Journal of Educational Evaluation for Health Professions

Research articles

The sights and insights of examiners in objective structured clinical examinations: Lauren Chong, Silas Taylor, Matthew Haywood, Barbara-Ann Adelstein, Boaz Shulruf; J Educ Eval Health Prof. 2017;14:34. Published online December 27, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.34

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Purpose
The objective structured clinical examination (OSCE) is considered to be one of the most robust methods of clinical assessment. One of its strengths lies in its ability to minimise the effects of examiner bias due to the standardisation of items and tasks for each candidate. However, OSCE examiners’ assessment scores are influenced by several factors that may jeopardise the assumed objectivity of OSCEs. To better understand this phenomenon, the current review aims to determine and describe important sources of examiner bias and the factors affecting examiners’ assessments.
Methods
We performed a narrative review of the medical literature using Medline. All articles meeting the selection criteria were reviewed, with salient points extracted and synthesised into a clear and comprehensive summary of the knowledge in this area.
Results
OSCE examiners’ assessment scores are influenced by factors belonging to 4 different domains: examination context, examinee characteristics, examinee-examiner interactions, and examiner characteristics. These domains are composed of several factors including halo, hawk/dove and OSCE contrast effects; the examiner’s gender and ethnicity; training; lifetime experience in assessing; leadership and familiarity with students; station type; and site effects.
Conclusion
Several factors may influence the presumed objectivity of examiners’ assessments, and these factors need to be addressed to ensure the objectivity of OSCEs. We offer insights into directions for future research to better understand and address the phenomenon of examiner bias.

Citations

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Does following an “excellent” candidate in the objective structured clinical examination affect your checklist score?
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Jr-Wei Wu, Hao-Min Cheng, Shiau-Shian Huang, Jen-Feng Liang, Chia-Chang Huang, Ling-Yu Yang, Boaz Shulruf, Ying-Ying Yang, Chen-Huan Chen, Ming-Chih Hou, Wayne Huey-Herng Sheu
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Medical school grades may predict future clinical competence
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Development and Evaluation of an Online Exam for Exercise Physiology During the COVID-19 Pandemic
Amanda L Burdett, Nancy van Doorn, Matthew D Jones, Natalie CG Kwai, Rachel E Ward, Silas Taylor, Boaz Shulruf
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eOSCE stations live versus remote evaluation and scores variability
Donia Bouzid, Jimmy Mullaert, Aiham Ghazali, Valentine Marie Ferré, France Mentré, Cédric Lemogne, Philippe Ruszniewski, Albert Faye, Alexy Tran Dinh, Tristan Mirault, Nathan Peiffer Smadja, Léonore Muller, Laure Falque Pierrotin, Michael Thy, Maksud Assa
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Equal Z standard-setting method to estimate the minimum number of panelists for a medical school’s objective structured clinical examination in Taiwan: a simulation study
Ying-Ying Yang, Pin-Hsiang Huang, Ling-Yu Yang, Chia-Chang Huang, Chih-Wei Liu, Shiau-Shian Huang, Chen-Huan Chen, Fa-Yauh Lee, Shou-Yen Kao, Boaz Shulruf
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Majid Yousefi Afrashteh
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Examiners’ decision‐making processes in observation‐based clinical examinations
Bunmi S. Malau‐Aduli, Richard B. Hays, Karen D’Souza, Amy M. Smith, Karina Jones, Richard Turner, Lizzi Shires, Jane Smith, Shannon Saad, Cassandra Richmond, Antonio Celenza, Tarun Sen Gupta
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Henok Fisseha, Hailemichael Desalegn
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Comparison of the effects of simulated patient clinical skill training and student roleplay on objective structured clinical examination performance among medical students in Australia
Silas Taylor, Matthew Haywood, Boaz Shulruf
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Boaz Shulruf, Gary Velan, Lesley Forster, Anthony O’Sullivan, Peter Harris, Silas Taylor
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Clinical empathy in medical students in India measured using the Jefferson Scale of Empathy–Student Version: Anirban Chatterjee, Rajkrishna Ravikumar, Satendra Singh, Pranjal Singh Chauhan, Manu Goel; J Educ Eval Health Prof. 2017;14:33. Published online December 27, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.33

