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1.
Eval Program Plann ; 103: 102415, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38460323

RESUMO

This study aims to evaluate the performance of industrial engineering programs across various Higher Education Institutions (HEIs) in Colombia, focusing on the SaberPRO test outcomes from 2016 to 2018. The evaluation considers three primary dimensions: the type of funding (public vs. private HEIs), geographical region, and program accreditation status. The methodology involved gathering and analyzing Saber Pro test results from students enrolled in industrial engineering programs at 82 Colombian HEIs during the specified period. In Colombia, the SaberPRO Exam, administered by the Colombian Institute for the Evaluation of Education (ICFES), is a critical measure for assessing the quality of future industrial engineering graduates. This research employs an analytical framework that includes Analysis of Variance (ANOVA) and hypothesis testing for mean comparisons to scrutinize the performance of these programs. Findings reveal notable disparities in performance between public and private institutions and between accredited and non-accredited programs. Additionally, through Multiple Factor Analysis (MFA), the study identifies the competencies with the highest discriminative capacity, recognizing 15 exemplary programs out of the 82 evaluated.


Assuntos
Currículo , Avaliação Educacional , Humanos , Colômbia , Avaliação de Programas e Projetos de Saúde , Universidades
2.
Educ Health (Abingdon) ; 36(2): 80-82, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38047336

RESUMO

Background: Underrepresented minorities in medicine (URMM) may face financial and social limitations when applying to medical schools. The computer-based assessment for sampling personal characteristics (CASPER) test is used by many medical schools to assess the nonacademic competencies of applicants. Performance on CASPER can be enhanced by coaching and mentorship, which URMMs often lack, for affordability reasons, when applying to medical schools. Methods: The CASPER Preparation Program (CPP) is a free, online, 4-week program to help URMM prepare for the CASPER test. CPP features free medical ethics resources, homework and practice tests, and feedback from tutors. Two of CPPs major objectives include relieving URMM of financial burdens and increasing their accessibility to mentorship during the COVID-19 pandemic. A program evaluation was conducted using anonymous, voluntary postprogram questionnaires to assess CPPs efficacy in achieving the aforementioned objectives. Results: Sixty URMMs completed the survey. The majority of the respondents strongly agreed or agreed that CPP relieves students of financial burden (97%), is beneficial for applicants with low-socioeconomic statuses (98%), provides students with resources they could not afford (n = 55; 92%), and enables access to mentors during the pandemic (90%). Discussion: Pathway coaching programs, such as the CASPER Preparation Program, have the potential to offer URMMs mentorship and financial relief, and increase their confidence and familiarity with standardized admission tests to help them matriculate into medical schools.


Assuntos
COVID-19 , Educação Médica , Estudantes de Medicina , Humanos , Pandemias , COVID-19/epidemiologia , Grupos Minoritários/educação , Mentores , Faculdades de Medicina
3.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 26(6): 233-240, Dic. 2023. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-230617

RESUMO

Introducción: La autoevaluación se ha definido como el proceso mediante el cual los alumnos deciden si han alcanzado o no los estándares definidos. La autoevaluación es una herramienta valiosa para identificar debilidades y fortalezas en los estudiantes de Medicina. Objetivo: Comparar los resultados de una prueba de autoevaluación basada en criterios con los resultados de un examen estandarizado para evaluar conocimientos disciplinares en Fisiología. Sujetos y métodos: En este trabajo desarrollamos y aplicamos una herramienta de autoevaluación a estudiantes de segundo año de la carrera de Medicina en la asignatura de Fisiología de la Facultad de Medicina de la Universidad Nacional Autónoma de México. Luego recopilamos comentarios y los dividimos en calificaciones clasificadas como ‘calificaciones altas’ y ‘calificaciones bajas’. Finalmente, comparamos los resultados de la autoevaluación con los de una prueba objetiva (prueba estandarizada) que evalúa los conocimientos disciplinares de fisiología. Resultados: Los alumnos que consideran que han realizado un esfuerzo y trabajo constante durante el curso se valoran mejor que los alumnos que no lo hacen. Por otro lado, encontramos diferencias significativas entre la prueba objetiva y la autoevaluación. Conclusiones: La autoevaluación basada en criterios puede ayudar a evaluar cualidades más allá del conocimiento disciplinario.(AU)


