Brian J. Hess

Practice‐Based Learning Can Improve Osteoporosis Care

To examine physician engagement in practice‐based learning using a self‐evaluation module to assess and improve their care of individuals with or at risk of osteoporosis.

Dyadic validity of the Decisional Conflict Scale: common patient/physician measures of patient uncertainty were identified

OBJECTIVES We aimed to assess the dyadic validity of the Decisional Conflict Scale (DCS) for assessing shared decision making in clinical consultations. We applied dyadic criteria, which consider the patient and physician as an interactive dyad instead of as independent individuals, to identify common patient/physician measures of patient uncertainty. STUDY DESIGN AND SETTING Patients and their physicians, participating in a randomized clustered trial, completed separately an adapted version of the DCS with five subscales. We performed factor analysis on the full DCS and each subscale independently. We defined a measure as dyadic when measurement invariance across patients and physicians was supported. RESULTS We analyzed 332 paired responses (physicians with adults or with parents and children) at study entry and 339 at exit. Factor analysis showed that the full DCS is not a valid dyadic measure. However, independent analysis of each subscale showed measurement invariance for values clarity, support, and effective decision (comparative fit index range, 0.93-1; root mean square error of approximation range, 0-0.07; and P-value > 0.05). CONCLUSION Application of our dyadic validation criterion indicated that the full DCS cannot be considered a dyadic measure. However, three of its subscales, values clarity, support and effective decision, are valid dyadic measures.

Performance on the adult rheumatology in-training examination and relationship to outcomes on the rheumatology certification examination.

The American College of Rheumatology (ACR) Adult Rheumatology In‐Training Examination (ITE) is a feedback tool designed to identify strengths and weaknesses in the content knowledge of individual fellows‐in‐training and the training program curricula. We determined whether scores on the ACR ITE, as well as scores on other major standardized medical examinations and competency‐based ratings, could be used to predict performance on the American Board of Internal Medicine (ABIM) Rheumatology Certification Examination.

Relationship between performance on the Rheumatology in‐training and certification examinations

The American College of Rheumatology (ACR) Adult Rheumatology In‐Training Examination (ITE) is a feedback tool designed to identify strengths and weaknesses in the content knowledge of individual fellows‐in‐training and the training program curricula. We determined whether scores on the ACR ITE, as well as scores on other major standardized medical examinations and competency‐based ratings, could be used to predict performance on the American Board of Internal Medicine (ABIM) Rheumatology Certification Examination.