Jean-Guy Blais

Clinical reasoning difficulties: A taxonomy for clinical teachers

Background: Clinical reasoning is the cornerstone of medical practice. To date, there is no established framework regarding clinical reasoning difficulties, how to identify them, and how to remediate them. Aim: To identify the most common clinical reasoning difficulties as they present in residents’ patient encounters, case summaries, or medical notes. To develop a guide to support medical educators’ process of educational diagnosis and management in this area. Methods: We used a participatory action research method. We carried out eight iterative reflective cycles with a group of clinical teachers. The repeated phases of experimentation and observation were conducted by participants in their own clinical teaching setting. Our findings were tested and validated on both an individual and collective basis Results: We found five categories of clinical reasoning difficulties as they present in the clinical teaching settings. We identified indicators for each. Indicators may be different depending on the type of supervision. These findings were assembled and organized to construct a guide for clinical teachers. Conclusions: The guide should assist clinical teachers in detecting clinical reasoning difficulties during clinical teaching and in providing remediation that is tailored to the specific difficulty identified. Its development furthers our understanding of clinical reasoning difficulties and provides a useful tool.

An international online survey of the practices and perceptions of higher education professors with respect to the assessment of learning in the classroom

In a context where public action must demonstrate its effectiveness and efficiency, and where the links between teaching and the quality of learning are regularly highlighted, it seems relevant to identify the trends and logic that govern university professors’ decisions with respect to the modes of learning assessment favoured within the framework of their delivery of teaching services. Moreover, given that university teaching practices are changing rapidly due to the introduction of different views of the learning process, one might conclude that the same holds for assessment practices. Through our research work, we led to the development of a trilingual (English, French and Spanish) online survey devoted to an international investigation into the classroom assessment practices of higher education teachers. This survey proposes an online platform that will allow institutions of higher learning to document some of their current practices and to compare observed trends with what is happening elsewhere, in accordance with differing missions and traditions. These research notes are thus intended to describe the survey itself and to show how the questionnaire and individual items were structured, in addition to providing an overview of treatments within and between institutions that followed the testing.

Teaching Multiethnic Urban Adolescents How to Enhance Their Competencies: Effects of a Middle School Primary Prevention Program on Adaptation

This study evaluated a program that promoted adaptation of students in their first year of secondary school. Participants included 896 multiethnic urban students mostly from socioeconomically disadvantaged families. The program focused on developing healthy self-perceptions, and cognitive, affective and behavioral skills. Multiple regression analyses revealed the predicted positive effects of the program on psychological and social outcomes. However, there was also an unexpected negative outcome for a subgroup of students (11%) made vulnerable by stressful family experiences. These findings broaden our understanding of the effects of such programs and underline the need to address the specific coping competencies of students more at-risk.

SIMCAT 1.0 : A SAS computer program for simulating computer adaptive testing

Monte Carlo methodologies are frequently applied to study the sampling distribution of the estimated proficiency level in adaptive testing. These methods eliminate real situational constraints. However, these Monte Carlo methodologies are not currently supported by the available software programs, and when these programs are available, their flexibility is limited. Here, a commented computer program coded in SAS 6.08—and ulterior versions—language is proposed. SIMCAT 1.0 is aimed at the simulation of adaptive testing sessions under different adaptive expected a posteriori (EAP) proficiency-level estimation methods (Blais & Raı̂che, 2005; Raı̂che & Blais, 2005) based on the one-parameter Rasch logistic model. These methods are all adaptive in the a priori proficiency-level estimation, the proficiency-level estimation bias correction, the integration interval, or a combination of these factors. The use of these adaptive EAP estimation methods diminishes considerably the shrinking, and therefore biasing, effect of the estimated a priori proficiency level encountered when this a priori is fixed at a constant value independently of the computed previous value of the proficiency level. SIMCAT 1.0 also computes empirical and estimated skewness and kurtosis coefficients, such as the standard error, of the estimated proficiency-level sampling distribution. In this way, the program allows one to compare empirical and estimated properties of the estimated proficiency-level sampling distribution under different variations of the EAP estimation method: standard error and bias, like the skewness and kurtosis coefficients.