RESUMO
Physicians who are excessively underconfident or overconfident about their knowledge may have impaired clinical judgement. Confidence weighting of multiple choice examinations asks test-takers to state how confident they are that the answers they selected are correct. This previously described method allows the examinee to receive 'overconfidence' and 'underconfidence' scores. This study was designed to test the hypothesis that these scores would correlate with faculty assessment of pediatric residents' confidence level as observed in the clinical setting. Thirty-three pediatric residents took an examination of general pediatric knowledge using confidence weighting method. Percentage of questions answered correctly ranged from 40 to 81%. There was an association between increasing overconfidence and lower examination scores (r = 0.58; p = 0.001). Increasing overconfidence was also associated with decreasing underconfidence (r = 0.38; p = 0.04). Five faculty members, the program director and the chief resident were asked to rate their perceptions of the residents' confidence on a Likert-type scale. The period of observation ranged from 9 months to 3 years. Linear regression demonstrated an association between underconfidence indices and observed confidence in the clinical setting (r = 0.39; p = 0.03). In addition, three of four residents who left the program had either over- or underconfidence indices greater than one standard deviation from the mean. These results indicate that the multiple choice examination with confidence weighting can predict residents who will be judged as underconfident by clinical preceptors. This finding is important in light of our impression that such house officers often have difficulties later during their residencies.
Assuntos
Internato e Residência , Pediatria/educação , Autoimagem , Humanos , Aprendizagem , Análise de RegressãoAssuntos
Osteíte Deformante/epidemiologia , Negro ou Afro-Americano , Idoso , População Negra , Canadá , Humanos , Indígenas Norte-Americanos , Jamaica , Pessoa de Meia-Idade , Osteíte Deformante/diagnóstico por imagem , Pelve/diagnóstico por imagem , Radiografia , Reino Unido , Estados Unidos , População BrancaAssuntos
Articulação do Quadril , Osteoartrite/epidemiologia , Feminino , Humanos , Jamaica , Masculino , Ocupações , Fatores Sexuais , Suíça , Reino UnidoAssuntos
Humanos , Masculino , Feminino , Articulação do Quadril , Osteoartrite/epidemiologia , Reino Unido , Jamaica , Ocupações , Fatores Sexuais , SuíçaAssuntos
Osteoartrite/epidemiologia , Doenças da Coluna Vertebral/epidemiologia , Adulto , Artrite Reumatoide/epidemiologia , Vértebras Cervicais/diagnóstico por imagem , Feminino , Humanos , Disco Intervertebral/diagnóstico por imagem , Jamaica , Região Lombossacral/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
The prevalence of degenerative joint disease has been measured in a random sample of adults aged 35-64 years living in a rural area in Jamaica and compared with that found in similar surveys in the United Kingdom. Radiological evidence of osteo-arthrosis in general showed the same prevalence in the two races, with the exception of certain joints which showed significant differences. Lumbar disk degeneration was also found to have a similar prevalence, though the involvement of multiple disks was significantly more common in Jamaica. Cervical disk degeneration was both more common and more severe in Jamaica. Symptoms in Jamaica were less frequent in relation to all sites of osteo-arthrosis except the cervical spine, and Jamaicans seemed to have fewer symptoms and less incapacity than Englishmen with the same degree of disk degeneration.(Summary)
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Osteoartrite/epidemiologia , Doenças da Coluna Vertebral/epidemiologia , Artrite Reumatoide/epidemiologia , Vértebras Cervicais/diagnóstico por imagem , Disco Intervertebral/diagnóstico por imagem , Jamaica , Região Lombossacral/diagnóstico por imagemAssuntos
Clima , Artropatias/epidemiologia , Inglaterra , Feminino , Humanos , Jamaica , Masculino , Tempo (Meteorologia)Assuntos
Artrite Reumatoide/epidemiologia , Adolescente , Adulto , Negro ou Afro-Americano , Idoso , Testes de Aglutinação , População Negra , Epidemiologia , Europa (Continente) , Feminino , Geografia , Humanos , Indígenas Norte-Americanos , Jamaica , Masculino , Pessoa de Meia-Idade , América do Norte , Radiografia , População BrancaRESUMO
The prevalence of rheumatoid arthritis has been compared in eight population samples in America and Europe, in which routine x rays were taken of the hands and feet. All the x rays were read by one observer. No relationship to lattitude was discovered. The prevalence of "definite" arthritis was not significantly different in the three racial groups included in these surveys, but "probable" disease was more common in the Negro population in Jamaica than in the Amerindians or Caucasians. Radiological evidence of erosive arthritis was more frequent in the Jamaican than in the Amerindian, and the Amerindian than the Caucasian. Serological tests for rheumatoid factor were more often positive in the Amerindian and erosive changes more severe. The implications of these findings are discussed.(Summary)