Development and preliminary testing of a virtual reality measurement for assessing intake assessment skills.

Objective structured clinical examinations (OSCEs) have been widely used in health care education to simultaneously assess knowledge, skill and attitude. Due to the high cost of running an OSCE, its application in professional psychology is still limited. To solve this problem, virtual standardised patient (VSP) implementations in creating psychology OSCEs can be a cost-effective method for administering a psychology OSCE regularly. This study aimed to develop and examine the psychometric properties of the VSP version of the Intake OSCE (VSP-Intake OSCE) in measuring psychologists' psychological assessment competencies (PACs) from entry to early practice. The initial development of the VSP-Intake OSCE contains a VSP station and a follow-up written station to measure PACs when conducting an intake assessment. To administer the VSP station, we built a new VSP system that allows psychologists to interact with a VSP verbally. A sample of 36 participants, including 27 graduate students and nine psychologists, were recruited to examine the psychometric properties of the VSP-Intake OSCE. As a newly developed instrument, the VSP-Intake OSCE revealed good inter-rater reliability and construct validity. We believe using VSP implementations to develop psychology OSCEs will be essential in promoting OSCE applications in professional psychology.

Psychometric testing of the short version of the world health organization quality of life (WHOQOL-BREF) questionnaire among pulmonary tuberculosis patients in Taiwan.

BACKGROUND: Studies on the effects of tuberculosis on a patient's quality of life (QOL) are scant. The objective of this study was to evaluate the psychometric properties of the Taiwan short version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire using patients with tuberculosis in Taiwan and healthy referents. METHODS: The Taiwanese short version of the WHOQOL-BREF was administered to patients with tuberculosis undergoing treatment and healthy referents from March 2007 to July 2007. Patients with tuberculosis (n = 140) and healthy referents (n = 130), matched by age, sex, and ethnicity, agreed to an interview. All participants lived in eastern Taiwan. Reliability assessments included internal consistency, whereas validity assessments included construct validity, convergent validity, and discriminant validity. RESULTS: More than half of these patients and referents were men (70.7% and 66.2%, respectively), and their average ages were 50.1 and 47.9 years, respectively. Approximately 60% of patients and referents were aboriginal Taiwanese (60.7% and 61.1%, respectively). The proportion with low socioeconomic status was greater for these patients. The internal consistency reliability coefficients were .92 and .93 for the patients and healthy referents, respectively. Exploratory factor analysis on the healthy referents displayed a 4-domain model, which was compatible with the original WHOQOL-BREF 4-domain model. However, for the TB patient group, after deleting 3 items, both exploratory and confirmatory factor analysis revealed a 6-domain model. CONCLUSION: Psychometric evaluation of the Taiwan short version of the WHOQOL-BREF indicates that it has adequate reliability for use in research with TB patients in Taiwan. However, the factor structure generated from this TB patient sample differed from the WHO's original 4-factor model, which raised a validity concern to apply the Taiwan short version of the WHOQOL-BREF to Taiwanese TB patients. Future research recruiting another sample to revisit this validity issue must be conducted to determine the validity of the WHOQOL-BREF TW in patients with TB.

Anxiety and stress reduction in medical education: an intervention.

OBJECTIVES: To assess the effectiveness of a stress reduction elective on Year 2 medical students and to assess the sustainability of any noted improvement. METHODS: A new elective entitled 'Mind-Body Medicine: an Experiential Elective' was offered to Year 2 medical students. It was based on a course developed by the Center for Mind-Body Medicine. Enrolled students were surveyed on the first (time 1) and last (time 2) days of the elective and again 3 months later (time 3). Four validated self-report instruments were used to examine effects on anxiety, stress, mood states and depression. A comparison group of non-enrolled classmates completed the same instruments during the same timeframes. The study began in autumn 2004 and ended in June 2005. RESULTS: Participating students had higher initial anxiety scores than students in the comparison group. Anxiety in the study group declined significantly during the course, with enrolled students becoming indistinguishable from non-enrolled counterparts. These decreased anxiety levels were sustained for 3 months following the conclusion of the course. CONCLUSIONS: This elective was successful in attracting students who were more anxious than their peers. Enrolees had higher baseline anxiety levels than their peers. The course decreased anxiety levels. The significant drop in anxiety scores of the study group suggests that this mind-body elective was an effective way to decrease anxiety in these pre-clinical medical students. Decreases in anxiety were sustained 3 months after the course ended, indicating that the benefits of the course may be longlasting.