Danette McKinley - Academia.edu (original) (raw)
Papers by Danette McKinley
International Best Practices for Evaluation in the Health Professions, 2022
BMC Medical Education, 2021
During the COVID-19 pandemic, despite many widespread calls for social distancing, recommendation... more During the COVID-19 pandemic, despite many widespread calls for social distancing, recommendations have not been followed by some people and the high rate of non-compliance has significantly affected lives all around the world. It seems that the rate of non-compliance with the recommendations among medical students has been as high as the rest of the other youth. In the time that students are removed from clinical environments and most physician teachers are strained in providing services to patients, medical students can be trained in interdisciplinary behavior change counseling programs and they can be employed in delivering virtual consultations to the patients referred to medical centers.In this quick review, we provide an argument regarding the importance of integrating the topic of patients’ social history into the undergraduate medical curriculum and the necessity of teaching theories of behavior change to medical students. Hypotheses are proposed that focus on the importance...
Please help populate SUNScholar with the full text of SU research output. Also - should you need ... more Please help populate SUNScholar with the full text of SU research output. Also - should you need this item urgently, please send us the details and we will try to get hold of the full text as quick possible. E-mail to scholar@sun.ac.za. Thank you.Geneeskunde en GesondheidswetenskappeSentrum vir Gesondheidsberoepe Onderwy
Academic Medicine, 2021
Supplemental Digital Content is available in the text. Purpose International medical graduates (I... more Supplemental Digital Content is available in the text. Purpose International medical graduates (IMGs), approximately 25% of the U.S. physician workforce, have unique needs as they enter residency programs. This study identified wellness barriers and challenges that IMGs encounter as they transition to the United States. Method The authors analyzed results from 3 open-ended questions in a 21-item survey. This survey was administered in December 2019 to 11,504 IMG resident physicians sponsored by the Educational Commission for Foreign Medical Graduates’ J-1 visa program. These questions asked respondents to describe challenges to their wellness, how they maintain wellness, and resources that would have aided their transition. Data were analyzed using a mixed-methods approach, including both qualitative descriptions and category frequencies. Results Of the surveys administered, 7,817 responses (68% response rate) were received. Respondents identified challenges navigating cultural differences (1,314, 17%), health care system (1,108, 14%), distance from family and friends (890, 11%), bureaucratic barriers (724, 9%), and language/communication and finances (575, 7%; 565, 7%, respectively). They also specified that friendships/relationships (2,800, 36%) followed by exercise (2,318, 30%), family (1,822, 23%), socialization (1,001, 13%), and healthy eating (775, 10%) were factors important to their wellness. Respondents requested more information about socialization (741, 9%), bureaucratic support (456, 6%), IMG support networks (427, 5%), financial support (404, 5%), and greater online resources (240, 3%). Conclusions IMGs have needs and concerns specific to their demographic group. Participants’ responses suggested that they wanted additional support in the workplace and their personal lives. Answers also indicated that IMGs experienced a unique set of stressors such as fluctuating immigration laws that U.S. medical graduates do not face. Finally, this study supports a body of research that connects social and physical wellness. By identifying and describing these challenges, the authors seek to inform the development of specific programs and resources to improve IMG resident wellness.
Revista Brasileira de Educação Médica, 2019
Background An outcome-based curriculum helps to communicate expectations of performance to studen... more Background An outcome-based curriculum helps to communicate expectations of performance to students and clinical teachers. The Mini Clinical Evaluation Exercise (mini-CEX) is a useful tool for workplace-based formative assessment. The objective of this study was to use workplace-based assessment and student feedback to evaluate an Obstetrics and Gynecology (Ob&Gyn) clerkship curriculum. Methods A cross-sectional study was conducted with faculty members and medical students in an Ob&Gyn clerkship. The Mini-CEX was introduced into the clerkship assessment system, together with multiple choice question (MCQ) tests. This tool evaluates the history collection, physical examination, clinical judgment, professionalism and humanism, and also gives an overall score at the end of the test. At the end of the rotation, questionnaires were used to collect the students’ perceptions about their skills acquisition during the program. The results of the Mini-CEX, the MCQ test, and questionnaire resp...
