Self-evaluation Scores Research Articles

The efficacy of a novel percutaneous endoscopic gastrostomy simulator using three-dimensional printing technologies.

We developed a novel training simulator for percutaneous endoscopic gastrostomy (PEG) and determined its efficacy and realism in PEG insertion training. The gastrostomy simulator was made using three-dimensional printing and silicone molding technology. The simulator is of two types: pull type and introducer type. We enrolled 20 participants, comprising 10 beginners with no experience of PEG insertion and 10 PEG-experienced endoscopists. Each participant underwent two training sessions for the two simulator types. We recorded the simulation time, self-evaluation, and difficulty score based on a 5-score scale for PEG insertion among the participants. Subsequently, simulator performance was assessed via a questionnaire based on a 7-point Likert scale. The mean time to completion of PEG simulation decreased from 11.9 (5.2) to 9.0 (4.0) min for the pull type and from 13.8 (7.0) to 12.0 (5.8) min for the introducer type in the beginner group. The mean self-evaluation scores of beginners increased from 2.2 (1.1) to 3.1 (0.7) (pull type) and from 2.2 (1.2) to 3.3 (0.8) (introducer type). The mean procedure difficulty scores of beginners decreased from 3.4 (1.1) to 2.7 (0.9) (pull type) and from 4.4 (0.5) to 3.0 (0.8) (introducer type). The improvement of skill score was 6.3 (1.2) for the beginner group. The general realism score of the simulator for handling was judged to be 6.0 (0.9) by the experienced group. The three-dimensional-printed simulator for PEG insertion can be useful for training of beginner endoscopists and shows good efficacy and realism.

Development on a hip functional score of adults based on patient-reported outcomes

Objective To develop a simple and patient-reported scoring system for evaluating the efficacy of functional reconstruction of adult hip diseases. Methods A candidate indicators list to evaluate hip function was established through literatures review and panel discussion. Using two rounds of Delphi method, experts were invited to judge and score the importance of screening indicators including pain, daily living ability, activity level, labor ability and self-assessment score of the overall hip status,with explanation of the degree of similarity and the basis for determination. In the second round of consultation, the content of integrity and rationality of the scale were added for evaluation. The final indexes of the scale were determined according to the boundary value of the indexes (average value, full frequency, coefficient of variation). The positive coefficient, authoritative coefficient, and coordination coefficient of the two rounds were calculated, and then the weights of each index was identified to form the final rating scale. Results Two rounds of Delphi reclaimed 25 and 24 experts’ responses, which from 28 and 25 questionnaires, and the positive coefficients of the two rounds experts were 89.3% and 96%, respectively. The authoritative coefficient of the first and second level indicators were generally above 0.85; and both of the expert coordination coefficient with the index importance (so called as Kendall coefficient) were above 0.3, and the second round of the coefficient was higher than the first one, and it indicated the final one was better at the consistency. The candidate index of bus in the mobility was rejected in accordance with the threshold of the boundary value on the importance. Finally, it was determined that the hip scoring system (Shanghai Sixth People’s Hospital, SSPH) consisted of two parts: the first part had ten indicators out of four dimensions such as pain, daily living ability, activity level, and labor ability; and the weight scores of these four aspects were 45, 25, 21, 9, respectively. The second part was the patient's self-evaluation score for the overall status of the hip (VAS, out of 100 points); the total score was the sum of the two parts, and the final weights accounted for 85% and 15% between the two parts respectively. Conclusion The SSPH hip score based on patient-reported outcomes formed by the Delphi is simple and feasible, and it can be used as a reference for evaluating the clinical efficacy of hip functional reconstruction. Key words: Delphi technique; Hip joint; Outcome assessment (Health Care)

Research on the horizontal equity of inpatient benefits among NCMS enrollees in China: evidence from Shaanxi Province

