Patients'' psychological and cosmetic experience after immediate breast reconstruction

To prepare freshmen dental students for clinical experiences, standardized patients (SPs) were used to teach basic skills in communication, examination, and record keeping. SPs allow students to practice and be assessed in a realistic, predetermined, and controlled setting. The SP cases integrated the clinical content from freshman "Preventive Periodontics" with the behavioral content taught in "Basic Patient Management." Six SP cases were developed: two oral hygiene instruction cases, two medical and dental history cases, and two head and neck examination cases. One case of each type was used for instructing the students, and the others were used for assessing student competency at the end of the course. The SP methodology was evaluated by comparing the performance of freshmen, who had taken the course, with sophomores, who had only traditional clinical experiences. To make the comparison, sophomores participated in the same SP assessment as the freshmen. Scores for both groups were analyzed in three skill areas: interpersonal, technical, and record keeping. Freshmen scored higher in all three skill areas, with significant differences of 21% in technical skills and 31% in record keeping skills.     

Comparison of standardized patients and faculty in teaching medical interviewing

PURPOSE: This randomized controlled study compared the interviewing skills of first-year medical students receiving feedback primarily from standardized patients (SPs) with those of students receiving feedback primarily from faculty. METHOD: All 154 first-year students at the University of Oklahoma College of Medicine in 1993-94 were video-taped to assess baseline and post-instruction interviewing skills. All the students, randomized to one of three study groups, attended two four-hour workshops on interviewing skills. Instruction in the groups was as similar as possible except in the matter of who provided feedback. Two rating systems were used to rate the videotaped interviews for performances of targeted skills. RESULTS: Complete, usable data were available for 120 (78%) of the students. Skill ratings using the Arizona Clinical Interview Rating Scale were significantly higher for the "types of questions used" and "use of empathy" items in the SP-led feedback group. No significant difference in ratings was detected among the groups as measured by the Rotor Interactional Analysis System. CONCLUSION: The SPs were at least as effective as the faculty in effecting behavioral changes in the first-year medical students' interviewing skills.     

Student Responses to Activities Designed to Develop Generic Professional Skills

This paper reports on student responses to a range of assessment activities in a final-year engineering unit. Existing assessment activities were supplemented with new activities, the overall aim being to link the assessment activities more effectively to the material being studied, and to develop a range of generic skills important in professional engineering practice. A class survey was undertaken at the beginning of the semester to establish the initial attitudes to the new assessment activities. This was followed up with an end-of-semester survey to determine the change in perceived value of the assessment activities, and to collect student feedback regarding the activities. The perceived value of the assessment activities was determined using a Likert rating scale, while student feedback was collected using open-ended questions. The assessment activities evaluated were group work, case study investigation, report writing, oral presentation, group self-assessment, industrial interviews, and written reflective journals. The responses indicate that engineering students value a range of assessment activities. They value highly visits to real engineering organizations, and—contrary to popular belief—value and enjoy oral presentation exercises.     

Performance of "standardized examinees" in a standardized-patient examination of clinical skills

PURPOSE: As a first step in testing the utility of using trained "standardized examinees" (SEs) as a quality-assurance measure for the scoring process in a standardized-patient (SP) examination, to test whether medical residents could simulate students in an SP examination and perform consistently to specified levels under test conditions. METHOD: Fourth-year students from the Baltimore-Washington Consortium for SPs participated in a National Board of Medical Examiners Prototype Examination of clinical skills consisting of twelve 15-minute student-patient encounters in 1994-95. For this examination, internal medicine residents were trained to act as ordinary candidates and to achieve target scores by performing to a set level on specific checklist items used by SPs for recording interviewing, physical-examination, and communication skills. The "strong SEs" were trained to score 80% correct on six of the examination's 12 cases (study cases), and the "weak SEs" were trained to score 40% correct on the same six cases. The strong and weak SEs' checklist scores on the study cases were compared through independent, two-tailed t-tests. When there was less than 85% agreement on specific checklist items in each case between the SE training and the SP recording, videotapes of the cases were reviewed; in such cases an SE's performance was the final score agreed upon after review. RESULTS: Seven SEs took the SP examination and were not detected by the SPs. There was a total of 84 discrepancies between predicted and recorded checklist scores across 659 checklist items in 40 encounters scored by the SPs. After correcting the discrepancies based on videotape review, the estimated actual mean score was 77.3% for the strong SEs and 44.0% for the weak SEs, and was higher for the strong SEs in each study case. The overall fidelity of the SEs to their training was estimated to be 97%, and the overall SP accuracy was estimated to be 91%. The videotape review revealed 47 training-scoring discrepancies, most in the area of communication skills. CONCLUSION: This study suggests that SEs can be trained to specific performance levels and may be an effective internal control for a high-stakes SP examination. They may also provide a mechanism for refining scoring checklists and for exploring the validity of SP examinations.     

