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Valid assessment of interprofessional education and collaborative practice (IPECP) is challenging. The number of instruments that measure various aspects of IPECP, or in various sites is growing, however. The Interprofessional Professionalism Assessment (IPA) measures observable behaviors of health care professionals-in-training that demonstrate professionalism and collaboration when working with other health care providers in the context of people-centered care. The IPA instrument was created by the Interprofessional Professionalism Collaborative (IPC), a national group representing 12 entry-level health professions and one medical education assessment organization. The instrument was created and evaluated over several years through a comprehensive, multi-phasic process: 1) development of construct and observable behaviors, 2) instrument design, expert review and cognitive interviews, and 3) psychometric testing. The IPA contains 26 items representing six domains of professionalism (altruism and caring, excellence, ethics, respect, communication, accountability), and was tested by 233 preceptors rating health profession learners in the final year of their practical training. These preceptors represented 30 different academic institutions across the U.S., worked in various types of practice sites, and evaluated learners representing 10 different entry-level health professions. Exploratory factor analysis suggested four factors (communication, respect, excellence, altruism and caring) using 21 items with the least amount of missing data, and confirmed, for the most part, a priori expectations. Internal consistency reliability coefficients for the entire instrument and its four subscales were high (all greater than 0.9). Psychometric results demonstrate aspects of the IPA's reliability and validity and its use across multiple health professions and in various practice sites.

Students entering the first year of nine combined baccalaureate‐MD degree (CD) programs were administered the Matriculating Student Questionnaire (MSQ) of the Association of American Medical Colleges. A profile of the CD students’ perspectives on becoming a physician was compared with the profile of traditional medical students who responded to the MSQ. CD students chose medicine as a career goal earlier in life than their traditional counterparts. They also had more positive perceptions of medicine. Their decisions regarding future career interests in medicine differed in some respects from those of traditional students. Larger percentages of CD students were female, had Asian backgrounds, and had physician fathers. The views of CD students were partly related to the type of CD program they attended and to demographic/background characteristics, including age, which was suggested by preliminary comparisons between premedical students and CD students.

This study investigated the notion that the daily stresses we all experience impact more profoundly on health than do the more major life events. Questionnaire data were collected from 203 respondents within the Geelong community using a stratified sampling technique. It was predicted that the “hassle” means in this Australian sample would be similar to the “hassle” means obtained in two American studies. However, it was expected that the pattern of hassles would be different between the Australian and American studies because the Australian research used a broader demographic sample. With reference to the American results it was predicted that hassles would relate more strongly to psychological and somatic health than major life events. These predictions were all supported. Hassles did impact on health more significantly than did life events, and the hassle-health relationship held across a broader demographic sample than those used in the American studies. Indications are that research in this ...

Verbal expressions of probability are used in daily conversations, physician-physician and physician-patient communications, and questionnaire and interview responses. To assess the degree of agreement among English-speaking Australian adults in allocating numerical probabilities to these verbal expressions of probability, 966 interviewees provided estimates for 60 isolated expressions of probability and a sequence of seven items placed in a sequence. Means and median scores appeared to be consistent with common sense and with findings from other countries. Mirror-imaged terms were neither symmetrical nor equidistant, with the means and medians for the positive terms being closer to the mid-points of the scale than the means and medians of the negative terms. Items in a sequence of probability terms showed greater symmetry and less variability than isolated expressions. For most items, there was an unacceptably high level of within-subject and between-subject variability. Although subjects with higher levels of education and/ or mathematics education showed less variability, these factors accounted for very little of the variance. The greater variability in Australian results relative to those reported elsewhere was partly attributed to the use of interviews rather than questionnaires. There were no particular stems that yielded greater consistency. It was concluded that the use of these expressions leads to very imprecise communication.

