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Study objective: Clinical reasoning is a crucial skill for all residents to acquire during their training. During most patient encounters in pediatric emergency medicine, physicians and trainees are challenged by diagnostic, investigative, and treatment uncertainties. The Script Concordance Test may provide a means to assess reasoning skills in the context of uncertainty in the practice of pediatric emergency medicine. We gathered validity evidence for the use of a pediatric emergency medicine Script Concordance Test to evaluate residents'' reasoning skills. Methods: A 1-hour test containing 60 questions nested in 38 cases was administered to 53 residents at the end of their pediatric emergency medicine rotation at 1 academic institution. Twelve experienced pediatricians were part of a reference panel to establish the basis for the scoring process. Results: An optimized version of the test, based on positive item discrimination data, contained 30 cases and 50 questions. Scores ranged from 48% to 82%, with a mean score of 69.9 (SD=11.5). The reliability of the optimized test (Cronbach''s α) was 0.77. Performance on the test increased as the level of experience of the residents increased. The residents considered the Script Concordance Test true to real-life clinical problems and had enough time to complete the test. Conclusion: This pediatric emergency medicine Script Concordance Test was reliable and useful to assess the progression of clinical reasoning during residency training. [Copyright &y& Elsevier]

Objective: The study was undertaken to evaluate the psychometric properties of the Interactive Voice Response (IVR) instrument to assess laparoscopic surgical skills of residents.Study Design: Surgical competence of obstetric-gynecologic residents at the University of Ottawa (Canada) was evaluated after observed performance of skills. Three questions addressing general domains of surgical skill were rated per surgery using a 5-point Likert scale: overall, 993 surgical ratings were made by 29 residents and 13 faculty preceptors.Results: With use of a generalizability study, a minimum of 12 preceptor ratings (G=0.80) are needed to obtain reliable measures of residents' surgical skills. Item analysis indicated that the three items on the instrument were highly correlated (Cronbach alpha=.92). Elements of construct validity were evident for diagnostic and simple laparoscopic procedures.Conclusion: The IVR instrument can be a valid and reliable measure of residents' surgical skills. The IVR ratings functioned as a global rating scale, capturing overall elements of surgical skills. The ratings on the IVR tool had construct validity with improved performance with increased surgical training and experience. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to evaluate the study habits (SHs) of surgery residents preparing for the annual American Board of Surgery In-Training Examination (ABSITE).Methods: A validated instrument developed to assess SHs in college students, the Survey of Study Habits and Attitudes (SSHA), was modified slightly for use with residents. The modified SSHA contains 2 subscale scores, work methods and delay avoidance, and a combined overall study habit score. A total of 59 residents from 2 academic general surgical residency programs were administered the modified SSHA. The SSHA scores were correlated to performance on the in-training examination.Results: There was a small but significant correlation between scores on the modified SSHA instrument and performance on the ABSITE overall (r = 0.29; P <.05; r2 = 0.0841). Linear-regression analysis showed that the clinical component and overall performance on the ABSITE were significantly predicted by the total SH scores. Overall total ABSITE percent correct scores were significantly predicted by residency levels of training and the overall SSHA scales (delay avoidance and work methods). Together they predicted 63% of the total variance in the overall performance scores. Residency level was the strongest predictor. SH performance accounted for 5.9% of the total variance beyond that contributed by residency level of training.Conclusions: The correlations of surgical resident ABSITE performance with SSHA scores were on the same order of magnitude as those of college students and academic performance with the original SSHA. Although SH in this study accounted for a measurable yet small contribution to ABSITE performance, this contribution was not enough to consider using the SSHA instrument in its current modified form as a diagnostic and counseling tool. Published instruments not specifically designed for residents may not be tailored enough to measure residents'' unique SH. [Copyright &y& Elsevier]