Introduction: Self-assessment has been defined as the process by which students decide whether or not they haveachieved the defined standards. Self-assessment is a valuable tool to identify weaknesses and strengths in medical students. Objective: To compare the results of a self-assessment test based on criteria with the results of a standardized exam to assess disciplinary knowledge in physiology. Subjects and methods. In this work we developed and applied a self-assessment tool to second-year medical students in the physiology course of the Faculty of Medicine of the National Autonomous University of Mexico. We then collected feedback and divided it into ratings categorized as: ‘high scores’ and ‘low scores.’ Finally, we compared the results of the self-assessment with those of an objective test (standardized test) that assesses disciplinary knowledge of physiology. Result: Students who consider that they have made a constant effort and work during the course value themselves better than students who do not. On the other hand, we found significant differences between the objective test and the selfassessment. Conclusions: Criteria-based self-assessment can help assess qualities beyond disciplinary knowledge.(AU)


Assuntos
Humanos , Masculino , Feminino , Estudantes de Medicina , Educação Médica , Fisiologia/educação , Autoavaliação (Psicologia) , México , Estudos de Avaliação como Assunto , Pesquisa Qualitativa
4.
Soc Sci Res ; 114: 102915, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37597929

RESUMO

There is a growing debate about the proper age at which teens should be given permission to own a personal smartphone. While experts in different disciplines provide parents and educators with conflicting guidelines, the age of first smartphone acquisition is constantly decreasing and there is still limited evidence on the impact of anticipating the age of access on learning outcomes. Drawing on two-wave longitudinal data collected on a sample of 1672 students in 2013 (at grade 5) and 2016 (at grade 8), this study evaluates whether obtaining the first personal smartphone at 10 or 11 years old, during the transition to lower secondary school (early owning), affected their language proficiency trends compared to receiving it from the age of 12 onwards (late owning). Results indicate an overall null effect of smartphone early owning on adolescents' language proficiency trajectories, while a negative effect is found on those who were already heavy screen media users before receiving the device.


Assuntos
Pais , Smartphone , Adolescente , Humanos , Criança , Instituições Acadêmicas , Estudantes , Idioma
5.
Turk J Med Sci ; 53(2): 552-562, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37476884

RESUMO

BACKGROUND: Type 2 diabetes mellitus (T2D) is a complex metabolic impairment. Beta cell (BC) failure is the most challenging among its pathogenetic mechanisms. Recognizing reversible contributors to BC failure could guide individualized approach to early T2D treatment. The aim of this study was to compare early short-term insulin treatment vs. glimepiride, both added to metformin, on BC function, glycemic and lipid control, during 12-month follow-up. METHODS: Eighty newly diagnosed T2D patients, 30-65 years of age, presenting with HbA1c ≥ 9% were enrolled in the study. They were randomly assigned to single-month initial insulin therapy (INS) added to metformin, or to glimepiride and metformin (OAD) as only treatment. Subjects assigned to initial insulin intervention were thereafter switched to OAD. C-peptide (C-Pep) was analyzed at baseline and 2 hours after standardized test meal (STM). All subjects were STM-retested after 3 and 12 months. HbA1c, serum lipids, BMI, HOMA IR, and HOMA B were assessed over follow-up. RESULTS: HbA1c was lower in INS vs OAD at 3-months: 6.26 ± 0.18% vs 6.78 ± 0.10% (p = 0.016), remaining so by 12 months (p =0.056). BMI-adjusted ΔC-Pep was greater in INS vs. OAD at 3 months (4.60 ± 0.59 vs. 3.21 ± 0.34 m2 /kg; p = 0.044), persisting by 12months (4.57 ± 0.56 vs. 3.04 ± 0.34 m2/kg; p = 0.023). Average ΔC-Pep improvement from recruitment to 3 months was 100.8% in INS,vs. 51.3% in OAD. Prevalence of STM-ΔC-Pep response greater than 2.4 ng/mL had risen 3.2-fold by 12 months in the INS, vs. 2.4-fold only in the OAD group (p = 0.018). DISCUSSION: Early short-term insulin intervention in newly diagnosed T2D improves beta cell function more than glimepiride, both added to metformin, resulting in a superior and longer lasting glycemic and lipid control.