33,203 View
442 Download
36 Web of Science
32 Crossref

Abstract PDF Supplementary Material

Purpose
The purpose of this study was to assess the clinical empathy of a cohort of medical students spanning 4 years of undergraduate study and to identify factors associated with empathy.
Methods
A cross-sectional study to assess the empathy of undergraduate medical students at the University College of Medical Sciences and GTB Hospital in Delhi, India, was conducted using the Jefferson Scale of Empathy–Student Version. Demographic data were obtained using a pre-tested, semi-open-ended questionnaire.
Results
Of the 600 students, 418 participated in the survey (69.7%). The mean empathy score was 96.01 (of a maximum of 140), with a standard deviation of 14.56. The empathy scores decreased from the first to the third semester, plateaued at the fifth semester, and rose again in the seventh semester. Empathy was found to be significantly associated with the gender of the participant, with females having higher scores (P<0.001). The age of the participant, place of residence, whose decision it was for the student to enroll in an MBBS (bachelor of medicine and bachelor of surgery) program, and the choice of future specialty were not significantly associated with students’ empathy scores.
Conclusion
The study found significant gender differences in empathy among the participants. The empathy scores tended to decline initially and then rebound over time. The mean empathy levels found in this study are lower than those reported in most similar studies around the world; therefore, further studies are needed to analyze and address the underlying factors associated with this discrepancy.

Citations

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The Level of Empathy Among Medical Students at the University of Tabuk, Saudi Arabia
Omnia S El Seifi, Amal A Alenazi, Asmaa M Alfuhaymani, Alshaymaa A Alanazi, Omayrah A Alanazi, Lama A Alanazi, Nouf M Albalawi, Fatima S Alharbi, Dhuha A ALQasir
Cureus.2024;[Epub] CrossRef
Ebe ve Hemşirelerin Empati Becerileri ile Kültürlerarası İletişimleri Arasındaki İlişki
Aynur ERÇEK KARCI, Selma ŞEN
İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi.2024; 9(1): 19. CrossRef
The Greek Jefferson Scale of Empathy—Medical Student Version (JSE-S): Psychometric Properties and Its Associated Factors
Polychronis Voultsos, Petros Galanis, Marianna-Foteini A. Dafni, Venetia-Sofia Velonaki, Georgia-Neta Andreou, Leda Kovatsi
Behavioral Sciences.2024; 14(3): 195. CrossRef
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Gayatri Bhatia, Jyoti V. Shetty
Indian Journal of Psychological Medicine.2023; 45(2): 162. CrossRef
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Samir Kumar Praharaj, Santosh Salagre, Podila Sathya Venkata Narasimha Sharma
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Masooma Naseem, Burhanuddin Tahir, Afia Salman, Sara Qadir, Rida Farhan, Sajjad Ali, Zehra Naseem, Warda Ahmed, Mahfuza Anan
Annals of Medicine & Surgery.2023; 85(8): 3858. CrossRef
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The integrated curriculum and student empathy: a longitudinal multi-cohort analysis
Christiane R. Herber-Valdez, Julie A. Blow, Tammy T. Salazar, Kathryn V. Horn, Dyanne G. Herrera, Naomi L. Lacy, Lisa Beinhoff, J. Manuel de la Rosa
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Revisiting the trajectory of medical students’ empathy, and impact of gender, specialty preferences and nationality: a systematic review
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BMC Medical Education.2020;[Epub] CrossRef
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Usefulness of the DETECT program for assessing the internal structure of dimensionality in simulated data and results of the Korean nursing licensing examination: Dong Gi Seo, Younyoung Choi, Sun Huh; J Educ Eval Health Prof. 2017;14:32. Published online December 27, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.32

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Abstract PDF Supplementary Material

Purpose
The dimensionality of examinations provides empirical evidence of the internal test structure underlying the responses to a set of items. In turn, the internal structure is an important piece of evidence of the validity of an examination. Thus, the aim of this study was to investigate the performance of the DETECT program and to use it to examine the internal structure of the Korean nursing licensing examination.
Methods
Non-parametric methods of dimensional testing, such as the DETECT program, have been proposed as ways of overcoming the limitations of traditional parametric methods. A non-parametric method (the DETECT program) was investigated using simulation data under several conditions and applied to the Korean nursing licensing examination.
Results
The DETECT program performed well in terms of determining the number of underlying dimensions under several different conditions in the simulated data. Further, the DETECT program correctly revealed the internal structure of the Korean nursing licensing examination, meaning that it detected the proper number of dimensions and appropriately clustered the items within each dimension.
Conclusion
The DETECT program performed well in detecting the number of dimensions and in assigning items for each dimension. This result implies that the DETECT method can be useful for examining the internal structure of assessments, such as licensing examinations, that possess relatively many domains and content areas.