Using standardized patients and standardized physicians to improve patient-care quality: results of a pilot study

BACKGROUND: We conducted evaluation research with a sample of registered professional staff nurses in a large, inner-city, tertiary medical center for a pilot study of videotaped case scenarios using standardized patients and standardized physicians to enhance nurses' communication and collaboration skills. METHOD: Change scores from pre-test to post-test on a self-reported rating scale to assess nurse-physician-patient interactions and communications for 28 nurses were compared with a control group of 38 nurses who did not participate in the videotaped sessions. RESULTS: Repeated measures of analysis of variance (ANOVA) detected no statistically significant differences between the intervention and control groups. However, positive changes were noted in some aspects of nurse-physician and nurse-patient interactions in the intervention group. Immediate feedback from the videotaped scenarios heightened nurses' awareness of the impact of their body language. CONCLUSIONS: Nurses must continuously practice and enhance their collaborative and communication skills. This pilot study suggests that it is beneficial to use videotaping with standardized patients and standardized physicians to enhance such nurses' skills.     

Factors related to correspondence between teacher ratings of elementary student depression and student self-ratings.

Fourth through 6th graders (n?=?418) completed the Children's Depression Inventory (CDI; M. Kovacs, 1980). Each teacher (n?=?31) rated 6 students with high, low, or medium CDI scores (n?=?181) using the CDI items (teacher-CDI) and a single global rating. Remaining students received the global rating only. 16 teachers were randomly assigned to receive instruction on childhood depression. Contrary to earlier studies, moderate correspondence was found for both measures. Familiarity was related to correspondence, whereas confidence and student gender were unrelated to correspondence. Instruction improved knowledge, but not correspondence. School-related behaviors yielded the highest correspondence. The teacher-CDI displayed high test–retest reliability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do college teachers who voluntarily have courses evaluated receive higher student ratings?

Analyzed Instructional Development and Effectiveness Assessment (IDEA) student rating data from 13,063 classes from several academic fields and institutions. The purpose was to test the hypothesis that teachers who voluntarily continued to use the student rating form after a first mandatory use would be rated higher by students than "nonvolunteer" teachers, who chose not to use the rating. Classes were divided into 3 groups: volunteers, in which the decision to evaluate was entirely the instructor's; intermediate, in which the evaluation was required, but the instructor chose the class; and nonvolunteers, in which the instructor was required to have the class evaluated. Statistically significant differences among the 3 groups were found for 26 of the 39 IDEA items (probably because of the very large Ns). Based upon ω–2 analyses, none of these differences were of practical significance; none of the ω–2 values accounted for even 1% of the variance. It is concluded that voluntariness of evaluation need not be taken into consideration when using large, multi-institutional, comparative student rating data pools. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is effort enough, or does diligence count too? Student and teacher reactions to effort stability in failure.

Research indicates that although teachers encourage achievement through effort, students often minimize study to avoid the implication that they lack ability if they fail. Effort stability was examined in this context. Are steady, diligent workers evaluated differently from those who are erratic in their study patterns? Does a reputation for variable study patterns reduce shame by deflecting the causes of failure from low ability? 187 undergraduates (who had been rated on the Michigan State Self-Concept of Ability Scale) rated affective reactions to a series of hypothetical test failures along 2 dimensions: amount of overall effort and stability of effort. An additional 187 undergraduates in the role of teachers administered punishment to hypothetical students under the same conditions. Results indicate that although effort stability contributed little to variations in student affect, it did influence teacher judgments, suggesting that determination of feedback is a more complex process than implied by a simple distinction between teachers as reinforcers of modifiable (unstable) behavior and moralistic conveyors of a work ethic. (45 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An examination of depression in the spouses of stroke patients.

