Predictor Of Clinical Performance Research Articles

Predictors of Clinical Performance Among Emergency Nurses: A Cross-Sectional Study.

Poor nursing performance is considered a threat to patient safety, affecting the quality of care provided and ultimately impacting patient outcomes. The main aim of this study was to identify the predictors of nursing performance. A cross-sectional predictive design was used. A convenient sampling technique was used to recruit 251 emergency nurses in three health sectors. They were assessed using the secondary traumatic stress scale and the nursing performance scale. Data were collected between June and August 2022. Nurses experienced severe levels of secondary traumatic stress (M = 57.9, SD = 14.94). The nursing performance level was below average (M = 27.48, SD = 9.36), and the mental performance subscale received the lowest rating (M = 5.82, SD = 2.69). There was a strong negative association between the secondary traumatic stress total score and the total score of nursing performance (r = -.77). Additionally, factors such as high body mass index, smoking, the presence of chronic diseases, working overtime, and high levels of secondary traumatic stress were identified as significant predictors of nursing performance. It is recommended that emergency nurses be provided with treatment programs and interventions to reduce their secondary traumatic stress to improve their performance, thereby ensuring high-quality patient care.

A Phenomenological Exploration of Experiences Related to Learning Styles Among Undergraduate Medical Students in a Barbadian Medical School.

Learning style (LS) frameworks have been implemented by educators to promote participatory learning in order to strengthen learner engagement and to enhance learning outcomes. Self-efficacy has been shown to have an association with learning style and is a predictor of clinical performance and other qualities in medical students. This study examined the perspectives of second and final year medical students in a Caribbean-based medical school, relative to their learning approaches, teaching exposures and preparation for assessments. An interpretivist qualitative approach was used to analyze data from two focus groups, conducted as part of a sequential mixed-methods study (November 2018-February 2019) with medical students in the second and final year of study. Discussions were audio-recorded, transcribed verbatim, and inductively coded with in-depth thematic analysis assisted by NVivo software. Six Year 2 (Female: Male = 5:1) and seven Year 5 (Female: Male = 5:2) participants, ranging between 18 and 34 years and with a range of LS were recruited into the study. Analysis and data reduction produced three organizing themes: "Dynamics of information delivery and acquisition", "Pivoting", and "LS identification, awareness and mutability", and the global construct "Individual and environmental factors modulate the influence of LS preference in triggering self-efficacy". In managing information received in class, students used textbooks, YouTube videos, and collaborative learning to augment perceived gaps in lectures and their personal notes. Learning style self-awareness is useful for facilitating self-efficacy throughout medical school, especially at points of transition within the programme of study. LS theory and testing appear to be useful for student and teacher awareness. In practice, honing students' adaptability to varying learning settings may be more relevant in helping students achieve self-efficacy.

Predictors of clinical performance in comprehensive care cases in undergraduate dentists.

Achieving a high grade in the final-year comprehensive clinical care (CCC) course is not only important for the individual candidate but also to ensure competency of students as they transition from dental school into independent practice. Here, we aimed to identify predictors of success in the CCC that might prove useful to identify which, if any, students need focused intervention to improve their performance in the CCC. This was a cross-sectional study of two consecutive cohorts (2017-2018 and 2018-2019) of final-year (Year six) dental students (n= 180 females and n= 150 males) attending [King Abdulaziz University], Saudi Arabia. Age, gender, cumulative GPA to the start of Year six and assessment results were tabulated and analysed as independent variables in binary logistic regression to identify predictors of the final case grade (≤69% or >70%). Year five GPA (OR 1.07, 95% CI 1.02-1.12; p= .004) and female gender (OR 2.21, 95% CI 1.12-4.36; p= .02) were significantly associated with an increased odds of achieving a final case grade >70%. In particular, female students were over twice as likely as male students to achieve a higher score in their final case assessment. This study suggests that gender may influence final performance in the CCC. The better performance of females in the final CCC course than their male counterparts suggests that there may be a narrowing or even reversal of the historical gender gap in dental school performance. Both cognitive (GPA) and other (i.e. gender) factors influence clinical dental performance. Further work is required to establish what instructional modifications are required to accommodate these gender differences in CCC courses to pave the way for personalised teaching approaches to optimise educational outcomes.

