The purpose of this study was to evaluate the subjective shoulder value (SSV) and to compare it with the Constant score (CS). The SSV is defined as a patient’s subjective shoulder assessment ...expressed as a percentage of an entirely normal shoulder, which would score 100%. Patients who underwent operative treatment for rotator cuff repair (n = 247), arthroplasty (n = 83), or stabilization for recurrent anterior instability (n = 111) were included in this study. Correlation between the SSV and CS was highest postoperatively and was higher in the rotator cuff group (0.80) than in the osteoarthritis (0.69) and instability (0.61) groups. The relative CS could reliably predict the variance in the SSV in patients with rotator cuff tears (54%) and osteoarthritis (41%) and, to a lesser extent, in instability patients (23%). The SSV is an easily administered, responsive, and valid measure of shoulder function. The SSV may offer an improvement over the CS in assessing shoulder instability patients, as the CS may overestimate the results of these patients.
Background: The management of multiply injured trauma patients is a skill requiring broad knowledge, sound judgment, and leadership capabilities. The purpose of this study was to evaluate the ...effectiveness of a computer-based trauma simulator as a teaching tool for senior medical students.
Methods: All year-4 clinical clerks at the University of Toronto were approached to participate in a focused, 2-hour trauma management course. The volunteer rate for the course was 79%. Students were randomized to either computer-based simulator or seminar-based teaching groups. Outcome measures in this study were students’ trauma objective structured clinical examination (OSCE) scores.
Results: Both the trauma simulator and seminar teaching groups performed significantly better than the comparison group (no additional teaching) on the trauma OSCE patient encounter component, but not the written component of the examination. There was no significant difference in the performances of the trauma simulator and seminar teaching groups. Students overwhelmingly felt the trauma simulator was effective for their trauma teaching, and improved their overall confidence in clinical trauma scenarios.
Conclusions: There is a significant benefit associated with a focused, clinically based trauma management course for senior medical students. No additional improvement was noted with the use of a high fidelity computer-based trauma simulator.
Purpose: The purposes of this study were to develop and assess a rating form for selection of surgical residents, determine the criteria most important in selection, determine the reliability of the ...assessment form and process both within and across sites, and document differences in procedure and structure of resident selection processes across Canada.
Methods: Twelve of 13 English-speaking orthopedic surgery training programs in Canada participated during the 1999 selection year. The critical incident technique was utilized to determine the criteria most important in selection. From these criteria a 10-item rating form was developed with each item on a 5-point scale. Sixty-six candidates were invited for interviews across the country. Each interviewer completed one assessment form for each candidate, and independently ranked all candidates at the conclusion of all interviews. Consensus final rank orders were then created for each residency program. Across all programs, pairwise program-by-program correlations for each assessment parameter were made.
Results: The internal consistency of assessment form ratings for each interviewer was moderately high (mean Cronbach’s alpha = 0.71). A correlation between each item and the final rank order for each program revealed that the items work ethic, interpersonal qualities, orthopedic experience, and enthusiasm correlated most highly with final candidate rank orders (
r = 0.5, 0.48, 0.48, 0.45, respectively). The interrater reliabilities (within panels) and interpanel reliabilities (within programs) for the rank orders were 0.67 and 0.63, respectively. Using the Spearman-Brown prophecy formula, it was found that two panels with two interviewers on each panel are required to obtain a stable measure of a given candidate (reliabilities of 0.80). The average pairwise program-by-program correlations were low for the final candidate rank orders (0.14).
Conclusions: A method was introduced to develop a standard, reliable candidate assessment form to evaluate residency selection procedures. The assessment form ratings were found to be consistent within interviewers. Candidate assessments within programs (both between interviewers and between panels) were moderately reliable suggesting agreement within programs regarding the relative quality of candidates, but there was very little agreement across programs.