Examined the prevalence and correlates of depression in the spouses (SPs [mean age 61.8 yrs]) of 41 stroke patients (SPTs [mean age 65.6 yrs]). SPs reported their own mood on the Beck Depression Inventory (BDI) and rated their partners' (the SPTs') mood using the Hamilton Rating Scale for Depression (HRSD). A clinician evaluated the SPTs' mood using the HRSD and their cognitive/language and physical impairments using a battery of neuropsychological tests. Results indicated that 44% of the SPs were depressed. SP depression was not correlated with the severity of the SPTs' physical, cognitive, or language impairments. However, the SPs' perception of the SPTs' mood was a better predictor of the SPs' mood than was the clinicians' evaluation of the SPTs' mood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introducing Students to Professional Practice in Civil Engineering

This paper describes a module that was introduced into a civil engineering degree program with the help of professional engineers. The aim was to develop a bridge between the world of learning and professional practice by putting students in the role of consulting engineers working with industry to produce a feasible solution to a real inquiry from a client. The module is placed in context by comparing the goals of accredited civil engineering programs in the United Kingdom and America, by describing how it is linked to the degree program and by explaining the matrix developed to identify the skills the students needed to demonstrate their ability to practice as professional engineers. Details of the module are given with examples of student work and feedback.     

Identification of the genetic locus for keratosis palmaris et plantaris on chromosome 17 near the RARA and keratin type I genes

Although the letter of recommendation is the most commonly requested information relating to the personal qualities of applicants to dietetics internship programs, little research has focused on its value in selection decisions. The purpose of this study was to review how 318 letters of recommendation submitted on a standardized form related to the source of the reference and to the admission status of the applicants. The form contained 40 attributes that raters assigned to one of six categories. Nine of the 40 attributes were not rated by more than 75% of the raters, and 3 of the attributes were rated as outstanding by more than 60% of the raters. We concluded that these attributes did little to distinguish among applicants. The attribute maturity correlated 0.70 with 5 attributes and 0.99 with 2 attributes, so duplication of information existed. Raters were categorized as follows: adviser, major professor, other professor, employer, and other. The highest mean ratings were given by advisers; major professors rated students lowest. Analysis of variance supported a significant difference in rating by type of rater. Our findings suggest that fewer items should be used on a standardized form and that the type of rater should be specified if references are to distinguish among applicants.     

A process for identifying marginal performers among students in a clerkship

PURPOSE: To evaluate a review process for identifying marginal performers among students in a clerkship. METHOD: To better identify the marginal performers among the students participating in the medicine clerkship at the University of Minnesota Medical School--Minneapolis, the Medicine Clerkship Committee reviewed in 1990-91 and 1991-92 all students rated by faculty or housestaff as below expectations for any of nine areas of clinical performance (27 students of 890, 3%). (In the past, a student was considered to be a marginal performer only if he or she was assigned an unsatisfactory numerical grade, calculated from the nine ratings, or if written comments by housestaff and faculty and the opinions of the attending faculty and clerkship site coordinator indicated that the student should fail.) Chi-square analysis was used to compare the number of students judged to be marginal performers under the review process with the number of marginal performers in 1988-89 and 1989-90. The two groups were also compared based on their preclerkship performances on standardized examinations. RESULTS: Ten of those reviewed (37%) were judged to have performed marginally. Although the study group's performance on standardized examinations was not different from that of students during the previous two years, significantly fewer students were identified as marginal performers before the review process began than afterwards (2 of 867, 0.2%, versus 10 of 890, 1.1%, p < .05). CONCLUSION: Without changing the way in which faculty and housestaff evaluated students, the review process improved the medicine clerkship evaluation system by identifying significantly more students who were marginal performers.     

Students' sex preferences and sex role expectancies for counselors.

Examined sex role expectancies for counselors as a function of sex of student, preference for counselor's sex, and sex of counselor being rated. 128 male and 249 female college students were asked what sex of counselor they would prefer if they were seeking help with personal or social concerns, and then they were randomly assigned to rate their sex role expectancies for either a male or a female counselor, using the Bem Sex Role Inventory with modified instructions. Results indicate that male students expected counselors to be less masculine than did female students, that male counselors were expected to be masculine while female counselors were expected to be psychologically androgynous, and that students with sex preferences for counselors had more stereotyped expectancies for counselor characteristics than did students with no preference. Implications of these findings for the counseling setting are discussed. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An overview of the uses of standardized patients for teaching and evaluating clinical skills. AAMC

The author defines the term standardized patient (SP), the umbrella term for both a simulated patient (a well person trained to simulate a patient's illness in a standardized way) and an actual patient (who is trained to present his or her own illness in a standardized way). He first discusses the many values of simulated patients over actual patients as teaching and assessment tools in the classroom and refutes a few myths about the use of SPs. Then he recounts the origin and development of SPs over a three-decade period, beginning with his work as a neurologist at the Los Angeles County Hospital, where he trained a model from the art department to simulate a neurological patient and assist in the assessment of clinical clerks. He then describes additional roles of SPs that have developed, including: (1) their use in the Clinical Practice Examination created at Southern Illinois University School of Medicine and (2) the major use that has come into being over the last 10-15 years; facilitating the comprehensive assessment of clinical competence using multiple stations in examinations such as the objective structured clinical examination. He concludes with information about recent and current work on SPs, who are becoming more and more accepted in the assessment process, and urges skeptics not to make judgments about the value of SPs until they have experienced the technique firsthand and reviewed the literature concerning the extensive and often high-quality research about this assessment tool.     

