Mechanistic case diagramming: a tool for problem-based learning.

Without appropriate learning tools to guide the application of knowledge to clinical situations, medical students in a problem-based learning (PBL) curriculum may revert to traditional modes of learning and hence deprive themselves of PBL's educational benefits. The author describes a technique involving the stepwise diagramming of pathophysiologic mechanisms leading from underlying causes to the symptoms and findings presented in a PBL case. This technique can guide clinical reasoning during an initial problem encounter, the identification of pertinent learning issues, and the subsequent integration of knowledge as relevant to the patient's case. The author suggests that training students and tutors to use this technique may allow the former to fully realize the benefits of PBL, including the ability to organize information for use in clinical contexts and the ability to critically reflect upon their own learning.

Psychometric properties of the state-trait anxiety inventory for Asian/Pacific-islander adolescents.

Anxiety disorders are said to be universal across all cultures and recent reviews have found relatively high prevalence rates across different countries. However, the experience and interpretation of anxiety are strongly influenced by cultural factors. Demonstrating cross-cultural equivalence of measures of anxiety is essential to assure that comparisons between cultures will result in meaningful interpretations. Despite the State-Trait Anxiety Inventory being the most researched of anxiety measures from a cross-cultural basis, there is a lack of empirical studies on the psychometric properties of the STAI with adolescent Asian/Pacific Islanders. The present study examined the STAI using a large sample of ethnically diverse high school students in Hawaii. In general, a four-factor model (State-Anxiety Absent, State-Anxiety Present, Trait-Anxiety Absent, and Trait-Anxiety Present) provided the best fit based on a series of confirmatory factor analyses. Indicators of internal consistency supported the reliability of the factors and subscales, and the inter-factor correlations reflected positively on the concurrent validity of the different STAI factor and subscale measures. This study suggested cautious use and interpretation of one particular item (Trait Item 14 = I try to avoid facing a crisis or difficulty ), and cautious application of the STAI to Filipino adolescents (particularly Filipino males). Domains for further research are discussed.