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Meanings of Rough Sex across Gender, Sexual Identity, and Political Ideology: A Conditional Covariance Approach
Dubravka Svetina Valdivia, Debby Herbenick, Tsung-chieh Fu, Heather Eastman-Mueller, Lucia Guerra-Reyes, Molly Rosenberg
Journal of Sex & Marital Therapy.2022; 48(6): 579. CrossRef
The accuracy and consistency of mastery for each content domain using the Rasch and deterministic inputs, noisy “and” gate diagnostic classification models: a simulation study and a real-world analysis using data from the Korean Medical Licensing Examinat
Dong Gi Seo, Jae Kum Kim
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Estimation of item parameters and examinees’ mastery probability in each domain of the Korean Medical Licensing Examination using a deterministic inputs, noisy “and” gate (DINA) model
Younyoung Choi, Dong Gi Seo
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Journal of Educational Evaluation for Health Professions.2018; 15: 26. CrossRef

Educational/faculty development material

The reach of Spanish-language YouTube videos on physical examinations made by undergraduate medical students: José M. Ramos-Rincón, Isabel Belinchón-Romero, Francisco Sánchez-Ferrer, Guillermo Martínez-de la Torre, Meggan Harris, Javier Sánchez-Fernández; J Educ Eval Health Prof. 2017;14:31. Published online December 19, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.31

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220 Download
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Abstract PDF Supplementary Material

This study was conducted to evaluate the performance and reach of YouTube videos on physical examinations made by Spanish university students. We analyzed performance metrics for 4 videos on physical examinations in Spanish that were created by medical students at Miguel Hernández University (Elche, Spain) and are available on YouTube, on the following topics: the head and neck (7:30), the cardiovascular system (7:38), the respiratory system (13:54), and the abdomen (11:10). We used the Analytics application offered by the YouTube platform to analyze the reach of the videos from the upload date (February 17, 2015) to July 28, 2017 (2 years, 5 months, and 11 days). The total number of views, length of watch-time, and the mean view duration for the 4 videos were, respectively: 164,403 views (mean, 41,101 views; range, 12,389 to 94,573 views), 425,888 minutes (mean, 106,472 minutes; range, 37,889 to 172,840 minutes), and 2:56 minutes (range, 1:49 to 4:03 minutes). Mexico was the most frequent playback location, followed by Spain, Colombia, and Venezuela. Uruguay, Ecuador, Mexico, and Puerto Rico had the most views per 100,000 population. Spanish-language tutorials are an alternative tool for teaching physical examination skills to students whose first language is not English. The videos were especially popular in Uruguay, Ecuador, and Mexico.

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Qian Liu, Susan Geertshuis, Tehmina Gladman, Rebecca Grainger
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Opinion

An empirical approach to assessing training needs for emergency department management of intentional self-harm and related behaviors in the United States: Monica Whitehead, Jeffrey Shahidullah, Paul Kettlewell, Nicole Quinlan, Robert Strony; J Educ Eval Health Prof. 2017;14:30. Published online December 14, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.30

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Research articles

Efficacy of an asynchronous electronic curriculum in emergency medicine education in the United States: Alisa Wray, Kathryn Bennett, Megan Boysen-Osborn, Warren Wiechmann, Shannon Toohey; J Educ Eval Health Prof. 2017;14:29. Published online December 11, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.29

31,686 View
241 Download
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Abstract PDF Supplementary Material

