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PubMed2006

Faculty and staff teams: a tool for unifying the academic health center and improving mission performance.

The organizational structure of the academic health center (AHC) may present significant barriers to deep and lasting organizational change. The insular nature and structure often seen in academic departments and other units at AHCs result in competition for scarce resources, rather than in working together to add value to one another or to the organization as a whole. Successful unification around organizational performance goals is needed more than ever by AHCs as they struggle to meet their challenges. Over a five-year period (2000-2005) at the Penn State College of Medicine and Milton S. Hershey Medical Center, organizational inner cohesiveness was created through the use of teams that unified the clinical, academic, and research enterprises. Barriers that typically separate academic departments, such as a lack of understanding of the impact of organizational funds flow on each of the missions, were broken down. Traditional barriers between employees and management (e.g., poor communication, lack of clarity on organizational goals, and claims that neither side understood the other) were reduced. Problems that seemed to be intractable in the past such as an inequitable distribution of resources, responsibilities, and rewards, were solved through the implementation of a teams approach across departments and missions. The authors describe the creation and operation of these AHC-wide teams. The rationale for using teams is elucidated, the difference between teams and committees is defined, and data on five years of team performance are presented. The authors argue that the breadth of scope and comprehensiveness of the teams approach represents an effective model for implementing AHC-wide transformational change.

Academic Medical Centers↗
PubMed2006

Relationships between scores on the COMLEX-USA Level 2-Performance Evaluation and selected school-based performance measures.

The Comprehensive Osteopathic Medical Licensing Examination USA Level 2 Performance Evaluation (COMLEX-USA Level 2-PE) is a national multistation performance examination designed to examine students' osteopathic clinical skills. The current study examines the relationship between achievement levels on the COMLEX-USA Level 2-PE and selected school-related variables for the class of 2005 at the West Virginia School of Osteopathic Medicine in Lewisburg, WVa (N=70). Significant (P<.01) correlations between the COMLEX-USA Level 2-PE summary performance and selected academic achievement measures include: weighted Physical Diagnosis grade, 0.41; weighted year 1 and year 2 Osteopathic Principles and Practice grade, 0.37: overall year 2 grade point average, 0.42; the objective structured clinical evaluation (OSCE) Physical Examination score, 0.40; and the OSCE Total Station score, 0.33. While further research is needed, the current study found modest but notable relationships between school-generated academic variables and performance on the COMLEX-USA Level 2-PE, and therefore supports the validity of the COMLEX-USA Level 2-PE examination for assessing the clinical skills of future osteopathic physicians.

Achievement↗
PubMed2005

Perceived autonomy and relatedness as moderating the impact of teacher-student mentoring relationships on student academic adjustment.

This study examined the impact of a 10-hour teacher-student mentoring relationship on the academic adjustment of at-risk college students. A quasi-experimental design involving a comparison group (NM: students with No Mentor), a High Relatedness/Autonomy group (HR/HA: students who perceived high levels of relatedness and autonomy during the mentoring process) and a Low Relatedness/Autonomy group (LR/LA: students who perceived low levels of relatedness and autonomy during the mentoring process) was used for that purpose. Academic adjustment and performance were assessed before (Time 1) and five months after involvement in mentoring (Time 3) for all students. Perceived relatedness and autonomy were assessed after the last mentoring meeting (Time 2) for students involved in mentoring relationships only. Results indicated better social adjustment and institutional attachment in college for the HR students than for the LR and NM students, even after controlling for initial adjustment, performance and social network dispositions. In addition, the LR and LA students presented lower academic and emotional adjustment in college and lower academic performance than NM, HR, and HA students. The potential positive and negative impacts of mentoring relationships are discussed in light of autonomy and relatedness processes. Editors' Strategic Implications: Especially valuable is the articulation of why mentoring might be expected to affect social and academic adjustment outcomes via its effects on the development of autonomy and relatedness. Application of attachment theory and measurement to the study of mentoring is a strategy that shows promise.

