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This study assessed the effects of the type of medical curriculum on differential item functioning (DIF) and group differences at the test level in Level 1 of the Comprehensive Osteopathic Medical Licensing Examinations (COMLEX). The study also explored the relationship of the DIF and group differences at the test level. There are generally two types of osteopathic preclinical curriculum: traditional discipline-based and organ system-based. The June 1998 administration of COMLEX was used. This examination involved 800 multiple-choice items and 2,122 students from 17 osteopathic schools. Of these students, 578 studied an organ-system-based curriculum. The study reveals that the directions of the influences of curriculum type were consistent at the test and item levels, but the magnitude of the influences was minimal. At the total examination level, students from the system-based curriculum performed better but with no practical significance. At the item level, the majority of items were immune from the impact of curriculum, while more items of those that had significant DIF favored students in organ-system based curricula. It is concluded that the advantages of students in the system-based curricula on the total examination were due in part to items discriminative against students in the discipline-based curricula. (Contains 2 tables and 11 references.) (SLD)

A multilevel approach was proposed for the assessment of differential item functioning and compared with the traditional logistic regression approach. Data from the Comprehensive Osteopathic Medical Licensing Examination for 2,300 freshman osteopathic medical students were analyzed. The multilevel approach used three-level hierarchical generalized linear models. The software HLM for Windows executed the hierarchical linear model (HLM) analysis and the Statistical Analysis System Proc Logistic was used for the conventional logistic regression analysis. It was not surprising to see that HLM was more conservative in identifying DIF in this study. The study demonstrates that the multilevel approach to DIF is meaningful and the results of its use appear reasonable. Implications for use of the two approaches are discussed. (SLD)

This study compared personality traits of students in five health professions. The Myers-Briggs Type Indicator was completed by 1,508 osteopathic students, 654 pharmacy students, 165 physical therapy students, 211 physician assistant students, and 70 occupational therapy students. Comparing the extrovert/introvert dimension revealed that pharmacy students were more likely to score as introverted whereas students enrolled in the four other health fields were more likely to score as extroverts. Pharmacy students were more inclined to use the sensing function, while a greater proportion of osteopathic students preferred the intuitive function. For the five health professions, there were no significant differences across the thinking/feeling dimension. On the judgment/perception construct, pharmacy students were likely to favor the perceiving function. The dominant profile for osteopathic and physician assistant students was ESTJ, meaning that they are practical, realistic, with a natural head for business or mechanics. The dominant profile for physical and occupational therapy students was ESFJ, meaning they are warm-hearted, talkative, and interested in things that affect peoples's lives. The dominant profile for pharmacy students was ISTJ, meaning they are serious, thorough, logical, and realistic. The results support the notion that people choose professions partially based on personality traits. (Contains 24 references). (SW)

This longitudinal study investigates the growth of medical achievement as a multilevel process and emphasizes the structure of the growth. Subjects were students in all 15 U.S. osteopathic medical schools, a total of 1,060 (78 percent of the 1987 osteopathic cohort). Students took appropriate portions of the National Board of Osteopathic Medical Examiners' 3-part series of examinations in 1989, 1991, and 1992. Results indicate a substantial overall gain in medical achievement, with an achievement increase of 18 percent over the 3 years. Results also provide empirical evidence of discontinuity among the preclinical, clinical, and residency phases of medical education. Some of the schools had statistically zero, or negative growth, but there were substantial positive gains during clinical education for students in other schools. Institutional differences have sustained effects on student achievement growth both during and after medical school. An appendix discusses hierarchical linear modeling of the growth in general medical knowledge. One table and four figures present study data. (Contains 7 references.) (SLD)

As part of a longitudinal study of the growth of general medical knowledge among osteopathic medical students, a simple, convenient, and accurate vertical equating method was developed for constructing a scale for medical achievement. It was believed that Parts 1, 2, and 3 of the National Board of Osteopathic Medical Examiners' (NBOME) examination together represented the basic concepts and principles of the entire medical sciences, so all 3 (comprising 9 examinations in all) were combined in a linking chain into a large examination representing 2,814 items and 5,168 persons, although there was substantial missing data. The Rasch model measurement program BIGSTEPS was used to calibrate this huge examination. Despite the large amount of missing data, the program converged smoothly. Distributions of person ability were not affected by the equating. Results suggest that Rasch measurement one-step equating is a valid, efficient, and accurate way to construct a measure for longitudinal medical achievement studies. The one-step technique accomplished by BIGSTEPS provided good person ability estimates on the whole examination, and consistent difficulty estimates for items. Ten figures and two tables present details of the analyses. (SLD)

