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OBJECTIVE: To examine the history of personality disorder in the context of contemporary post-colonial Jamaican society. METHODS: The literature outlining the development and classification of personality disorder is reviewed. The social, psychiatric and epidemiological studies of personality disorder in Jamaica are presented. RESULTS: A categorical classification system of personality disorder has been in use by the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) from the mid 20th century. Challenging that approach is the Minnesota Multiphasic Personality Inventory (MMPI), which represents the dimensional method, which views pathology as a continuum from normal personality traits. Both systems suffer from an absence of cultural flexibility, an absence of a a system of severity, and a lack of treatment specificity, which foster misdiagnosis while making treatment planning difficult and unreliable. The proposed DSM-5 attempts to integrate a prototypematching system and identification of personality traits promises disappointing outcomes. The University of the West Indies, Section of Psychiatry, proposes a phenomenological nosological approach, advocating an alternate DSM Axis I category called Shakatani derived from Swahili shaka (problem), tani (power), and developing a 38-item Jamaica Personality Disorder Inventory (JPDI) screening questionnaire for diagnosing this condition. The epidemiological results using this instrument are reviewed, and the Jamaican print, broadcast and social media responses to this research in Jamaica are described. CONCLUSIONS: The heritage of slavery and colonial oppression in Jamaica has resulted in maladaptive personality disorders that have led to extremely high rates of homicide, violence and transgressive behaviour.

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OBJECTIVE: To describe the creation and validation of the Jamaica Personality Disorder Inventory (JPDI) screening questionnaire. METHOD: Using the phenomenological triad of power management, dependency and psychosexual issues, drafts of the JPDI were piloted on patients from psychiatric and medical wards. The JPDI consisted of 38 close-ended, yes/no questions. Validation was conducted in a sample of 200 patients, using the International Personality Disorder Examination-Screening Instrument (IPDE-S), the Brief Screen for Depression and consultant psychiatrists' Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) personality disorder interview. Construct validity was assessed through principal component factor analysis; Spearman correlation was used to assess criterion-related and discriminant validity; Cronbach's alpha was used to assess reliability of the entire scale as well as the resulting factors. The Multitrait Multimethod Matrix (MTMM) was used to assess discriminant and construct validity. RESULTS: Factor analysis revealed eight clusters consisting of 30 of the 38 questions, which had close congruence with the clinical triad. Cronbach's alpha for the entire scale was α = 0.79, ranging from a high 0.70 to 0.82 to low 0.63 to 0.45. The JPDI exhibited a sensitivity of 95.06% and a specificity of 67.71%. Significant correlation of scores for the JPDI and IPDE-S (r = 0.432, p = 0.000) and the JPDI and the DSM IV-TR diagnosis (r = 0.598, p = 0.000) established concurrent validity for the JPDI. Correlations (r = 0.293, p = 0.000) suggested that the JPDI possessed predictive validity. The complete sample matrix of the MTMM provided evidence of both convergent and discriminant validity, and thereby, construct validity. CONCLUSION: The JPDI demonstrated reliability, and criterion-related and discriminant validity.

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OBJECTIVE: To examine the distribution and clinically significant patterns of the phenomenology of a cohort of Jamaican patients with a Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis II diagnosis of personality disorder and to clarify the conventional diagnostic deficiencies of DSM-based personality disorder categories. METHODS: In a case-control study from the naturalistic clinical setting of a private psychiatric practice in Kingston, Jamaica, between 1974 and 2007, the phenomenology of a cohort of 351 patients with an Axis II DSM diagnosis of personality disorder is qualitatively described and quantitatively compared with that of a control group of patients with an Axis I DSM clinical diagnosis, matched for age, gender and socio-economic class. RESULTS: There were 166 males (47.3%); 238 (67.8%) of the patients were between age 18 and 39 years. Ethnically, 325 (92.6%) were Black, 10 (2.8%) White and 16 (4.6%) Other. The majority of patients (20.7%) had a DSM-IV diagnosis of dependent personality disorder. Patients with an Axis II diagnosis were significantly more likely to display symptoms of a 'clinical triad' of power management, dependency and psychosexual issues. Qualitative analysis of the phenomenological symptoms of personality disorder diagnosed patients suggests aetiological interconnections based on early childhood experiences as explained by object relations and attachment theories. CONCLUSIONS: The phenomenological approach to personality disorder may be a viable replacement for the four-cluster classification of DSM-IV in a Jamaican population with the clinical triad called Shakatani, derived from the Swahili words shaka (problem) and tani (power). This phenomenological approach may provide more clinical utility to practitioners.

