journal article
LitStream Collection
Home
Gierl, Mark J; Latifi, Syed; Lai, Hollis; Boulais, André‐Philippe; Champlain, André
doi: 10.1111/medu.12517pmid: 25200016
Context Constructed‐response tasks, which range from short‐answer tests to essay questions, are included in assessments of medical knowledge because they allow educators to measure students’ ability to think, reason, solve complex problems, communicate and collaborate through their use of writing. However, constructed‐response tasks are also costly to administer and challenging to score because they rely on human raters. One alternative to the manual scoring process is to integrate computer technology with writing assessment. The process of scoring written responses using computer programs is known as ‘automated essay scoring’ (AES). Methods An AES system uses a computer program that builds a scoring model by extracting linguistic features from a constructed‐response prompt that has been pre‐scored by human raters and then, using machine learning algorithms, maps the linguistic features to the human scores so that the computer can be used to classify (i.e. score or grade) the responses of a new group of students. The accuracy of the score classification can be evaluated using different measures of agreement. Results Automated essay scoring provides a method for scoring constructed‐response tests that complements the current use of selected‐response testing in medical education. The method can serve medical educators by providing the summative scores required for high‐stakes testing. It can also serve medical students by providing them with detailed feedback as part of a formative assessment process. Conclusions Automated essay scoring systems yield scores that consistently agree with those of human raters at a level as high, if not higher, as the level of agreement among human raters themselves. The system offers medical educators many benefits for scoring constructed‐response tasks, such as improving the consistency of scoring, reducing the time required for scoring and reporting, minimising the costs of scoring, and providing students with immediate feedback on constructed‐response tasks.
doi: 10.1111/medu.12512pmid: 25200017
Context North American medical students are more depressed and anxious than their peers. In the UK, the regulator now has responsibility for medical students, which may potentially increase scrutiny of their health. This may either help or hinder medical students in accessing appropriate care. The prevalences of anxiety, depression and psychological distress in medical students outside North America are not clear. A better understanding of the prevalence of, risk factors for and results of psychological distress will guide the configuration of support services, increasingly available for doctors, for medical students too. Objectives The aim of this study was to examine the prevalences of depression, anxiety and psychological distress in students in medical schools in the UK, Europe and elsewhere in the English‐speaking world outside North America. Methods A systematic review was conducted using search terms encompassing psychological distress amongst medical students. OvidSP was used to search the following databases: Ovid MEDLINE (R) from 1948 to October 2013; PsycINFO from 1806 to October 2013, and EMBASE from 1980 to October 2013. Results were restricted to medical schools in Europe and the English‐speaking world outside North America, and were evaluated against a set of inclusion criteria including the use of validated assessment tools. Results The searches identified 29 eligible studies. Prevalences of 7.7–65.5% for anxiety, 6.0–66.5% for depression and 12.2–96.7% for psychological distress were recorded. The wide range of results reflects the variable quality of the studies. Almost all were cross‐sectional and many did not mention ethical approval. Better‐quality studies found lower prevalences. There was little information on the causes or consequences of depression or anxiety. Conclusions Prevalences of psychological distress amongst medical students outside North America are substantial. Future research should move on from simple cross‐sectional studies to better‐quality longitudinal work which can identify both predictors for and outcomes of poor mental health in medical students.
doi: 10.1111/medu.12520pmid: 25200018
Context Despite considerable advances in the incorporation of professionalism into the formal curriculum, medical students and residents are too often presented with a mechanical, unreflective version of the topic that fails to convey deeper ethical and humanistic aspirations. Some misunderstandings of professionalism are exacerbated by commonly used assessment tools that focus only on superficially observable behaviour and not on moral values and attitudes. Methods Following a selective literature review, we engaged in philosophical ethical analysis to identify the key precepts associated with professionalism that could best guide the development of an appropriately reflective curriculum. Results The key precepts needed for a robust presentation of professionalism can be grouped under two headings: ‘Professionalism as a trust‐generating promise’ (representing commitment to patients’ interests, more than a mere business, a social contract, a public and collective promise, and hard work), and ‘Professionalism as application of virtue to practice’ (based on virtue, deeper attitudes rather than mere behaviour, and requiring of practical wisdom). Conclusions These key precepts help students to avoid many common, unreflective misunderstandings of professionalism, and guide faculty staff and students jointly to address the deeper issues required for successful professional identity formation.
Cherry, M Gemma; Fletcher, Ian; O'Sullivan, Helen
doi: 10.1111/medu.12526pmid: 25200019
Context In a previous study, we found that emotional intelligence (EI) mediates the negative influences of Year 1 medical students’ attachment styles on their provider–patient communication (PPC). However, in that study, students were examined on a relatively straightforward PPC skill set and were not assessed on their abilities to elicit relevant clinical information from standardised patients. The influence of these psychological variables in more demanding and realistic clinical scenarios warrants investigation. Objectives This study aimed to validate previous research findings by exploring the mediating effect of EI on the relationship between medical students’ attachment styles and their PPC across an ecologically valid PPC objective structured clinical examination (OSCE). Methods Year 2 medical students completed measures of attachment (the Experiences in Close Relationships–Short Form (ECR‐SF), a 12‐item measure which provides attachment avoidance and attachment anxiety dimensional scores) and EI (the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT), a 141‐item measure on the perception, use, understanding and management of emotions), prior to their summative PPC OSCE. Provider–patient communication was assessed using OSCE scores. Structural equation modelling (SEM) was used to validate our earlier model of the relationships between attachment style, EI and PPC. Results A total of 296 of 382 (77.5%) students participated. Attachment avoidance was significantly negatively correlated with total EI scores (r = −0.23, p < 0.01); total EI was significantly positively correlated with OSCE scores (r = 0.32, p < 0.01). Parsimonious SEM confirmed that EI mediated the negative influence of attachment avoidance on OSCE scores. It significantly predicted 14% of the variance in OSCE scores, twice as much as the 7% observed in the previous study. Conclusions In more demanding and realistic clinical scenarios, EI makes a greater contribution towards effective PPC. Attachment is perceived to be stable from early adulthood, whereas EI can be developed using targeted educational interventions. The validation of this theoretical model of PPC in Year 2 medical students strengthens the potential educational implications of EI.
Showing 1 to 10 of 15 Articles