BackgroundEquity is an important goal for countries in formulating relevant health policies, and research on the equity of health services is more important for China, where the gap between the rich and poor is widening. The aims of this study are to explore to what extent the benefit equity of New Rural Cooperative Medical System enrollees has been achieved and to determine the geographical disparities in Shaanxi province and thus provide suggestions for future policy formulations.MethodsData were obtained from the fifth Health Service Survey of Shaanxi province in 2013. A two-step mode was used to analyse the influencing factors of the inpatient benefit rate and inpatient compensation fee. Concentration indexes and concentration curves were applied to measure the inequity of the inpatient benefit rate and inpatient compensation fee. The decomposition method was employed to explore the source of inequity and horizontal inequity.ResultsBased on a sample of 38,032 enrollees, our results showed that there were pro-rich inequities in the inpatient benefit rate and compensation fee. The concentration index of the inpatient benefit rate and compensation fee in 2013 were 0.064 and 0.174, respectively. The economic level (224.62%), self-evaluated health status (− 25.89%) and occupation status (− 12.32%) were the primary three contributors to the inequity of the inpatient benefit rate, and the economic level (106.16%) and age (− 2.88%) were the first two contributors to the inequity of the compensation fee. There were regional differences in the sources of inequities. Moreover, pro-rich horizontal inequity remained after standardizing health care needs.ConclusionsOur results indicated that there were pro-rich inequities in the inpatient benefit rate and compensation fee in the New Rural Cooperative Medical System. The economic levels of enrollees accounted for most of the existing inequity, followed by self-evaluated health scores and age. Efforts should be made to strengthen policies and programmes in the New Rural Cooperative Medical System to achieve basic health services equity, such as implementing hierarchical medical treatments and reducing extra inpatient benefits for the rich.

Reliability and Validity of the Second Edition of Self-Evaluated Soccer Performance Score

This study aims, first, to make the second edition of the self-evaluation of soccer performance scores which was edited based on the first version of the soccer performance scores (Kawada et al., 2016), and second, to examine the reliability and validity of the second version. Each of 16 questions was evaluated by one professional soccer coach who had an university assistant professor with A-class license for soccer supervisor which was officially given by Union for European Football Association (UEFA), a university soccer team coach and a university soccer team general manager. This second edition which was newly evaluated was administered to 111 university soccer club players who included starting members in the first class (A) team in December 2015. One hundred and eight answers (97.8%) of 111 ones were used for the statistical analysis. After the validation analysis, this second edition can be estimated to be valuable for evaluating a valuable soccer performance scores.

Clinical observation on macular edema treated with treating different diseases with the same acupuncture comprehensive therapy

To compare the clinical efficacy of treating different diseases with the same acupuncture comprehensive therapy and intramuscular injection of ranibizumab in the treatment of macular edema, and to explore an effective treatment. A retrospective study was conducted, ①Acupuncture combined with EA at Xinming one (Extra), Sizhukong (TE 23), Tongziliao (GB 1), once every other day; ②acupoint injection, alternation with compound anisodine and mecobalamine injection at Qiuhou (EX-HN 7), Taiyang (EX-HN 5), once every other day; ③auricular acupressure at yan (LO5), gan (CO12), shen (CO10) and other points; ④plum-blossom needle at Zhengguang 1 (Extra), Zhengguang 2 (Extra), once every other day were given in the acupuncture group (20 cases, 24 affected eyes). Intramuscular injection of 0.5 mg ranibizumab was given in the ranibizumab group (22 cases, 23 affected eyes). The macular foveal thickness, early treatment diabetic retinopathy study of (ETDRS) visual acuity chart, self-evaluation scores of visual function impairment ophthalmopathy patient's quality of life scale were observed before treatment, after 3, 6, 9 and 12 months of treatment, and the clinical efficacy was evaluated. ①At all the observation time points of the treatment, the macular thickness was lower than that before treatment in the two groups (all P<0.05), and there was no significant difference between the acupuncture group and the ranibizumab group (all P>0.05). ②Visual acuity was higher than that before treatment at all the time points in the two groups (all P<0.05). After 3-months treatment, there was no statistical significance between the two groups (P>0.05). After 6, 9, and 12 months treatment, the visual acuity in the acupuncture group was better than that in the ranibizumab group (P<0.05, P<0.01). ③At all the time points, the quality of life scores were lower than those before treatment in the two groups (all P<0.05). There was no statistical significance in the ranibizumab group compared with those before treatment (all P>0.05). In 3, 6, 9 and 12 months of treatment, the quality of life scores in the acupuncture group was better than those in the ranibizumab group (P<0.05, P<0.01). ④The total effective rate of the acupuncture group was 79.2% (19/24), which was better than 30.4% (7/23) in the ranibizumab group (P<0.05). ⑤The improvement of visual acuity before and after treatment was negatively correlated with the course of disease (P<0.05), ie, the longer the disease course of the eyes, the worse the visual acuity and the worse the effect. Acupuncture comprehensive treatment can effectively treat macular edema, significantly improve the patient's vision, improve the subjective experience and the quality of life, and the shorter the course of the disease the more significant effect. Acupuncture comprehensive treatment is better than intramuscular injection of ranibizumab.