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OBJECTIVE: The object of this study is to establish the correlates of the phenomenology of conflict and power management in the Jamaican population. METHODS: A total of 1506 adult individuals were sampled from 2150 households using a stratified sampling method and assessed using the 12 questions of the Jamaica Personality Disorder Inventory (JPDI) on the phenomenology of conflict and power management that are grouped into the psychological features of aggressive social behaviour, unlawful behaviour, socially unacceptable behaviour and financial transgressive behaviour. The database of responses to the demographic and JPDI questionnaires was created and analysed using the Statistical Package for the Social Sciences (SPSS) version 17. RESULTS: Of the national population sampled, 69.1% denied having any phenomenological symptoms of abnormal power management relations while 30.9% of the population admitted to having some degree of conflict and power management, ranging from mild (10.3%), to moderate (17.1), or severe (3.5%). There were 46.55% of the population which had problems with aggressive social behaviour, 9.33% had problems with unlawful behaviour, 9.58% had problems with unacceptable social behaviour and 37.74% had problems with financial transgressive behaviour. Significant gender and socio-economic class patterns for conflict and power management were revealed. This pattern of conflict and power management behaviour is critical in understanding the distinction between normal and abnormal expression of these emotions and actions. CONCLUSION: Nearly one-third of the sample population ` studied reported problems with conflict, abnormal power and authority management, impulse control and serious aggressive and transgressive behaviour.

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OBJECTIVE: To establish the prevalence of psychological dependency in the Jamaican society in order to examine the relationship between the psychological correlates of dependency and socio-political dependency in this post-colonial country. METHODS: A total of 1506 adult individuals were sampled from 2150 households using a stratified sampling method and assessed using the 17 questions of the Jamaica Personality Disorder Inventory (JPDI) on the phenomenology of dependency that are grouped into the psychological features of physiological dependency, financial dependency, and psychological dependency. The database of responses to the demographic and JPDI questionnaires was created and analysed using the Statistical Package for the Social Sciences (SPSS) version 17. RESULTS: Of the national population sampled, 77.1% denied having any of these phenomenological symptoms of dependence while 22.63% of the population admitted to having some phenomenology of dependency, ranging from mild (5.6%), to moderate (12.1), or severe (4.9%). Substance use (physiological dependency) responders accounted for 21.23%, financial dependency responders for 43.45%, and psychological dependency responders for 15.96%. Significant gender and socio-economic class patterns of dependency were revealed. This substantial swathe of the Jamaican population acknowledged their own dependency and behavioural withdrawal response to physical or emotional loss in their life, and reported having dependency problems in managing their financial and monetary affairs. CONCLUSIONS: Three-quarters of the Jamaican responders of this survey ostensibly are free of the phenomenology of dependency while a more vulnerable one-quarter has insight that they are still locked in a struggle for psychological independence. The political and economic relations between psychological dependency and socio-political dependency are discussed.

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OBJECTIVE: To examine the relationship between the psychopathological correlates of psychosexual phenomena in post-colonial Jamaica. METHODS: A total of 1506 adult individuals were sampled from 2150 households using a stratified sampling method and assessed with the Jamaica Personality Disorder Inventory (JPDI). Responses to the seven questions on the psychological features of homosexual practices, sexual practices and dysfunction were tabulated and analysed using the Statistical Package for the Social Sciences (SPSS) version 17. RESULTS: Of the sample, 79.38% denied having phenomenological symptoms of psychosexual phenomena while 20.33% of the population admitted to having some degree of heterosexual and homosexual phenomena, ranging from mild (5.13%), to moderate (11.40), or severe (3.80%). Sixteen (1.06%) responders described homosexual practices in their lives, and 53 (3.52%) described thinking frequently about homosexual experiences in their subjective psychic lives. Significantly more (p > 0.001) male responders (348, 23.11%) had difficulty being sexually faithful to one person at a time than females (122, 8.10%). The lower class cohort members (348, 23.11%) were more likely to have had multiple sexual relationships over the previous 12 months than socio-economic class (SEC) 1-3 responders (54, 3.58%) and were more likely (681, 45.21%) to fantasize about sexual relationships with persons other than their partners (p < 0.001) than SEC 1-3 responders (94, 6.24%). CONCLUSION: Significant levels of multiple sexual partnerships and feelings of infidelity in a swathe of Jamaican people reveal underlying psychosexual anxiety and guilt, poor impulse control and difficulties with partner intimacy. This psychopathology is correlated to concomitant high-risk public health sexual behaviour such as teenage pregnancy, sexually transmitted diseases (STDs) and HIV/AIDS existing in the Jamaican society.

