personnel. The authors surveyed the educational administrators working in McMaster University's Department of Medicine residency program and found they felt they were receiving little useful feedback. The authors also surveyed the colleagues, residents, and administrative staff with whom the administrators worked and found they felt they had inadequate input into the administrators' evaluation. In response to these results, a measurement instrument was developed based on existing job descriptions and feedback was obtained on administrators' performance from relevant individuals. After three yearly evaluations, administrators and evaluators acknowledged much broader input into evaluation but saw little evaluation-related improvement in performance. Of the administrators, 85% felt the process should continue as did 91% of the evaluators. An evaluation process may not alter perceived performance when it is already good but there may be other benefits to rigorous evaluation.

Attitude of Health Personnel↗

Healthful behaviors: do they protect African-American, urban preadolescents from abusable substance use?

PURPOSE: Relationships between positive health behaviors and abusable substance use in preadolescent, urban, African-American schoolchildren were investigated. DESIGN: Personal interviews and classroom surveys were used to assess health behavior and abusable substance use cross-sectionally. SETTING: All respondents resided in the District of Columbia and attended the public school system. SUBJECTS: The sample consisted of 303 urban, African-American fourth and fifth graders (151 boys, 152 girls). MEASURES: Classroom surveys assessed drinking, drinking without parental knowledge, smoking, use of other abusable substances, friends' use, self-esteem, and academic performance. Personal interviews assessed children's diet, exercise, overall health behavior, and socioeconomic status. RESULTS: Logistic regressions showed that children who engaged in more health behaviors (exercise and proper nutrition) were one-third less likely to have smoked (OR=0.66) or to have drunk alcohol (OR=0.63) than those who engaged in fewer healthful activities. However, when gender, socioeconomic status, self-esteem, academic performance, personal use, and friends' use of other abusable substances were controlled, relationships were no longer statistically significant. CONCLUSIONS: These findings suggest that although positive health behaviors appear to be inversely related to abusable substance use in urban, African-American preadolescents, the relationship may be spurious.

Black or African American↗

School adjustment in adolescence for previously rejected, average and popular children.

BACKGROUND: Earlier research shows that peer-rejected children are at risk of a wide range of subsequent adjustment difficulties in different social contexts, as, for example, in school. AIMS: This study investigated the academic performance and school adjustment in adolescence of children with different peer status in middle childhood. SAMPLE: Age 15 boys and girls (N=90), who at age 10 and 11 were sociometrically rejected, popular, or of average popularity in their school class. METHODS: School marks, intelligence scales, and self-reports were used as adjustment measures. School dropout rate for boys was also included. RESULTS: The academic performance and intelligence level of rejected boys and girls were short of the standards of children from the other status groups, while the scores of popular boys and girls were of superior standard. There were some slight indications that rejected girls (but not rejected boys) had negative attitudes towards school and schoolwork, and that popular girls had positive school attitudes. The school dropout rate of rejected boys was much higher than that of other boys. CONCLUSIONS: The results show that the rejected children are a risk group for school problems also over a long period of time. Considering the important developmental aspects of the adolescence years, there appear to be good reasons, therefore, to worry about the future adulthood adjustment of peer-rejected children.

Adolescent↗

Factors related to school absenteeism in adolescents with recurrent headache.

OBJECTIVE: To examine possible risk and protective factors for school absenteeism among adolescents referred to a hospital-based behavioral treatment program. DESIGN: Data obtained from intake interviews, screening questionnaires, and baseline headache diaries of 283 consecutive adolescents referred for behavioral treatment of recurrent headache were reviewed for demographics, length of headache history, headache type, current headache activity, symptoms of anxiety and depression, perceived self-efficacy regarding headache control, school performance, participation in extracurricular activities, and school absenteeism. The study population was divided into 2 groups at the median number of days missed due to headache in the previous 6 months that school was in session. Adolescents who missed 2 or less days of school due to headache (low absenteeism) were compared with those who missed more than 2 days (high absenteeism). RESULTS: Compared with the low absenteeism group, the high absenteeism group had higher scores on the Children's Depression Inventory (8.7 +/- 6.5 versus 6.8 +/- 6.2, P <.05) and lower academic performance (2.1 +/- 1.0 versus 1.7 +/- 0.8, P <.0001). The 2 groups were not statistically different in age, sex, length of headache history, type of headache, current headache frequency or intensity scores, anxiety scores, self-efficacy ratings, or participation in extracurricular activities. CONCLUSIONS: In a referred population, students who missed more school due to headache had higher depression scores and lower academic performance than students who missed less school. A directional relationship, however, cannot be implied from these results. Future studies should investigate the complex relationship between recurrent adolescent headache, potential risk or protective factors, and school absenteeism.