Correlation between parental rearing patterns and self-consciousness of adolescents with cleft lip and palate

This study aimed to investigate the current situation of parental rearing patterns and self-consciousness of adolescents with cleft lip and palate. The relationship between parental rearing patterns and self-consciousness of adolescents was also analyzed to provide evidence for psychological intervention. The study was carried out on 400 adolescents (11-25 years old) with cleft lip and palate. The subjects were assessed with self-consciousness scale for patients with cleft lip and palate and Egna Minnen av Barndoms Uppforstran family rearing questionnaires to evaluate the current status of self-consciousness and parental rearing patterns in adolescents with cleft lip and palate and the relevance of the two factors. A total of 380 valid questionnaires were obtained. A significant relationship was found between parental rearing patterns and self-consciousness in adolescents with cleft lip and palate. A positive correlation was also observed between the scores of self-evaluation, self-confidence, others' evaluation and psychological endurance, interpersonal relationship, and parent-child relationship of adolescents with cleft lip and palate and the scores of their parents' emotional care. Confidence was negatively correlated with the scores of parents' refusal to deny, punishment, and severity. Good parental rearing patterns play a critical role in establishing self-confidence, improving social adaptability, and maintaining interpersonal and parent-child relationship. Parents should give much care while avoiding refusal, denial, and punishment.

AN EXPLORATION OF THE DEVELOPMENT OF VIETNAMESE CHILDREN’S SELF-CONTROL ABILITY

The purpose of the present research is to explore the development of self-control ability during childhood. A group of 360 children (185 boys and 175 girls from grades 2, 4, and 6) participated in the survey. They completed the Children’s Perceived Self-Control Scale (CPSC) which included the interpersonal self-control (ISC), the personal self-control (PSC), and the self-evaluation (SE) subscales. Results showed significant differences in ISC, SE and total scores among the second, fourth and sixth graders. On the total scores, the fourth graders had higher scores than the second and the sixth graders. Moreover, the scores of ISC of the fourth graders were higher than those of the sixth grades. There was no gender difference and interaction of gender and grade found. The results suggested that the development of self-control following a quadratic pattern increased and reached a peak in the fourth grade and then decreased during sixth grade time. Keywords: academic performance, self-control, self-ratings, Vietnamese children.

An analysis of residents' self-evaluation and faculty-evaluation in internal medicine standardized residency training program using Milestones evaluation system

