Ming Lee

Development and Validation of a Geriatrics Attitudes Scale for Primary Care Residents

OBJECTIVE: To develop and validate an instrument measuring attitudes toward older persons and caring for older patients.

Interrelations of empathy, cognition, and moral reasoning with dimensions of juvenile delinquency

The interrelations of a variety of indices of sociocognitive development (empathy, role-taking, logical cognition, and moral reasoning) were studied in delinquent and nondelinquent adolescents. Delinquent males (grouped into psychopathic, neurotic, and subcultural subgroups) and a matched nondelinquent comparison group were administered individually two empathy scales (the Davis Interpersonal Reactivity Index and the Mehrabian and Epstein Questionnaire Measure of Emotional Empathy), an adaptation of Byrnes and Flavells role-taking tasks, two Piagetian cognitive tasks, and two of Kohlbergs structured moral dilemmas. Delinquents as a group displayed significantly more immature modes of role-taking, logical cognition, and moral reasoning than did nondelinquents. The delinquent subgroups, however, did not significantly differ from one another on these dimensions. Role-taking, logical cognition, and moral reasoning were significantly related to one another. Anticipated differences in level of empathy between the delinquent and nondelinquent adolescents failed to occur. A number of interpretations for this unexpected finding are offered.

Multidimensional Attitudes of Medical Residents and Geriatrics Fellows Toward Older People

Objectives: To examine dimensions of a validated instrument measuring geriatric attitudes of primary care residents and performances on these dimensions between residents and fellows.

Assessing physical examination skills of senior medical students: knowing how versus knowing when.

Purpose. Literature has documented a lack of physical examination proficiency among medical students. To investigate UCLA medical students’ physical examination proficiency, this study compared their performance on a multiple-station Clinical Performance Examination (CPX) focused on clinical cases with that on a thorough physical examination objective structured clinical examination (OSCE) of the same organ systems. Method. One hundred sixty-three beginning fourth-year students participated in the study. Four organ systems were included in both the CPX and OSCE. Pearson’s correlation coefficients and paired-sample t-tests were conducted to determine the correlations between and differences in the two tests. Results. The physical examination scores on the CPX were significantly (p < .001) lower both by organ subscale and in total than those on the OSCE. Correlation coefficients between the two tests were negligible. Conclusions. The study suggests that fourth-year medical students may demonstrate competency in directed examination of organ systems while being unable to correctly apply those examination skills to the work-up of clinical cases.

Development and Validation of a Geriatrics Knowledge Test for Primary Care Residents

This study reports the development and preliminary validation of an instrument to measure geriatrics knowledge of primary care residents. A 23-item test was developed using questions selected from the American Geriatrics Societys Geriatrics Review Syllabus. Ninety-six internal medicine and family practice residents, 14 geriatrics fellows, and 11 geriatrics faculty members participated in the study. Findings support the reliability (Cronbachs α=0.66) and validity (content and “known groups”) of this short test. Predictive validity and sensitivity of the test to changes in knowledge will have to be further explored as residents progress through their training.

Development and Validation of a Geriatric Knowledge Test for Medical Students

Objectives: To assesses the reliability and validity of a geriatrics knowledge test designed for medical students.

Evaluating curricular effects on medical students' knowledge and self-perceived skills in cancer prevention.

Since the Report of the Project Panel on the General Professional Education of the Physician in 1980, there have been numerous recommendations for increasing attention to health promotion and disease prevention content in the medical student curriculum. The need for cancer prevention curriculum in particular was highlighted in the early 1990s, when a national survey by the American Association for Cancer Education indicated that 64% of the 1,038 faculty respondents felt that cancer prevention was underemphasized in their institutions’ medical student curricula. To put this in perspective, only 32% felt that cancer treatment was similarly underemphasized. Stimulated by a large percentage of UCLA graduating seniors indicating ‘‘inadequate’’ instruction in general prevention and screening on the 1996 AAMC Graduation Questionnaire and supported by a National Cancer Institute grant (R25 CA73914), we convened a panel of cancer control and prevention experts from four local institutions in 1997–98 to develop a set of instructional objectives to guide curricular revision in this area, ^http://www.medsch.ucla.edu/CaPrevent/competencies.pdf &. Using these objectives, a UCLA curriculum task force on cancer prevention worked with course directors to develop or revise instructional materials to emphasize cancer prevention, screening, and counseling. By January 2000, an enhanced cancer prevention curriculum had emerged to supplement existing instruction in cancer diagnosis and treatment and strategies for smoking cessation. In year one, we added two problem-based learning (PBL) cases and two standardized patient (SP) exercises, which focused on identifying risk factors and counseling for lifestyle change (for a total of 14 hours). In year two, we implemented a new SP case on breast cancer screening accompanied by a lecture on women’s cancer risks, and three hours of lecture on carcinogenesis (for a total of seven hours). In year three, we added computer-based simulations on skin cancer, a video and model for the prostate exam, and a SP case involving family counseling on breast cancer risk (for a total of seven hours). The present study was designed to evaluate the effects of this enhanced curriculum in cancer prevention on medical students’ knowledge and self-perceived competency in the use of counseling and screening examinations during each of the first three years of medical school. We also evaluated how three instructional strategies used—direct instruction, hands-on practice, and observation —contributed to these outcomes. Few studies exist in the literature evaluating this type of large-scale, multi-year curriculum project in cancer education.

Clinical competence understood through the construct validity of three clerkship assessments.

Medical Education 2011: 45: 849–857

Building Academic Geriatric Capacity: An Evaluation of the John A. Hartford Foundation Centers of Excellence Initiative

Almost 15 years ago, the John A. Hartford Foundation began its Centers of Excellence (CoE) program. In summer 2002, a quantitative and qualitative evaluation of the CoE program was conducted. The evaluation used previously collected quantitative data from surveys of program directors and graduates of fellowship programs, as well as interviews and surveys of currently funded CoEs.

Comparative values of medical school assessments in the prediction of internship performance

Abstract Background: Multiple undergraduate achievements have been used for graduate admission consideration. Their relative values in the prediction of residency performance are not clear. This study compared the contributions of major undergraduate assessments to the prediction of internship performance. Methods: Internship performance ratings of the graduates of a medical school were collected from 2012 to 2015. Hierarchical multiple regression analyses were used to examine the predictive values of undergraduate measures assessing basic and clinical sciences knowledge and clinical performances, after controlling for differences in the Medical College Admission Test (MCAT). Results: Four hundred eighty (75%) graduates’ archived data were used in the study. Analyses revealed that clinical competencies, assessed by the USMLE Step 2 CK, NBME medicine exam, and an eight-station objective structured clinical examination (OSCE), were strong predictors of internship performance. Neither the USMLE Step 1 nor the inpatient internal medicine clerkship evaluation predicted internship performance. The undergraduate assessments as a whole showed a significant collective relationship with internship performance (ΔR2 = 0.12, p < 0.001). Conclusions: The study supports the use of clinical competency assessments, instead of pre-clinical measures, in graduate admission consideration. It also provides validity evidence for OSCE scores in the prediction of workplace performance.