Student Response Rate Research Articles

67. HIPPOCRATES APPRENTICES ON EARTH: MEDICAL STUDENTS EXPERIENCES AND CONSENT FOR VAGINAL EXAMINATIONS OF ANAESTHETISED PATIENTS

Vaginal examinations (VEs) are an essential sexual health examination skill. Reports of students having difficulties getting experience with VEs are matched by reports of patients being examined without consent. This study prospectively aimed to find out what was happening when medical students sought consent for VEs of anaesthetised patients. All 66 2005 5th year medical students at OU, WSM & HS were asked to prospectively complete a 14 item questionnaire about their experience at gynaecology operating sessions. Chi-squared test determined result significance. Student response rate was 78%. 141/184 patients were asked if the student could attend the operation. Students asked 101 patients. Consultants were more likely ask on the student's behalf for males than females. p > 0.0010. All male students sought consent within 2 hours of operations. Some female students sought consent 5 or more hours beforehand; a significant gender difference (p > 0.0001). Five patients declined student attendance at their operation. When asked 96 patients (86.6%/-3.4%) agreed and 16 (13.3% +/-3.4%) declined permission for the student conducting a VE under anaesthesia; with no statistical gender difference in refusal rate. VEs were done on 82 patients; including 2 without consent. In 19 instances a student had consent but no examination was done. Eleven students (3 male, 6 female) did no examinations. The value of the examination for student learning was rated 4/5 by 73% students; with no statistical difference by gender or age. The implications of these findings for teaching sexual health skills to medical students are discussed.

Student Survey Response Rates across Institutions: Why Do they Vary?

While many studies have examined nonresponse in student surveys, little research investigates why some schools achieve higher student survey response rates than other schools. Using hierarchical linear modeling, we analyze survey data from 321 institutions that participated in the 2003 National Survey of Student Engagement to understand how characteristics of colleges and universities relate to student survey response rates. We find that the makeup of the student body, as well as institutional characteristics such public/private status and urban location affects response rates, and that the number of computers per undergraduate has a strong positive effect for web survey response rates.

What do medical students learn from early clinical experiences (ECE)?

What are the common learning themes perceived by medical students during ECE with varying practice settings and patient profiles? Retrospective qualitative and quantitative analyses of structured descriptive reports completed by one class (n = 92) for 895 observed patient encounters identified common learning themes. Identified themes were examined by practice setting and patient characteristics. Student response rates were 85 to 94% across settings. Fifty-five percent of ECE were in outpatient settings. Chief complaints were predominantly medical (67%); only 20% represented psychosocial and 8% preventive care, respectively (5% were ambiguous). The five most common learning themes (out of 13 themes coded) were communication (>50%), procedures/time management, cross-cultural issues, feeling useful as a student, and presenting medical problems. Cross-cultural issues were addressed mainly in community settings. Negative learning occurred only rarely (<3%). Student observations from ECE can be used by course managers to design effective early clinical exposures to address specific course learning objectives.

Prevalence of Childhood Asthma in Urban Communities: The Impact of Ethnicity and Income

The goal of this study was to assess the relationship between hospitalization rates and asthma prevalence in New York City children and investigate the role that sociodemographic factors play in asthma. A parent-report questionnaire was distributed in 26 randomly selected New York City public elementary schools, stratified according to neighborhood hospitalization rates. The overall student response rate was 76.9% (5250 students). Prevalence of current asthma was 17.9%, 9.59%, 6.39% (p < .001) in areas of high, median, and low asthma hospitalization rates, respectively. The overall prevalence of current asthma was 13.0%. Children living in predominantly low socioeconomic status (SES) communities had a 70% greater risk of current asthma, independent of their own ethnicity and income level. Asthma prevalence within different ethnic and income groups was consistently lower in neighborhoods of greater socioeconomic status, except among Puerto Rican children, who had high asthma prevalence, regardless of school attended or income. Prevalence of current asthma is strongly associated with attending a school in a low-income neighborhood. Although hospitalization rates have been used as an indicator of the burden of asthma in a neighborhood, it alone does not reflect the level of disparities that exist among communities with different socioeconomic backgrounds.