Achievement↗
PubMed1987

Performance of residents who had academic difficulties in medical school.

An assessment of how well graduates of one medical school performed in residency training was undertaken to assess the school's monitoring of students' performances. The minutes of the school's student progress committee for four years were reviewed to identify all students who had had academic difficulty. Seven students had been recommended for dismissal but ultimately graduated, 22 students were on academic probation for longer than one year, and 22 students were on academic probation for less than one year. The residency performance of 43 of these 51 students were compared with the performances of a randomly selected group of students who had had no academic difficulties and had graduated during the same period. Of 12 performance and knowledge items assessed by the residency directors for the studied graduates, the one dealing with quality of interaction with patients showed significant differences among the residents. The residents who had had academic difficulty had lower ratings on this item than the residents who had not had academic trouble. On all other items, those residents who had had academic difficulties received generally lower scores than the other residents, but the differences were not statistically significant. Of the seven students considered for dismissal, one had been dismissed and one had withdrawn from the residencies; the other five generally received positive ratings from their residency directors. The findings suggest that the medical school's overall monitoring of students' performance was working and confirmed the authors' opinion that each decision concerning a student with academic difficulties should be based on the student's individual situation.

Educational Measurement↗
PubMed2006

The physician-hospital team: a successful approach to improving care in a large academic medical center.

Initiatives to improve the quality and efficiency of care in academic medical centers (AMCs, teaching hospitals) can benefit the performance of academic departments as well as the hospital. However, the value of performance improvement programs in an AMC is often challenging. At Jefferson Medical College, clinical efficiency and bed availability are important priorities to the Department of Medicine. To this end, a multidisciplinary program was designed to (1) improve the quality and consistency of care by adapting and adopting national guidelines for patients with heart failure and acute coronary syndrome; (2) identify and improve hospital operational supports and maximize resource utilization; (3) increase hospital functional capacity to make way for increased volume; and (4) improve housestaff education and practice by using evidence-based approaches and by optimizing teaching relationships between housestaff and attending faculty. The eight-month project (November 2002 to July 2003) resulted in improvement in several quality measures including increased use of beta blockers and angiotensin converting enzyme inhibitors for heart failure patients, reduced length of stay for heart failure and acute coronary syndrome patients, and increased satisfaction of the clinicians involved in caring for these patients. However, the project was not without barriers including individual physician's unwillingness to embrace change and an inability to incentivize change. Development of faculty leadership skills and enhanced physician accountability helped in overcoming the challenges of change.

Academic Medical Centers↗
PubMedDate not supplied

Using FTE and RVU performance measures to assess financial viability of academic nurse-managed centers.

Financial performance measures are essential to improve the fiscal management of academic nurse-managed centers (ANMCs). Measures are compared among six ANMCs in a consortium and against an external, self-sustainable, profitable ANMC and national data for family practice physicians. Performance measures help identify a center's strengths and weaknesses facilitating the development of strategies aimed at a variety of targets (business practices related to revenue and costs) to improve financial viability. Using a variety of financial performance measures to inform decision making will aid ANMCs in keeping their doors open for business.

Academic Medical Centers↗
PubMed2003

How often do neuroradiologists perform sonography of the carotid arteries? A survey of academic and nonacademic radiology practices, with implications for fellowship training.