Objective: To assess the value of internal medicine residency training program at Peking Union Medical College Hospital (PUMCH), and the feasibility of applying revised Milestones evaluation system. Methods: Postgraduate-year-one to four (PGY-1 to PGY-4) residents in PUMCH finished the revised Milestones evaluation scales in September 2017. Residents' self-evaluation and faculty-evaluation scores were calculated. Statistical analysis was conducted on the data. Results: A total of 207 residents were enrolled in this cross-sectional study. Both self and faculty scores showed an increasing trend in senior residents. PGY-1 residents were assessed during their first month of residency with scores of 4 points or higher, suggesting that residents have a high starting level. More strikingly, the mean score in PGY-4 was 7 points or higher, proving the career development of residency training program. There was no statistically significant difference between total self- and faculty-evaluation scores. Evaluation scores of learning ability and communication ability were lower in faculty group (t=-2.627, -4.279, all P<0.05). The scores in graduate students were lower than those in standardized training residents. Conclusions: The goal of national standardized residency training is to improve the quality of healthcare and residents' career development. The evaluation results would guide curriculum design and emphasize the importance and necessity of multi-level teaching. Self-evaluation contributes to the understanding of training objectives and personal cognition.

Application of case-based multidisciplinary team teaching mode in clinical practice teaching of gynecology

Objective To explore the feasibility and evaluate the teaching effect of case-based multidisciplinary team teaching mode in clinical practice teaching of gynecology. Method According to different grade, 120 students were divided into experimental group and control group (60 students per group). The teaching content contained three malignant tumor cases, which were cervical cancer, endometrial cancer and ovarian cancer. The course needed 12 periods totally. The experimental group received multidisci-plinary team (MDT) teaching mode, and the control group received traditional lecture-based learning teaching mode (LBL). Teaching effect evaluation and test scores would be analyzed at the end of teaching. SPSS19.0 was used for t test and chi-square test. Results Our results showed that the theory test scores, practical skills test scores, the paperwork scores and the total scores of the students in MDT group were significantly higher than those in the traditional group (P<0.05). At the same time, the students' self-evaluation scores in the ability of information retrieval, acquisition, understanding, comprehensive and the ability of self-learning, learning interest, enthusiasm and teamwork were significantly higher than the traditional group (P<0.05). Conclusion MDT teaching mode is feasible, which can improve teaching effect and students' quality, and is worthy of advocating and popularization. Key words: Gynecology; Multidisciplinary team; Case-based learning; Clinical internship teaching

Relaxation Effects of Musically Guided Resonance Breathing: A Randomized Controlled Pilot Study

Recent evidence shows that both music therapy and resonance breathing (breathing at about 0.1 Hz) may be effective in treating stress-related symptoms and promoting relaxation. However, no study has yet explored the potential of integrating the working mechanisms into a combined approach using live played music to guide respiration. Therefore, the objective of the present pilot study was to evaluate the psychophysiological effects of a combined intervention. A total of 60 healthy adults were randomized to either the experimental group or the control group (where participants listened to prerecorded relaxation music). Heart rate and heart rate variability were extracted for the following 5-minute segments: Resting baseline, stress task, intervention, resting post-intervention. Additionally, self-evaluation scores for relaxation and general well-being were assessed with visual analogue scales. Significant time × group interaction effects were found for general well-being (p = .028) and heart rate variability as measured by RMSSD (p &lt; .001), indicative of increased parasympathetic outflow in the experimental group. In conclusion, the combination of music therapy and resonance breathing seems to be a well-received and effective way to induce relaxation and well-being in healthy adults.

Application of interrupted suture at exercise position in total knee arthroplasty