Assessment of non-scholastic skills (non-clinical) in trainee residents.

Doctors are clinicians and are trained in clinical work. Many non-clinical qualities, apart from the ability to examine and treat, matter a lot in their professional success. Traditionally, knowing the book well or mastering the content of the curriculum was considered enough to succeed in a medical career, but recent recognition of having good communication skills in a physician has changed the medical curricula the world over. A recent look at the formative assessments done to see the on-job trainees during their residencies in various countries, like India, the United States and Turkey, has revealed that most trainees are overworked and find it difficult to cope with the demanding training requirements centred around mastering the clinical skills. The supervisors are also very busy. Non-scholastic abilities, like good emotional quotient and extracurricular activities that do not directly relate to things learnt from the book or the ward are being graded as very important for medical students because all these abilities are essential for a doctor not only to help the patients medically and psychologically, but also emotionally. He should be able to protect his self from care-provider's stresses. Personal qualities of a doctor are seen as important predictors of clinical performance in medicine. There are opportunities during training that the senior trainer can become a role model and impart non-scholastic skills most effectively. Supervisors must show their trainees how to behave with a patient. This change in attitude and behaviour has to be induced by performing these things in front of the trainee residents. The problem with non-scholastic skills, unlike the scholastic cognitive/psychomotor domains, is that these skills are quite elusive to routine assessments. However, lone reliance upon a final examination for assessing attitudes can be biased. If the behaviour of residents is to be tested in an exit examination they are likely to behave more consciously only to pass the examination, which is called the Hawthorne effect. No one can ensure that one behaves in a uniform manner in every social situation. Our responses may vary every day in the face of emerging challenges. Probably a balanced combination of formative plus summative assessment supplemented with a well-planned continuous internal assessment is the answer.

Association Between Critical Thinking and Academic Performance in Dental Hygiene Students.

Critical thinking is a key element of complex problem-solving that facilitates health professionals' clinical practice and professional behavior. Despite the importance of critical thinking, the measurement of critical thinking skills and its associations with academic performance remains a challenge. The aim of this study was to determine the associations between critical thinking and academic performance among undergraduate dental hygiene students. All 63 third- and fourth-year baccalaureate degree dental hygiene students (Class of 2018 and Class of 2017, respectively) in The Ohio State University Dental Hygiene Program were invited to participate in this quantitative, cross-sectional research study. Critical thinking was measured with the California Critical Thinking Disposition Inventory (CCTDI) and the Health Sciences Reasoning Test with Numeracy (HSRT-N). A total of 45 students completed the two tests, for an overall response rate of 71.4%. For the Class of 2018, the response rate was 90.6% (n=29), and for the Class of 2017, the response rate was 51.6% (n=16). The results showed the CCTDI and HSRT-N scores were higher for the Class of 2017 than the Class of 2018, suggesting that critical thinking skills were being developed across the course of the curriculum. The CCTDI was not significantly correlated with or a predictor of academic performance. The HSRT-N was more correlated with clinical performance than was the CCTDI, and HSRT-N components were found to be predictors of clinical performance. Continued attention is needed in the development and measurement of critical thinking skills to improve the academic and clinical performance of undergraduate dental hygiene students.

Association Between Emotional Intelligence and Academic Performance Among Dental Hygiene Students.

