Search

Scand J Prim Health Care 2003;21:000-000. ISSN 0281-3432 Objective - To assess organisational determinants in the prevention of cardiovascular disease. Design - A cross-sectional study. Setting and subjects - 130 general practices in The Netherlands. Data were collected using questionnaires. A causal model was designed and analysed by path analysis. Main outcome measures - Relationships between preventive activities, practice management and practice characteristics. Results - Important differences between adequacy of equipment and practice organisation were found. Record-keeping was significantly better when working experience of the GPs was less than 15 years, when the practice consisted only of female GPs, and when the practice had written protocols for cardiovascular disease management and the staff held regular scheduled meetings (teamwork). Teamwork also showed a significant relation with follow-up activities. The influence of non-measured variables in the model was considerable. Conclusion - In exploring the organisational setting as a barrier to prevention and disease management, the designed model showed no major effects. Despite the wide variety of practice organisational items investigated, a strong influence of non-measured variables was evident. Teamwork in the practices proved to be related to both follow-up and record-keeping. Younger and female GPs were further predictors of adequate record-keeping. [ABSTRACT FROM AUTHOR]

The use of written knowledge tests in (medical) education is widespread. Only few of them are thoroughly validated. Usually, validity studies are restricted to establishing ‘face‐validity’, the apparent similarity between test‐material and real life problems. Reliability studies are usually restricted to estimation of the coefficient alpha, representing the reproducibility of rank‐ordering of students at repeated test administration. This study addresses reliability from a broader perspective, using generalizability theory. The approach enables faculty to gain insight into the suitability of the test to serve different educational goals. A written knowledge test was examined, applied in postgraduate training for general practice in the Netherlands. Test‐reliability was approached from different perspectives: the norm‐oriented perspective, aiming at rank‐ordering (groups of) students, the domain‐oriented perspective, aiming at determining the absolute score level of (groups of) students and the decision‐oriented perspective, aiming at taking pass‐fail decisions. Reliability estimates differed for the different perspectives. The implication of the results and feasible options to increase reliability are discussed. [ABSTRACT FROM PUBLISHER]