Purpose
The aim of this study was to measure the effect of an iPad-based asynchronous curriculum on emergency medicine resident performance on the in-training exam (ITE). We hypothesized that the implementation of an asynchronous curriculum (replacing 1 hour of weekly didactic time) would result in non-inferior ITE scores compared to the historical scores of residents who had participated in the traditional 5-hour weekly didactic curriculum.
Methods
The study was a retrospective, non-inferiority study. conducted at the University of California, Irvine Emergency Medicine Residency Program. We compared ITE scores from 2012 and 2013, when there were 5 weekly hours of didactic content, with scores from 2014 and 2015, when 1 hour of conference was replaced with asynchro-nous content. Examination results were compared using a non-inferiority data analysis with a 10% margin of difference.
Results
Using a non-inferiority test with a 95% confidence interval, there was no difference between the 2 groups (before and after implementation of asynchronous learning), as the confidence interval for the change of the ITE was −3.5 to 2.3 points, whereas the 10% non-inferiority margin was 7.8 points.
Conclusion
Replacing 1 hour of didactic conference with asynchronous learning showed no negative impact on resident ITE scores.

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Ronald Rivera, Jonathan Smart, Sangeeta Sakaria, Alisa Wray, Warren Wiechmann, Megan Boysen-Osborn, Shannon Toohey
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Developing a framework for evaluating the impact of Healthcare Improvement Science Education across Europe: a qualitative study: Manuel Lillo-Crespo, M. Cristina Sierras-Davó, Rhoda MacRae, Kevin Rooney; J Educ Eval Health Prof. 2017;14:28. Published online November 29, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.28

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Abstract PDF Supplementary Material

Purpose
Frontline healthcare professionals are well positioned to improve the systems in which they work. Educational curricula, however, have not always equipped healthcare professionals with the skills or knowledge to implement and evaluate improvements. It is important to have a robust and standardized framework in order to evaluate the impact of such education in terms of improvement, both within and across European countries. The results of such evaluations will enhance the further development and delivery of healthcare improvement science (HIS) education. We aimed to describe the development and piloting of a framework for prospectively evaluating the impact of HIS education and learning.
Methods
The evaluation framework was designed collaboratively and piloted in 7 European countries following a qualitative methodology. The present study used mixed methods to gather data from students and educators. The framework took the Kirkpatrick model of evaluation as a theoretical reference.
Results
The framework was found to be feasible and acceptable for use across differing European higher education contexts according to the pilot study and the participants’ consensus. It can be used effectively to evaluate and develop HIS education across European higher education institutions.
Conclusion
We offer a new evaluation framework to capture the impact of HIS education. The implementation of this tool has the potential to facilitate the continuous development of HIS education.

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Evaluation of cost-effectiveness of single-credit traffic safety course based on Kirkpatrick model: a case study of Iran
Mina Golestani, Homayoun Sadeghi-bazargani, Sepideh Harzand-Jadidi, Hamid Soori
BMC Medical Education.2024;[Epub] CrossRef
Yemen Advanced Field Epidemiology Training Program: An Impact Evaluation, 2021
Maeen Abduljalil, Abdulhakeem Al Kohlani, Aisha Jumaan, Abdulwahed Al Serouri
Epidemiologia.2023; 4(3): 235. CrossRef
How, and under what contexts, do academic–practice partnerships collaborate to implement healthcare improvement education into preregistration nursing curriculums: a realist review protocol
Lorraine Armstrong, Chris Moir, Peta Taylor
BMJ Open.2023; 13(10): e077784. CrossRef
Developing the American College of Surgeons Quality Improvement Framework to Evaluate Local Surgical Improvement Efforts
Clifford Y. Ko, Tejen Shah, Heidi Nelson, Avery B. Nathens
JAMA Surgery.2022; 157(8): 737. CrossRef
Kirkpatrick Model: Its Limitations as Used in Higher Education Evaluation
Michael CAHAPAY
International Journal of Assessment Tools in Education.2021; 8(1): 135. CrossRef
Transforming the Future Healthcare Workforce across Europe through Improvement Science Training: A Qualitative Approach
Maria Cristina Sierras-Davo, Manuel Lillo-Crespo, Patricia Verdu, Aimilia Karapostoli
International Journal of Environmental Research and Public Health.2021; 18(3): 1298. CrossRef
Qualitative evaluation of an educational intervention about healthcare improvement for nursing students
María Cristina Sierras-Davó, Manuel Lillo-Crespo, Patricia Verdú Rodríguez
Aquichan.2021; 21(1): 1. CrossRef
Evaluation of Advanced Field Epidemiology Training Programs in the Eastern Mediterranean Region: A Multi-Country Study
Mohannad Al Nsour, Yousef Khader, Haitham Bashier, Majd Alsoukhni
Frontiers in Public Health.2021;[Epub] CrossRef
The United Kingdom Field Epidemiology Training Programme: meeting programme objectives
Paola Dey, Jeremy Brown, John Sandars, Yvonne Young, Ruth Ruggles, Samantha Bracebridge
Eurosurveillance.2019;[Epub] CrossRef
Mapping the Status of Healthcare Improvement Science through a Narrative Review in Six European Countries
Manuel Lillo-Crespo, Maria Cristina Sierras-Davó, Alan Taylor, Katrina Ritters, Aimilia Karapostoli
International Journal of Environmental Research and Public Health.2019; 16(22): 4480. CrossRef