Annals of Global Health, 2015
report, a presenter will share an interesting patient case that is open for both groups of reside... more report, a presenter will share an interesting patient case that is open for both groups of residents to discuss and work through. Outcomes & Evaluation: In this setting, Haitian residents can learn about the diagnostic and therapeutic process in patients who have often been referred from outside hospitals for higher level tertiary care. During the Haiti resident cases, Dartmouth-Hitchcock residents can learn the value of more basic investigative practices and what the best diagnostic and treatment strategies are when resources are scarce. Both parties can learn a great deal from each other in recognizing the vast differences in medical systems and how geo-political and socioeconomical factors play large roles in healthcare delivery. However, perhaps one of the most valuable lessons gained from these conferences is that despite so many differences in our backgrounds and resources, there are countless aspects of good patient care that are universal to all healthcare providers. Going Forward: This pilot project has had to withstand several challenges in its early years of development. The language barrier between residents was an initial concern and hindered the free flow of discussion between groups. Having bilingual presentation slides and a Funding: There is currently no funding required for this initiative.
Human Resources for Health, 2021
Background Shortages and maldistribution of healthcare workers persist despite efforts to increas... more Background Shortages and maldistribution of healthcare workers persist despite efforts to increase the number of practitioners. Evidence to support policy planning and decisions is essential. The World Health Organization has proposed National Health Workforce Accounts (NHWA) to facilitate human resource information systems for effective health workforce planning and monitoring. In this study, we report on the accreditation practices for accelerated medically trained clinicians in five countries: Ethiopia, Ghana, Kenya, Malaysia, and Mongolia. Method Using open-ended survey responses and document review, information about accreditation practices was classified using NHWA indicators. We examined practices using this framework and further examined the extent to which the indicators were appropriate for this cadre of healthcare providers. We developed a data extraction tool and noted any indicators that were difficult to interpret in the local context. Results Accreditation practices i...
Advances in Health Sciences Education, May 1, 2007
The ECFMG Clinical Skills Assessment (CSA) was developed to evaluate whether graduates of interna... more The ECFMG Clinical Skills Assessment (CSA) was developed to evaluate whether graduates of international medical schools are ready to enter graduate training programs in the United States. The performance-based patient note exercise is specifically used to assess an examinee's ability to summarize, synthesize and interpret the data collected in a patient interview. The purpose of this study was to investigate whether choice of composition method (typing or writing) affected the psychometric properties of the scores. Using data for a 1-year period, the validity and reliability of typed and written notes was contrasted. Although the characteristics of individuals who chose whether or not to type were different, the statistical analyses indicated that, controlling for examinee ability, physician examiner ratings of the written summaries were not influenced by composition method. The results of this study suggest that the psychometric properties of the patient note scores are invariant with respect to composition method.
Http Dx Doi Org 10 1207 S15328015tlm1601_5, Jun 15, 2010
If the sequence of administration of encounters in performance-based examinations has an apprecia... more If the sequence of administration of encounters in performance-based examinations has an appreciable impact on examinee performance, the validity of any associated assessment decisions could be compromised. The purpose of this article was to determine if the order in which encounters occurred in a multistation standardized patient assessment had an effect on examinee performance and, if so, could this be explained by examinee experience and familiarity with the assessment. Analysis of the scores of over 11,000 examinees who took a 10-station clinical skills assessment was performed to determine trends across the cases. The results showed that administration sequence does have significant, albeit small, impact on examinee performance. In general, examinees perform slightly better as they proceed through the assessment, especially in the first few encounters. The possible reasons for this effect were difficult to establish, but it is likely that comfort with the examination format plays a significant role. For a given assessment, all examinees saw the same cases in a fixed sequence. Therefore, as long as performance gains are relatively small and consistent, it is unlikely that sequence effects compromised the fairness of the assessment.
