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Aniort J, Trefond J, Tanguy G, Bataille S, Burtey S, Pereira B, Garrouste C, Philipponnet C, Clavelou P, Heng AE, Lautrette A. Impact of reference panel composition on scores of script concordance test assessing basic nephrology knowledge in undergraduate medical education. MEDICAL TEACHER 2024; 46:110-116. [PMID: 37544894 DOI: 10.1080/0142159x.2023.2239441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
PURPOSE In the assessment of basic medical knowledge, the composition of the reference panel between specialists and primary care (PC) physicians is a contentious issue. We assessed the effect of panel composition on the scores of undergraduate medical students in a script concordance test (SCT). METHODS The scale of an SCT on basic nephrology knowledge was set by a panel of nephrologists or a mixed panel of nephrologists and PC physicians. The results of the SCTs were compared with ANOVA for repeated measurements. Concordance was assessed with Bland and Altman plots. RESULTS Forty-five students completed the SCT. Their scores differed according to panel composition: 65.6 ± 9.73/100 points for nephrologists, and 70.27 ± 8.82 for the mixed panel, p < 0.001. Concordance between the scores was low with a bias of -4.27 ± 2.19 and a 95% limit of agreement of -8.96 to -0.38. Panel composition led to a change in the ranking of 71% of students (mean 3.6 ± 2.6 places). CONCLUSION The composition of the reference panel, either specialist or mixed, for SCT assessment of basic knowledge has an impact on test results and student rankings.
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Affiliation(s)
- Julien Aniort
- Nephrology, Dialysis and Transplantation Department, Gabriel Montpied Hospital, Clermont-Ferrand, France
- Human Nutrition Unit, Clermont Auvergne University INRAE UMR 1019, Clermont-Ferrand, France
| | - Jeromine Trefond
- General Practitioner Department, Clermont-Ferrand Medical School, Clermont Auvergne University, Clermont-Ferrand, France
| | - Gilles Tanguy
- General Practitioner Department, Clermont-Ferrand Medical School, Clermont Auvergne University, Clermont-Ferrand, France
| | - Stanislas Bataille
- Phocean Nephrology Institute, ELSAN, Clinique Bouchard, Marseille, France
- C2VN, Aix-Marseille Univ, INSERM, INRAE UMR 1076, Marseille, France
| | - Stephane Burtey
- C2VN, Aix-Marseille Univ, INSERM, INRAE UMR 1076, Marseille, France
- Centre de Néphrologie et Transplantation Rénale, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - Bruno Pereira
- Biostatistics Unit, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Cyril Garrouste
- Nephrology, Dialysis and Transplantation Department, Gabriel Montpied Hospital, Clermont-Ferrand, France
| | - Carole Philipponnet
- Nephrology, Dialysis and Transplantation Department, Gabriel Montpied Hospital, Clermont-Ferrand, France
| | - Pierre Clavelou
- Neuro-Dol, INSERM, CHU Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Anne-Elisabeth Heng
- Nephrology, Dialysis and Transplantation Department, Gabriel Montpied Hospital, Clermont-Ferrand, France
- Human Nutrition Unit, Clermont Auvergne University INRAE UMR 1019, Clermont-Ferrand, France
| | - Alexandre Lautrette
- Intensive Care Unit, Centre Jean Perrin, Clermont-Ferrand, France
- LMGE (Laboratoire MicroOrganisme Genome et Environnement), Clermont Auvergne University CNRS UMR 6023, Clermont-Ferrand, France
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Podlipski PL, Tran E, Chrusciel J, Kaladjian A, Sanchez S. [Management of suicidal crisis in general practice: evaluation of care practices according to patient age]. Soins Psychiatr 2022; 43:42-48. [PMID: 35598914 DOI: 10.1016/j.spsy.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Nearly 800,000 people die by suicide each year worldwide. Up to 75% of suicidal patients consulted their general practitioner in the months preceding their attempt. A study, conducted among 167 practitioners in Champagne-Ardenne in 2016-2017, aims to evaluate the practices of general practitioners in the management of suicidal crisis, particularly according to the age of the patient. It provides elements for reflection on their role in suicide prevention.
