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Overview: Epilepsy is a serious, common neurologic disease that affects people of all ages. As underscored in the 2012 Institute of Medicine report Epilepsy Across the Spectrum: Promoting Health and Understanding, the millions of people living with epilepsy in the United States face the challenges of seeking out high-quality, coordinated health care and community services; overcoming epilepsy misinformation and stigma; and finding understanding and support in their communities. This article, the first in a two-part series, discusses new research that has increased our understanding of epilepsy's etiology and pathophysiology, new definitions that are changing the ways we evaluate and treat this disease, conditions that frequently present with epilepsy, and psychosocial challenges faced by people with epilepsy. Part 2, which will appear in next month's issue, reviews comprehensive nursing care and evidence-based treatment for epilepsy and presents resources for people with epilepsy and their families.

Background: The hurricane disasters of 2005 and the threat of pandemic infectious diseases compel medical educators to develop emergency preparedness training for medical students and other health care professional students., Description: This article describes an experiential exercise for learning a number of the general core competencies in the 2003 AAMC report titled "Training Future Physicians about Weapons of Mass Destruction." A modified tabletop exercise for medical and veterinary students, which was developed and implemented in 2005, is described. The exercise focused on Highly Pathogenic Avian Influenza (HPAI), an emerging infectious disease scenario that raised the possibility of biological attack. The students were assigned roles in small groups, such as community physicians, hospital personnel, public health officials, veterinarians, school nurses, and emergency managers. Fifteen faculty members were recruited from these various areas of expertise. Pre- and posttesting of medical students showed significant gains in knowledge. The authors describe the scenario, small-group role playing, study questions, injects, Web sites and readings, and evaluation tools., Conclusions: This experiential exercise is an effective, inexpensive, and easily adapted tool for promoting multiple competencies in mass health emergency preparedness for a variety of health care students including medical, veterinary, public health, and nursing students.

Background: Translating research into practice and policy is a complex process that links the research enterprise and health care delivery system of the United States. The Agency for Healthcare Research and Quality (AHRQ) Partnerships for Quality (PFQ) initiative expanded the scope of research translation beyond clinical practice, highlighting the role of strategic partners. A work group of AHRQ grantees developed a framework for systematic evaluation of the impact of strategic partnerships on research translation., Methods: The evaluation framework posits a hierarchy of impacts that cumulatively lead to observable patient outcomes. The evaluation framework captures (1) health care outcomes improvement, (2) clinical practice changes, (3) policies, procedures, and protocols, and (4) research and knowledge. After the framework and tool were subjected to face-validity critique among PFQ investigators, the concept of synergy was added. PFQ investigators pilot-tested the evaluation framework, and the PFQ tool was refined further., Results: Early feedback from PFQ grantees suggested that the framework is generalizable and potentially useful to guide investigators in capturing impacts of their work that might otherwise go unrecognized or trivialized., Discussion: The PFQ Evaluation Tool, a pragmatic approach for evaluating the impact of partnership-driven translation projects, provides a comprehensive evaluation of impacts, including synergistic outcomes.

Purpose: In 1998, the Medical Schools Objectives Project (MSOP) Report listed the minimum routine technical procedures that graduating medical students should be proficient to perform. The authors conducted a survey to determine to what extent basic technical skills are being taught formally and how student competence in these skills is being evaluated in U.S. medical schools., Method: A questionnaire of five items, designed to supplement existing information in CurrMIT, the national curriculum database for medical schools, was transmitted electronically via the AAMC listserv to associate deans for academic affairs., Results: Sixty-two of the 126 medical schools (52%) responded to the survey. Most agreed that graduating medical students should be proficient to perform basic technical skills. Fifty-five percent of the respondents required students to keep logs of procedures performed. A majority responded that their students were proficient to perform venipuncture, IV placement, suturing lacerations, Foley catheter placement, and arterial puncture. The responding schools stated that few students are proficient in thoracentesis and intubation of children and neonates., Conclusions: It is likely that half of the medical schools are not attaining the MSOP objective of rigorously teaching and evaluating technical procedures. Currently, more measures and more sophisticated measures of physicians' performance are being implemented in medical practice. The authors' findings call attention to this educational need and act as a stimulus to improve this aspect of medical education.