Birth, 2016
Cesarean rates in Brazil have reached over 50 percent of all births. Multiple factors have been s... more Cesarean rates in Brazil have reached over 50 percent of all births. Multiple factors have been studied aiming to explain these rates. Mode of delivery preferences among university students may provide insights into strategies to reduce those numbers. A cross-sectional study was conducted enrolling students who attended Health Sciences and Human Sciences undergraduate programs in 2013. Participants answered a semi-structured questionnaire about which mode of delivery they considered the "best" (less risky and more beneficial) and the "preferred" mode (the one they would choose for themselves or their partners). Pearson chi-square was used to assess association among variables. Multiple regression analysis identified independent factors associated with the outcome measures. Among the 797 students who provided complete responses (76% response rate), the mean age was 22.6 years, 61.6 percent were female, 2.6 percent had previous pregnancies, and 56.7 percent were born by cesarean. Vaginal birth was chosen as the "best" mode of delivery by 91.2 percent, and the "preferred" mode by 75.5 percent of students. Being male, born vaginally, and a Health Sciences student was associated with a preference for vaginal birth. Being a Health Sciences student and born vaginally was associated with considering vaginal birth the "best" mode of delivery. Our findings indicate that the recognition of the benefits of vaginal birth do not always translate into a personal preference for vaginal birth. The student's own mode of birth was a strong predictor of their preferences for mode of delivery.
Assessing Competence in Professional Performance across Disciplines and Professions, 2016
Advances in Health Sciences Education Theory and Practice, May 1, 2010
Due to the high-stakes nature of medical exams it is prudent for test agencies to critically eval... more Due to the high-stakes nature of medical exams it is prudent for test agencies to critically evaluate test data and control for potential threats to validity. For the typical multiple station performance assessments used in medicine, it may take time for examinees to become comfortable with the test format and administrative protocol. Since each examinee in the rotational sequence starts with a different task (e.g., simulated clinical encounter), those who are administered non-scored pretest material on their first station may have an advantage compared to those who are not. The purpose of this study is to investigate whether pass/fail rates are different across the sequence of pretest encounters administered during the testing day. First-time takers were grouped by the sequential order in which they were administered the pretest encounter. No statistically significant difference in fail rates was found between examinees who started with the pretest encounter and those who encountered the pretest encounter later in the sequence. Results indicate that current examination administration protocols do not present a threat to the validity of test score interpretations.
Advances in Health Sciences Education, Feb 1, 2004
The ECFMG Clinical Skills Assessment (CSA ) was developed to evaluate whether graduates of intern... more The ECFMG Clinical Skills Assessment (CSA ) was developed to evaluate whether graduates of international medical schools (IMGs) are ready to enter graduate training programs in the United States. The patient note (PN) exercise, conducted after a 15-minute interview with a standardized patient (SP), is specifically used to assess a candidate's ability to summarize and synthesize the data collected. On a yearly basis, approximately 75,000 patient notes are reviewed and scored by physician raters. Recent changes to the PN scoring rubric, combined with enhancements to quality assurance procedures, mandate that additional evidence be provided to support the intended use of PN scores. The purpose of this study was to further investigate the psychometric adequacy of PN scores. Generalizability analyses suggest that while variability in PN ratings can be attributed to the choice of rater, candidate scores are reproducible over the 10-encounter CSA. The relationship of PN scores with other related ability measures and select candidate characteristics provides additional evidence to support the validity of the written exercise.
... J Gen Intern Med. 1996;11:490-3. Cited Here... 7. Mangione S, Peitzman S. Revisiting physical... more ... J Gen Intern Med. 1996;11:490-3. Cited Here... 7. Mangione S, Peitzman S. Revisiting physical diagnosis during the medical residency: it is time for a logbook-and more. Acad Med. ... Chair: Beth Dawson. Editor: M. Brownell Anderson. Foreword by Beth Dawson, PhD. ...
