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1.
Acad Med ; 96(7): 992-996, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-33830952

RESUMEN

PROBLEM: There is an unmet need for economically feasible, valid, reliable, and contextually relevant assessments of interprofessional collaborative knowledge and skills, particularly at the early stages of health professions education. This study sought to develop and gather content and internal structure validity for an Interprofessional Situational Judgement Test (IPSJT), a tool for the measurement of students' interprofessional collaborative intentions during the early stages of their professional development. APPROACH: After engaging in an item development and refinement process (January-June 2018), an 18-question IPSJT was administered to 953 first-year students enrolled in 10 health professions degree programs at the University of Florida Health Science Center in October 2018. The IPSJT's performance was evaluated using item-level analyses, item difficulty, test-retest reliability, and exploratory factor analysis. OUTCOMES: Seven hundred thirty-seven (77.3%) students consented to the use of their data. Student IPSJT scores ranged from 0 to 69, averaging 42.68 (standard deviation = 12.28), with some statistically significant differences in student performance by health professions degree program. IPSJT item difficulties ranged from 0.13 to 0.92. Once one item with poor properties was excluded from analysis, the IPSJT demonstrated an overall reliability of 0.62. Students were more successful at identifying the least effective than the most effective responses. Test-retest reliability provided evidence of consistency (r = 0.50, P < .001) and similar item difficulty across administrations. An exploratory factor analysis indicated a 3-factor model with multiple cross-factor loadings. NEXT STEPS: This work represents the first step toward the development of a valid, reliable IPSJT for early learners. The emergent 3-factor model provides evidence that multiple competencies can be assessed in early learners via this tool. Additional research is necessary to build a more robust question bank, explore different scoring and response methods, and gather additional sources of validity evidence, including relations to other variables.


Asunto(s)
Competencia Clínica/estadística & datos numéricos , Empleos en Salud/educación , Relaciones Interprofesionales/ética , Juicio/fisiología , Centros Médicos Académicos/organización & administración , Conducta Cooperativa , Análisis Factorial , Florida , Humanos , Conocimiento , Aprendizaje/fisiología , Evaluación de Resultado en la Atención de Salud , Reproducibilidad de los Resultados , Proyectos de Investigación/estadística & datos numéricos , Estudiantes de Medicina/psicología , Encuestas y Cuestionarios
2.
J Consult Clin Psychol ; 84(8): 682-698, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27018531

RESUMEN

OBJECTIVE: Although efficacious interventions exist for childhood conduct problems, a majority of families in need of services do not receive them. To address problems of treatment access and adherence, innovative adaptations of current interventions are needed. This randomized control trial investigated the relative efficacy of a novel format of parent-child interaction therapy (PCIT), a treatment for young children with conduct problems. METHOD: Eighty-one families with 3- to 6-year-old children (71.6% boys, 85.2% White) with diagnoses of oppositional defiant or conduct disorder were randomized to individual PCIT (n = 42) or the novel format, Group PCIT. Parents completed standardized measures of children's conduct problems, parenting stress, and social support at intake, posttreatment, and 6-month follow-up. Therapist ratings, parent attendance, and homework completion provided measures of treatment adherence. Throughout treatment, parenting skills were assessed using the Dyadic Parent-Child Interaction Coding System. RESULTS: Parents in both group and individual PCIT reported significant improvements from intake to posttreatment and follow-up in their children's conduct problems and adaptive functioning, as well as significant decreases in parenting stress. Parents in both treatment conditions also showed significant improvements in their parenting skills. There were no interactions between time and treatment format. Contrary to expectation, parents in Group PCIT did not experience greater social support or treatment adherence. CONCLUSIONS: Group PCIT was not inferior to individual PCIT and may be a valuable format to reach more families in need of services. Future work should explore the efficiency and sustainability of Group PCIT in community settings. (PsycINFO Database Record


Asunto(s)
Conducta Infantil/psicología , Trastorno de la Conducta/terapia , Relaciones Padres-Hijo , Psicoterapia de Grupo/métodos , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino
3.
J Emerg Trauma Shock ; 5(1): 23-7, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22416150

RESUMEN

INTRODUCTION: Poor teamwork leads to preventable medical errors, and thus negatively impacts medical care. One way to improve teamwork is training. A multimodality team training program was designed to impact the attitudes and behavior of first-year residents who will encounter medical situations in the trauma room. The training program included low-fidelity role plays, lectures, and high-fidelity simulation with feedback. MATERIALS AND METHODS: The training program was a one-day workshop that was conducted twice, once for each of the two groups over two days at the beginning of the academic year in July. A total of 41 first-year interns (10 Emergency Medicine and 31 Surgery) were recruited for participation. Participants completed a Situational judgment test (SJT) on trauma teamwork before training. The training began with a low-fidelity simulation that served as an icebreaker to team concepts. Subsequently, a lecture with discussion provided key points regarding teamwork in the trauma room. A high-fidelity simulation then allowed participation in one of four trauma room scenarios with medical expert debriefing. The course concluded with a course summary and an assessment of participant attitudes regarding training along with a second administration of SJT. RESULTS: Participant reactions to the training were positive overall. Results of SJT showed a positive effect for team training in three of the four possible comparisons. CONCLUSION: The program was well received by the residents. Results suggest that a comprehensive training approach using role play, lecture, and simulation can positively affect behavioral choices for teamwork in the trauma room.

4.
Med Educ ; 45(12): 1181-9, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-21988659

RESUMEN

CONTEXT: The objective structured clinical examination (OSCE) is comprised of a series of simulations used to assess the skill of medical practitioners in the diagnosis and treatment of patients. It is often used in high-stakes examinations and therefore it is important to assess its reliability and validity. METHODS: The published literature was searched (PsycINFO, PubMed) for OSCE reliability estimates (coefficient alpha and generalisability coefficients) computed either across stations or across items within stations. Coders independently recorded information about each study. A meta-analysis of the available literature was computed and sources of systematic variance in estimates were examined. RESULTS: A total of 188 alpha values from 39 studies were coded. The overall (summary) alpha across stations was 0.66 (95% confidence interval [CI] 0.62-0.70); the overall alpha within stations across items was 0.78 (95% CI 0.73-0.82). Better than average reliability was associated with a greater number of stations and a higher number of examiners per station. Interpersonal skills were evaluated less reliably across stations and more reliably within stations compared with clinical skills. CONCLUSIONS: Overall scores on the OSCE are often not very reliable. It is more difficult to reliably assess communication skills than clinical skills when considering both as general traits that should apply across situations. It is generally helpful to use two examiners and large numbers of stations, but some OSCEs appear more reliable than others for reasons that are not yet fully understood.


Asunto(s)
Competencia Clínica/normas , Evaluación Educacional/métodos , Evaluación Educacional/normas , Educación Médica , Educación de Pregrado en Medicina/normas , Humanos , Anamnesis/normas , Reproducibilidad de los Resultados
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