Emotional intelligence (EI) has been increasingly associated with the success of health care professionals, including dental professionals. Mental health, physical health, and life satisfaction all have been linked to having a high EI. The aim of this study was to determine any associations between EI scores and academic and clinical performance in a cohort of undergraduate dental hygiene students. All 63 first- and second-year dental hygiene students enrolled at The Ohio State University in the spring term 2017 were invited to participate in this quantitative cross-sectional study. The survey consisted of demographic questions and 30 emotional quotient self-assessment checklist questions divided into six EI subsets. The EI subset scores were then correlated with students' academic and clinical grades. A total of 45 students completed the questionnaire, for a response rate of 71.4%. Most of the participants scored between 16 and 19 for each EI domain, meaning they had a moderate EI level. A significant regression equation of EI subset scores and clinical GPA was found (F(3,41)=7.474, p<0.001), with an R2 of 0.354. Simple linear regression was calculated to predict clinical performance based on EI, and a significant regression equation was found (F(3,41)=6.727, p<0.001), with an R2 of 0.330. The EI subsets of self-control, motivation, and self-confidence were found to be predictors of overall academic performance. The EI subsets of social competence, empathy, and motivation were found to be predictors of clinical performance. These results suggest that more attention to the development of emotional intelligence may lead to improved academic and clinical performance among undergraduate dental hygiene students.

Chairside CAD/CAM materials. Part 3: Cyclic fatigue parameters and lifetime predictions

ObjectivesChemical and mechanical degradation play a key role on the lifetime of dental restorative materials. Therefore, prediction of their long-term performance in the oral environment should base on fatigue, rather than inert strength data, as commonly observed in the dental material’s field. The objective of the present study was to provide mechanistic fatigue parameters of current dental CAD/CAM materials under cyclic biaxial flexure and assess their suitability in predicting clinical fracture behaviors. MethodsEight CAD/CAM materials, including polycrystalline zirconia (IPS e.max ZirCAD), reinforced glasses (Vitablocs Mark II, IPS Empress CAD), glass-ceramics (IPS e.max CAD, Suprinity PC, Celtra Duo), as well as hybrid materials (Enamic, Lava Ultimate) were evaluated. Rectangular plates (12×12×1.2mm3) with highly polished surfaces were prepared and tested in biaxial cyclic fatigue in water until fracture using the Ball-on-Three-Balls (B3B) test. Cyclic fatigue parameters n and A* were obtained from the lifetime data for each material and further used to build SPT diagrams. The latter were used to compare in-vitro with in-vivo fracture distributions for IPS e.max CAD and IPS Empress CAD. ResultsSusceptibility to subcritical crack growth under cyclic loading was observed for all materials, being more severe (n≤20) in lithium-based glass-ceramics and Vitablocs Mark II. Strength degradations of 40% up to 60% were predicted after only 1 year of service. Threshold stress intensity factors (Kth) representing the onset of subcritical crack growth (SCG), were estimated to lie in the range of 0.37–0.44 of KIc for the lithium-based glass-ceramics and Vitablocs Mark II and between 0.51–0.59 of KIc for the other materials. Failure distributions associated with mechanistic estimations of strength degradation in-vitro showed to be useful in interpreting failure behavior in-vivo. The parameter Kth stood out as a better predictor of clinical performance in detriment to the SCG n parameter. SignificanceFatigue parameters obtained from cyclic loading experiments are more reliable predictors of the mechanical performance of contemporary dental CAD/CAM restoratives than quasi-static mechanical properties.

MSC Functional Phenotype: Assay, Age and Source Dependence

We recently reported the use of human umbilical cord perivascular cells (HUCPVCs), delivered in a collagen sponge, in the healing of calvarial osteotomies in immune-suppressed rats, following their osteogenic differentiation in vitro. We compared these cells with a human bone marrow (BM) immortalized cell line, and also used conditioned medium from the latter to stimulate the osteogenic differentiation of the HUCPVCs. Our results showed that HUCPVCs provided statistically significant bony repair compared to controls, but failed to show osteogenic differentiation in vitro. On the contrary, BM cells exhibited high levels of alkaline phosphatase expression in vitro, in osteogenic assays, but when loaded onto collagen scaffolds and implanted did not produce a statistically different amount of bone from either sham or collagen-only controls. Our results demonstrated that the in vitro assays employed did not predict in vivo outcomes, and that the BM-MSC cell line employed, or CM from such cells, provided no osteogenic advantage over the use of HUCPVCs alone in vivo. Here, we discuss these findings in light of the contradictory findings of the functional phenotype of MSC within the context of the assay employed, the age of the donor, and the tissue source of the cells. From a therapeutic perspective, it is clear that only in vivo assays should be employed as predictors of clinical performance and that cells sourced from tissue originating from younger donors may be functionally more potent than adult tissue derived MSC sources.

