Evaluation & the Health Professions

Hoffman, Arthur; Feinglass, Joe; Orsay, Charles; Croke, Kevin

doi: 10.1177/016327878901200101pmid: 10312911

We compared the actual diagnosis and treatmnent costs for nine colon cancer and 19 polyp patients detected by occult blood rsceening with excess hospitalization costs incurred by a comparable group of traditionally deteced patients. Program benefits were calculatedfrom data on group differentials in surgical length of stay, readmissions in the year following surgery, and preventive polvpectomnies. A sensitivity analysis was performed to evaluate varying estimates of ite per ientatge of polyps that may have become cancers, the urgency of presentation of clinically apparent cancer, and the inclusion or exclusion of the observed differences for hospitalization in the year after surgery. Two year program benefits varied from 59% to 185% of program costs. Adjusting estimates with DRG weightings for resource intensity produced considerably higher beneffis. All estimates ofprogram benefits are con ser ative because screened patients were compared with the 15-20% least severely ill, Most favorably staged of all traditionally detected colon cancer patients admitted. Results indicate that occult blood screening progranms may produce significant benefits derived from outpatient diagnosis, preventive polypectonmies, coordination of care between medical and surgical services, and enhanced patient education.

Rothman, Arthur I.; Cleave-Hogg, D.; Sellers, E. M.

doi: 10.1177/016327878901200102pmid: N/A

In mosn mnedical schools intellectual, interpersonal, and ethical development of students are ti/e core constituents of statements of educational goals and objectives. Paradoxica/lk; it inay be that the dominant features of the educational environments of these schools serve to inhibit student development in these areas. T/iis report describes one of a series of inivestigations, carried out at the Faculty of Medicinie of a large Canadian university, testing the hypothesis of a mismatch between educational goals and the educational environiment. In this study the perceptions of course and topic supervisors, who are responsible for t/ie planning, coordination, presentation, and evaluation of the discrete courses thai make tip the undergraduate medical curriculum, are described and analyzed with reference to A rgyris and Schon 's Model 1 and Model 2 definitions of institutional environmnents.

Waigandt, Alex; Chang, Jane

doi: 10.1177/016327878901200103pmid: N/A

The present study was designed to compare the pharmacology training of nurse practitioner programs with medical and dental progranms. In all, 73 schools in 14 states were selected Jbr the study. This sample was composed of 40 nurse practitioner programs, 19 schools of medicine, and 14 schools of dentistry. The major findings were that (1) significan t differences were found among the three sch7ool types on didactic hours spent on basic pharmacologicalprinciples, central nervous system depressants and stimulants, psychopharmacology, drug effects on the nervous system, cardiovascular agent, endocrine agents, chemotherapy, and poisons and antidotes; and (2) no statistically significant differences were found among the t ree schools in ocular pharmacology, respiratory and gastrointestinal tract agents, and drug interactions.

Gross, Leon J.; Scott, Joanne W.

doi: 10.1177/016327878901200104pmid: 10292127

There has been increased pressure in recent years for examinations used for occupational and profe ssional credentialing to be offered in several languages. When credentialing programs are international in scope, rather than national, examination translation may be a necessity, and a validation of the translation will be required. Yet, few candidates may sit for the translated version, jeopardizing the power and generalizability of statistical analysis. How should a board proceed in meeting its linguistic responsibility wheui faced with a small n? This article describes such a situation, and the linguistic and psychometric procedures that were developed and applied on a pilot translation by the International Board of Lactation Consultant Examiners (IBLCE).

Benedict, M. Beth; Glasser, Jay H.; Lee, Eun Sul

doi: 10.1177/016327878901200105pmid: 10292128

This research applied the life table technique to nursing personnel data in two types of hospitals to illustrate how administrators can examine patterns of continued employment. Although a large proportion of nurses were short-stay employees, the teaching hospital was found to have a higher retention rate than the community hospital corporation. The retention patterns are examined by personal and professional characteristics, as well as by reason for termination. Implications of our findings are discussed with respect to policy concerns related to hiring, retention, productivitv, and staff development.

Haladyna, Thomas M.; Shindoll, Russelyn Roby

doi: 10.1177/016327878901200106pmid: N/A

Writing multiple-choice test items has been typically characterized as more of an art than a science. Textbooks commonly offer advice on how to write items, but most inexperienced item writers, despite having expertise in a content area, have difficulty phrasing the stem. A technique is described that has been successfully used in several testing programs in the health professions. This technique, item shell, provides a basis for getting item writers started in the difficult process of w, iting the effective multiple-choice item.