Mary S. Oh

Does medical school performance predict radiology resident performance

RATIONALE AND OBJECTIVES The authors performed this study to examine the relationship, if any, of a large number of measures of medical school performance with radiology residency performance. MATERIALS AND METHODS Applications of 77 radiology residents enrolled from 1991 to 2000 were reviewed. Medical school grades, deans letter summary statements, letters of recommendation, selection to Alpha Omega Alpha (AOA), and National Board of Medical Examiners (NBME) and U.S. Medical Licensing Examination (USMLE) Step 1 scores were recorded. Student t tests, analysis of variance, and correlation coefficients were used to examine the relationship between these measures of medical school performance and subsequent performance during radiology residency as determined by rotation evaluations, retrospective faculty recall scores, and American College of Radiology (ACR) and American Board of Radiology (ABR) examination scores. Resident performance was also correlated with prestige of the medical school attended. RESULTS Preclinical grades of Honors or A; clinical grades of Honors or A in medicine, surgery, and pediatrics; and high NBME/USMLE scores strongly predicted success on the ABR written clinical examination but did not predict rotation performance. Most other measures of medical school performance, including outstanding Deans letters and letters of recommendation, AOA selection during the senior year, and high medical school prestige did not predict high examination scores or superior rotation performance during residency. CONCLUSION Success on the ABR examination can be predicted by medical school success in preclinical courses, some clinical courses, and USMLE examination scores. Deans letters, letters of recommendation, AOA selection during the senior year, and medical school prestige do not appear to predict future resident performance as reliably.

Perceived Effectiveness, Cost, and Availability of Patient Education Methods and Materials

To determine the efficacy of and need for patient education methods and media, a needs assessment was sent to 816 members of the American Association of Diabetes Educators. Respondents (n=325, 40%) included 62% RNs, 36% RDs, 1% other; 62% CDEs. Their mean number of years experience in diabetes education was 8.5, and 99% routinely provided patient education. Respondents indicated that videotapes and slide tapes were the most educationally effective media and books and audiotapes were the least effective. Booklets and videotapes were the most cost-effective and computer-assisted instruction the least effective. While respondents perceived one-to-one counseling, skills training, and diabetes content sessions to be the three most educationally effective methods, support groups and large and small discussion groups were seen as the three most cost-effective educational methods. Among nine potential barriers to quality patient education listed, educators rated lack of third-party reimbursement as a major barrier most frequently and national availability of quality education materials as a barrier least frequently.

A comparison of the diabetes-related attitudes of health care professionals and patients

The following study compares the diabetes-related attitudes of sampled health care professionals and patients with diabetes. Attitudes were measured with a revised version of the Diabetes Attitude Scale (DAS) which includes seven factors representing attitudes towards: (1) the need for special training in order to provide diabetes care; (2) patient compliance; (3) the seriousness of noninsulin-dependent diabetes (NIDDM); (4) the relationship between blood glucose levels and the complications of diabetes; (5) the impact of diabetes on the patients life; (6) patient autonomy; and (7) team care. The highest levels of agreement among patients and professionals concerned the seriousness of NIDDM and the relationship between blood glucose control and the development of the complications of diabetes. The most striking finding of the study was that patients tended to express a significantly more judgmental, moralistic attitude toward patient behavior than did health care professionals.

How well does applicant rank order predict subsequent performance during radiology residency

RATIONALE AND OBJECTIVES Residency selection committees expend substantial time and resources on assessing the quality of residency applicants to derive an appropriate rank order for the National Residency Matching Program. The authors determined whether there is a relationship between the rank number or rank percentile of applicants selected for a residency training program and subsequent radiology residency performance. MATERIALS AND METHODS Records of radiology residents completing their residency between 1991 and 1998 were reviewed. Available rank numbers and rank percentiles for each resident were compared with subsequent performance, as assessed subjectively by 4th-year radiology rotation evaluation forms and retrospective recall of four senior faculty members and objectively by numerical and percentile scores on the written portion of the American Board of Radiology (ABR) examinations. Correlation coefficients were obtained for each comparison. RESULTS Rank number and rank percentile were not significantly correlated with 4th-year resident rotation evaluations or ABR written examination scores or percentiles. A small correlation existed between rank order and retrospective evaluation of resident performance by the four senior faculty. CONCLUSION Applicant rank number and rank percentile do not correlate with subsequent radiology residency performance as assessed on rotation evaluation forms or the ABR written examinations.