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Affiliation(s)
- Pierre-Luc Podlipski
- Pôle de psychiatrie des adultes, centre hospitalier universitaire de Reims, faculté de médecine de Reims, rue du Général-Koenig, 51100 Reims, France
| | - Eric Tran
- Pôle territorial santé publique et performance, unité de recherche clinique et de recherche en soins, Hôpitaux Champagne Sud, 101 avenue Anatole-France, 10000 Troyes, France
| | - Jan Chrusciel
- Pôle territorial santé publique et performance, unité de recherche clinique et de recherche en soins, Hôpitaux Champagne Sud, 101 avenue Anatole-France, 10000 Troyes, France
| | - Arthur Kaladjian
- Pôle de psychiatrie des adultes, centre hospitalier universitaire de Reims, faculté de médecine de Reims, rue du Général-Koenig, 51100 Reims, France
| | - Stéphane Sanchez
- Pôle territorial santé publique et performance, unité de recherche clinique et de recherche en soins, Hôpitaux Champagne Sud, 101 avenue Anatole-France, 10000 Troyes, France.
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Clavier T, Ramen J, Dureuil B, Veber B, Hanouz JL, Dupont H, Lebuffe G, Besnier E, Compere V. Use of the Smartphone App WhatsApp as an E-Learning Method for Medical Residents: Multicenter Controlled Randomized Trial. JMIR Mhealth Uhealth 2019; 7:e12825. [PMID: 30964435 PMCID: PMC6477573 DOI: 10.2196/12825] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/17/2019] [Accepted: 02/23/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The WhatsApp smartphone app is the most widely used instant messaging app in the world. Recent studies reported the use of WhatsApp for educational purposes, but there is no prospective study comparing WhatsApp's pedagogical effectiveness to that of any other teaching modality. OBJECTIVE The main objective of this study was to measure the impact of a learning program via WhatsApp on clinical reasoning in medical residents. METHODS This prospective, randomized, multicenter study was conducted among first- and second-year anesthesiology residents (offline recruitment) from four university hospitals in France. Residents were randomized in two groups of online teaching (WhatsApp and control). The WhatsApp group benefited from daily delivery of teaching documents on the WhatsApp app and a weekly clinical case supervised by a senior physician. In the control group, residents had access to the same documents via a traditional computer electronic learning (e-learning) platform. Medical reasoning was self-assessed online by a script concordance test (SCT; primary parameter), and medical knowledge was assessed using multiple-choice questions (MCQs). The residents also completed an online satisfaction questionnaire. RESULTS In this study, 62 residents were randomized (32 to the WhatsApp group and 30 to the control group) and 22 residents in each group answered the online final evaluation. We found a difference between the WhatsApp and control groups for SCTs (60% [SD 9%] vs 68% [SD 11%]; P=.006) but no difference for MCQs (18/30 [SD 4] vs 16/30 [SD 4]; P=.22). Concerning satisfaction, there was a better global satisfaction rate in the WhatsApp group than in the control group (8/10 [interquartile range 8-9] vs 8/10 [interquartile range 8-8]; P=.049). CONCLUSIONS Compared to traditional e-learning, the use of WhatsApp for teaching residents was associated with worse clinical reasoning despite better global appreciation. The use of WhatsApp probably contributes to the dispersion of attention linked to the use of the smartphone. The impact of smartphones on clinical reasoning should be studied further.
