R.J.I. Hoogenboom

Effectiveness of clinical rotations as a learning environment for achieving competences

Competences are becoming more and more prominent in undergraduate medical education. Workplace learning is regarded as crucial in competence learning. Assuming that effective learning depends on adequate supervision, feedback and assessment, the authors studied the occurrence of these three variables in relation to a set of clinical competences. They surveyed students at the end of their rotation in surgery, internal medicine or paediatrics asking them to indicate for each competence how often they had received observed and unobserved supervision, the seniority of the person who provided most of their feedback, and whether the competence was addressed in formal assessments. Supervision was found to be scarce and mostly unobserved. Senior staff did not provide much feedback, and assessment mostly targeted patient-related competences. For all variables, the variation between students exceeded that between disciplines. We conclude that conditions for adequate workplace learning are poorly met and that clerkship experiences show huge inter-student variation.

Effectiveness of basic clinical skills training programmes: a cross-sectional comparison of four medical schools

Training in physical diagnostic skills is an important part of undergraduate medical education. The objective of this study was to study the outcome of skills training at four medical schools.

The effect on reliability of adding a separate written assessment component to an objective structured clinical examination.

To determine the effect on test reliability when a separate written assessment component is added to an objective structured clinical examination (OSCE).

Relative or Absolute Standards in Assessing Medical Knowledge Using Progress Tests

Norm-referenced pass/fail decisions are quite common in achievement testing in health sciences education. The use of relative standards has the advantage of correcting for variations in test-difficulty. However, relative standards also show some serious drawbacks, and the use of an absolute and fixed standard is regularly preferred. The current study investigates the consequences of the use of an absolute instead of a relative standard. The performance of the developed standard setting procedure was investigated by using actual progress test scores obtained at the Maastricht medical school in an episode of eight years. When the absolute instead of the relative standard was used 6% of the decisions changed: 2.6% of the outcomes changed from fail to pass, and 3.4% from pass to fail. The failure rate, which was approximately constant when using the relative standard, varied from 2% to 47% for different tests when an absolute standard was used. It is concluded that an absolute standard is precarious because of the variations in difficulty of tests.

Correlation of a written test of skills and a performance based test: a study in two traditional medical schools

Studies in innovative curricula have shown that a written test of skills is potentially able to predict OSCE scores. In this study we verified the potential of a written test of skills as an alternative to an OSCE in two traditional medical schools. A 12 station OSCE was scored using detailed checklists and global rating scales. The written test of skills consisted of 132 true-false questions. Students were assessed immediately before graduation in 1997. The size of the reported correlations confirms that the written test of skills can be used to predict performance-based test scores in traditional medical schools to some extent. For research purposes, particularly for outcome research to compare curricula of medical schools, a written test of skills is a viable alternative to performance-based testing. A written test of skills is unable to replace the OSCE for assessment of individual students.

Is Tutor Performance Dependent on the Tutorial Group's Productivity?: Toward Further Resolving of Inconsistencies in Tutor Performance

Background: Many studies have been conducted on tutor performance in problem-based curricula. In the past, the implicit assumption behind these studies was that tutor performance is a relatively stable characteristic. More recent studies demonstrate that a tutors performance may be dependent on other circumstances, such as the level of structure in the curricular materials. The aim of this study was to investigate whether a tutors performance is also dependent on the tutorial groups productivity. Purpose: The idea is that low-productive tutorial groups require much more input from a tutor than high-productive groups. In the problem-based curriculum under investigation, most tutors guide 2 tutorial groups within the same unit. A salient finding in this problem-based curriculum was that some tutors who guide 2 tutorial groups within the same unit have discrepancies in their tutor performance across the 2 groups. This finding might be explained by differences in both tutorial groups. In this study, first ...

The versatility of progress testing assessed in an international context: a start for benchmarking global standardization?