The Physical Examination of Patients With Abdominal Pain: The Long-Term Effect Of Adding Standardized Patients and Small-Group Feedback to a Lecture Presentation

Background: One of the most effective methods for teaching physical diagnosis may be standardized patient instructors. Purpose: To determine if a lecture plus standardized patient instructors with small-group sessions is more effective than a lecture alone for teaching the evaluation of patients with abdominal pain. Methods: Control (class of 2001) and intervention (class of 2002) groups both attended a lecture on the abdominal examination. The intervention group then underwent an exercise with standardized patient instructors and a review session with surgical faculty. An evaluation 18 months later used standardized patient instructors to complete evaluations assessing history-taking and physical examination skills. Results: The intervention group performed significantly better than the control group on both the history and the physical examination subscales. Conclusion: It is possible to have an important, measurable, and lasting effect on physical examination skills by adding standardized patient instructors and small-group discussion to a lecture presentation.

Patient-provider perceptions of diabetes and its impact on self-management: a comparison of African-American and White patients

Aims  To compare patient–provider differences in diabetes‐related perceptions between African‐American and White patients and to examine its association with self‐care behaviours.

Decreasing rate of fatty involution at screening mammography

RATIONALE AND OBJECTIVES This study was performed to document the perceived decrease in fatty involution at screening mammography during the past decade and evaluate the influence of hormone replacement therapy (HRT). MATERIALS AND METHODS In December 1996, the mammograms of 261 consecutive screening patients with a comparison study obtained 5 years earlier were evaluated, and their breasts were categorized according to Breast Imaging Reporting and Data System categories for breast density. The women, aged 50-59 years, included 119 who had been receiving HRT for 0.25-15 years (mean, 3 years). From the files, 261 age-matched screening mammograms from 1986 were obtained; these patients also had comparison mammograms from 1981. Analysis of variance was used to determine differences between the 1980s group, the 1990s group receiving HRT, and the 1990s group not receiving HRT. Scheffé tests were used for post hoc comparisons. Stepwise regression analysis was used to evaluate the relative influence of age, decade, score of the first mammogram, and HRT. RESULTS Breast density for the 1991 mammograms did not differ significantly from that in 1981 (P < .05). Initial breast density was the best predictor of final breast density in both decades (P < .001), regardless of HRT status. The change in breast density (toward fatty) over the 5-year interval in the 1980s (mean, 0.48) was significantly greater than that in both 1990s groups (mean for HRT group, 0.11; no HRT, 0.30; P < .05). CONCLUSION These results confirm that breast density at screening mammography in the 1990s did not decrease with age at the same rate as in the 1980s, even in patients not receiving HRT.

Effect of curricular change on student perceptions of the learning environment

Background: The University of Michigan Medical School implemented a new 1st‐year curriculum designed in part to redress environmental stressors identified in the previous curriculum. A centralized action‐oriented evaluation program also was implemented to ensure the achievement of curricular goals. Description: We describe the initial effects of planned curricular reform on students’ perceptions of the learning environment. Evaluation: Survey data on students’ satisfaction with the learning environment were collected at years end before and after implementation of the new 1st‐year program. The attitudes of women and African American students were examined because of their known disproportionate dissatisfaction. Conclusions: Effect size analysis indicated a real and practical improvement in all students’ ratings of the new learning environment overall. Research on the long‐term environmental effects of curricular reform is ongoing. We anticipate that interactions among faculty, students, and administrator...

The importance of race in medical student performance of an AIDS risk assessment interview with simulated patients

This study was done to ascertain the effect of race on medical student–patient communication. The primary hypothesis was that interviewing performance scores would be higher when race of student and race of simulated patient instructor (SPI) were concordant than when they were discordant.

Does a 2.5-year self-management education and support intervention change patterns of healthcare use in African-American adults with Type 2 diabetes?

To investigate the impact of a 2.5‐year diabetes self‐management education and support intervention on healthcare use and to examine factors associated with patterns of healthcare use.