BACKGROUND AND PURPOSE: Debate in the neuroradiology community surrounds the amount of formal training in sonography of the carotid arteries that should be provided to fellows. This study was designed to assess current practice patterns at both academic and nonacademic practices regarding the performance of carotid sonography. METHODS: A neurovascular radiology survey was sent to all 102 program directors of neuroradiology fellowships in the United States and Canada (academic practices). The survey was also sent to 146 randomly selected senior members of the ASNR (three per state, except one each for Alaska and Vermont) who were not affiliated with fellowship programs (nonacademic practices). RESULTS: Fifty-seven surveys from academic practices and 70 surveys from nonacademic practices were returned. Radiologists at academic practices performed approximately 42% of studies (general radiologists or sonography specialists, 36%; neuroradiologists, 5%; cardiovascular radiologists, 1%). Nonradiologists performed approximately 58% of studies (vascular surgeons, 47%; neurologists, 10%; cardiologists, 1%; neurosurgeons, <1%). Neuroradiologists performed carotid sonography at 11% (6/57) of academic practices. On average, radiologists at nonacademic practices performed approximately 62% of studies (general radiologists or sonography specialists, 38%; neuroradiologists, 15%; cardiovascular radiologists, 9%). Nonradiologists performed approximately 38% of studies (vascular surgeons, 25%; neurologists, 6%; cardiologists or internists, 6%). Neuroradiologists performed carotid sonography at 53% (37/70) of nonacademic practices. CONCLUSION: At most academic practices, neuroradiologists do not perform sonography of the carotid arteries. This may explain the reluctance of some fellowships to provide formal training in this technique. In contrast, although neuroradiologists perform carotid sonography at a majority of the nonacademic practices, the percentage of studies that they perform is small; moreover, neuroradiologists perform far fewer studies than do general radiologists or sonography specialists.

Canada↗
PubMed2004

Prior academic background and student performance in assessment in a graduate entry programme.

OBJECTIVES: This study aims to identify whether non-science graduates perform as well as science graduates in Basic and Clinical Sciences (B & CS) assessments during Years 1-3 of a four-year graduate-entry programme at the University of Sydney (the 'USydMP'). METHODS: Students were grouped into five categories: Health Professions (HP), Biomedical Sciences (BMS), Other Biology (BIOL), Physical Sciences (PHYS) or Non-Science (NONS). We examined the performance rank of students in each of the five groups for single best answer (SBA) and modified essay (MEQ) assessments separately, and also calculated the relative risk of failure in the summative assessments in Years 2 and 3. RESULTS: Students with science-based prior degrees performed better in the SBA assessments. The same occurred initially in the MEQs, but the effect diminished with time. The HP students performed consistently better but converged with other groups over time, particularly in the MEQs. Relative performance by the NONS students improved with time in both assessment formats. Overall, differences between the highest and lowest groups were small and very few students failed to meet the overall standard for the summative assessments. HP and BMS students had the lowest failure rate. NONS students were more likely to fail the assessments in Year 2 and 3, but their pass rates were still high. Female students performed significantly better overall at the end of Year 2 and in Year 3. There were only minor differences between Australian resident and International students. CONCLUSION: While there are small differences in performance in B & CS early in the programme, these lessen with time. The study results will inform decisions regarding timing of summative assessments, selection policy and for providing additional support to students who need it to minimize their risk of failure. Readers should note that this paper refers to student performance in only one of the four curriculum themes, where health professional and science graduates would be expected to have a significant advantage.

Achievement↗
PubMed1983

The relationship of allergies and allergy treatment to school performance and student behavior.

The purposes of this project were to study the relationship of allergies and allergy treatment to school behavior. Parents of allergic and nonallergic children (grades K-12 and from different socioeconomic status) completed a survey form. The 400 parent respondents reported no significant difference between allergic and nonallergic children in terms of academic and language performance, retention, diagnosis as handicapped, or behavior problems; allergic children were absent from school more. Eustachian tube dysfunctions were significantly related to academic and behavior problems. Certain medications were related to overactive types of behavior. Parents who considered their children's behavior as inappropriate tended to contribute a portion of it to side effects of medication. 65% of the parents reported positive results from treatment on behavior at home; they tended to be unsure of the impact on school behavior. Direct relationship of allergy and allergy treatment on academic performance is questionable, except for the impact of upper respiratory problems on listening and attention. Use of certain medications with already behavior disordered children requires caution. Better communication among physicians, teachers and parents is advised.