Absenteeism↗

The parallel rural community curriculum: an integrated clinical curriculum based in rural general practice.

INTRODUCTION: In an attempt to address the rural medical workforce maldistribution and the concurrent inappropriate caseload at the urban tertiary teaching hospitals, Flinders University and the Riverland Division of General Practice decided to pilot, in 1997, an entire year of undergraduate clinical curriculum in Australian rural general practice. This program is called the Parallel Rural Community Curriculum (PRCC). This paper is a discussion of the aims of the programme; student selection; practice recruitment; curriculum structure, and academic content, together with lessons learnt from the evaluation of the first cohort of students' experience of the course. METHODS: Independent external evaluators undertook a thematic analysis of a series of structured interviews of students and faculty involved in both the PRCC and the traditional curriculum. The mean examination results were determined and a rank order comparison of student academic performance was undertaken. RESULTS: The eight selected volunteer students reported greater access to patients and clinical learning opportunities than their mainstream counterparts and learned clinical decision making in the context of the whole patient, their family, and the available community resources. They identified patients with 'core' clinical conditions and had a longitudinal exposure to common diseases, whereas hospital-based peers had a cross-sectional exposure to highly filtered illness. The PRCC students' academic performance improved in comparison with that of their tertiary hospital peers' and in comparison to their own results in previous years. CONCLUSION: The PRCC curriculum has cut across the traditional clinical discipline boundaries by teaching in an integrated way in rural general practice. It has affirmed the potential role of true generalist physicians in undergraduate medical education.

Community Medicine↗

Expectancies and attributions for hyperactive and medicated hyperactive students.

The present study seeks to document some social consequences of prescribing stimulant medication to a hyperactive child. Eighty students and 15 teachers provided expectancies and attributions for the academic performance of hypothetical medicated and nonmedicated hyperactive children. Both teachers and peers were found to have higher expectancies for the medicated than for the nonmedicated child. Data suggest that these differential expectancies may arise from different explanations for success. The success of the medicated child was attributed to a stable factor (medication), while the nonmedicated child's success was seen as due to an unstable cause (effort). Implications of these differential expectancies and attributions for the academic performance of medicated and nonmedicated hyperactive students are discussed.

Achievement↗

The impact of culturally relevant violence prevention models on school-age youth.

The Family and Community Violence Prevention (FCVP) Program was established in 1994 to address the escalation of youth violence among ethnic minorities. This federally funded program adapted the public health model and organized Family Life Centers throughout the country to serve youth who were considered to be at risk for violence and other abusive behaviors. The purpose of this three-year study, 1999-2002, was to determine the effectiveness of the FCVP Program's six-component curriculum in reducing violence among participants. Results from posttest scores of 2,315 youth showed girls 12 and over to be most at risk for deviant behaviors; the program was most effective with boys under age 12. Academic performance and bonding to school were protective factors whereas exposure to violence was a risk factor for all four ethnic groups studied--African Americans, Hispanics, Native Americans, and Native Hawaiians. EDITORS' STRATEGIC IMPLICATIONS: Cultural anthropologists, public health specialists, and school officials should know that prevention programs can be designed to reflect the unique, culturally appropriate norms of specific ethnic minority groups, even as these programs address shared risk factors. The authors discuss the promising strategy of enhancing academic performance and school bonding to serve as protective factors against school violence, but they also describe age, gender, and cultural differences that must be addressed in future research.

Adolescent↗

A meta-analysis of the published research on the effects of child sexual abuse.

A meta-analysis of the published research on the effects of child sexual abuse (CSA) was undertaken for 6 outcomes: posttraumatic stress disorder (PTSD), depression, suicide, sexual promiscuity, victim-perpetrator cycle, and poor academic performance. Thirty-seven studies published between 1981 and 1995 involving 25,367 people were included. Many of the studies were published in 1994 (24; 65%), and most were done in the United States (22; 59%). All six dependent variables were coded, and effect sizes (d) were computed for each outcome. Average unweighted and weighted ds for each of the respective outcome variables were .50 and .40 for PTSD, .63 and .44 for depression, .64 and .44 for suicide, .59 and .29 for sexual promiscuity, .41 and .16 for victim-perpetrator cycle, and .24 and .19 for academic performance. A file drawer analysis indicated that 277 studies with null ds would be required to negate the present findings. The analyses provide clear evidence confirming the link between CSA and subsequent negative short- and long-term effects on development. There were no statistically significant differences on ds when various potentially mediating variables such as gender, socioeconomic status, type of abuse, age when abused, relationship to perpetrator, and number of abuse incidents were assessed. The results of the present meta-analysis support the multifaceted model of traumatization rather than a specific sexual abuse syndrome of CSA.

