Creating an objective structured teaching examination to evaluate a dental faculty development program

This article describes the creation of an objective structured teaching examination (OSTE) to assess a dental faculty development program. An OSTE is a performance-based measure that utilizes standardized students and is designed to measure observable teaching skills. In spring 2010, the authors developed, implemented, and evaluated an OSTE to assess a New York University College of Dentistry (NYUCD) faculty development program, Class ACTS (Advanced Clinical Teaching Scholars). They created a three-station OSTE to measure changes in teaching skills resulting from participation in Class ACTS. Dental student teaching assistants were trained to act as standardized students and patients and to use the rating forms. The faculty members' OSTE scores and ratings increased after participating in the Class ACTS program in all fifteen teaching domains tested, and statistically significant improvements occurred in nine of the fifteen domains. A search of the relevant literature suggests that this is the first time that an OSTE has been used to assess a faculty development program in dental education. This study's results appear to support NYUCD's faculty development efforts to improve the teaching skills of its faculty members.     

Effects of personalised cue form on the learning of subordinate category names by aphasic and non-brain-damaged subjects

Background. Personalised cueing is a training method designed to facilitate naming of unknown, realistic visual stimuli (dog breed names). Creation of a personalised cue is similar to the use of mnemonic devices by normal individuals to remember important bits of information. Theoretical support for the method comes from Craik and Lockhart's depth-of-processing model of memory (1972). Several studies have shown that training with personalised cueing methods results in significantly higher levels of long-term naming accuracy than when subjects are trained with phonological cueing techniques. However, it has also been observed that all individuals are not equally proficient in creating personalised cues and that the nature of the information in personalised cues varies markedly from individual to individual. Aims. The objective of this study was to determine if the type of information contained in a personalised cue (cue form) affects the degree to which these cues facilitate learning of subordinate category names (dogs). Methods & Procedures. 600 personalised cues developed by 15 non-brain-damaged (NBD) and 15 aphasic individuals to learn the names of unknown dog breeds (e.g., Maltese) were examined. The cues were classified as one of five cue forms by three judges on two separate occasions approximately 1 month apart. Examination of intra-judge agreements for the cue forms yielded a total of 251 cues for analysis of cue form effects (127 aphasic; 124 non-brain-damaged). Outcomes and Results. To examine the effects of cue form on facilitation of naming, weighted recall scores were calculated for each cue based on accurate naming on probes one week, one month, and 6 months after training. Kruskal-Wallis analysis of variance by ranks (KWANOVA) was used to determine the effects of cue form on learning of the subordinate category names. Significant cue forms effects were found for aphasic but not non-brain-damaged participant cues. Mann-Whitney post-hoc comparisons of aphasic cues revealed that cues containing semantic information had significantly higher mean rankings than those containing phonological information and those containing a combination of phonological and semantic information. Conclusions. Two implications arise from the study with respect to the use of personalised cueing as a clinical procedure. One is that it may be necessary to exert some limited control over the creative process of developing a personalised cue to ensure the inclusion of semantic information in the cue itself. A second is that individuals who have problems accessing semantic information may require some training before attempting to create personalised cues. In such instances, it would be important to obtain information about the source of the individual's anomic deficits through careful testing before embarking on a training programme featuring personalised cueing.     

Racial and ethnic disparities in the use of antipsychotic medication: a systematic review and meta-analysis

Objective

To conduct a systematic review and meta-analysis of published evidence on ethnic or racial disparities in the outpatient use versus non-use of antipsychotics and in the outpatient use of newer versus older antipsychotics.

Method

Electronic databases were searched for potentially relevant studies. Two independent reviewers conducted the review in three stages: title review, abstract review and full-text review. Included studies were those that: (a) report measures of disparity in the outpatient use of antipsychotic drugs in clearly defined racial or ethnic groups (b) have a primary focus on ethnic or racial disparities, and (c) have adjusted for factors known to influence medicine use. Odds ratios were pooled following the inverse-variance method of weighting effect sizes. I ² statistics were calculated to quantify the amount of variation that is likely due to heterogeneity between studies. Funnel plots were produced and Egger’s statistic was calculated to assess potential publication bias.

Results

No significant differences were found in the odds of using any antipsychotics among African Americans (OR = 1.01, CI = 0.99–1.02) compared with non-African Americans and among Latinos (OR = 0.98, CI = 0.86–1.13) compared with non-Latinos. Small to moderate but statistically non-significant disparities were also noted in other ethnic groups: Asians (OR = 1.10, CI = 0.88–1.36), Maoris (OR = 0.78, CI = 0.53–1.13) and Pacific Islanders (OR = 0.97, CI = 0.84–1.11). Among those who received antipsychotic medication, African Americans (OR = 0.62, CI = 0.50–0.78) and Latinos (OR = 0.77, CI = 0.73–0.81) appeared to have lower odds of receiving newer antipsychotics compared with non-African Americans and non-Latinos.

Conclusion

No significant ethnic disparities in the use versus non-use of any antipsychotics were observed, but, among those who received antipsychotic treatment, ethnic minorities were consistently less likely than non-ethnic minorities to be treated with newer antipsychotics.     

Reconceptualizing causative factors and intervention strategies in the eating disorders: a shift from body image to self-concept impairments

In this report, we argue that impairments in self-concept development function as a cognitive vulnerability that contributes to the formation of the eating disorders (ED) of anorexia nervosa (AN) and bulimia nervosa (BN). More specifically we argue that impairments in development of the total collection of identities that comprise the self-concept contribute to body image disturbances which in turn, motivate the eating and body-weight attitudes and behaviors that characterize the disorders. First, we review current understandings of the role of body image disturbances in the ED and discuss limitations of this approach. Then we review theories from psychoanalytic and feminist traditions that suggest that identity disturbances are a key factor in the etiology of the ED. Next, results of studies that examine identity disturbances in the ED are reviewed. Results of a study of women with AN and BN using the schema model of the self-concept as the theoretical framework showed that women with few positive and many negative self-cognitions are particularly vulnerable to cultural messages about body weight and form weight-related cognitions about the self that contribute to disordered eating attitudes and behaviors. Finally, the implications of these findings for primary and secondary level prevention of ED are addressed.     

Validation of the Readiness for Return-To-Work Scale in Outpatient Occupational Rehabilitation in Canada

Purpose To examine construct and concurrent validity of the Readiness for Return-To-Work (RRTW) Scale with injured workers participating in an outpatient occupational rehabilitation program. Methods Lost-time claimants (n?=?389) with sub-acute or chronic musculoskeletal disorders completed the RRTW Scale on their first day of their occupational rehabilitation program. Statistical analysis included exploratory and confirmatory factor analyses of the readiness items, reliability analyses, and correlation with related scales and questionnaires. Results For claimants in the non-job attached/not working group (n?=?165), three factors were found (1) Contemplation (2) Prepared for Action-Self-evaluative and (3) Prepared for Action-Behavioural. The precontemplation stage was not identified within this sample of injured workers. For claimants who were job attached/working group in some capacity (n?=?224), two factors were identified (1) Uncertain Maintenance and (2) Proactive Maintenance. Expected relationships and statistically significant differences were found among the identified Return-To-Work (RTW) readiness factors and related constructs of pain, physical and mental health and RTW expectations. Conclusion Construct and concurrent validity of the RRTW Scale were supported in this study. The results of this study indicate the construct of readiness for RTW can vary by disability duration and occupational category. Physical health appears to be a significant barrier to RRTW for the job attached/working group while mental health significantly compromises RRTW with the non-job attached/not working group.