Absenteeism↗
PubMed1999

Test anxiety versus academic skills: a comparison of two alternative models for predicting performance in a statistics exam.

BACKGROUND: Two competing theoretical models to explain academic performance were proposed. The interference model stresses the detrimental effect of task-irrelevant thoughts during the test-taking situation whereas the deficit model suggests Study Habits and domain-specific skills as main predictors of test performance. AIMS: The study compares the two models by determining the relative contribution of Test Anxiety, Study Habits, and Maths Skill to performance in a statistics exam. SAMPLE: Sixty-six undergraduate students who were enrolled in the first semester of two parallel introductory statistic courses participated in the study. METHOD: Hierarchical regression analyses were performed on the performance in the final statistics exam. The unique variance attributable to Test Anxiety, Study Habits, and Maths Skill was calculated. RESULTS: Both Maths Skill and Test Anxiety added unique variance in explaining performance, whereas Study Habits did not. Although Maths Skill emerged as relatively more important than Test Anxiety, a purely deficit-based account nevertheless appears untenable because interfering effects of Test Anxiety during the examination also contributed an important portion of variance. CONCLUSIONS: It is recommended that cognitive-attentional accounts stressing test anxiety be supplemented by a deficit formulation, and that multimodal counselling address both Test Anxiety and skill deficits. COMMENT: Methodological problems in investigating the causal relationship between skill deficits, anxiety, and performance are discussed.

Adult↗
PubMed1990

Academic selection criteria and subsequent performance.

In this paper we have attempted to determine if there are any aspects of the academic history of a student, prior to admission to the University of Leicester medical course, that correlate with his or her subsequent performance in that course. The analyses presented suggest that a student's overall performance in GCE O- and A-level examinations correlates with subsequent performance at various stages of the medical course. In addition, there is a correlation between performance in the medical course and performance in A-level chemistry and biology but not mathematics, physics or general studies. Students who resat two or more A-level subjects performed at a lower level throughout the course than those with only one or no resits. These results emphasize the importance of academic criteria in the medical student selection process.

Achievement↗
PubMed2003

Endovascular interventional neuroradiologic procedures: who is performing them, how often, and where? A survey of academic and nonacademic radiology practices.

BACKGROUND AND PURPOSE: In this report, the authors assess practice patterns at both academic and nonacademic centers regarding the treatment of aneurysms with Guglielmi detachable coils (GDCs), thrombolysis of the carotid-vertebral arteries, and stent placement with angioplasty of the carotid arteries. METHODS: A neurovascular radiology survey was sent to 102 directors of neuroradiology fellowship programs in the United States and Canada ("academic centers"). The survey was also sent to senior members of the American Society of Neuroradiology (three per state) who were not affiliated with fellowship programs ("nonacademic centers"). RESULTS: Fifty-seven surveys from academic practices and 70 surveys from nonacademic practices were returned. A total of 4361 procedures (2283 GDC; 949 thrombolysis; 1129 stent placement) were performed; 84% were performed at academic centers and 16% at nonacademic centers. Ninety percent of GDC, 71% of thrombolysis, and 82% of stent placement procedures were performed at academic centers. Seven academic and three nonacademic centers performed 48% of all GDC procedures; eight academic and four nonacademic centers performed 45% of all thrombolysis procedures; eight academic centers performed 50% of all stent placement procedures. A total of 544/4361 (12%) procedures were performed by nonradiologists. At academic centers, 14% of procedures were performed by nonradiologists; participation by nonradiologists was greatest for carotid stent placement (24% of procedures). At nonacademic centers, only 5% of procedures were performed by nonradiologists. CONCLUSION: According to this survey, most endovascular interventional neuroradiologic procedures are performed at academic centers; given the survey population, this study likely identifies the lower limit of participation by nonradiologists (12%). Performance of these procedures is concentrated in relatively few centers, and these data raise questions about the overall use of intraarterial thrombolytic therapy for acute infarction.