Child↗

Incremental validity of WISC-III profile elevation, scatter, and shape information for predicting reading and math achievement.

The use of cognitive subtest profiles to hypothesize about children's learning strengths and weaknesses implicitly assumes that subtest profiles are predictive of academic performance. To test this assumption, Wechsler Intelligence Scale for Children-Third Edition (WISC-III) subtest profiles were decomposed into elevation, scatter, and shape components and sequentially regressed onto reading and math achievement scores for 1,118 nonexceptional and 538 exceptional students. Profile elevation was statistically and practically significant for both exceptional (R = .36-.61) and nonexceptional (R = .72-.75) students. Profile scatter did not aid in the prediction of achievement. Profile shape accounted for an additional 5%-8% of the variance in achievement measures. It was concluded that using WISC-III subtest scatter and shape to predict academic performance was not supported by the accumulated scientific evidence.

Adolescent↗

Learning to reflect and to attribute constructively as basic components of self-regulated learning.

BACKGROUND: Higher education is facing a number of problems: adjusting to larger and more heterogeneous student populations, increasing the number of graduating students, and preparing for lifelong learning. Improving learning competence can make a substantial contribution to solving each of these major concerns. The growing knowledge base on self-regulated learning was taken as one of the main starting points for our study. AIMS: In this article we report on reflection and attribution as basic components of self-regulated learning. We examine their trainability and their effect on academic performance. This study is part of a wider research project aimed at improving meta-cognitive knowledge as well as affective, conative and regulation skills. The experimental treatment consisted of an integrated set of instructional conditions, which were operationalized in a series of training sessions, as well as practice and transfer tasks. SAMPLE: The participants in this study were 141 first year students of business economics. The experimental group and both control groups each consisted of 47 students. METHOD: The effects of the learning environment were investigated using a quasiexperimental design. To control for unintended effects of the design the experimental and the first control group had the same number of teaching hours (time-on-task) and both teachers and students were not informed about the experimental design. Attribution and reflection behaviour was measured through specific assignments; study results during and after the intervention period were taken as indicators of academic performance. To test the hypotheses, t tests and effect-sizes were calculated. RESULTS: After the intervention the experimental students showed a higher degree of reflective behaviour than the control students. Moreover, their attribution skills had also measurably improved. The experimental students obtained better study results than their peers in the control groups. CONCLUSIONS: This intervention study, focused on the combined training of learning to reflect and to attribute constructively, provides evidence of the successful fostering both of meta-cognitive and of conative learning activities resulting in a positive impact on academic achievement.

Adolescent↗

Anabolic-steroid use, strength training, and multiple drug use among adolescents in the United States.

OBJECTIVE: This study examined the relationships between anabolic-steroid use and the use of other drugs, sports participation, strength training, and school performance among a nationally representative sample of US high school students. DESIGN: Randomized survey data from the 1991 Centers for Disease Control and Prevention Youth Risk Behavior Survey. SETTING: Public and private schools in the 50 United States and District of Columbia. PATIENTS: A total of 12,272 9th through 12th grade students. MAIN OUTCOME MEASURED: Prevalence of anabolic-steroid use. RESULTS: The frequency of anabolic-steroid use was significantly associated with the frequency of use of cocaine, the use of other drugs such as amphetamines and heroin, tobacco smoking, and alcohol use. The weighted prevalences of anabolic-steroid use were higher among male (4.08%) than female students (1.2%). Students living in the South (3.46%) reported higher prevalences than students in the Midwest (3.0%), West (2.02%), or Northeast (1.71%). Students with self-perceived below-average academic performances (5.10%) and students reporting injected drug use also reported higher anabolic-steroid use (51.57%). Based on a multiple logistic regression, the following variables were found to be significant predictors of anabolic-steroid use: injectable drug use (odds ratio [OR], 17.86), use of other drugs (OR, 4.19), male gender (OR, 2.79), alcohol use (OR, 1.38), and strength training (OR, 1.73). The variables that were significantly associated with anabolic-steroid use varied by gender and by region of the country. CONCLUSION: These data suggest that adolescent anabolic-steroid users in this country are more likely to engage in strength training, injected drug use, and the use of multiple drugs, even after controlling for sports participation and poorer academic performance. These data confirm previous findings of an association between multiple drug use and anabolic-steroid use. Also, engaging in strength-training exercises continued to be associated with anabolic-steroid use after controlling for drug use and other predictors.

Adolescent↗