Association Between Endovascular Performance in a Simulated Setting and in the Catheterization Laboratory

Simulation-based assessment studies have related simulator performance to clinical experience instead of actual clinical performance. This study validates a novel rating scale for coronary angiography (CA) performance and at the same time explores the association between CA performance in a simulated setting and in the catheterization laboratory. Ten cardiologists and cardiology residents with varying degrees of CA experience performed 2 CAs in the catheterization laboratory and 2 CAs in a simulated setting. The residents had prior simulator experience opposite cardiologists. Two raters assessed the operators' video-recorded performances using the novel CA rating scale (CARS). The correlation between CARS scores in the catheterization laboratory and the simulated setting was R = 0.20 (P = 0.195). Residents' scores were higher in the simulated setting than in the catheterization laboratory. The correlation between operators' previous clinical experience in CA and CARS scores was R = 0.65 (P = 0.005) in the catheterization laboratory and R = 0.11 (P = 0.353) in the simulated setting. The association between CA performance in a simulated setting and actual performance in the catheterization laboratory is not linear. The novel rating scale for CA (CARS) seems to be a valid proficiency assessment instrument in the catheterization laboratory. Familiarity with the simulator may overestimate proficiency, which means that simulator performance as a predictor of clinical performance should be interpreted with caution.

Contemporary adhesive bonding: bridging the gap between research and clinical practice

The dawn of minimally invasive dentistry has led to the development of materials which rely on the use of effective adhesion to bond to remaining tooth tissue. Successful adhesive bonding is dependent upon appreciating the quality of the dental substrate, appropriate clinical handling of the material and patient, together with an appreciation of the chemistry of the adhesive. This paper outlines the current status of contemporary bonding, with particular emphasis on translating laboratory-based evidence into clinical practice. Using laboratory-based evidence, the ability of a bond to achieve a seal to enamel appears to be the best predictor of clinical performance. This article discusses the issues raised when translating research data about adhesive bonding from the laboratory to clinical dental practice.

Critical Evaluation of Adhesive Test Methods Used in Dentistry

Through the years, numerous articles dealing with dental adhesives have been published in the dental literature. A critical comparison of such articles reveals large differences in measured values, differences that not only seem to be between products, but also between different research groups. Because of these differences, the objective of this paper was to critically review some fundamental aspects of adhesion, and relate those aspects to dental adhesive studies. The outcome of that review was not very encouraging, because research, particularly in fields such as mechanical engineering and physics, does not support the notion of an overall adhesive strength value as we usually define in dentistry. Instead, adhesive studies should approach the problem from a fracture mechanics point of view rather than from an overall strength point of view. This review reveals that it is time to abandon traditional strength testing and move toward an increased use of fracture toughness tests and fatigue tests. Having said that, it is also important to realize and accept that as long as we do not have strong evidences correlating clinical success with any particular adhesive test method, in vitro tests should not be used as predictors of clinical performance. Only when we have reliable correlations between in vitro test results and clinical performance such methods will have any practical meaning.

Information Collected During the Residency Match Process Does Not Predict Clinical Performance