Opinion

Utility of eye-tracking technology for preparing medical students in Spain for the summative objective structured clinical examination: Francisco Sánchez-Ferrer, J.M. Ramos-Rincón, M.D. Grima-Murcia, María Luisa Sánchez-Ferrer, Francisco Sánchez-del Campo, Antonio F. Compañ-Rosique, Eduardo Fernández-Jover; J Educ Eval Health Prof. 2017;14:27. Published online November 12, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.27

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Assessment methods and the validity and reliability of measurement tools in online objective structured clinical examinations: a systematic scoping review
Jonathan Zachary Felthun, Silas Taylor, Boaz Shulruf, Digby Wigram Allen
Journal of Educational Evaluation for Health Professions.2021; 18: 11. CrossRef
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Yera Hur
Journal of Educational Evaluation for Health Professions.2017; 14: 36. CrossRef

Research articles

Perception survey on the introduction of clinical performance examination as part of the national nursing licensing examination in Korea: Su Jin Shin, Yeong Kyeong Kim, Soon-Rim Suh, Duk Yoo Jung, Yunju Kim, Mi Kyoung Yim; J Educ Eval Health Prof. 2017;14:26. Published online October 25, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.26

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Abstract PDF

Purpose
The purpose of this study was to analyze opinions about the action plan for implementation of clinical performance exam as part of the national nursing licensing examination and presents the expected effects of the performance exam and aspects to consider regarding its implementation.
Methods
This study used a mixed-methods design. Quantitative data were collected by a questionnaire survey, while qualitative data were collected by focus group interviews with experts. The survey targeted 200 nursing professors and clinical nurses with more than 5 years of work experience, and the focus group interviews were conducted with 28 of professors, clinical instructors, and nurses at hospitals.
Results
First, nursing professors and clinical specialists agreed that the current written tests have limitations in evaluating examinees’ ability, and that the introduction of a clinical performance exam will yield positive results. Clinical performance exam is necessary to evaluate and improve nurses’ work ability, which means that the implementation of a performance exam is advisable if its credibility and validity can be verified. Second, most respondents chose direct performance exams using simulators or standardized patients as the most suitable format of the test.
Conclusion
In conclusion, the current national nursing licensing exam is somewhat limited in its ability to identify competent nurses. Thus, the time has come for us to seriously consider the introduction of a performance exam. The prerequisites for successfully implementing clinical performance exam as part of the national nursing licensing exam are a professional training process and forming a consortium to standardize practical training.

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The Clinical Nursing Competency Assessment System of Ghana: Perspectives of Key Informants
Oboshie Anim-Boamah, Christmal Dela Christmals, Susan Jennifer Armstrong
SAGE Open.2022; 12(2): 215824402210899. CrossRef
Adaptation of Extended Reality Smart Glasses for Core Nursing Skill Training Among Undergraduate Nursing Students: Usability and Feasibility Study
Sun Kyung Kim, Youngho Lee, Hyoseok Yoon, Jongmyung Choi
Journal of Medical Internet Research.2021; 23(3): e24313. CrossRef
Nursing Students’ Experiences on Clinical Competency Assessment in Ghana
Oboshie Anim-Boamah, Christmal Dela Christmals, Susan Jennifer Armstrong
Nurse Media Journal of Nursing.2021; 11(3): 278. CrossRef
Clinical nursing competency assessment: a scoping review
Oboshie Anim-Boamah, Christmal Dela Christmals, Susan Jennifer Armstrong
Frontiers of Nursing.2021; 8(4): 341. CrossRef
Factors Influencing the Success of the National Nursing Competency Examination taken by the Nursing Diploma Students in Yogyakarta
Yulia Wardani
Jurnal Ners.2020; 14(2): 172. CrossRef

