Beth Dawson

Social cognitive theory and physical activity during breast cancer treatment

PURPOSE/OBJECTIVES To measure the association between physical activity and social cognitive theory constructs during breast cancer treatment. DESIGN Cross-sectional survey. SETTING Midwestern, academic oncology clinic. SAMPLE 21 primarily Caucasian (90%) female patients with breast cancer undergoing treatment. 76% were > 50 years old; 76% had stage I or II disease. 17 completed the study. METHODS Survey (structured interview or self-administration), chart audit, pedometer, and seven-day physical activity recall. MAIN RESEARCH VARIABLES Steps per day, energy expenditure, self-efficacy, barriers, partners and role models, prior physical activity counseling, physical activity knowledge, pretreatment physical activity, outcome expectations and values, goals, reinforcement management, and emotional well-being. FINDINGS A higher average of steps per day was significantly associated with having an exercise role model and higher annual income. A higher daily energy expenditure (kilocalories per kilogram body weight per day) was significantly associated with higher barrier self-efficacy, higher task self-efficacy, having an exercise partner, having an exercise role model, higher physical activity enjoyment, and lower negative value score. CONCLUSIONS Social cognitive theory may provide a useful framework for understanding physical activity among patients with breast cancer during treatment, but correlation strength varies with physical activity measurement type. IMPLICATIONS FOR NURSING Social cognitive theory and physical activity during breast cancer treatment warrant additional study with larger sample sizes and multivariate analyses. Interventions to increase physical activity among patients with breast cancer may use social cognitive theory and assess theory constructs as potential mediators or moderators in intervention evaluation.

Guidelines for assessing clinical competence

Medical organizations responsible for assessing the clinical competence of large numbers of examinees have traditionally used written, oral, and observation‐based examination methods. The results from these examinations form the basis for major professional decisions regarding promotion or privileges of medical students or physicians. In this article, we present a set of guidelines that examining bodies should follow in developing and implementing assessment procedures that are a valid reflection of examinees’ current level of competence and of their ability to perform satisfactorily at the next stage of training or practice. The guidelines are based on our collective experiences as well as the growing literature on assessment of clinical competence. The discussion covers issues that have not been fully addressed in previously published reviews, including identifying the competencies to be tested, selecting appropriate and realistic test methods, dealing with test administration and scoring, and setting s...

Sensitivity of the modified Angoff standard‐setting method to variations in item content

This study examined the sensitivity of the modified Angoff standard‐setting method to differences in item content when examinee performance data were provided for the judges. Three medical certifying examinations contained subsets of “core”; items. Compared to the remainder of the examinations, the core subsets were written to test points that were relatively more critical for patient outcome, more frequently encountered, and/or where there was some evidence that intervention would have an effect on patient outcome. Results comparing standardized distances showed that judges set tougher standards for the core items than for the noncore items and that the differences between performance data and standards varied for core and noncore items and for item types. It was concluded that content and judgment remain important features of the standard‐setting process, and judges are not simply adding or subtracting a constant to the performance data they are given.

Performance on the NBME Part I Examination-Reply

In Reply. —The statement referenced by Dr Nickens follows our description of various programs under way at some medical schools to assist students with relatively poor academic backgrounds and our subsequent suggestion that research investigating the effectiveness of these programs is needed. Some programs focus on helping students improve skills so they become more successful candidates for medical school. For instance, over the past 20 years, more than 600 students have participated in the Medical/Dental Education Preparatory Program at Southern Illinois University School of Medicine, and 60% of them have been admitted to health professions schools. Other programs, such as the one at the University of Hawaii John A. Burns School of Medicine, work with students to improve study skills after they have matriculated. We recognize thatProject 3000 by 20001aims to increase the number of minority students actually enrolled in medical schools and did not intend to