To determine whether information collected during the National Resident Matching Program (NRMP) predicts clinical performance during residency. Ten faculty members rated the overall quality of 69 pediatric house officers as clinicians. After rating by the faculty, folders were reviewed for absolute rank on the NRMP match list; relative ranking (where they ranked in their postgraduate year 1 [PGY-1] group); scores on part I of the National Board of Medical Examiners (NBME) examination; grades during medical school pediatrics and internal medicine rotations; membership in the Alpha Omega Alpha Medical Honor Society; scores of faculty interviews during intern application; scores on the pediatric in-service examination during PGY-1; and scores on the American Board of Pediatrics certification examination. There was substantial agreement among faculty raters as to the overall quality of the residents (agreement rate, 0.60; kappa = 0.50; P = .001). There was little correlation between faculty ratings and absolute (r = 0.19; P = .11) or relative (r = 0.20; P = .09) ranking on the NRMP match list. Individuals ranked in the top 10 of the match list had higher faculty ratings than did their peers (mean +/- SD, 3.66+/-1.22 vs. 3.0+/-1.27; P = .03), as did individuals ranked highest in their PGY-1 group (mean +/- SD, 3.88+/-1.45 vs. 3.04+/-1.24; P = .03). There was no correlation between faculty ratings and scores on part I of the NBME examination (r = 0.10; P = .49) or scores on the American Board of Pediatrics certification examination (r = 0.22; P = . 11). There were weak correlations between faculty ratings and scores of faculty interviews during the intern application process (r = 0.27; P = .02) and scores on the pediatric in-service examination during PGY-1 (r = 0.28; P = .02). There was no difference in faculty ratings of residents who were elected to Alpha Omega Alpha during medical school (mean +/- SD, 3.32+/-1.21) as compared with those who were not (mean +/- SD, 3.08+/-1.34) (P = .25). There is significant agreement among faculty raters about the clinical competence of pediatric residents. Medical school grades, performance on standardized examinations, interviews during the intern application process, and match-list ranking are not predictors of clinical performance during residency.

Moral Reasoning as a Predictor of Clinical Practice: The Development of Physical Therapy Students Across the Professional Curriculum

ABSTRACT The purpose of this study was to test the relationship between moral reasoning, as demonstrated on the Defining Issues Test (DIT), and clinical performance of physical therapist students. Moral reasoning was also tested against eight admission variables as predictors of clinical performance. Subjects were 58 physical therapist students (II male, 47 female) enrolled in three programs. The DIT was administered to all subjects during their first week in the programs. Clinical performance ratings were collected at the conclusion of the students' first clinical affiliation. Participating programs agreed to use the Clinical Competence Scale as the clinical performance instrument. Data quality analysis was conducted to assess consistent application of the evaluation instrument by clinical instructors. Statistical procedures were conducted in three clusters of analysis: (1) Pearson product moment correlation coefficients computed for interval variables and clinical performance ratings, (2) multiple regression of clinical performance with moral reasoning (DIT), including an indicator variable for a qualitative factor clinical setting type, and (3) chi-square test with moral reasoning and clinical performance each distributed into three levels (high, medium, low). An alpha level of. 05 was used to test for significance. Moral reasoning (DIT) was the only variable to demonstrate a significant relationship with clinical performance (r=.28). Multiple regression of clinical per/ormance with moral reasoning, with facility type as a covariant, was significant (r=.44), accounting for 19.4% of the variance. Chi-square analysis resulted in a significant difference from expected frequency for the defined levels of moral reasoning and clinical performance. These find ings are consistent with previous research in medicine and nursing supporting moral reasoning as a predictor of clinical performance. As professional health care providers, physical therapists must possess the necessary moral reasoning skills and perspectives to recognize and resolve ethical dilemmas in clinical practice. In addition, the literature supports a link between the ability to resolve ethical conflicts and the ability to effectively manage complex practice issues. Understanding the relationship between moral reasoning and effective clinical practice is important in designing physical therapy curricula and supporting the development of students. INTRODUCTION The evolution of physical therapy toward professional autonomy requires that physical therapists expertly and efficiently evaluate patients and manage their care within an increasingly complex health care environment. 1-3 The successful physical therapist possesses the knowledge and clinical skills prescribed in professional competencies4 as well as the ability to synthesize, evaluate, and prioritize complex elements of patient management.2 Professional practice also includes the expectation that physical therapists will be morally accountable for this expertise and responsive to the ethical issues frequently occurring in physical therapy practices-8 The expansion of managed care, with increased oversight by financing agencies and incentives for controlling costs, virtually ensures the presence of ethical problems for providers as they attempt to balance patient need, professional obligations, and organizational expectations.9,10 Thus, competence in physical therapy includes the moral reasoning skills and perspectives necessary to recognize and address these ethical issues. The challenge for physical therapy educators is to understand and develop strategies for selecting and preparing students to function at this professional level. A variety of admission criteria are used by physical therapy programs to select those candidates who can be expected to succeed in the academic curriculum and ultimately in professional practice. While these admission criteria are useful in predicting student performance in the academic components of the curriculum, studies have demonstrated little or no correlation between conventional admission criteria and measures of performance in the clinical setting. …