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OBJECTIVE: To assess the clinical outcome of patients with personality disorder, receiving treatment with psychohistoriographic brief psychotherapy (PBP). METHOD: Patients seen in the author's private practice from 1974-2010 with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) personality disorder diagnosis were treated with PBP. Demographic, clinical responses and one-year clinical outcome measures were disaggregated and analysed, using SPSS, version 17. RESULTS: One hundred patients completed treatment with PBP, male:female 34:64; mean age of 35.86 ± 10.28 (range 16 - 66) years. Forty-five per cent were married, 73% were of predominantly African racial origin, with 59% from socio-economic class (SEC) I and 39% from SEC II and III. The presenting complaints were interpersonal conflict (35%), anxiety (21%) and depressed mood (20%). Major depression (30%), substance abuse disorder (18%) and generalized anxiety disorder (13%) were the most common Axis I diagnoses. Histrionic personality disorder (39%) and avoidant personality disorder (35%) were the main Axis II diagnoses. Psychohistoriography was completed with all patients, and charted by 96%. Transference variants were experienced by all patients and worked through with 87%. The quadranting process was completed by 42% with goal setting instituted by 96% and actualization scoring fully completed by 34%. A continuous exercise programme was instituted by all patients, and was maintained by 56% at one-year follow-up. Ninety-four per cent reported fair (10%), good (68%) to very good/excellent (16%) improvement on completion of PBP, with 72% assessed as maintaining fair to good clinical improvement by the therapist at one-year follow-up. CONCLUSION: Patients with personality disorders showed clinical improvement one year after being treated with psychohistoriographic brief psychotherapy.

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OBJECTIVE: To identify the prevalence and correlates of personality disorder in a representative sample of the Jamaican population using the Jamaica Personality Disorder Inventory (JPDI). METHOD: A four-stage stratified random sampling method was used to obtain a representative population sample consisting of 1506 Jamaicans, M:F = 727 (48.3%):779 (51.7%), ages 18-64 years. A demographic questionnaire and the JPDI were administered to all participants. RESULTS: Two-fifths of the population (41.4%) scored above the scale's cut-point indicating a diagnosis of personality disorder with the level of severity ranging from mild to severe. Persons with personality disorder were significantly more likely to be single (63%), male (60%), between the ages 18 and 44 years (77%) and of a lower socio-economic status (65%) (p < 0.50 to p < 0.001). CONCLUSION: This is the only population study of personality disorder recorded in the English-speaking Caribbean. This suggests a high risk of behavioural dysfunction in the Jamaican population, having significant implications in light of the country's high rate of crime and violence. The findings highlight the need to develop effective and targeted prevention and intervention measures.

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OBJECTIVE: To ascertain whether the public scholarship of the epidemiology of personality disorder (PD) in Jamaica prompted a health promotion outcome. METHODS: A January 2011 to December 2012 trawl of news media articles linking 'PD' to published public scholarship articles on the epidemiology of PD recorded titles and contents of the reports that were culled to capture the emotional responses and psychological defence mechanisms expressed. These were analysed with concomitant social, psychological or behavioural activities occurring in Jamaica, using SPSS version 17 software. RESULTS: Two public scholarship interventions to two major broadsheet newspapers triggered 25 contributed articles, which in turn prompted 160 responses from the public, five commentaries on leading radio stations and four Internet blogs. One hundred and sixty-six (84.2%) of the titles targeted PD in the Jamaican nation; 31 (13.7) articles targeted PD in leaders, athletes, inmates, individuals, families and productivity in Jamaica. One hundred and fifty-five (79.1%) expressed agreement with the scientific epidemiological observations, while 20.9% (n = 41) expressed disagreement. Eighty-two (41.8%) of the responses expressed rationalizations, 47 (24%) were expressions of reaction formation, 27 (13.8%) were in frank denial, while 25 (12.8%) were expressing open acting out responses or blunt projection (15, 7.7%) to the published epidemiology. The difference between 139 (70.9%) popular media responses to contemporary social problems and 57 (29.1%) reports that made no reference to social problems was statistically significant (p < 0.03). CONCLUSIONS: The hypothesis that public scholarship reports prompted a popular media response, generating a health promotion outcome linking contemporary social events to this medical research is confirmed.