International Best Practices for Evaluation in the Health Professions, 2022
BMC Medical Education, 2021
During the COVID-19 pandemic, despite many widespread calls for social distancing, recommendation... more During the COVID-19 pandemic, despite many widespread calls for social distancing, recommendations have not been followed by some people and the high rate of non-compliance has significantly affected lives all around the world. It seems that the rate of non-compliance with the recommendations among medical students has been as high as the rest of the other youth. In the time that students are removed from clinical environments and most physician teachers are strained in providing services to patients, medical students can be trained in interdisciplinary behavior change counseling programs and they can be employed in delivering virtual consultations to the patients referred to medical centers.In this quick review, we provide an argument regarding the importance of integrating the topic of patients’ social history into the undergraduate medical curriculum and the necessity of teaching theories of behavior change to medical students. Hypotheses are proposed that focus on the importance...
Please help populate SUNScholar with the full text of SU research output. Also - should you need ... more Please help populate SUNScholar with the full text of SU research output. Also - should you need this item urgently, please send us the details and we will try to get hold of the full text as quick possible. E-mail to scholar@sun.ac.za. Thank you.Geneeskunde en GesondheidswetenskappeSentrum vir Gesondheidsberoepe Onderwy
Academic Medicine, 2021
Supplemental Digital Content is available in the text. Purpose International medical graduates (I... more Supplemental Digital Content is available in the text. Purpose International medical graduates (IMGs), approximately 25% of the U.S. physician workforce, have unique needs as they enter residency programs. This study identified wellness barriers and challenges that IMGs encounter as they transition to the United States. Method The authors analyzed results from 3 open-ended questions in a 21-item survey. This survey was administered in December 2019 to 11,504 IMG resident physicians sponsored by the Educational Commission for Foreign Medical Graduates’ J-1 visa program. These questions asked respondents to describe challenges to their wellness, how they maintain wellness, and resources that would have aided their transition. Data were analyzed using a mixed-methods approach, including both qualitative descriptions and category frequencies. Results Of the surveys administered, 7,817 responses (68% response rate) were received. Respondents identified challenges navigating cultural differences (1,314, 17%), health care system (1,108, 14%), distance from family and friends (890, 11%), bureaucratic barriers (724, 9%), and language/communication and finances (575, 7%; 565, 7%, respectively). They also specified that friendships/relationships (2,800, 36%) followed by exercise (2,318, 30%), family (1,822, 23%), socialization (1,001, 13%), and healthy eating (775, 10%) were factors important to their wellness. Respondents requested more information about socialization (741, 9%), bureaucratic support (456, 6%), IMG support networks (427, 5%), financial support (404, 5%), and greater online resources (240, 3%). Conclusions IMGs have needs and concerns specific to their demographic group. Participants’ responses suggested that they wanted additional support in the workplace and their personal lives. Answers also indicated that IMGs experienced a unique set of stressors such as fluctuating immigration laws that U.S. medical graduates do not face. Finally, this study supports a body of research that connects social and physical wellness. By identifying and describing these challenges, the authors seek to inform the development of specific programs and resources to improve IMG resident wellness.
Revista Brasileira de Educação Médica, 2019
Background An outcome-based curriculum helps to communicate expectations of performance to studen... more Background An outcome-based curriculum helps to communicate expectations of performance to students and clinical teachers. The Mini Clinical Evaluation Exercise (mini-CEX) is a useful tool for workplace-based formative assessment. The objective of this study was to use workplace-based assessment and student feedback to evaluate an Obstetrics and Gynecology (Ob&Gyn) clerkship curriculum. Methods A cross-sectional study was conducted with faculty members and medical students in an Ob&Gyn clerkship. The Mini-CEX was introduced into the clerkship assessment system, together with multiple choice question (MCQ) tests. This tool evaluates the history collection, physical examination, clinical judgment, professionalism and humanism, and also gives an overall score at the end of the test. At the end of the rotation, questionnaires were used to collect the students’ perceptions about their skills acquisition during the program. The results of the Mini-CEX, the MCQ test, and questionnaire resp...