Studies in psychology and clinical decision making have shown that research subjects and physicians are often overconfident in the accuracy of their judgments. In these studies, groups of 20 first-year and 27 third-year osteopathic medical students at the Ohio University College of Osteopathic Medicine (Athens) were slightly underconfident in their ability to classify artificially-generated abnormal heart rhythms, with good "calibration" at higher confidence levels. Evaluating individuals on "adjusted resolution," which provides an index of the ability to sort correct and incorrect diagnoses into different confidence levels, reveals a curvilinear relationship between diagnostic metacognition (adjusted resolution) and accuracy. The best metacognition was found in subjects achieving 70 to 85 percent diagnostic accuracy. Implications of these findings are discussed. Three figures illustrate the discussion, and an appendix contains a diagram of the decomposition of mean probability scores. (SLD)

In this study of the physical facilities of the nation's health professions schools, all schools of dentistry, medicine, optometry, osteopathy, pharmacy, podiatry, public health, and veterinary medicine, and all parent institutions of the schools, were surveyed in May of 1973. The major goals of this pioneering survey were to assess the nature and use of existing, under construction, and planned facilities, and to forecast the anticipated replacement or expansion of facilities in the following decade. At the time of this writing, three years after the first survey, very few of the data are obsolete. Information on nonclinical instruction facilities has to do with amount, condition, and perceived needs for room types: classrooms, class laboratories, research and research training space, library space, auditoria, faculty offices, administrative areas, animal facilities, and other kinds of space. Clinical teaching facilities available to the schools are also inventoried in square footage and in terms of beds, examination rooms, and ambulatory patient stations. Analyses are made of resource utilization. Census data are projected to determine use of facilities and output of health professionals in future years. (Author/MSE)

Health sciences education planning for California for 1980-82 is examined. The adequacy of educational programs in meeting the needs of California for professional personnel in medicine, nursing, dentistry, pharmacy, and optometry is assessed. Data on enrollments and graduation rates in these fields are updated from the 1978 plan, and similar data on the fields of osteopathy and podiatry are included. Progress in implementing recommendations from the 1978 plan is assessed, and the role of nurse practitioners in geriatric health care is examined. The most recent Health Manpower Plan and the State Health Plan are also reviewed. Various careers that are included in the generic term of allied health are identified, a classification structure for allied health is presented, and the educational and training programs in these fields are described with respect to institutional setting, enrollments, and numbers of graduates. Additionally, preventive health care, and the educational components that provide the professional personnel for prevention vis-a-vis cure in health care are briefly reviewed. Some general areas of discussion include graduate medical education, attrition in the nursing profession, programs in nurse-midwifery, and information needs for health science planning. Recommendations of the Graduate Medical Education National Advisory Committee are appended. (SW)

A detailed statistical review of state support for health manpower training during 1973, 1974, and 1975 with an inventory of state expenditures for specific health occupations in 32 states are presented in Volume One of this two-volume study conducted for the Health Resources Administration. Objectives of the study included: investigation of the availability of data on state and local support for health manpower training and development of methods for obtaining these data; and utilization of these procedures to collect information for FY 1974 and FY 1975. The two-phase study methodology is explained and financial data and program statistics for all major health professions and allied health occupations are presented. Financial support categories include: institutional support, capital outlay, student aid, and direct support. For each of the 32 states examined in depth, state funds by institutions and program are tabulated for each financial support category. Total financial support for health manpower training for all 50 states was $1.5 million during FY 1974, an increase of 23 percent over FY 1973. For 32 states the mean per capita higher education appropriation for health manpower training programs was $46.35, with an average figure of $5.29. Variations in program expenditures in different states ranged from a high of $15.26 per capita for Oregon to a low of $1.97 for Massachusetts. It is recommended that: the survey be repeated on a regular basis; the scope of the survey be increased; a mail survey be conducted; an index be developed and printed; and an in-depth analysis of state support be conducted that coordinates federal and state support indices. A glossary of related terms is provided. (SF)