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OBJECTIVE: To establish the aetiology and historical prevalence of personality disorder in violent homicidal men in Jamaica. METHODS: Examination and analysis of primary data from the psychosocial case study interviews of 36 convicted murderers from the Jamaican Government Barnett Commission of Enquiry in 1976. The disaggregated social and clinical data were analysed using a Chi-square statistical analysis. RESULTS: The mean age at time of arrest for the male convicted murderers was 24.26 ± 8.48 years. Twenty-three (66%) of the subjects had loving relationships with mothers, particularly in those men reared in the rural areas. Twenty-one (59%) cases showed marked paternal rejection and absence of integrated family life. Twenty-four (69%) of the cases experienced severe parental disciplinary methods, and two-thirds were illiterate or barely literate. Twenty-nine (83%) were from very poor socio-economic conditions. Thirty (86%) of all the murder victims were adult males. There were significant differences between the urban reared murderers (URM) and rural reared murderers (RRM). Sixteen (94%) of the victims of the URM ensued from robbery and police confrontation, while 13 (72%) of the victims of the RRM resulted from domestic disputes (p < 0.00). Seventeen (49%) of the men had normal personalities; 18 (51%) were diagnosed as having antisocial and inadequate personalities. Diagnosis of primary data using Diagnostic and Statistical Manual of Mental Disorders fourth edition, text revision (DSM-IV-TR) criteria revealed 23 (66%) men with Antisocial Personality Disorder (APD). There were significantly more APD in the URM than the RRM (p < 0.01). CONCLUSIONS: Antisocial personality disorder as an aetiological precursor of homicidal violence represents a major public health problem in contemporary Jamaica.

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OBJECTIVE: To determine the prevalence of personality disorders in patients admitted to the psychiatric wards of the University Hospital of the West Indies (UHWI). METHOD: Patients (n = 100) sequentially admitted to the psychiatric wards of the UHWI were assessed for personality disorder using the gold standard of a consultant assessment using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM IV-TR) diagnostic criteria for personality disorder, the International Personality Disorder Examination Screening questionnaire (IPDE-S), and the Jamaica Personality Disorder Inventory (JPDI). RESULTS: The three assessment instruments identified a prevalence of personality disorder in the cohort of patients of 51% consultant DSM-IV-TR assessment, 57% JPDI and 86% IPDE-S. The prevalence rate identified by the IPDE-S was significantly higher that the local instruments used (p < 0.000). CONCLUSIONS: The prevalence of personality disorder assessed by the JPDI and the consultant DSM IV-TR instruments in Jamaica is comparable to the prevalence rate of studies in other countries in a similar population.

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OBJECTIVE: To determine the prevalence of personality disorders in patients admitted to the general medical wards of the University Hospital of the West Indies (UHWI). METHOD: Patients (n = 100) sequentially admitted to the general medical wards of the UHWI were assessed for the diagnosis of personality disorder using the gold standard of a consultant assessment based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM IV-TR) diagnostic criteria for personality disorder, the International Personality Disorder Examination Screening questionnaire (IPDE-S) and the Jamaica Personality Disorder Inventory (JPDI). RESULTS: The three assessment instruments identified a prevalence of personality disorder in the cohort of patients of 21% consultant DSM IV-TR assessment, 28% JPDI and 70% IPDE-S. The prevalence rate identified by the IPDE-S was significantly higher than the local instruments used (p < 0.000). CONCLUSIONS: The prevalence of personality disorder assessed by the JPDI and the IPDE-S and the consultant DSM IV-TR instruments in Jamaica is significantly higher than the prevalence rate of studies in other countries.