To investigate the effectiveness of interrupted suture under exercise position in total knee arthroplasty (TKA). Eighty-four patients with osteoarthritis who were treated with TKA between July 2015 and July 2016 were enrolled in the study. All patients were randomly divided into control group and observation group with 42 cases in each group. There was no significant difference in gender, age, side, body mass index, and osteoarthritis grading between 2 groups ( P>0.05). The incisions were interrupted sutured at the knee flexion position in control group and at the exercise position in observation group. Preoperative and postoperative treatments of 2 groups were same. The incision length, suture time, total tramadol usage, intraoperative blood loss, stitches removal time, hospitalization time, incidence of postoperative complication, the incision healing score (HWES), and satisfaction score of incisional self evaluation (Liktert score) were recorded and compared between 2 groups. The visual analogue scale (VAS) score was used to evaluate the incision pain at pre- and post-operation. The hospital for special surgery (HSS) score and range of motion (ROM) were also used to assess the knee function. There was no significant difference in incision length, incidence of postoperative complication, HWES score, stitching time, and hospitalization time between 2 groups ( P>0.05). The suture time, intraoperative blood loss, and Likter score were significantly lower in control group than those in observation group ( P<0.05), but the total tramadol usage was significantly higher in control group than that in observation group ( P<0.05). All patients were followed up. The follow-up time ranged from 12 to 24 months (mean, 14.7 months) in control group and from 12 to 23 months (mean, 15.3 months) in observation group. There was no significant difference in VAS scores between 2 groups before operation, before going to bed at the 1st day, and after suture removal ( P>0.05). The VAS score of observation group after flexion and extension exercises at the 1st day was significantly lower than that of control group ( P<0.05). There was no significant difference in HSS score and ROM between 2 groups before operation and at 12 months after operation ( P>0.05). The HSS score and ROM in observation group at discharge and at 1, 3, and 6 months after operation were superior to those in control group ( P<0.05). Compared with interrupted suture at flexion knee position, the application of interrupted suture at exercise positon in TKA had the advantages of less postoperative pain and good incision healing, and can get satisfactory early joint function recovery. But significant difference in the long-term effectiveness of the two methods was not found.

The Rosacea-specific Quality-of-Life instrument (RosQol): Revision and validation among Chinese patients.

Rosacea is a common chronic facial disorder that affects patients' health-related quality of life; the only questionnaire designed specifically for rosacea is the Rosacea-specific Quality-of-Life instrument (RosQol). However, the questionnaire has not been validated among Chinese patients. This study aimed to validate the Chinese version of the RosQol. First, we translated the questionnaire into Chinese. Then, rosacea patients completed the RosQol and Dermatology Life Quality Index, indicating the disease's impact on their lives. We also collected patients' demographic and clinical data, including symptom self-evaluation scores and rosacea severity scores. Internal consistency was determined by using Cronbach's alpha, test-retest reliability, and Spearman's correlation. Criterion-related validity and internal construct validity were also determined. Most RosQol items showed good internal consistency. However, items 13 and 19 were not sufficiently sensitive for use in the Chinese population; we deleted them and constructed the adjusted Chinese-version RosQol, which had good reliability and validity. When patients' clinical symptoms changed, the scores on the relevant dimensions of the adjusted RosQol also changed. Some RosQol items were not suitable for use in the Chinese sample. The adjusted Chinese-version RosQol was easy to complete, well received by patients, and demonstrated acceptable validity and reliability.

Differences in characteristics of raters who use the visual estimation method in hospitals based on their training experiences

Despite a clinical need, only a few studies have provided information concerning visual estimation training for raters to improve the validity of their evaluations. This study aims to describe the differences in the characteristics of raters who evaluated patients' dietary intake in hospitals using the visual estimation method based on their training experiences. We collected data from three hospitals in Tokyo from August to September 2016. The participants were 199 nursing staff members, and they completed a self-administered questionnaire on demographic data; working career; training in the visual estimation method; knowledge, attitude, and practice associated with nutritional care; and self-evaluation of method validity of and skills of visual estimation. We classified participants into two groups, experienced and inexperienced, based on whether they had received training. Square test, Mann-Whitney U test, and univariable and multivariable logistic regression analysis were used to describe the differences between these two groups in terms of their characteristics; knowledge, attitude, and practice associated with nutritional care; and self-evaluation of method validity and tips used in the visual estimation method. Of the 158 staff members (79.4%) (118 nurses and 40 nursing assistants) who agreed to participate in the analysis, thirty-three participants (20.9%) were trained in the visual estimation method. Participants who had received training had better knowledge (2.70±0.81, score range was 1-5) than those who had not received any training (2.34±0.74, p=0.03). Score of self-evaluation of method validity of the visual estimation method was higher in the experienced group (3.78±0.61, score range was 1-5) than the inexperienced group (3.40±0.66, p<0.01). Mean total scores of using tips in the visual estimation method in the experienced and inexperienced groups were 19.6±1.76 and 17.9±2.28, respectively (score range was 6-24), differing significantly between the two groups (p<0.01). Multivariable logistic regression revealed that participants who had been trained had adequate knowledge (OR: 2.78, 95% CI: 1.05-7.35) and frequently used tips in visual estimation (OR: 1.85, 95% CI: 1.26-2.73). Trained participants had more required knowledge and they used visual estimation tips more frequently than participants who had not been trained in the visual estimation method. This study provides new evidence for the importance of training clinical staff members to use the visual estimation method appropriately and makes suggestions to improve the validity of the visual estimation method.