Evaluation of a worksheet to structure teaching and learning outpatient internal medicine

The Worksheet for Ambulatory Medicine (WAM) is an educational tool designed to enhance teaching and learning outpatient internal medicine. It was developed to identify student learning needs, focus teaching, and structure educational and patient care activities in a clinic setting. The purpose of the study was to assess the feasibility and educational value of using the WAM with medical students and preceptors. Sixty-five third- and fourth-year medical students and 12 supervising faculty at two university-based general medicine outpatient clinics used the WAM during required internal medicine clerkships. Students and faculty completed written evaluations. Results are reported as percentages of respondents agreeing or disagreeing with a variety of statements, and mean rating scores for several questions designed to assess the feasibility and educational value of using the worksheet. Student response rate was 89%; 83% found the WAM easy to use; 65% found it too structured. Half said the worksheet helped diagnostic decision making and note writing, and two-thirds thought it promoted careful thinking about differential diagnosis and aided in identifying learning issues. Some 56% said using the WAM motivated outside reading. Most students found it helpful for identifying patient agendas and focusing case presentations (61% and 67%, respectively). Only 36% said the WAM helped with time management. Most preceptors thought the WAM helped identify learning issues, focus case presentations and clarify student expectations. There was less agreement among preceptors that it allowed them to demonstrate clinical reasoning or provide students with more autonomy in decision making. Nearly half the preceptors did not find it helpful with time management. Both students and preceptors rated the overall value and usefulness of the WAM as good to very good, and a majority recommended that others use it. Using the Worksheet for Ambulatory Medicine was feasible and educationally valuable for many third- and fourth-year medical students and their preceptors in a required ambulatory internal medicine clerkship.

Evaluation of a worksheet to structure teaching and learning outpatient internal medicine

The Worksheet for Ambulatory Medicine (WAM) is an educational tool designed to enhance teaching and learning outpatient internal medicine. It was developed to identify student learning needs, focus teaching, and structure educational and patient care activities in a clinic setting. The purpose of the study was to assess the feasibility and educational value of using the WAM with medical students and preceptors. Sixty-five third- and fourth-year medical students and 12 supervising faculty at two university-based general medicine outpatient clinics used the WAM during required internal medicine clerkships. Students and faculty completed written evaluations. Results are reported as percentages of respondents agreeing or disagreeing with a variety of statements, and mean rating scores for several questions designed to assess the feasibility and educational value of using the worksheet. Student response rate was 89%; 83% found the WAM easy to use; 65% found it too structured. Half said the worksheet helped diagnostic decision making and note writing, and two-thirds thought it promoted careful thinking about differential diagnosis and aided in identifying learning issues. Some 56% said using the WAM motivated outside reading. Most students found it helpful for identifying patient agendas and focusing case presentations (61% and 67%, respectively). Only 36% said the WAM helped with time management. Most preceptors thought the WAM helped identify learning issues, focus case presentations and clarify student expectations. There was less agreement among preceptors that it allowed them to demonstrate clinical reasoning or provide students with more autonomy in decision making. Nearly half the preceptors did not find it helpful with time management. Both students and preceptors rated the overall value and usefulness of the WAM as good to very good, and a majority recommended that others use it. Using the Worksheet for Ambulatory Medicine was feasible and educationally valuable for many third- and fourth-year medical students and their preceptors in a required ambulatory internal medicine clerkship.

Adolescent vegetarians: how well do their dietary patterns meet the healthy people 2010 objectives?

To examine whether adolescent vegetarians were more likely than nonvegetarian peers to meet the dietary recommendations of the Healthy People 2010 objectives and to examine differences in other nutrients between these 2 groups. A total of 4746 adolescents from 31 middle and high schools in the Twin Cities area of Minnesota. Data were collected via self-report surveys, with a student response rate of 81.5%. Urban secondary schools. Participants were equally divided by sex. The mean age was 14.9 years; 34.3% were in junior high school and 65.7% in high school. The racial/ethnic distribution was 48.5% white, 19.0% African American, 19.2% Asian American, 5.8% Hispanic, 3.5% American Indian, and 3.9% mixed or other. Questions on vegetarian status and whether particular foods (eggs, dairy foods, chicken, fish) were excluded. Dietary intake was assessed using the Youth and Adolescent Food Frequency Questionnaire. Vegetarian adolescents were significantly more likely than nonvegetarian adolescents to meet the Healthy People 2010 objectives. This was particularly noteworthy for total fat (70% vs 48%), saturated fat (65% vs 39%), daily servings of vegetables (26% vs 14%), and 5 or more servings of fruits and vegetables (39% vs 28%). Vegetarians were also less likely to eat fast food or drink regular soda and fruit drinks. Vegetarians consumed less vitamin B(12), more diet soda, more caffeine, and more iron. Adolescent vegetarians have a dietary pattern that is more likely than nonvegetarians to meet the Healthy People 2010 objectives.

Students' evaluation of online course materials in fixed prosthodontics: a case study.