Sharing and collaboration relating to progress testing already takes place on a national level and allows for quality control and comparisons of the participating institutions. This study explores the possibilities of international sharing of the progress test after correction for cultural bias and translation problems. Three progress tests were reviewed and administered to 3043 Pretoria and 3001 Maastricht medical students. In total, 16% of the items were potentially biased and removed from the test items administered to the Pretoria students (9% due to translation problems; 7% due to cultural differences). Of the three clusters (basic, clinical and social sciences) the social sciences contained most bias (32%), basic sciences least (11%). The differences that were found, comparing the student results of both schools, seem a reflection of the deliberate accentuations that both curricula pursue. The results suggest that the progress test methodology provides a versatile instrument that can be used to assess medical schools across the world. Sharing of test material is a viable strategy and test outcomes are interesting and can be used in international quality control.

Effects of an in-training assessment programme on supervision of and feedback on competencies in an undergraduate Internal Medicine clerkship

Assessment drives the educational behaviour of students and supervisors. Therefore, an assessment programme targeted at specific competencies may be expected to motivate supervisors and students to pay more attention to those competencies. In-training assessment (ITA) is regarded as a feasible method for assessing a broad range of competencies. Before and after the implementation of an ITA programme in an undergraduate Internal Medicine clerkship we surveyed students on the frequency of unobserved and observed supervision, and the quality of feedback as inferred from the seniority of the person providing it. After the implementation of the ITA programme supervision increased, but the difference was not statistically significant. The quality of feedback showed no significant change either. Inter-student variation in supervision and feedback remained invariably high after the implementation of the ITA programme. Whether these results are attributable to the way the programme was implemented or to the way the results were assessed remains to be clarified.

Feasibility and reliability of an in‐training assessment programme in an undergraduate clerkship

Introduction  Structured assessment, embedded in a training programme, with systematic observation, feedback and appropriate documentation may improve the reliability of clinical assessment. This type of assessment format is referred to as in‐training assessment (ITA). The feasibility and reliability of an ITA programme in an internal medicine clerkship were evaluated. The programme comprised 4 ward‐based test formats and 1 outpatient clinic‐based test format. Of the 4 ward‐based test formats, 3 were single‐sample tests, consisting of 1 student−patient encounter, 1 critical appraisal session and 1 case presentation. The other ward‐based test and the outpatient‐based test were multiple sample tests, consisting of 12 ward‐based case write‐ups and 4 long cases in the outpatient clinic. In all the ITA programme consisted of 19 assessments.

Correlates of emotional intelligence: Results from a multi-institutional study among undergraduate medical students

Abstract Background: Emotional Intelligence (EI) is the ability to deal with your own and others emotions. Medical students are inducted into medical schools on the basis of their academic achievement. Professionally, however, their success rate is variable and may depend on their interpersonal relationships. EI is thought to be significant in achieving good interpersonal relationships and success in life and career. Therefore, it is important to measure EI and understand its correlates in an undergraduate medical student population. Aim: The objective of study was to investigate the relationship between the EI of medical students and their academic achievement (based on cumulative grade point average [CGPA]), age, gender and year of study. Methods: A cross-sectional survey design was used. The SSREIS and demographic survey were administered in the three medical schools in Saudi Arabia from April to May 2012. Results: The response rate was 30%. For the Optimism subscale, the mean score was M = 3.79, SD ± 0.54 (α = 0.82), for Awareness-of-emotion subscale M = 3.94, SD ± 0.57 (α = 0.72) and for Use-of-emotion subscale M = 3.92, SD ± 0.54 (α = 0.63). Multiple regression showed a significant positive correlation between CGPA and the EI of medical students (r = 0.246, p = 0.000) on the Optimism subscale. No correlation was seen between CGPA and Awareness of Emotions and Use of Emotions subscales. No relationship was seen for the other independent variables. Conclusion: The current study demonstrates that CGPA is the only significant predictor, indicating that Optimism tends to be higher for students with a higher CPGA. None of the other independent variables (age, year of study, gender) showed a significant relationship.