Flexible intramedullary nailing for fixation of displaced midshaft clavicle fractures

Introduction: Fracture of the clavicle is common in occurrence with incidence of approximately 5% of all fractures seen in hospital emergency. These fractures are generally managed conservatively. Titanium elastic nails are a promising minimally invasive treatment for displaced mid-clavicular fractures, which may be an alternative to plate fixation or even nonoperative treatment. Objective: The aim of this study was to assess the cosmetic outcome (malunion, asymmetry, and scar formation), rate of bone healing and alignment of the clavicle ( 30°) related to the flexible intramedullary nailing of midshaft fracture clavicle. Materials and Methods: Between June 2012 and June 2014 in GMC and Hospital Amritsar, 50 patients with displaced, noncomminuted fracture of midshaft clavicle of either side underwent flexible intramedullary nailing with titanium elastic nail. Implant removal was performed in 90% cases after the fracture united completely. Results: In this study, all fractures were united. Mean duration of radiological union was 10.3 weeks ranging from 6 to 20 weeks. Mean disabilities of arm shoulder and hand score after 6 months of follow-up was 7.7 ranging from 0.8 to 44.2. Mean constant self-evaluated score was 80.2 ranging from minimum 43 to maximum 98 after 6 months of follow-up. Conclusion: Flexible intramedullary nailing, a minimally invasive technique for stabilization of displaced midshaft clavicle fractures is a simple procedure with excellent functional outcome in terms of quick return to activities and a high patient satisfaction rate with very good cosmetic outcome.

The investigation of the depression levels of parents of children with autism

The aim of this study was to investigate the depression levels of parents of children with autism. The depression levels of mothers (N=35) and fathers (N=23) of autistic children educated in special education and rehabilitation centers were examined. In this study, socio-demographic features i.e., gender, age, education of mothers and fathers, occupation, were collected and the Beck Depression Inventory was applied to the parents to determine the risk factors of depression, symptom levels. The inventory includes 21 phrases of self-evaluation and possible scores range from 0 - 63. In the statistical analysis of the data, frequency values were applied to the evaluation of the demographic status. The mean and standard deviation were determined to evaluate the depression levels. T-tests were performed to compare the depression levels of mothers and fathers. An Anova test was performed to assess the relationships between the parameters. As a result, it was determined that mothers of autistic children have medium levels of depression (18,80±11,05), and fathers of autistic children have mild levels of depression. T-test analysis showed no significant differences between depression levels of mothers and fathers (p&lt;0,05). Additionally; when income rates, occupations and educational status parameters were taken into account there was no significant difference according to the Anova test (p&lt;0,05). In conclusion, mothers of autistic children have higher depression levels than the fathers.