The purpose of this study was to assess a new online course format for dental students. Preclinical Fixed Prosthodontics I is a didactic and laboratory course given in the first year of the dental school curriculum. In the spring semester of 1999, the didactic portion of the course was offered in a web-based format as a supplement to the traditional lecture format. The study population was 53 first year dental students at one school. The study design was a one group post test without a control group. The online questionnaire consisted of multiple choice questions, Leikert scale questions and open-ended questions. Data were collected using Filemaker Pro and analyzed using Epilnfo. Student response rate was 96% (52/53). All of the students responded that they felt comfortable with their computer skills in utilizing this course format. Most (96%) responded that the online materials were either very helpful or helpful to them. About half, (54%) recommended that the online format be continued as a supplement to traditional lectures, while 28% recommended replacing traditional lectures with the new format in order to provide more laboratory time in the course. The syllabus, lecture materials, bulletin board and handouts were found to be the most helpful online features. The least helpful features were the listserve, decision tree, and e-mail options. Most frequently mentioned strengths of the online material were listed as 1) the ability to view material at their own pace and at a time convenient to them, 2) quality photographs in lecture materials and 3) online quizzes. Weaknesses of the course were ranked by students as 1) problems with access to the materials and the intranet system, 2) taking quizzes online and 3) difficulty in printing the web-based lecture materials. The delivery of web-based material as a course supplement in Fixed Prosthodontics I was determined to be an overall success. Fine tuning of problems with access to the materials took place throughout the course. The student feedback will help direct future development of web-based course materials in the dental school curriculum.

Youth Risk Behavior Surveillance National Alternative High School Youth Risk Behavior Survey, United States, 1998

Alternative high schools serve approximately 280,000 students nationwide who are at high risk for failing or dropping out of regular high school or who have been expelled from regular high school because of illegal activity or behavioral problems. Such settings provide important opportunities for delivering health promotion education and services to these youth and young adults. However, before this survey, the prevalence of health-risk behaviors among students attending alternative high schools nationwide was unknown. The Youth Risk Behavior Surveillance System (YRBSS) monitors the following six categories of priority health-risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The national Alternative High School Youth Risk Behavior Survey (ALT-YRBS) is one component of the YRBSS; it was conducted in 1998 to measure priority health-risk behaviors among students at alternative high schools. The 1998 ALT-YRBS used a three-stage cluster sample design to produce a nationally representative sample of students in grades 9-12 in the United States who attend alternative high schools. The school response rate was 81.0%, and the student response rate was 81.9%, resulting in an overall response rate of 66.3%. This report summarizes results from the 1998 ALT-YRBS. The reporting period is February-May 1998. In the United States, 73.6% of all deaths among youth and young adults aged 10-24 years results from only four causes--motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1998 ALT-YRBS demonstrate that many students at alternative high schools engage in behaviors that increase their likelihood of death from these four causes. During the 30 days preceding the survey, 51.9% had ridden with a driver who had been drinking alcohol, 25.1% had driven a vehicle after drinking alcohol, 32.9% had carried a weapon, 64.5% had drunk alcohol, and 53.0% had used marijuana. During the 12 months preceding the survey, 15.7% had attempted suicide, and 29.0% had rarely or never worn a seat belt. Substantial morbidity among school-aged youth and young adults also results from unintended pregnancies and STDs, including HIV infection. ALT-YRBS results indicate that in 1998, a total of 87.8% of students at alternative high schools had had sexual intercourse, 54.1% of sexually active students had not used a condom at last sexual intercourse, and 5.7% had ever injected an illegal drug. Among adults aged > or = 25 years, 66.5% of all deaths result from two causes--cardiovascular disease and cancer. Most risk behaviors associated with these causes of death are initiated during adolescence. In 1998, a total of 64.1% of students at alternative high schools had smoked cigarettes during the 30 days preceding the survey, 38.3% had smoked a cigar during the 30 days preceding the survey, 71.2% had not eaten > or = 5 servings of fruits and vegetables during the day preceding the survey, and 81.0% had not attended physical education (PE) class daily. Comparing ALT-YRBS results with 1997 national YRBS results demonstrates that the prevalence of most risk behaviors is higher among students attending alternative high schools compared with students at regular high schools. Some risk behaviors are more common among certain sex and racial/ethnic subgroups of students. ALT-YRBS data can be used nationwide by health and education officials to improve policies and programs designed to reduce risk behaviors associated with the leading causes of morbidity and mortality among students attending alternative high schools.

Increasing learning rates by increasing student response rates: A summary of research.