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Affiliation(s)
- Thomas Clavier
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | - Julie Ramen
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | - Bertrand Dureuil
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | - Benoit Veber
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | - Jean-Luc Hanouz
- Department of Anesthesiology and Critical Care, Caen University Hospital, Normandie Université, Caen, France
| | - Hervé Dupont
- Department of Anesthesiology and Critical Care, Amiens University Hospital, Amiens, France
| | - Gilles Lebuffe
- Pôle d'Anesthésie-Réanimation, Lille University Hospital, Lille, France
| | - Emmanuel Besnier
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | - Vincent Compere
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France
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Background noise lowers the performance of anaesthesiology residents' clinical reasoning when measured by script concordance: A randomised crossover volunteer study. Eur J Anaesthesiol 2018; 34:464-470. [PMID: 28394819 DOI: 10.1097/eja.0000000000000624] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Noise, which is omnipresent in operating rooms and ICUs, may have a negative impact not only patients but also on the concentration of and communication between clinical staff. OBJECTIVE The present study attempted to evaluate the impact of noise on the performance of anaesthesiology residents' clinical reasoning. Changes in clinical reasoning were measured by script concordance tests (SCTs). DESIGN This was a randomised and crossover study. SETTING Single centre at Rouen University Hospital in April 2014. POPULATION All year 1 to 4 residents enrolled in the anaesthesiology training programme were included. INTERVENTION Performance was assessed using a 56-item SCT. Two resident groups were formed, and each was exposed to both quiet and noisy atmospheres during SCT assessment. Group A did the first part of the assessment (28 SCT) in a quiet atmosphere and the second part (28 SCT) in a noisy atmosphere. Group B did the same in reverse order. MAIN OUTCOME MEASURES The primary outcome of this study was residents' performance as measured by SCT, with and without noise (mean of 100 points 95% confidence interval). RESULTS Forty-two residents were included. Residents' performance, measured by SCT, was weaker in a noisy environment than in a quiet environment [59.0 (56.0 to 62.0) vs 62.8 (60.8 to 64.9), P = 0.04]. This difference lessened as medical training advanced, as this difference in performance in noisy vs quiet environments was not observed in year 3 and 4 residents [62.9 (59.2 to 66.5) vs 64.0 (61.9 to 66.1), P = 0.60], whereas it was higher for year 1 and 2 residents [54.8 (50.6 to 59.1) vs 61.5 (57.9 to 65.1), P = 0.02]. CONCLUSION Our study suggests that noise affects clinical reasoning of anaesthesiology residents especially junior residents when measured by SCT. This observation supports the hypothesis that noise should be prevented in operating rooms especially when junior residents are providing care.
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Le test de concordance de script : un outil pédagogique multimodal. Rev Med Interne 2018; 39:566-573. [DOI: 10.1016/j.revmed.2017.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 12/17/2017] [Accepted: 12/28/2017] [Indexed: 11/18/2022]
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Atayee RS, Lockman K, Brock C, Abazia DT, Brooks TL, Pawasauskas J, Edmonds KP, Herndon CM. Multicentered Study Evaluating Pharmacy Students’ Perception of Palliative Care and Clinical Reasoning Using Script Concordance Testing. Am J Hosp Palliat Care 2018; 35:1394-1401. [DOI: 10.1177/1049909118772845] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: As the role of the pharmacist on the transdisciplinary palliative care team grows, the need for adequate instruction on palliative care and clinical reasoning skills in schools of pharmacy grows accordingly. Methods: This study evaluates second- and third-year pharmacy students from 6 accredited schools of pharmacy that participated in surveys before and after the delivery of a didactic palliative care elective. The survey collected student demographics, perceptions of the importance of and student skill level in palliative care topics. The script concordance test (SCT) was used to assess clinical decision-making skills on patient cases. Student scores on the SCT were compared to those of a reference panel of experts. Results: A total of 89 students completed the pre-/postsurveys and were included in data analysis. There was no statistically significant difference in student perceived importance of palliative care skills before and after the elective. Students from all 6 institutions showed significant increase in confidence in their palliative care skills at the end of the course. There was also a significant improvement across all institutions in clinical reasoning skills in most of the SCT questions used to assess these skills. Conclusions: Students choosing an elective in palliative care likely do so because they already have an understanding of the importance of these topics in their future practice settings. Delivery of a palliative care elective in the pharmacy curriculum significantly increases both student confidence in their palliative care skills and their clinical reasoning skills in these areas.
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Affiliation(s)
- Rabia S. Atayee
- UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA
- Department of Medicine, Palliative Care Team, UC San Diego Health, CA, USA
| | | | - Cara Brock
- College of Pharmacy, Roosevelt University, Schaumburg, IL, USA
| | - Daniel T. Abazia
- Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ, USA
| | - Tracy L. Brooks
- Manchester University College of Pharmacy, Fort Wayne, IN, USA
| | | | - Kyle P. Edmonds
- UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA
- Department of Medicine, Palliative Care Team, UC San Diego Health, CA, USA
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