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OBJECTIVE: To use historiography in the analysis of the fictional writings of a Jamaican novelist to identify aspects of psychopathology of Jamaican people. METHOD: Each of 12 stories of "The World is a High Hill" by novelist Erna Brodber was assigned an explanatory title and a 'psychic centrality'. A narrative qualitative analysis of the fourteen main themes of each story was created using a Lickert scale, calculating the psychopathological penetrance or weighted significance of each theme. RESULTS: The four main psychic centrality containments that emerged from this analysis were the black/white racial paradox (n = 4, 33%) and the partisan/political paradox (n = 1, 8%), the sexual/duplicity paradox (n = 5, 43%) and the social/spiritual paradox (n = 2, 17%). Five of fourteen themes reached maximal penetrance: family (92%), representation of generations with families (92%), issues of intimacy (92%), sex (75%) and issues of dependency (67%). Seven themes - personal and social conflicts (64%), issues of child development (53%), sexual identity (50%), pregnancy (48%), and political (42%), racial (36%), and religious (33%) conflicts reached moderate penetrance. The two themes of migration (30%) and homosexuality (14%) reached minimal penetrance. CONCLUSIONS: The analysis reveals a profound and practical historiographic representation of the contemporary scotoma that currently paralyses many Jamaicans as a product of the enslavement of Africans in the New World, and mirrors the clinical syndrome of personality disorder revealed from contemporary Jamaican medical research.

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Involuntary commitment and custodialization were the principal tenets of British colonial public policy provisions for the management of the violent, disturbed mentally ill in Jamaica and the West Indies. Over the fifty years following Jamaica's political independence from Britain, a community engagement mental health programme has developed through a decolonization process that has negated involuntary certification, incarceration and custodialization, has promoted family therapy and short stay treatment in conventional primary and secondary care health facilities, and has promoted reliance on traditional and cultural therapies that have been extremely successful in the treatment of mental illness and the reduction of stigma in Jamaica. Collaborations involving The University of the West Indies, the Jamaican Ministry of Health and the Pan American Health Organization have been seminal in the development of the decolonizing of public policy initiatives, negating the effects of involuntary certification that had been imposed on the population by slavery and colonization. This collaboration also catalysed the psychiatric training of medical, nursing and mental health practitioners and the execution of community mental health policy in Jamaica.

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The intellectual exploration of phenomenological and psychiatric discovery that has flowered in the Caribbean in the period of political independence from British colonization is a reflection of the scholarship that has emerged from the academic nurturance by The University of the West Indies. Burgeoning migration of Caribbean people to England in the twentieth century has resulted in high reported rates of psychosis for this migrant population. Caribbean research into this condition has revealed that there exist hostile racial and environmental challenges in Britain that have had a profound pathological effect on the mental health of African Caribbean migrants. These findings have significantly shifted the pendulum of understanding of the aetiology of this condition from a genetic to a biopsychosocial position. Research has also revealed longstanding psychopathological effects of slavery and colonialism in the Caribbean that have had significantly negative long term effects on the mental health of many within the Caribbean population. Current research suggests that there is a need to nurture protective strategies to enhance resilience and social capital, which would ensure the wellness and continued survival of Caribbean people in spite of the many challenges they face.

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OBJECTIVE: To compare the medical research output of the Section of Psychiatry, The University of the West Indies (UWI), Mona, before and after the implementation of strategies aimed at stimulating research. METHOD: Specific strategies such as weekly research and journal club meetings, with an emphasis on team activities and the establishment of bi-annual targets for submission of research papers were instituted in 2000. All research outputs from the Section of Psychiatry over the period 1995 to 2005 were identified from the Departmental Reports of the University of the West Indies and the published abstracts of the UWI Faculty of Medical Sciences and the Caribbean Health Research Council annual research conferences. A number of variables were extracted from each paper and comparisons made between the five-year period before and the five-year period after the implementation of the research enhancing strategies. Statistical analyses were performed with the Statistical Package for the Social Sciences (SPSS; version 11.5) and included chi-squared and Mann Whitney U tests. RESULTS: One-hundred and sixty-two items of research output were identified for the entire period under study. In the period after the implementation of the research enhancing strategies, there were significant increases in the total research output (p = 0.008) and refereed publications (p = 0.016). CONCLUSIONS: There were considerable increases in the overall research output of the department as well as in many sub-categories of output. These strategies are presented as a model to other departments seeking to augment their output of research.