Annals of Global Health, 2015
report, a presenter will share an interesting patient case that is open for both groups of reside... more report, a presenter will share an interesting patient case that is open for both groups of residents to discuss and work through. Outcomes & Evaluation: In this setting, Haitian residents can learn about the diagnostic and therapeutic process in patients who have often been referred from outside hospitals for higher level tertiary care. During the Haiti resident cases, Dartmouth-Hitchcock residents can learn the value of more basic investigative practices and what the best diagnostic and treatment strategies are when resources are scarce. Both parties can learn a great deal from each other in recognizing the vast differences in medical systems and how geo-political and socioeconomical factors play large roles in healthcare delivery. However, perhaps one of the most valuable lessons gained from these conferences is that despite so many differences in our backgrounds and resources, there are countless aspects of good patient care that are universal to all healthcare providers. Going Forward: This pilot project has had to withstand several challenges in its early years of development. The language barrier between residents was an initial concern and hindered the free flow of discussion between groups. Having bilingual presentation slides and a Funding: There is currently no funding required for this initiative.
Human Resources for Health, 2021
Background Shortages and maldistribution of healthcare workers persist despite efforts to increas... more Background Shortages and maldistribution of healthcare workers persist despite efforts to increase the number of practitioners. Evidence to support policy planning and decisions is essential. The World Health Organization has proposed National Health Workforce Accounts (NHWA) to facilitate human resource information systems for effective health workforce planning and monitoring. In this study, we report on the accreditation practices for accelerated medically trained clinicians in five countries: Ethiopia, Ghana, Kenya, Malaysia, and Mongolia. Method Using open-ended survey responses and document review, information about accreditation practices was classified using NHWA indicators. We examined practices using this framework and further examined the extent to which the indicators were appropriate for this cadre of healthcare providers. We developed a data extraction tool and noted any indicators that were difficult to interpret in the local context. Results Accreditation practices i...
Advances in Health Sciences Education, May 1, 2007
The ECFMG Clinical Skills Assessment (CSA) was developed to evaluate whether graduates of interna... more The ECFMG Clinical Skills Assessment (CSA) was developed to evaluate whether graduates of international medical schools are ready to enter graduate training programs in the United States. The performance-based patient note exercise is specifically used to assess an examinee's ability to summarize, synthesize and interpret the data collected in a patient interview. The purpose of this study was to investigate whether choice of composition method (typing or writing) affected the psychometric properties of the scores. Using data for a 1-year period, the validity and reliability of typed and written notes was contrasted. Although the characteristics of individuals who chose whether or not to type were different, the statistical analyses indicated that, controlling for examinee ability, physician examiner ratings of the written summaries were not influenced by composition method. The results of this study suggest that the psychometric properties of the patient note scores are invariant with respect to composition method.
Http Dx Doi Org 10 1207 S15328015tlm1601_5, Jun 15, 2010
If the sequence of administration of encounters in performance-based examinations has an apprecia... more If the sequence of administration of encounters in performance-based examinations has an appreciable impact on examinee performance, the validity of any associated assessment decisions could be compromised. The purpose of this article was to determine if the order in which encounters occurred in a multistation standardized patient assessment had an effect on examinee performance and, if so, could this be explained by examinee experience and familiarity with the assessment. Analysis of the scores of over 11,000 examinees who took a 10-station clinical skills assessment was performed to determine trends across the cases. The results showed that administration sequence does have significant, albeit small, impact on examinee performance. In general, examinees perform slightly better as they proceed through the assessment, especially in the first few encounters. The possible reasons for this effect were difficult to establish, but it is likely that comfort with the examination format plays a significant role. For a given assessment, all examinees saw the same cases in a fixed sequence. Therefore, as long as performance gains are relatively small and consistent, it is unlikely that sequence effects compromised the fairness of the assessment.