Evaluation of a course to prepare international students for the United States Medical Licensing Examination step 2 clinical skills exam: Rachel B. Levine, Andrew P. Levy, Robert Lubin, Sarah Halevi, Rebeca Rios, Danelle Cayea; J Educ Eval Health Prof. 2017;14:25. Published online October 24, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.25

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Abstract PDF

Purpose
United States (US) and Canadian citizens attending medical school abroad often desire to return to the US for residency, and therefore must pass US licensing exams. We describe a 2-day United States Medical Licensing Examination (USMLE) step 2 clinical skills (CS) preparation course for students in the Technion American Medical School program (Haifa, Israel) between 2012 and 2016.
Methods
Students completed pre- and post-course questionnaires. The paired t-test was used to measure students’ perceptions of knowledge, preparation, confidence, and competence in CS pre- and post-course. To test for differences by gender or country of birth, analysis of variance was used. We compared USMLE step 2 CS pass rates between the 5 years prior to the course and the 5 years during which the course was offered.
Results
Ninety students took the course between 2012 and 2016. Course evaluations began in 2013. Seventy-three students agreed to participate in the evaluation, and 64 completed the pre- and post-course surveys. Of the 64 students, 58% were US-born and 53% were male. Students reported statistically significant improvements in confidence and competence in all areas. No differences were found by gender or country of origin. The average pass rate for the 5 years prior to the course was 82%, and the average pass rate for the 5 years of the course was 89%.
Conclusion
A CS course delivered at an international medical school may help to close the gap between the pass rates of US and international medical graduates on a high-stakes licensing exam. More experience is needed to determine if this model is replicable.

Citations

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Cultural Considerations in the Formal Process of Simulation Curriculum Adaptation: A Scoping Review
Matthew D. Charnetski, Maryam Asoodar, Hao Yu, Walther van Mook
Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare.2023;[Epub] CrossRef
Immigrant Neurologists in the United States
Abhimanyu Mahajan, Zachary London, Andrew M. Southerland, Jaffar Khan, Erica A. Schuyler
Neurology.2021; 96(8): 378. CrossRef
Three Decades Later: A Scoping Review of the Literature Related to the United States Medical Licensing Examination
Hanin Rashid, Kristen M. Coppola, Robert Lebeau
Academic Medicine.2020; 95(11S): S114. CrossRef
Improving Passage Rate on USMLE Step 2 Clinical Skills: Results from a Pilot Program
Michael S. Ryan, Melissa Bradner, Fidelma Rigby, Bennett Lee, Elizabeth Waterhouse, Catherine Grossman
Medical Science Educator.2019; 29(3): 709. CrossRef

Does the acceptance of hybrid learning affect learning approaches in France?: Lionel Di Marco, Alain Venot, Pierre Gillois; J Educ Eval Health Prof. 2017;14:24. Published online October 20, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.24

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Abstract PDF

Purpose
Acceptance of a learning technology affects students’ intention to use that technology, but the influence of the acceptance of a learning technology on learning approaches has not been investigated in the literature. A deep learning approach is important in the field of health, where links must be created between skills, knowledge, and habits. Our hypothesis was that acceptance of a hybrid learning model would affect students’ way of learning.
Methods
We analysed these concepts, and their correlations, in the context of a flipped classroom method using a local learning management system. In a sample of all students within a single year of study in the midwifery program (n= 38), we used 3 validated scales to evaluate these concepts (the Study Process Questionnaire, My Intellectual Work Tools, and the Hybrid E-Learning Acceptance Model: Learner Perceptions).
Results
Our sample had a positive acceptance of the learning model, but a neutral intention to use it. Students reported that they were distractible during distance learning. They presented a better mean score for the deep approach than for the superficial approach (P< 0.001), which is consistent with their declared learning strategies (personal reorganization of information; search and use of examples). There was no correlation between poor acceptance of the learning model and inadequate learning approaches. The strategy of using deep learning techniques was moderately correlated with acceptance of the learning model (r_s= 0.42, P= 0.03).
Conclusion
Learning approaches were not affected by acceptance of a hybrid learning model, due to the flexibility of the tool. However, we identified problems in the students’ time utilization, which explains their neutral intention to use the system.