Effect of schedule on reactogenicity and antibody persistence of acellular and whole-cell pertussis vaccines: value of laboratory tests as predictors of clinical performance

The performance of four acellular pertussis vaccines containing between two and five pertussis antigens combined with diphtheria and tetanus toxoids was compared with that of British whole-cell diphtheria/tetanus/pertussis (DTP) vaccine both in laboratory assays for potency, toxicity and immunogenicity, and for reactogenicity and immunogenicity in infants. Clinical responses were evaluated in double blind randomized Phase II trials using 3/5/9 month and 2/3/4 month schedules. The acellular DTPs had much lower toxicity than whole-cell DTP in laboratory tests and were significantly less pyrogenic than whole-cell DTP under both schedules. Local reactions were not consistently lower in acellular than whole-cell vaccinees and varied with the source of the diphtheria and tetanus antigens used. Differences in endotoxin level and content of active pertussis toxin (PT) between acellular DTP vaccines were not clinically significant. The reactogenicity advantage of the acellular vaccines was substantially reduced under the 2/3/4 month schedule due to the reduced reactogenicity of the whole-cell DTP vaccine when given at a younger age. There was no relationship between antigen content measured in micrograms per dose and ELISA antibody responses to filamentous haemagglutinin (FHA) and PT in infants, nor was murine immunogenicity predictive of immunogenicity in humans. Antibody response to PT was attenuated in the whole-cell group under the 2/3/4 month schedule but was unaffected in the group receiving acellular vaccines with individually purified components; antibody response to pertactin (69 kDa antigen) was similar in recipients of the whole-cell and component acellular vaccines under the 2/3/4 month schedule. PT antibody persistence until 4–5 years of age was significantly better in recipients of the component acellular than either the whole-cell vaccine or the co-purified acellular vaccine under the 3/5/9 month schedule. However, diphtheria antitoxin levels were reduced in acellular vaccine recipients under both schedules. Despite significantly lower tetanus potencies of the acellular vaccines in laboratory tests, no differences were found in tetanus anti-toxin responses in children.

Surface texture changes of a composite brushed with “tooth whitening” dentifrices

Objectives. The aim of this investigation was to evaluate the significance of selected surface texture parameters used to describe and quantify the effect of tooth brushing with various “tooth whitening” dentifrices on a resin composite surface in vitro. Methods. Specimens of a microfil resin composite were brushed with selected dentifrices. Surface texture profiles were acquired and analyzed both pre- and post-brushing using a contact diamond stylus. The selected parameters chosen to describe the surface texture were Ra, Rz, Rpm and the Rpm:Rz ratio. Differences between toothpastes were assessed using an ANOVA and a multiple comparisons test, the Student Newman-Keuls procedure. P and t values were calculated to determine if any of the surface roughness parameters were significantly changed by brushing. Results. The results indicate that there were significant changes in the surface texture of the resin composite following tooth brushing with the selected dentifrices. For example, the use of Clinomyn significantly increased the surface roughness of the resin composite, as measured by the Rz parameter, from 2.19 ± 1.67 μm to 10.02 ± 2.57 μm (p < 0.05). In addition, the surface texture parameters chosen to describe the properties of the surface should reflect a knowledge of profile shape such as Rpm:Rz ratio, and care should be taken if measurements of surface texture of dental restorative materials are to be used as predictors of clinical performance. Significance. All the toothpastes chosen for this investigation left a surface on the resin composite which may be prone to crack propagation during “vertical barrelling” movements generated during mastication. However, this may be more of a function of the rigidity of the restorative material rather than the surface left after tooth brushing.