Expenses that health professions students incurred, sources of income to meet those expenditures, and indebtedness incurred by the students during the 1976-77 school year were studied. A questionnaire, which is appended, was mailed to a sample of students registered in schools of dentistry, optometry, osteopathic medicine, pharmacy, podiatry, public health, and veterinary medicine. Based on information provided by the respondents, estimates are made of the relevant sociodemographic characteristics and financial activities of all students registered in these health professions schools. Among the findings are the following: podiatry and osteopathy students reported the highest average annual expenditures of $11,720 and $11,070 respectively, while pharmacy students reported the lowest of $6,740; in each health profession students attending private schools reported average school expenses that were about 150 percent greater than those reported in public schools; married students, especially those with children, reported that they spent more on food, lodging, and other items than did single students; most students financed their education with income obtained from nonrefundable sources; students most frequently reported that they received the largest proportion of their income from their own earnings and savings and from contributions made by their spouses and parents; approximately 40 percent of all health professions students reported that they were in debt prior to entering professional school, and the average debt reported by these was $7,000; and of those students who reported prior indebtedness, most were in debt because of preprofessional school educational expenditures. (SW)

Information about state support for health professions education and for students attending health professions schools is presented, based on a request by the Senate Subcommittee on Health and Scientific Research. The Subcommittee will be considering legislation, during the 96th Congress, to extend and modify Titles VII and VIII of the Public Health Service Act, which authorize federal programs affecting the training and deployment of health personnel. State financial aid to selected health professions education from 1975 through 1980 is assessed, including three separate fiscal periods, and the relationship between federal capitation, state institutional aid, and tuition revenues is explored. Based on a survey of the states and site visits, information is also presented on state scholarships and loans, and on growth and changes in states' efforts to tie student financial assistance to future service payback principally in underserved communities. Trends in state commitments to the following health professions are analyzed: medicine; osteopathy; dentistry; optometry; pharmacy; podiatry; veterinary medicine; and diploma, associate-level, and baccalaureate-level nursing. Appended materials include: state financial aid program descriptions and statistical data for the 50 states and the District of Columbia; information on the health professions federal student assistant programs, 1979-80; and a description of the study methodology. (SW)

Educators in dentistry and osteopathy discuss efforts within their fields to diversify clinical education. Dental school changes focus on curriculum reform, closer education-care delivery relationship, patient centeredness, comprehensive care experiences, and patient care as a distinct mission of dental education. Efforts in osteopathy emphasize understanding of all body subsystems, using a holistic approach. Implications for optometry are considered. (MSE)

The West Virginia School of Osteopathic Medicine's successful interstate educational exchange program through the Southern Regional Education Board is described, and concerns are expressed for the program's future. Suggestions are offered for establishing similar multistate programs that promote education in medical specialties and encourage physicians to return to their home states. (Author/MSE)

The Interdisciplinary Generalist Curriculum Project was developed to encourage schools of medicine and colleges of osteopathic medicine to implement interdisciplinary generalist curricula in the preclinical years. Five sites were competitively established as demonstration projects, and rigorous attention to creating and maintaining an interdisciplinary focus was emphasized to move medical education institutions toward production of generalist physicians. (JDD)

The American Optometric Association's current review of procedures for accrediting optometric residencies is discussed. Reasons for the review (projected growth of programs and revised standards) are discussed, procedures currently in place for accrediting programs in osteopathy, dentistry, pharmacy, podiatry, and optometry are summarized; and task force recommendations are made. (MSE)

Explores cost implications of residency programs within the Veterans Administration health care system, particularly the costs and benefits of residencies in family medicine, osteopathic medicine, and general dentistry, because they resemble optometric residencies most closely. Costs of an existing vision therapy residency are examined, and factors to consider in deciding to initiate a residency program are outlined. (MSE)