Academic Medical Centers↗
PubMed2006

Impact of isolated clinical performance feedback on clinical productivity of an academic surgical faculty.

BACKGROUND: There is increasing financial pressure to maximize clinical productivity for academic physicians. We examined whether clinical performance feedback alone could contribute to improving the clinical productivity of surgeons in an academic department of surgery. STUDY DESIGN: We implemented a clinical performance feedback program in January 2003. We then compared clinical productivity in terms of relative value units (RVUs) of surgeons for 18 months before and 18 months after this intervention, using each surgeon as his or her own control. Regression was performed with dependent variable ln (monthly RVUs) and independent variables "calendar month," "pre/post" January 2003, and "surgeon." The coefficient on "pre/post" reflected average change in RVUs. We also surveyed faculty on their use of and attitudes toward this feedback. RESULTS: There was a 58% survey response. Ninety-two percent of responding faculty reported that they viewed and used the performance feedback, and that it affected their practice. Ninety-two percent believed the information accurately reflected their performance, 89% thought that the comparisons were useful, and 79% desired more feedback information, specifically, comparisons with external benchmarks. When RVU data were examined, the coefficient on change pre- and postintervention indicated a 7.4% increase in productivity (p < 0.001), or a 6.0% increase (p=0.003) after exclusion of outliers. CONCLUSIONS: Performance feedback was associated with a small (6.0%) but significant improvement in productivity in this academic surgical faculty group. Performance feedback can be useful and should be used in conjunction with other management tools for this population.

Academic Medical Centers↗
PubMed1995

A clinical and phenomenological study of 185 Spanish adolescents with anorexia nervosa.

The objectives of the present study were the following to determine the socio-familial, academic and interpersonal characteristics specific to anorexia nervosa (AN); to study comorbidity in patients with anorexia and morbidity in their parents; and to ascertain whether patients with anorexia nervosa in Spain are similar to those in other countries. The research team revised the clinical records of 185 Spanish adolescents with AN (aged 11-18 years). The results were compared with those obtained from a group of 185 psychiatric patients without AN matched by sex, age, time of consultation and centre. No significant differences were found with regard to broken home, birth order or parent-patient conflict. The parents of patients with anorexia have a higher standard of education and develop more affective disorders. When compared with other patients, the individuals with anorexia nervosa perform much better academically but are more socially withdrawn. Males with anorexia nervosa perform worse academically than females and have more anxiety diagnoses. Patients with anorexia have a high comorbidity for affective and obsessive-compulsive disorders. Sufferers from anorexia nervosa in Spain are clinically analogous to patients with anorexia in other countries. The two characteristics specific to these patients are a high standard of academic performance and an intense degree of social withdrawal, although there are certain factors common to other pathologies relating to adolescence.

Adolescent↗
PubMed2001

Need for cognition and cognitive performance from a cross-cultural perspective: examples of academic success and solving anagrams.

The cross-cultural validity of the Need for Cognition Scale and its relationship with cognitive performance were investigated in two studies. In the first study, the relationships between the scale and university entrance scores, course grades, study skills, and social desirability were examined. Using the short form of the Turkish version of the Need for Cognition Scale (S. Gülöz & C. J. Sadowski, 1995) no correlation with academic performance was found but there was significant correlation with a study skills scale and a social desirability scale created for this study. When regression analysis was used to predict grade point average, the Need for Cognition Scale was a significant predictor. In the second study, participants low or high in need for cognition solved multiple-solution anagrams. The instructions preceding the task set the participants' expectations regarding task difficulty. An interaction between expectation and need for cognition indicated that participants with low need for cognition performed worse when they expected difficult problems. Results of the two studies showed that need for cognition has cross-cultural validity and that its effect on cognitive performance was mediated by other variables.

Achievement↗