Jean-Francois Lemay

''A Chance To Show Yourself'' - how do applicants approach medical school admission essays?

Background: Although essay questions are used in the admissions process in many medical schools, there has been little research on how applicants respond to essay questions. Aims: The purpose of this study was to explore how applicants to medical school approach essay questions used in the selection process. Methods: Qualitative analysis was conducted on 240 randomly selected essays written by individuals applying to a single Canadian medical school in 2007 using a modified grounded theory approach to develop a conceptual framework which was checked in interviews with applicants. Results: Three core variables were identified: “balancing service and reward,” “anticipating the physician role,” and “readiness.” We described the overall approach of applicants as “taking stock,” writing about their journeys to the selection process, their experiences of the process itself, and about their anticipated future in medicine. Conclusion: Our findings suggest a disconnect between the approach of the applicants (to “show themselves” and be selected as individuals) and the stated intent of the process (to select applicants based on “objective” criteria). Our findings raise important questions about how applicants represent themselves when applying for medical school and suggest that it is important to understand the applicants point of view when developing questions for selection processes.

Evolutions in clinical reasoning assessment: The Evolving Script Concordance Test

Abstract Introduction: Script concordance testing (SCT) is a method of assessment of clinical reasoning. We developed a new type of SCT case design, the evolving SCT (E-SCT), whereby the patient’s clinical story is “evolving” and with thoughtful integration of new information at each stage, decisions related to clinical decision-making become increasingly clear. Objectives: We aimed to: (1) determine whether an E-SCT could differentiate clinical reasoning ability among junior residents (JR), senior residents (SR), and pediatricians, (2) evaluate the reliability of an E-SCT, and (3) obtain qualitative feedback from participants to help inform the potential acceptability of the E-SCT. Methods: A 12-case E-SCT, embedded within a 24-case pediatric SCT (PaedSCT), was administered to 91 pediatric residents (JR: n = 50; SR: n = 41). A total of 21 pediatricians served on the panel of experts (POE). A one-way analysis of variance (ANOVA) was conducted across the levels of experience. Participants’ feedback on the E-SCT was obtained with a post-test survey and analyzed using two methods: percentage preference and thematic analysis. Results: Statistical differences existed across levels of training: F = 19.31 (df = 2); p < 0.001. The POE scored higher than SR (mean difference = 10.34; p < 0.001) and JR (mean difference = 16.00; p < 0.001). SR scored higher than JR (mean difference = 5.66; p < 0.001). Reliability (Cronbach’s α) was 0.83. Participants found the E-SCT engaging, easy to follow and true to the daily clinical decision-making process. Conclusions: The E-SCT demonstrated very good reliability and was effective in distinguishing clinical reasoning ability across three levels of experience. Participants found the E-SCT engaging and representative of real-life clinical reasoning and decision-making processes. We suggest that further refinement and utilization of the evolving style case will enhance SCT as a robust, engaging, and relevant method for the assessment of clinical reasoning.

Contribution of SWEET to improve paediatric diabetes care in developing countries.

Diabetes affects many children living in developing countries. Through an informal survey, five SWEET (Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers from developing countries (Mali, Costa Rica, Argentina and two from India) share their perspective on caring for children with diabetes. Each center provides a description of the population of children with diabetes they serve, the organization of care, and the challenges encountered on a daily basis in the provision of this care. In the second part, we summarize the anticipated benefits and challenges associated with participation in SWEET. This resulting article is a testimony of the reality of managing diabetes by dynamic teams striving to achieve recommended standards of care for pediatric diabetes in an environment with limited resources.

Metabolic control of type 1 diabetes in youth with autism spectrum disorder: A multicenter Diabetes-Patienten-Verlaufsdokumentation analysis based on 61 749 patients up to 20 years of age

A paucity of reports in the literature exists concerning the co‐existence between autism spectrum disorder (ASD) and type 1 diabetes (T1D).