Assuntos
Diabetes Mellitus Tipo 2 , Metformina , Humanos , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/tratamento farmacológico , Quimioterapia Combinada , Hemoglobinas Glicadas , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Lipídeos , Metformina/uso terapêutico
6.
Int J Educ Dev ; 100: 102788, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37153857

RESUMO

During 2020, the Covid-19 pandemic unleashed a socioeconomic crisis in most countries, as well as strict restrictions on mobility and social distancing were implemented. The pandemic brought a severe socioeconomic shock -decreasing economic activity- and forced policy responses that affected the education sector -notably school closures-. There is scarce evidence on the implications of the pandemic and its socioeconomic consequences on learning inequality, particularly in the Latin-American context. The aim of this paper is to measure the change in learning inequality during the years of the pandemic (2020-2021) in Colombia. To measure learning inequality, we use the results of a standardize exam taken by all upper secondary education graduates in the country. To capture inequality, we use secondary-level students' characteristics, their households, and schools' characteristics. Our econometric results suggest an increase in learning inequality between 48% and 372% depending on the dimension studied, except for gender where learning inequality decreased. Moreover, through dynamic specifications, we determine that for all the analyzed dimensions the 2020-2021 period represents a change in the trend of learning inequality as in the periods prior to the pandemic inequality gaps decreased or, at least, remained constant. We conclude with concrete and immediate policy recommendations to target the learning processes of vulnerable students and bridge learning gaps.

7.
BMC Med Educ ; 23(1): 113, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36793040

RESUMO

BACKGROUND: Underrepresented Minorities in Medicine (URMMs) may face financial and social limitations when matriculating into medical schools. Performance on situational judgment tests such as Computer-based Assessment for Sampling Personal Characteristics (CASPER) can be enhanced by coaching and mentorship. The CASPER Preparation Program (CPP) coaches URMMs to prepare for the CASPER test. During the coronavirus 2019 pandemic (COVID-19), CPP implemented novel curricula on the CASPER Snapshot and CanMEDS roles. METHODS: Pre and post-program questionnaires were completed by the students, which assessed their: 1) confidence in understanding the CanMEDS roles, and 2) perceived confidence in performing well and their familiarity and preparedness with the CASPER Snapshot. With a second post-program questionnaire, participants' scores on the CASPER test as well as medical school application outcome were also assessed. RESULTS: Participants reported a significant increase in the URMMs' knowledge, self-perceived competency to complete the CASPER Snapshot, and their anxiety significantly decreased. The level of confidence in understanding CanMEDS roles for a career in healthcare increased as well. The majority (91%) agreed that the feedback received from tutors was adequate and the virtual component of the program was beneficial during COVID-19. 51% of students scored in the highest quartile on the CASPER test and 35% received an offer of admission from CASPER-requiring medical schools. CONCLUSION: Pathway coaching programs have the potential to increase confidence and familiarity amongst URMMs for the CASPER tests and CanMEDS roles. Similar programs should be developed with the aim to increase the chances of URMMs matriculating into medical schools.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Estudantes , Julgamento
8.
Integr Environ Assess Manag ; 19(4): 1089-1109, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36597818

RESUMO

The toxicity and ecotoxicity of pesticide active ingredients are evaluated by a number of standardized test methods using vertebrate animals. These standard test methods are required under various regulatory programs for the registration of pesticides. Over the past two decades, additional test methods have been developed with endpoints that are responsive to endocrine activity and subsequent adverse effects. This article examines the available test methods and their endpoints that are relevant to an assessment of endocrine-disrupting properties of pesticides. Furthermore, the article highlights how weight-of-evidence approaches should be applied to determine whether an adverse response in (eco)toxicity tests is caused by an endocrine mechanism of action. The large number of endpoints in the current testing paradigms for pesticides make it unlikely that endocrine activity and adversity is being overlooked. Integr Environ Assess Manag 2023;19:1089-1109. © 2023 Bayer CropScience and The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).


Assuntos
Disruptores Endócrinos , Praguicidas , Animais , Animais Selvagens , Praguicidas/toxicidade , Disruptores Endócrinos/toxicidade , Medição de Risco/métodos , Vertebrados , Ecotoxicologia/métodos
9.
Med Educ Online ; 28(1): 2152162, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36443907

RESUMO

INTRODUCTION: Performance on the certifying examinations such as the American Board of Internal Medicine Certification Exam (ABIM-CE) is of great interest to residents and their residency programs. Identification of factors associated with certification exam result may allow residency programs to recognize and intervene for residents at risk of failing. Despite this, residency programs have few evidence-based predictors of certification exam outcome. The change to pass-or-fail score reporting of the USA Medical Licensing Exam (USMLE) Step 1 removes one such predictor. MATERIALS AND METHODS: We performed a retrospective study of residents from a medium-sized internal medicine residency program who graduated from 1998 through 2017. We used univariate tests of associations between ABIM-CE result and various demographic and scholastic factors. RESULTS: Of 166 graduates, 14 (8.4%) failed the ABIM-CE on the first attempt. Failing the first attempt of the ABIM-CE was associated with older median age on entering residency (29 vs 27 years; P = 0.01); lower percentile rank on the Internal Medicine In-Training Examination (IM-ITE) in each of the first, second, and third years of training (P < 0.001 for all); and lower scores on the USMLE Steps 1, 2 Clinical Knowledge, and 3 (P < 0.05 for all). No association was seen between a variety of other scholastic or demographic factors and first-attempt ABIM-CE result. DISCUSSION: Although USMLE step 1 has changed to a pass-or-fail reporting structure, there are still other characteristics that allow residency programs to identify residents at risk of ABIM-CE first time failure and who may benefit from intervention.