Face-to-Face vs On-line: An analysis of Profile, Learning, Performance and Satisfaction among Post Graduate Students

The aim of this study is to explore the differences between face-to-face and on-line students in a post graduate education program. The variables considered are Post Graduate Student's profile, competences and learning outcomes, academic performance and satisfaction. The sample was composed by 47 students (64% face-to-face). Analysis of variance (ANOVA) and student's t utilizing SPPS Statistics 22.0 were performed. Results showed differences in all variables: (i) Regarding student profile, face-to-face students were younger and from a broader range of nationalities; (ii) Both students' profiles showed positive and significant differences between their pre-post competences, learning outcomes and self-evaluation scores in several of the programs courses. Moreover, there were significant differences when considering specific courses and profiles; (iii) Face-to-face students obtained better grades in 4 out of 7 courses of the post graduate program; (iv) Finally, face-to-face students reported higher satisfaction and a more positive perception of the teaching methodologies utilized than on-line students. Theoretical and practical implications are discussed to improve specific teaching methodologies for on-line students.

Improving clinical practice ability of nursing undergraduates via double evaluation

Objective To explore the effect of improving clinical practice ability of nursing undergraduates via double evaluation. Methods From September 2015 to May 2016, 61 nursing undergraduates enrolled in 2012 to Guangzhou University of Chinese Medicine were selected by convenience sampling method and divided randomly according to their student number into experimental group (30 cases) and control group (31 cases) . According to the double evaluation method adopted in the experimental group, clinical teaching scheme was modified dynamically. In the control group, clinical teaching was conducted according to clinical teaching scheme made by the university, with OSCE and evaluation form of clinical practice ability as tools for observer and self evaluation. Results Within the experimental group, both scores of observer evaluation in OSCE and scores of self evaluation in clinical practice behavior showed a trend of going up in phases (P<0.05) . In comparison of observer evaluation in OSCE at the 9th month, scores of the experimental group were all higher than those in the control group in all dimensions except writing of nursing documents (P<0.05) . In comparison of self evaluation in clinical practice behavior at the 9th month, scores of the experimental group were all higher than those in the control group in all dimensions except communication ability, slightly lower (P<0.05) . Conclusions With the double evaluation method adopted, dynamically modified clinical teaching scheme according to phases can obviously improve clinical practice ability of nursing students. Key words: Education, nursing; Nursing undergraduates; Clinical teaching; Double evaluation; Clinical practice ability

Evaluation of clinical teaching quality in competency-based residency training in Lithuania

Background and aimIn 2013, all residency programs at the Lithuanian University of Health Sciences were renewed into the competency-based medical education curriculum (CBME). In 2015, we implemented the validated EFFECT questionnaire together with the EFFECT-System for quality assessment of clinical teaching in residency training.The aim of this study was to investigate the influence of characteristics of the resident (year of training) and clinical teacher (gender, age, and type of academic position) on teaching quality, as well as to assess areas for teaching quality improvement. Materials and methodsResidents from 7 different residency study programs filled out 333 EFFECT questionnaires evaluating 146 clinical teachers. We received 143 self-evaluations of clinical teachers using the same questionnaire. Items were scored on a 6-point Likert scale. Main outcome measures were residents’ mean overall (MOS), mean subdomain (MSS) and clinical teachers’ self-evaluation scores. The overall comparisons of MOS and MSS across study groups and subgroups were done using Student's t test and ANOVA for trend. The intraclass correlation coefficient (ICC) was calculated in order to see how residents’ evaluations match with self-evaluations for every particular teacher. To indicate areas for quality improvement items were analyzed subtracting their mean score from the respective (sub)domain score. ResultsMOS for domains of “role modeling”, “task allocation”, “feedback”, “teaching methodology” and “assessment” valued by residents were significantly higher than those valued by teachers (P<0.01). Teachers who filled out self-evaluation questionnaires were rated significantly higher by residents in role modeling subdomains (P<0.05). Male teachers in (sub)domains “role modeling: CanMEDS roles and reflection”, “task allocation”, “planning” and “personal support” were rated significantly higher than the female teachers (P<0.05). Teachers aged 40 years or younger were rated higher (P<0.01). Residents ratings by type of teachers’ academic position almost in all (sub)domains differed significantly (P<0.05). No correlation observed between MOS of a particular teacher and MOS as rated by residents (ICC=0.055, P=0.399). The main areas for improvement were “feedback” and “assessment”. ConclusionsResident evaluations of clinical teachers are influenced by teachers’ age, gender, year of residency training, type of teachers’ academic position and whether or not a clinical teacher performed self-evaluation. Development of CBME should be focused on the continuous evaluation of quality, clinical teachers educational support and the implementation of e-portfolio.