In this baseline study, the authors analyze in detail many of the factors that influenced the research career intentions of the 1994 U.S. graduates of MD-only programs. Studies of the research interests of the nation's medical school graduates are important because MD-PhD programs do not produce sufficient numbers of physician-scientists, and the remainder must come from the regular population of medical graduates. Data on school characteristics and medical students' demographics, research career intentions, and educational experiences were derived from the AAMC's Institutional Profile System (IPS), Student Application and Information Management System (SAIMS), Matriculating Student Questionnaire (MSQ), and Medical School Graduation Questionnaire (GQ). The 1994 GQ was used as the index instrument to make the correlations reported in this article. A number of findings emerged concerning the 1994 graduates. A greater percentage of these students who began medical school with strong research career intentions and maintained these intentions had entered private medical schools. The lower rate of research interest amongst the students enrolled in public medical schools was compounded by the significantly greater loss of earlier research intentions of those in public schools compared with those in private schools.(ABSTRACT TRUNCATED AT 250 WORDS)

Questionnaire data was collected from a sample of 306 student nurses from three institutions (university, college of advanced education and hospital) during the second week of the first year of their course, and from 189 students from two of the institutions (university and CAE) at the conclusion of their first year of education. The main sources of stress on both occasions were essentially the same for women and men, and for students from the different institutions. These concerns focussed on study-related issues, the emotional demands of nursing, the use of technical equipment, interpersonal interaction, and lack of time for family and personal pursuits. It was suggested that these concerns could be reduced through the introduction of education in study skills, the provision of the opportunity to gain hands-on experience with technical equipment, and the development of social skills.

CD8 + T cells are crucial for host defense against viruses and tumor cells. Upon antigen recognition, CD8 + T cells proliferate and acquire effector functions. From mouse studies mainly, CD4 + CD25 + T cells have been recognized to have suppressive immunomodulatory activity. Because of a concern that human CD4 + CD25 + T cells contain both activated and regulatory T cells we chose to study this population from human cord blood (CB) which contains naive cells, which are not activated. Human CB cells were isolated using magnetic cell separation of CD4 + cells and subsequent purification by magnetic beads of these cells that co-expressed CD25. We assessed whether CD4 + CD25 + T cells from cord blood influenced function of autologous effector CD8 + T cells. Upon co-culturing CB CD8 + T cells with autologous CD4 + CD25 + cells, we found that CD4 + CD25 + T cells positively promoted CD8 + T cell function. This included induction of Granzyme B (GrB), a protease crucial for killing target cells and a hallmark of CD8 + T cell effector function. GrB expression was detected by intracytoplasmic flow cytometry. We also assessed effects on NKG2D, a costimulatory receptor known to promote CD8 + T cell effector responses to viruses and tumor cells. It is believed that down-modulation of NKG2D expression is a major obstacle for CD8 + T cell-mediated tumor rejection often observed in cells from cancer patients. Ligation-induced down-regulation of NKG2D expression was observed after culturing CD8 + T cells on anti-NKG2D-coated plates; effects that were dose-dependent. We examined whether the CD4 + CD25 + cells could enhance restoration of expression of NKG2D on CD8 + T cells by stimulating CD8 + T cells with anti-CD3 and IL-15 in the presence or absence of CD4 + CD25 + T cells. Consistent with the previous noted positive effect of CD4 + CD25 + T cells on GrB expression, they also enhanced NKG2D expression during anti-CD3 stimulation. We then determined if CD4 + CD25 + T cells had effects on CD8 + T cell cytotoxicity against the C1R B lymphoblast cell line, that expresses major histocompatibility complex (MHC) class I related chain A (MICA), a ligand for NKG2D. Consistent with the positive effects of CD4 + CD25 + T cells on expression of GrB and NKG2D, CD4 + CD25 + T cells enhanced the cytotoxic activity of CD8 + T cells to MICA-expressing target cells. In summary, CD4 + CD25 + T cells isolated from CB enhanced induction of GrB and NKG2D expression in autologous CD8 + T cells during anti-CD3 and IL-15 stimulation, which helps to explain the stimulatory effect of CD4 + CD25 + T cells on autologous CD8 + T cell cytotoxicity. Our results with human CB CD4 + CD25 + T cells may reflect actions of subpopulations of these cells. Further characterization of subsets of CD4 + CD25 + T cells are necessary to better define the specific population with the stimulatory actions on autologous CD8 + T cells that we observed. More defined characterization of CD4 + CD25 + T cells are warranted before such cells are used for clinical intervention in human disorders.