Assuntos
Medicina Interna , Internato e Residência , Humanos , Adulto , Estudos Retrospectivos , Certificação , Capacitação em Serviço
10.
MedEdPublish (2016) ; 13: 308, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-39185002

RESUMO

Objectives: This study aims to show whether correlation exists between pediatric residency applicants' quantitative scores on the United States Medical Licensing Exam Step 2 Clinical Knowledge examination and their subsequent performance in residency training based on the Accreditation Council for Graduate Medical Education Milestones, which are competency-based assessments that aim to determine residents' ability to work unsupervised after postgraduate training. No previous literature has correlated Step 2 Clinical Knowledge scores with pediatric residency performance assessed by Milestones. Methods: In this retrospective cohort study, the United States Medical Licensing Exam Step 2 Clinical Knowledge Scores and Milestones data were collected from all 188 residents enrolled in a single categorical pediatric residency program from 2012 - 2017. Pearson correlation coefficients were calculated amongst available test and milestone data points to determine correlation between test scores and clinical performance. Results: Using Pearson correlation coefficients, no significant correlation was found between quantitative scores on the Step 2 Clinical Knowledge exam and average Milestones ratings (r = -0.1 for post-graduate year 1 residents and r = 0.25 for post-graduate year 3 residents). Conclusions: These results demonstrate that Step 2 scores have no correlation to success in residency training as measured by progression along competency-based Milestones. This information should limit the importance residency programs place on quantitative Step 2 scores in their ranking of residency applicants. Future studies should include multiple residency programs across multiple specialties to help make these findings more generalizable.

11.
Proc Natl Acad Sci U S A ; 119(34): e2117868119, 2022 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-35969764

RESUMO

Racial/ethnic disparities in academic performance may result from a confluence of adverse exposures that arise from structural racism and accrue to specific subpopulations. This study investigates childhood lead exposure, racial residential segregation, and early educational outcomes. Geocoded North Carolina birth data is linked to blood lead surveillance data and fourth-grade standardized test scores (n = 25,699). We constructed a census tract-level measure of racial isolation (RI) of the non-Hispanic Black (NHB) population. We fit generalized additive models of reading and mathematics test scores regressed on individual-level blood lead level (BLL) and neighborhood RI of NHB (RINHB). Models included an interaction term between BLL and RINHB. BLL and RINHB were associated with lower reading scores; among NHB children, an interaction was observed between BLL and RINHB. Reading scores for NHB children with BLLs of 1 to 3 µg/dL were similar across the range of RINHB values. For NHB children with BLLs of 4 µg/dL, reading scores were similar to those of NHB children with BLLs of 1 to 3 µg/dL at lower RINHB values (less racial isolation/segregation). At higher RINHB levels (greater racial isolation/segregation), children with BLLs of 4 µg/dL had lower reading scores than children with BLLs of 1 to 3 µg/dL. This pattern becomes more marked at higher BLLs. Higher BLL was associated with lower mathematics test scores among NHB and non-Hispanic White (NHW) children, but there was no evidence of an interaction. In conclusion, NHB children with high BLLs residing in high RINHB neighborhoods had worse reading scores.


Assuntos
Desempenho Acadêmico , Exposição Ambiental , Habitação , Intoxicação por Chumbo , Segregação Social , Desempenho Acadêmico/estatística & dados numéricos , Criança , Pré-Escolar , Exposição Ambiental/estatística & dados numéricos , Habitação/normas , Habitação/estatística & dados numéricos , Humanos , Chumbo , Intoxicação por Chumbo/epidemiologia , Grupos Raciais
12.
J Dent Educ ; 86(7): 823-829, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35859336

RESUMO

Standardized testing has been utilized by K-12 schools, undergraduate and graduate programs, as well as employers. Historically, it has been seen as an efficacious way to identify the best performing candidates to receive program entry or move forward in a hiring process. However, there is significant evidence mounting about the limitations of standardized testing and, yet, we persist with them because of their relative ease. The purpose of this perspective paper is to begin a conversation about the place of standardized tests in dental education and its relationship to institution goals related to diversity, equity, and inclusion.