Construct validation of a strategy model of student self-regulated learning.

Using student interviews, teacher ratings, and achievement test outcomes, we validated a strategy model of student self-regulated learning as a theoretical construct. Forty-four male and 36 female high school students were asked to describe their use of 14 self-regulated learning strategies in six contexts, and their teachers rated these students for their self-regulated learning during class. Factor analyses of the teachers' ratings along with students' scores on a standardized test of mathematics and English revealed a single self-regulated learning factor that accounted for nearly 80% of the explained variance and two smaller factors that were labeled Student Verbal Expressiveness and Achievement. Students' reports of using self-regulated learning strategies during a structured interview correlated .70 with the obtained teachers' rating factor and were negatively related to the Student Verbal Expressiveness and Achievement factors. Our results indicate both convergent and discriminative validity for a self-regulated learning construct. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validity and usefulness of student evaluations of instructional quality.

The average of a total of 720 undergraduates' evaluations for each section of a computer programing course correlated positively with the average of student performance on a standardized final examination. Since alternative explanations were ruled out, results support the validity of the student evaluations. Half of the 18 instructors (feedback) were also given the results of student evaluations conducted during the term. Students in the feedback sections later rated their instructors as better teachers, but performed no better on the standardized final examination. Findings suggest student evaluations are valid measures of instructional quality and provide useful feedback to the instructor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of performance feedback from behaviorally anchored rating scales.

Compared a behaviorally anchored rating scale (BARS) developed according to the procedure of H. Bernardin et al (see record 1976-08614-001) with a summated rating scale. Using both scale formats (designed to evaluate teaching effectiveness), 859 undergraduates rated 32 instructors during spring classes, and 314 undergraduates rated 19 instructors during summer classes. Students rated instructors halfway through the course and at its end. Instructors received feedback from the 1st rating period on either the BARS (including written behavioral observations) or on the summated rating format. Analyses of covariance revealed no format effect on the performance ratings obtained during the 2nd rating period in the spring experiment. BARS feedback, however, produced greater behavioral change among instructors than did feedback from the alternative format used during the summer experiment. (34 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Screening for emotional and behavioral risk among students with limited English proficiency.

Students with limited English proficiency (LEP) make up one of the fastest growing segments of the student population; however, LEP status is often related to poor academic and behavioral outcomes. Teacher-reported behavioral rating scales can be informative measurements to screen and identify students at risk for behavioral and emotional problems. Given the focus on early identification and the changing demographics in schools, it is important to research the validity of screening instruments, as well as more comprehensive assessments, among LEP students. Items on a teacher-rated screener and a comprehensive behavioral rating scale were evaluated for invariance across two language groups. Results showed that the majority of items could be considered invariant across groups. This study also examined how behavioral ratings on invariant measures differed at the mean level between LEP and non-LEP students. LEP students were rated as having more learning problems and fewer adaptive skills; no significant differences were found for internalizing and externalizing problems. Results highlight the need for further research on this topic. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Effect of teacher sex, student sex, and teacher warmth on the evaluation of college instructors.

Examined the influence of teacher sex, student sex, and teacher warmth as perceived by students and teachers on teacher evaluation. Male and female instructors in the same department were matched on the level of course taught. 22 pairs of courses evaluated by 838 college students were obtained. Twenty Instructional Improvement Questionnaire items that directly evaluate instructor performance were analyzed using a 3-factor analysis of variance and the .0025 level of significance. No interactions between faculty sex, student sex, and teacher warmth were found. When Ss rated their instructor's interest and warmth, teachers who were warmer and primarily interested in students received higher ratings in teaching effectiveness. When teachers rated themselves on warmth and interest, self-ratings interacted with faculty sex. Generally, female teachers received higher effectiveness ratings than did male teachers when they considered themselves low in warmth or interested in course content. Male teachers who rated themselves high in warmth or primarily interested in students received higher ratings than did male teachers who rated themselves low in warmth or primarily interested in course content, respectively. (PsycINFO Database Record (c) 2010 APA, all rights reserved)