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OBJECTIVE: To compare the medical research output of the Section of Psychiatry, The University of the West Indies (UWI), Mona, before and after the implementation of strategies aimed at stimulating research. METHOD: Specific strategies such as weekly research and journal club meetings, with an emphasis on team activities and the establishment of bi-annual targets for submission of research papers were instituted in 2000. All research outputs from the Section of Psychiatry over the period 1995 to 2005 were identified from the Departmental Reports of the University of the West Indies and the published abstracts of the UWI Faculty of Medical Sciences and the Caribbean Health Research Council annual research conferences. A number of variables were extracted from each paper and comparisons made between the five-year period before and the five-year period after the implementation of the research enhancing strategies. Statistical analyses were performed with the Statistical Package for the Social Sciences (SPSS; version 11.5) and included chi-squared and Mann Whitney U tests. RESULTS: One-hundred and sixty-two items of research output were identified for the entire period under study. In the period after the implementation of the research enhancing strategies, there were significant increases in the total research output (p = 0.008) and refereed publications (p = 0.016). CONCLUSIONS: There were considerable increases in the overall research output of the department as well as in many sub-categories of output. These strategies are presented as a model to other departments seeking to augment their output of research.

OBJETIVO: Comparar la producción médico-investigativa del Departamento de Psiquiatría de la Universidad de West Indies (UWI), Mona, antes y después de la implementación de las estrategias encaminadas a estimular la investigación. MÉTODO: En el año 200, se instituyeron estrategias específicas, tales como reuniones semanales del club de investigación y publicaciones, con énfasis en las actividades en equipo y el establecimiento de objetivos semestrales para la presentación de trabajos de investigación. Todas las producciones investigativas del Departamento de Psiquiatría durante el periodo de 1995 al 2005, fueron identificadas a partir de los informes Departamentales de la Universidad de West Indies y los resúmenes publicados por las conferencias anuales de la Facultad de Ciencias Médicas de UWI y el Consejo Caribeño de Investigaciones de la Salud. Se extrajeron un número de variables de cada trabajo y se hicieron comparaciones entre el quinquenio anterior y el posterior a la implementación de las estrategias del perfeccionamiento de las investigaciones. Se realizaron análisis estadísticos con el Paquete Estadístico para las Ciencias Sociales (SPSS; versión 11.5) y se incluyeron pruebas U de Mann-Whitney y Chi-cuadrado. RESULTADOS: Se identificaron ciento sesenta y dos ítems de output investigativo para todo el periodo en estudio. En el periodo posterior a la implementación de las estrategias de perfeccionamiento de las investigaciones, hubo aumentos significativos en la producción investigativa total (p = 0.008) y en las publicaciones referenciadas (p = 0.016). CONCLUSIONES: Hubo aumentos considerables en la producción investigativa general del departamento, así como en muchas subcategorías de producción. Estas estrategias se presentan como un modelo para otros departamentos que buscan aumentar su producción investigativa.

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OBJECTIVE: To compare the performance of medical students in the Objective Structured Clinical Examination (OSCE) of thefinal MBBS Examination across the four campuses of The University of the West Indies, over a two-year period DESIGN AND METHODS: All final examination results of the Medicine and Therapeutics OSCE were collectedfrom the Faculty of Medical Science at the four campuses of The University of the West Indies and analyzed using both parametric (t-tests and ANOVAs) and non-parametric tests (chi-squared tests). RESULTS: Results indicated that students achieved significantly higher mean scores in the 2002 examination than in 2001 (t = 3.85, df = 415, p = 0.000). There were no significant differences between campuses with regards to the mean corrected score in 2001. Also in 2001, in adult stations, all campuses achieved significantly higher scores than Jamaica. However, in Jamaica, mean child health station scores were significantly higher than all other campuses and, the mean score in Trinidad and Tobago was higher than the Bahamas and Barbados. In 2002, all other campuses achieved significantly higher scores than Trinidad and Tobago and females performed significantly better than males with regards to overall mean scores (t = 2.814, df = 189, p = 0.005). Also in 2002, Barbados achieved significantly higher mean corrected scores than Trinidad and Tobago (F = 4.649, df = 3191; p = 0.004) and Barbados and Trinidad and Tobago both obtained significantly higher mean child health station scores than Jamaica. CONCLUSIONS: The important conclusion from this study is that the OSCE scores in Medicine and Therapeutics are generally uniform across the four campuses of the University, thereby confirming the consistency of the approach to teaching and helping to validate the efficacy and veracity of the medical graduate being produced by The University of the West Indies.