Summary of Teacher-Led Procedures Wait-times, choral responding, and response cards increase the number of studentsresponding to task stimuli following teacher questions. Consequently, these proce-dures can increase the number and the rate of complete learning trials duringrecitation. However , each of thes e procedure s has uniqu e strength s and shortcomings .Increasing wait times may increase the number of students responding; but, becausethese cognitive responses are unobservable, teachers can not monitor or evaluateresponses. Respons e cards occasio n observable written responses which teachers canmonitor. After asking a question, the teacher can determine who is responding andevaluate the accuracy of those responses. This can allow teachers to encourageresponding from all students and provide corrective feedback to students who aremaking errors . However, writin g response s take s time . Therefore, response card s maybe less efficient (lower learning trial rates) than longer wait times and calling on onestudent to respond aloud when questions require long responses .Choral responding is overt and efficient. However, teachers have difficultydetermining which students are responding and evaluating response accuracy(Narayan et al., 1990). Therefore, when students have obtained some degree ofaccuracy, choral responding may prove to be useful for increasing fluency becauseit allow s for a larg e numbe r of response s in a brie f perio d of time . Chora l respondingmay also be useful when the goal response is verbal. For example, you could notuse response cards for sight-word responding. When teachers are presenting taskstimuli and providing feedback they can control the pace of instruction. ReducingITIs and increasing wait times may improve the quality and possibly the quantityof learning trials in a fixed period of time. Teachers can also control the form andtiming of responses . Choral responding and response card research reviewed showhow altering the form (written as opposed to subvocal) or timing (unison or one ata time) of responses can increase rates of responding and learning rates in groupsof students.

Selected behaviors that increase risk for HIV infection, other sexually transmitted diseases, and unintended pregnancy among high school students--United States, 1991.

In light of sexual activity sexually transmitted disease rates unintended pregnancy and HIV infections having increased among adolescents in the US since the 1970s 1991 self-reported data are reviewed from students in grades 9-12 about behavior which may place them at risk of supporting these trends. Data are drawn from state and local and national components of the Centers for Disease Control Youth Risk Behavior Surveillance System. For state and local surveys school response rates ranged 48-100% student response rates ranged 44-96% and sample sizes over 23 states and 10 cities ranged 369-5834 students. 12272 students were surveyed at the national level of which 90% responded; national school response rate was 75%. 33-79% students at state and local levels and 54% students nationally reported ever having sexual intercourse; 54-78% locally and 69% nationally reported being currently sexually active; and 8-46% locally and 19% nationally reported having had sexual intercourse with 4 or more partners during their lifetime. Male students were generally more likely to report ever having had sexual intercourse and having had 4 or more partners during their lifetime while female students were more likely to report being currently sexually active. 1-4% locally and 2% nationally reported IV drug use; 5% or less reported IV drug use overall. Of those reporting current sexual activity 58-87% locally and 82% nationally reported they or their partner used contraception at last sexual intercourse; 28-53% locally and 46% nationally reported that the method employed was a condom. Finally both sexes reported similar rates of contraceptive use.

Assessment and Accountability in Secondary Physical Education

Accountability surrounds us in our daily lives. It is a key to keeping students on task and augmenting learning. Physical educators can use various types of accountability to increase the quantity and quality of student response rates. Accountability can take avariety of forms, with grading being used most often, along with public recognition, high-tech heart monitoring equipment, trophies, and other material rewards. Authentic assessments are becoming another way to hold students and teachers accountable for subject matter competency rather than completion of a class. When accountability and assessment are used in conjunction with goal setting and task-oriented teaching, instructional alignment occurs. Assessment and accountability need to be applied to the instructional task system as part of an effective physical education program.

Strategies to Increase Student Response Rates to Mail Surveys

This article discusses two studies in which different methods were used to try to improve the undergraduate student response rate to mail surveys. The first study showed that students receiving raffle tickets with their surveys were more likely to respond than those receiving no raffle ticketes; however, the differences were statistically significant only for students living in residence halls on campus (i.e., freshman and sophmores) and not for those living off-campus. The second study showed that nonrespondents who were telephoned before the second mailing of a questionnaire were much more likely to respond than those nonrespondents who were not called.

Teacher presentation rate and point delivery rate. Effects on classroom disruption, performance accuracy, and response rate.

In a class of five disruptive students, the effects of teacher presentation rate of academic response opportunities and point delivery were assessed on classroom disruption, performance accuracy, and student response rate. Two levels of teacher presentation rate were paired with two point delivery rates resulting in four treatment conditions: high point rate/fast presentation; high point rate/slow presentation; low point rate/fast presentation; low point rate/ slow presentation. Using a multielement design, it was demonstrated that the fast presentation rate was associated with significantly less disruptive behavior than the slow presentation rate. Point delivery had little effect. For some subjects the slow presentation rate was associated with higher student performance accuracy, although the fast presentation rate produced high overall rates of correct performance.

Student Perceptions of Instruction

With the increase in specialization occur ring in all professions, the use of multiple instructor courses appears to be a future trend in professional and graduate schools. This study describes a method of obtaining student perceptions of the instruction received in 333 lectures given by 175 instructors in an Introduction to Clinical Medicine course. An 87% response rate was obtained from the 199 students—a 36% increase over that obtained from the same students using a more common method. The experimental method proved to be administratively parsimonious. Suggestions for improving the student response rate and for promoting a more careful consideration by the students of their ratings are reported.