Predictors of clinical performance among internal medicine residents

To determine whether personal characteristics influence residents' psychological states during training and to evaluate the relative importance of personal characteristics and psychological states in predicting clinical performance. Cohort study utilizing prospective, serial surveys of emotions (anxiety, depression, competence) and attitudes (satisfaction with the decision to become a physician) among two classes of internal medicine residents during all years of their training. Subjects completed a socio-demographic survey at the conclusion of training, and faculty-assigned clinical ranks and examination scores were used to rate their clinical performances. Personal characteristics had a stronger relationship to psychological states during the first training year than in subsequent years. The highest association was found for depression, for which 25% of the variation was accounted for by personal characteristics. The combination of personal characteristics and psychological states explained 48% of the variation in clinical ranks and 38% of the variation in American Board of Internal Medicine certifying examination scores. There are recognizable relationships among the personal characteristics of residents, their psychologic states during training, and their clinical performances. These results should be helpful to program directors and faculty in identifying potentially weak residents and avoiding pitfalls when working with troubled residents.

Using a standardized-patient examination to establish the predictive validity of the MCAT and undergraduate GPA as admissions criteria.

Performance of senior medical students on an objectively scored examination of clinical competence based on standardized-patient cases was used to assess the predictive validity of the two most commonly used admission measures, the Medical College Admissions Test and the undergraduate grade point average. The students were in the classes of 1986 and 1987 at Southern Illinois University School of Medicine. The correlations of the admissions measures with clinical performances were quite weak, and none of the admissions measures consistently showed a clear advantage as a predictor of clinical performance. Correlations of the admissions measures with scores on National Board of Medical Examiners (NBME) Part I and Part II examinations were small to moderate, although somewhat larger than the correlations with clinical performances. Correlations were corrected for attenuation due to differential unreliabilities of the clinical examination results and the scores on NBME examinations, and for restriction of range due to the stringent medical school selection process. Corrected correlations were small to moderate and showed the same pattern as the uncorrected ones. The study documents that traditional admissions measures are useful for selecting students who will perform effectively in clinical as well as basic science settings.

Personality test measures in optometry school admissions.

Predicting clinical competence among optometry students from data obtainable at the time of admissions is the focus of this study. Preoptometry grades, Optometry College Admission Test (OCAT) scores, and applicant scores on a standardized personality inventory were tested as predictors of faculty ratings of student performance in optometry clinics. Students' clinical performance was best predicted by certain personality dimensions, objectively measured by the California Psychological Inventory (CPI). Preoptometry grades and OCAT scores, although significantly correlated with optometry grades, were generally poor predictors of clinical performance. For men, achievement drive, self-confidence, and tolerance and for women, self-confidence, assertiveness, and interpersonal effectiveness were the personal qualities most highly correlated with instructors' ratings of performance. The study demonstrates that these personal qualities, as well as the degree to which an applicant presents a "good impression," can be objectively assessed at the time of application to optometry school.

Moral Judgment as a Predictor of Clinical Performance

Moral Judgment as a Predictor of Clinical Performance

Who Should be Optometrists?*

Selection of students into optometry courses is commonly on the basis of results at the matriculation examinations at the end of secondary schooling. These examination results are a reasonable predictor of first year examination results but they are a poor predictor of clinical performance in later years of the course. Selection on the basis of results in the first year of tertiary education is also a poor predictor of final year clinical performance. Interviews and headmaster reports are often advocated as a means of selecting students into professional courses but these methods have been shown to be of little value. Recent evidence has shown that tests of personality can help identify those students who will be effective clinicians but universities and other tertiary institutions can be expected to be reluctant to use non-academic criteria for selection. The optometry course itself can be used as the instrument for selection of those who should enter the optometry profession if the emphasis in examinations is shifted away from the assessment of scholarly achievement to the assessment of clinical effectiveness. Such a move would require the establishment of a terminal degre in visual science for optometry students who lack clinical aptitude but are otherwise competent. It would also require more systematic instruction in the interpersonal skills which are an important aspect of clinical competence.