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OBJECTIVE: To compare the performance of medical students in the Objective Structured Clinical Examination (OSCE) of thefinal MBBS Examination across the four campuses of The University of the West Indies, over a two-year period DESIGN AND METHODS: All final examination results of the Medicine and Therapeutics OSCE were collectedfrom the Faculty of Medical Science at the four campuses of The University of the West Indies and analyzed using both parametric (t-tests and ANOVAs) and non-parametric tests (chi-squared tests). RESULTS: Results indicated that students achieved significantly higher mean scores in the 2002 examination than in 2001 (t = 3.85, df = 415, p = 0.000). There were no significant differences between campuses with regards to the mean corrected score in 2001. Also in 2001, in adult stations, all campuses achieved significantly higher scores than Jamaica. However, in Jamaica, mean child health station scores were significantly higher than all other campuses and, the mean score in Trinidad and Tobago was higher than the Bahamas and Barbados. In 2002, all other campuses achieved significantly higher scores than Trinidad and Tobago and females performed significantly better than males with regards to overall mean scores (t = 2.814, df = 189, p = 0.005). Also in 2002, Barbados achieved significantly higher mean corrected scores than Trinidad and Tobago (F = 4.649, df = 3191; p = 0.004) and Barbados and Trinidad and Tobago both obtained significantly higher mean child health station scores than Jamaica. CONCLUSIONS: The important conclusion from this study is that the OSCE scores in Medicine and Therapeutics are generally uniform across the four campuses of the University, thereby confirming the consistency of the approach to teaching and helping to validate the efficacy and veracity of the medical graduate being produced by The University of the West Indies

Objetivo: Comparar el rendimiento académico de los estudiantes de medicina en el examen clínico objetivo estructurado del examen final de MBBS, en los cuatro campus de La Universidad de West Indies, en un período de dos años. Diseño y métodos: Se recopilaron todos los resultados del examen final de ECOE de Medicina y Terapéutica de la Facultad de Ciencias Médicas, en los cuatro campus de la Universidad de West Indies. Los datos fueron analizados usando tanto tests paramétricos (tests t y ANOVAs) como tests no paramétricos (tests de chi-quadrado). Resultados: Los resultados indicaron que los estudiantes alcanzaron puntuaciones significativamente más altas en el examen del 2001 que en el del 2002 (t = 3.85, df = 415, p = .000). No hubo diferencias significativas entre los distintos campus con respecto a los resultados corregidos promedios 2001. También en 2001, en las unidades asistenciales de adultos, todos los campus lograron resultados significativamente más altos que Jamaica. Sin embargo, en Jamaica, los resultados promedios de las unidades pediátricas fueron significativamente más altos que en todos los otros campus, y el resultado promedio en Trinidad y Tobago fue más alto que en Bahamas y Barbados. En 2002, todos los otros campus lograron resultados significativamente más altos que Trinidad y Tobago, y las mujeres obtuvieron rendimientos significativamente mejores que los de los hombres, con respecto a los resultados promedios generales (t = 2.814, df = 189, p = .005). También en 2002, Barbados alcanzó resultados corregidos promedios significativamente más altos que Trinidad y Tobago (F = 4.649, df = 3,191; p = .004), mientras que Barbados así como Trinidad y Tobago, obtuvieron resultados significativamente más altos en la unidades pediátricas, en comparación con Jamaica. Conclusiones: La conclusión principal de este estudio es que los resultados del OSCE en Medicina y Terapéutica son generalmente uniformes en los cuatro campus de la Universidad, confirmando de ese modo la solidez del enfoque de la enseñanza, y contribuyendo a validar la eficacia y calidad del graduado de medicina egresado de la Universidad de West Indies.

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