The Effect of Recorded Video Monitoring on Students’ Self Reflection of Patient‐Physician Interaction

The aim of this study is to examine the effect of recorded video monitoring on students’ self-reflection after completing their clinical performance examination. Taking into account the particular cases involved in the examination, the present study utilized history-taking, physical examination, and patient education as bases for evaluating information-establishment ability, and asking, listening, understanding, explaining, and connectedness as the bases for evaluating patient-physician interaction ability. Student self-monitoring through recorded video feedback was carried out three days after completion of their clinical performance examination. Students self-evaluated their performance with a 10-point scale before and after self-monitoring. The results of this study show that students have a general tendency to lower their own self-evaluation scores after self-monitoring. Although there was not a statistically significant change of interrelationship in the information-establishment ability evaluation, there was a meaningful change of interrelationship in the patient-physician interaction ability evaluation after self-monitoring; specifically, in the case of acute lower abdominal pain, a high correlation was found (r=0.31, p=0.02) between the evaluation scores of standardized patients and students related to patient-physician interaction ability. This implies that self-monitoring enables the students to acquire a reflective viewpoint from which to evaluate their own performance. Therefore, it can be said that self-monitoring through recorded video feedback is a valuable method for students to use in reviewing their performance in patient-physician interactions.

Methods To Evaluate An Introductory Motivational Interviewing Workshop For Healthcare Professionals That Promote Weight Management

PURPOSE: To evaluate the effect of a behavior change counseling training intervention on clinician proficiency. METHODS: In this observational study, a self-selected group of 13 female clinicians (62% physicians/mid-levels) were evaluated before and after an introductory training in motivational interviewing (MI). Two experienced trainers conducted a standard 2-day workshop that focused on weight management. The clinicians were evaluated with the CARE Measure for 4-wks before and 6-wks after the workshop. This confidential 10-item questionnaire assessed relational empathy from the patient perspective on completion of clinical visits (n=531). The CARE Measure was scored on a 1-5 Likert scale. The clinicians provided an audio-taped recording of a clinical visit of their choice pre and post workshop (PW). The recording was anonymously analyzed by a coding expert. The MITI 4.2 Coding Instrument scored the visits on global ratings that used a 1-5 scale and an objective behavioral count to determine MI proficiency. A pre and PW clinician self-evaluation measured perceived proficiency and intent to use MI. RESULTS: The overall mean score for the CARE Measure was 48.8 (SD=3.1) out of a maximum of 50 at baseline (BL) and 48.9 (SD=3.0) PW (p>0.05). The overall mean global rating for the MITI was 3.6 (SD=1.2) out of a maximum 5 at BL and 3.8 (SD=0.9) PW (p>0.05). For the behavioral count, the mean reflection-to-question ratio was 0.4 (SD=0.3) at BL and 0.5 (SD=0.3) PW (p>0.05). The mean MI adherent behavior count was 7.5 (SD=6.6) at BL and 8.3 (SD=3.8) PW (p>0.05). The mean MI non-adherent behavior count was 1.4 (SD=0.6) at BL and 0.2 (SD=0.6) PW (p>0.05). The mean persuasion behavioral count with and without permission was 6.8 (SD=3.5) at BL and 2.9 (SD=1.5) at PW (p<0.05). The mean overall self-perceived proficiency and intent to use MI was 7.6 (SD=1.1) at BL and 8.8 (SD=0.7) PW (p<0.05). CONCLUSIONS: Preliminary findings of this pilot study did not identify significant change in MI proficiency. However, trainees used significantly less persuasion, patient evaluations remained high and clinician self-evaluation scores improved significantly. Short-term measures from these varied methods of evaluation may provide useful feedback to clinicians for ongoing MI skill development.