Sixteen premedical students from underrepresented minority groups participated in a six-week, six-course program at the Chicago College of Osteopathic Medicine (Illinois). Academic performance before and during program participation was compared for students subsequently offered or denied admission. Accepted and denied students could be distinguished by program and course performance, but not by prior performance, supporting the program's effectiveness. (Author/MSE)

The three volume report includes (1) an executive summary; (2) a comprehensive report reviewing the literature on current faculty development needs in schools of osteopathic medicine; and (3) a volume of resource materials. The study gauges the formal organizational and programmatic factors that influence the success of faculty development programs in medical settings, and provides materials to assist in the implementation of faculty development assessment programs. The project considers issues in two broad areas: instructional skills--i.e., the training faculty members have had for the teaching role and current educational practices employed-- as well as interest level in instructional skills and educational issues identified by the faculty; and program assessment. The latter section reviews the literature of faculty development models, programs and program evaluation, surveys and assesses five model faculty development projects, and assesses sources of funding for faculty development models. Some major findings of the survey are that the majority of faculty have had no formal preparation in instructional skills and that formal preparation in instructional skills is highly valued by those who have participated in courses, workshops, or training sessions on educational issues. The resource volume consists of a bibliography in faculty development, a directory of faculty development consultants, and guidelines for securing private and federal funding. (Author/PHR)

The nationwide program of financial aid for students enrolled in medicine and osteopathy, sponsored by the Robert Wood Johnson Foundation, is evaluated. The foundation made scholarship and loan funds available to students with minority backgrounds, to women students, and to students from rural areas. The evaluation study sought to determine whether students selected for financial aid tended to choose generalist careers and subsequent practice in underserved areas, and whether the funds were needed. The decision to support students from minority backgrounds appeared to be leading to the anticipated results, but it was less clear whether support awarded to women and students from rural backgrounds accomplished a similar purpose. Until federal financial support reduced in 1975-76, there was a surplus of aid funds available to students. Specific findings regarding black physicians are presented. Among the study conclusions are the following: targeting on particular groups of students can only modestly change the selection of career and practice location; and external funds to support needy students in schools of medicine and osteopathy are now critically needed. (SW)

As part of a larger study of the success and problems of women as applicants to and students in the schools of eight health professions, the study of osteopathic medicine involved interviews with administrators, faculty, and medical students. Its central purpose was to identify any characteristics of the profession--in its history, organization, and any other important features--that might contribute to an understanding of the role and status of women in it, and the barriers faced by women in the profession's schools. An introduction to the profession of osteopathy gives a sense of its history, work, focus, organization, and women's status in it. Included in addition are a short set of recommendations for the schools and associations, and direct quotes from the interview, giving a vivid description of some of the unique problems encountered by women in osteopathy. Some statistical tables are included. (MSE)

The study focused on women's education in eight health professions: medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, pharmacy, and public health. Its central tasks were to identify and explore the barriers to success that women face as school applicants and students. Almost 600 interviews were conducted with administrators, faculty members, and students in 27 schools, and were supplemented by over 60 student group interviews. In the final report are included: a detailed description of the study design; its findings and conclusions concerning the relationships of women with the professions and the schools, seven key resources for increased access to this education, and barriers faced by women in the professional training sequence; conceptual models for success in recruitment, admissions, and professional education, and strategies for testing the models; and recommendations for affirmative action enforcement, health manpower legislation, student financial aid, future research, policy, and future program efforts. Extensive data tables and measurement instruments are included. (MSE)

The study focused on eight health professions: medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, pharmacy, and public health. Its central tasks were to identify and explore the barriers to success that women face as medical/professional school applicants and students and to describe the discrimination process that limits women's entry into these professions. The study's purpose was to develop a set of conceptual models of the recruitment, admissions, and education systems to maximize equal opportunities for women and to encourage their success. These efforts were generated by concern over the underrepresentation of women as practitioners in these eight fields, and the suggestion is made that the schools' policies and practices and the professions' structures and histories may help explain this situation. Recommendations are made for legislation concerning health manpower and student financial aid, for criteria or research, policy, and program activities, and for the professional training sequence. (MSE)