Birth, 2016
Cesarean rates in Brazil have reached over 50 percent of all births. Multiple factors have been s... more Cesarean rates in Brazil have reached over 50 percent of all births. Multiple factors have been studied aiming to explain these rates. Mode of delivery preferences among university students may provide insights into strategies to reduce those numbers. A cross-sectional study was conducted enrolling students who attended Health Sciences and Human Sciences undergraduate programs in 2013. Participants answered a semi-structured questionnaire about which mode of delivery they considered the "best" (less risky and more beneficial) and the "preferred" mode (the one they would choose for themselves or their partners). Pearson chi-square was used to assess association among variables. Multiple regression analysis identified independent factors associated with the outcome measures. Among the 797 students who provided complete responses (76% response rate), the mean age was 22.6 years, 61.6 percent were female, 2.6 percent had previous pregnancies, and 56.7 percent were born by cesarean. Vaginal birth was chosen as the "best" mode of delivery by 91.2 percent, and the "preferred" mode by 75.5 percent of students. Being male, born vaginally, and a Health Sciences student was associated with a preference for vaginal birth. Being a Health Sciences student and born vaginally was associated with considering vaginal birth the "best" mode of delivery. Our findings indicate that the recognition of the benefits of vaginal birth do not always translate into a personal preference for vaginal birth. The student's own mode of birth was a strong predictor of their preferences for mode of delivery.
Assessing Competence in Professional Performance across Disciplines and Professions, 2016
Advances in Health Sciences Education Theory and Practice, May 1, 2010
Due to the high-stakes nature of medical exams it is prudent for test agencies to critically eval... more Due to the high-stakes nature of medical exams it is prudent for test agencies to critically evaluate test data and control for potential threats to validity. For the typical multiple station performance assessments used in medicine, it may take time for examinees to become comfortable with the test format and administrative protocol. Since each examinee in the rotational sequence starts with a different task (e.g., simulated clinical encounter), those who are administered non-scored pretest material on their first station may have an advantage compared to those who are not. The purpose of this study is to investigate whether pass/fail rates are different across the sequence of pretest encounters administered during the testing day. First-time takers were grouped by the sequential order in which they were administered the pretest encounter. No statistically significant difference in fail rates was found between examinees who started with the pretest encounter and those who encountered the pretest encounter later in the sequence. Results indicate that current examination administration protocols do not present a threat to the validity of test score interpretations.
Advances in Health Sciences Education, Feb 1, 2004
The ECFMG Clinical Skills Assessment (CSA ) was developed to evaluate whether graduates of intern... more The ECFMG Clinical Skills Assessment (CSA ) was developed to evaluate whether graduates of international medical schools (IMGs) are ready to enter graduate training programs in the United States. The patient note (PN) exercise, conducted after a 15-minute interview with a standardized patient (SP), is specifically used to assess a candidate's ability to summarize and synthesize the data collected. On a yearly basis, approximately 75,000 patient notes are reviewed and scored by physician raters. Recent changes to the PN scoring rubric, combined with enhancements to quality assurance procedures, mandate that additional evidence be provided to support the intended use of PN scores. The purpose of this study was to further investigate the psychometric adequacy of PN scores. Generalizability analyses suggest that while variability in PN ratings can be attributed to the choice of rater, candidate scores are reproducible over the 10-encounter CSA. The relationship of PN scores with other related ability measures and select candidate characteristics provides additional evidence to support the validity of the written exercise.
... J Gen Intern Med. 1996;11:490-3. Cited Here... 7. Mangione S, Peitzman S. Revisiting physical... more ... J Gen Intern Med. 1996;11:490-3. Cited Here... 7. Mangione S, Peitzman S. Revisiting physical diagnosis during the medical residency: it is time for a logbook-and more. Acad Med. ... Chair: Beth Dawson. Editor: M. Brownell Anderson. Foreword by Beth Dawson, PhD. ...