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Lei Zhu, Hui Xiong, Yan Ning, Miaomiao Lv
Sustainability.2023; 15(9): 7120. CrossRef
Online learning and teaching approaches used in midwifery programs: A scoping review
Terri Downer, Michelle Gray, Tanya Capper
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Elizabeth Ann Florence, Tammi Kolski
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User-centered evaluation of Discord in midwifery education during the COVID-19 pandemic: Analysis of the adaptation of the tool to student needs
Lionel Di Marco
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Computational and Mathematical Methods in Medicine.2021; 2021: 1. CrossRef
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Fares Gouzi, François Bughin, Lucie Barateau, Agathe Hubert, Savine Volland, Dalila Laoudj-Chenivesse, Emilie Passerieux, Régis Lopez, Antonia Perez-Martin, Iris Schuster-Beck, Stephan Matecki, Michel Dauzat, Yves Dauvilliers, Maurice Hayot, Jacques Merci
Pédagogie Médicale.2018; 19(2): 77. CrossRef

Opinion

Suggestions for a standard clinical practice curriculum and learning objectives for physical therapy education in Korea: Tae Young Oh, Kyung Soon Lee, Byung Jo Kim; J Educ Eval Health Prof. 2017;14:23. Published online October 19, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.23

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Integrated clinical experience with concurrent problem-based learning is associated with improved clinical reasoning among physical therapy students in the United States
Brad Warren Willis, Anita Sethi Campbell, Stephen Paul Sayers, Kyle Gibson
Journal of Educational Evaluation for Health Professions.2018; 15: 30. CrossRef

Research articles

Unmet needs in health training among nurses in rural Chinese township health centers: a cross-sectional hospital-based study: Yan Mo, Guijie Hu, Yanhua Yi, Yanping Ying, Huiqiao Huang, Zhongxian Huang, Jiafeng Lin; J Educ Eval Health Prof. 2017;14:22. Published online October 4, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.22

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Abstract PDF

Purpose
Maintaining a sufficient and competent rural nursing workforce is an important goal of the Chinese health delivery system. However, few studies have investigated the health training status or conducted a needs assessment of rural Chinese nurses during this time of great transformations in health policy. This study was conducted to explore the current health training status of nurses working in rural Chinese township health centers (THCs) and to ascertain their perceived needs.
Methods
A cross-sectional survey using a self-administered structured questionnaire was conducted among 240 THC nurses in Guangxi Zhuang Autonomous Region, China from March 2014 to August 2014. The survey questionnaire was adapted from the Second Chinese Survey of Demographic Data and Training Demand for Health Professionals in THCs developed by the Ministry of Education.
Results
The nurses in THCs were young, with a low educational level. Their perceived needs for health training included further clinical studies at city-level hospitals to improve their skills and theoretical studies at medical universities in emergency medicine and general practice. Overall, 71.9% of the nurses with a secondary technical school background expected to pursue junior college studies, and 68.5% of the nurses with a junior college education expected to pursue a bachelor’s degree. A decentralized program with theoretical studies at medical universities and practical studies at county hospitals was regarded as feasible by 66.9% of the respondents.
Conclusion
Health-training programs for nurses in Chinese THCs must be improved in terms of coverage, delivery mode, and content. A decentralized degree-linked training program in which medical universities and city hospitals collaborate would be an appropriate mode of delivery.

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Business Cycle and Public Health: The Moderating Role of Health Education and Digital Economy
Xing Zhang, Yingying Xu
Frontiers in Public Health.2022;[Epub] CrossRef
Needs and difficulties of Tibetan rural health care workers participating in professional training
Ling Chen, Jie Liu, Zhihui Zheng, Sangphel Yeshi
Australian Journal of Rural Health.2021; 29(4): 578. CrossRef
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Xin Shen, Jingru Li, Tianyi Dong, Hui Cao, Jing Feng, Zihui Lei, Zijian Wang, Xiaotong Han, Chuanzhu Lv, Yong Gan
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Current issues and areas for improvement in the Korean Dental Hygienist National Licensing Examination: an expert Delphi survey among dental hygienists: Yoon-Sook Hwang, Hyun-Sook Kang, Soo-Hwa Kim, Hee-Jung Moon, Sun-Mi Lee, Jae-Yeon Jung, Su-Jeong Hwang, Jung-Eun Ha; J Educ Eval Health Prof. 2017;14:21. Published online September 13, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.21

