Advances in health sciences education : theory and practice
-
Adv Health Sci Educ Theory Pract · Oct 2016
Multicenter StudyInterprofessional rhetoric and operational realities: an ethnographic study of rounds in four intensive care units.
Morning interprofessional rounds (MIRs) are used in critical care medicine to improve team-based care and patient outcomes. Given existing evidence of conflict between and dissatisfaction among rounds participants, this study sought to better understand how the operational realities of care delivery in the intensive care unit (ICU) impact the success of MIRs. We conducted a year-long comparative ethnographic study of interprofessional collaboration and patient and family involvement in four ICUs in tertiary academic hospitals in two American cities. ⋯ Moreover, physicians' de facto control of rounds often meant that they resembled medical rounds (their historical predecessors), and sidelined other providers' contributions. This study suggests that the MIRs model, as presently practiced, might not be well suited to the provision of team-based, patient-centered care. In the interest of interprofessional collaboration, of the optimization of clinicians' time, of high-quality medical education and of patient-centered care, further research on interprofessional rounds models is needed.
-
Adv Health Sci Educ Theory Pract · Mar 2010
Multicenter StudyTwo models of raters in a structured oral examination: does it make a difference?
Oral examinations have become more standardized over recent years. Traditionally a small number of raters were used for this type of examination. Past studies suggested that more raters should improve reliability. ⋯ Reliability was higher for the candidate-specific raters. Inter-rater reliability, internal consistency and a study of station inter-correlations suggested that a halo effect may be present for candidates examined by candidate-specific raters. This study suggests that although the model of candidate-specific raters was more reliable than the model of station-specific raters for the overall examination, the presence of a halo effect may influence individual examination outcomes.
-
Adv Health Sci Educ Theory Pract · Jan 2003
Multicenter StudyA sequenced OSCE for licensure: administrative issues, results and myths.
In response to stakeholder demands for a more cost-effective clinical examination, the Medical Council of Canada adopted a sequenced format for the OSCE component of its licensure examination. The sequenced OSCE was administered in 1997 at 14 sites and assessed 1,796 test takers. The 10-station screening test had an alpha = 0.66 (M = 61.3%, SD = 4.7%). ⋯ The logistical problems that were encountered were largely due to the constraints of administering a multi-site OSCE. Although the sequenced format was cost effective and psychometrically acceptable, the response of many test takers and faculty members was negative. Consequently, it is the logistical and political lessons that may be the most generalizable.