The veterinary school admission interview is a widely used selection tool, yet concerns persist about its reliability, validity, and cost. Relative to medicine, optometry, and dentistry schools, veterinary schools have been more likely to conduct panel interviews and to fix the interview's weight in selection decisions, strategies that increase interview validity. This article provides strategies for further increasing the veterinary school interview's validity. Interview reliability and validity studies point to key strategies the veterinary school admissions committee can implement before the interview: (1) establishing the interview's purpose(s); (2) conducting a "job" analysis to identify desirable candidate skills, knowledge, and attributes; (3) developing a structured and panel interview where interviewers, if possible, are blind to other admission data; (4) training interviewers; (5) setting a reasonable interview schedule; and (6) determining methods for analyzing applicant data. During the interview, interviewers should proceed through a structured series of steps: (1) open the interview with a specified agenda; (2) probe for information using structured questions and anchored rating scales; (3) close the interview to allow for candidate questions; and (4) evaluate the interview data. After the interview, the admissions committee should (1) analyze the interview data within and across interviewers and (2) analyze the data across all selection tools in order to assign relative weights to the selection tools.

An analysis of the admission interview used by schools in four health professions (veterinary medicine, allopathic medicine, optometry, and dentistry) portrays a largely similar approach to selection interviews: INTERVIEW USE: At least 80% of schools interview applicants. For schools that offer interviews, at least 40% of candidates are interviewed (a strong academic profile is the number one determinant of receiving an interview offer). The interview is one of the three most important selection tools used by schools. Less than 26% of schools fix the interview's weight in the selection process (fixed weights range from 31% to 35%). INTERVIEW PURPOSE AND CONTENT: The most common purposes of the interview are to (1) gather information, (2) make decisions, (3) verify information provided in other parts of the application, (4) recruit candidates, and/or (5) promote public relations. The most common characteristics and skills interviewers are interested in assessing are motivation for the profession, interpersonal skills, and communication skills. The desire to assess cognitive ability with the interview (>25% of schools) is surprising in view of the use of other selection tools (e.g., GPA). INTERVIEW FORMAT: Medical schools are more likely to offer two interviews per candidate, while optometry schools are more likely to offer one interview per candidate. Individual interviews (one interviewer, one candidate) are the predominant format among medical schools, while panel interviews (more than one interviewer, one candidate) are the most common format among optometry schools. The duration of the interview is 30 to 45 minutes. Interview questions most often address facts and knowledge, hypothetical situations, and the ability to meet program requirements. Most interviews do not meet the criteria for a structured interview, which has demonstrated greater validity and reliability than semi-structured or unstructured interviews. INTERVIEWERS: Interviewers are most likely to be health care faculty members (e.g., veterinarians at a veterinary school). Interviewers receive limited training. RECOMMENDATIONS FOR INCREASING INTERVIEW RELIABILITY AND VALIDITY: The purpose(s) of the interview must be clearly articulated so that the interview and interviewer training can be designed to achieve that purpose. Interview structure should be increased by developing a "job analysis" set of questions that is posed to all candidates and scored using behavioral anchors. Interviewers should receive more training in rater bias, listening skills, and interview structure. Panel interviews should be used to increase reliability. Interviewers should not have access to the candidate's application unless the interview is used to verify information. To increase the utility of the interview in the selection process, the weight of the interview in relation to other selection components should be determined.

Although the interview is widely used in the selection of applicants for admission to U.S. medical schools, little is known about current interview practices. The authors formulated a 46-item questionnaire concerning the interview process for medical school applicants, then in 1989 sent it to admission officials at all the 127 LCME-accredited schools in the United States. The questionnaire concerned the interview's status as a predictor; interviewers and interview structure; interviewer training; and the utility of interview data. Seventy-two percent of those sent the questionnaire completed and returned it. The responding admission officials indicated that the interview had two major purposes at their schools: as a means of assessing candidates' noncognitive skills and as a public relations tool. Most schools' interview processes were loosely to moderately structured, and interviewers received minimal training. It is concluded that the interview's role is primarily subjective and that it has a definite but imprecise influence on admission decisions.