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Abstract PDF: Purpose
This study aimed to investigate current issues and areas for improvement in the Korean Dental Hygienist National Licensing Examination (KDHNLE) through an expert Delphi survey.
Methods
A Delphi survey was conducted from May through August 2016 in Korea. This Delphi survey included 20 persons representing the field of dental hygiene (7 groups from various dental hygiene-related organizations). The Delphi survey was administered through e-mail as 3 rounds of questionnaire surveys regarding the issues facing the KDHNLE and potential solutions to those challenges. The primary Delphi survey was an open questionnaire. In each round, subjects’ responses were categorized according to the detailed themes of their responses. The minimum value of the content validity ratio of the survey results was determined by the number of panels participating in the Delphi survey.
Results
Issues facing the KDHNLE were identified from the results of the Delphi survey. The following 4 items had an average importance score of 4.0 or higher and were considered as important by over 85% of the panels: the failure of the practical test to reflect actual clinical settings, the focus of the practical test on dental scaling, the gap between the items evaluated on the national examination and actual practical work, and insufficiency in strengthening the expertise of licensed dental hygienists. The following items were suggested for improvement: more rigorous rater training, adjustment of the difficulty of the licensing examination, the introduction of a specialized dental hygienist system, and more rigorous refresher training for licensed dental hygienists.
Conclusion
Based on the above results, the KDHNLE should be improved according to the core competencies of dental hygienists, including on-site clinical practice experience.

Technical report

Item development process and analysis of 50 case-based items for implementation on the Korean Nursing Licensing Examination: In Sook Park, Yeon Ok Suh, Hae Sook Park, So Young Kang, Kwang Sung Kim, Gyung Hee Kim, Yeon-Hee Choi, Hyun-Ju Kim; J Educ Eval Health Prof. 2017;14:20. Published online September 11, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.20

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Abstract PDF

Purpose
The purpose of this study was to improve the quality of items on the Korean Nursing Licensing Examination by developing and evaluating case-based items that reflect integrated nursing knowledge.
Methods
We conducted a cross-sectional observational study to develop new case-based items. The methods for developing test items included expert workshops, brainstorming, and verification of content validity. After a mock examination of undergraduate nursing students using the newly developed case-based items, we evaluated the appropriateness of the items through classical test theory and item response theory.
Results
A total of 50 case-based items were developed for the mock examination, and content validity was evaluated. The question items integrated 34 discrete elements of integrated nursing knowledge. The mock examination was taken by 741 baccalaureate students in their fourth year of study at 13 universities. Their average score on the mock examination was 57.4, and the examination showed a reliability of 0.40. According to classical test theory, the average level of item difficulty of the items was 57.4% (80%–100% for 12 items; 60%–80% for 13 items; and less than 60% for 25 items). The mean discrimination index was 0.19, and was above 0.30 for 11 items and 0.20 to 0.29 for 15 items. According to item response theory, the item discrimination parameter (in the logistic model) was none for 10 items (0.00), very low for 20 items (0.01 to 0.34), low for 12 items (0.35 to 0.64), moderate for 6 items (0.65 to 1.34), high for 1 item (1.35 to 1.69), and very high for 1 item (above 1.70). The item difficulty was very easy for 24 items (below −2.0), easy for 8 items (−2.0 to −0.5), medium for 6 items (−0.5 to 0.5), hard for 3 items (0.5 to 2.0), and very hard for 9 items (2.0 or above). The goodness-of-fit test in terms of the 2-parameter item response model between the range of 2.0 to 0.5 revealed that 12 items had an ideal correct answer rate.
Conclusion
We surmised that the low reliability of the mock examination was influenced by the timing of the test for the examinees and the inappropriate difficulty of the items. Our study suggested a methodology for the development of future case-based items for the Korean Nursing Licensing Examination.

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Kyunghee Kim, So Young Kang, Younhee Kang, Youngran Kweon, Hyunjung Kim, Youngshin Song, Juyeon Cho, Mi-Young Choi, Hyun Su Lee
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Nandita Bhanja Chaudhuri, Debayan Dhar, Pradeep G. Yammiyavar
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