Assuntos
Avaliação Educacional , Critérios de Admissão Escolar , Humanos , Seleção de Pessoal , Estudantes
13.
Polymers (Basel) ; 14(9)2022 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-35566903

RESUMO

Recent research trends focus on developing bio-based (derived from agricultural byproducts) fiber-reinforced polymer (FRP) composites for structural applications. Fire resistance is one of the key issues that need to be addressed for the use of these FRP materials in buildings. The thermal and mechanical properties of the constituent materials essentially determine the fire performance (and the fire resistance rating) of a structural member, and these properties vary with temperature. Further, the properties of composite materials such as the FRP are highly influenced by the composition and type of fibers and matrix, and these thermo-mechanical properties also vary significantly with temperature. Due to this variation, the fire resistance of FRP materials (both conventional and bio-based) poses a major concern for use in buildings. Currently, very few standardized test procedures are available for evaluating the high-temperature material properties of FRP composites. In this paper, a review of testing protocols and procedures for undertaking tests on FRP materials at various elevated temperatures for evaluating their properties is carried out. Recommendations are provided on the most suitable test methods, specimen conditions, testing regime, and other issues associated with testing at elevated temperatures. In addition, the applicability of the proposed test methods is illustrated through a case study on conventional FRP specimens. Further, the applicability of the recommended test procedures for measuring high-temperature properties of bio-based FRP composites is highlighted.

14.
J Intell ; 10(2)2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35466235

RESUMO

When seeking to explain the eventual outcomes of a higher education experience, do the personal attributes and background factors students bring to college matter more than what the college is able to contribute to the development of the student through education or other institutional factors? Most education studies tend to simply ignore cognitive aptitudes and other student characteristics-in particular the long history of research on this topic-since the focus is on trying to assess the impact of education. Thus, the role of student characteristics has in many ways been underappreciated in even highly sophisticated quantitative education research. Conversely, educational and institutional factors are not as prominent in studies focused on cognitive aptitudes, as these fields focus first on reasoning capacity, and secondarily on other factors. We examine the variance in student outcomes due to student (e.g., cognitive aptitudes) versus institutional characteristics (e.g., teachers, schools). At the level of universities, two contemporary U.S. datasets are used to examine the proportion of variance accounted for in various university rankings and long-run salary by student cognitive characteristics and institutional factors. We find that depending upon the ways the variables are entered into regression models, the findings are somewhat different. We suggest some fruitful paths forward which might integrate the methods and findings showing that teachers and schools matter, along with the broader developmental bounds within which these effects take place.

15.
Nurse Educ Today ; 111: 105312, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35287063

RESUMO

BACKGROUND: History-taking is an essential skill for nurses. In nursing education, it is necessary to objectively assess history-taking skills in a way that accurately reflects differences among students. Current history-taking evaluation methods lack objectivity, consistency and standardization, which makes it difficult to identify factors that influence history-taking skill. A virtual standardized patient (VSP) can provide history-taking practice with repeatability and consistency. It can make objective and standardized assessment possible by eliminating the subjectivity of different teachers and patients. PURPOSE: To evaluate the history-taking skills of nursing undergraduates using a VSP, and to explore its independent influencing factors. METHODS: A cross-sectional design was employed with a sample of convenience from 3 universities. All 174 nursing undergraduates had their history-taking level evaluated using one VSP via computer or mobile terminal. For each query raised by the students, the VSP could give a preset response. The responses were assigned corresponding scores according to their importance, with a total score of 100. The students' general demographics were documented, and their self-efficacy, critical thinking and communication skills were measured online with the Nursing History-taking Self-Efficacy Questionnaire, Yoon's Critical Thinking Disposition Instrument and the Supportive Communicative Scale. Univariate analysis, Pearson correlation analysis and multiple linear regression were performed. RESULTS: The mean total history-taking score was 58.53 ± 14.32. History-taking scores were well discriminated among the students tested, with 10% of the students scoring above 80, 37% between 60 and 80, 22% between 50 and 60 and 31% scored below 50. The history-taking level of the nursing students was significantly associated with ethnicity, previous academic performance, and Supportive Communicative Scale scores. CONCLUSIONS: Using the VSP as a history-taking assessment method is an effective way to achieve a relatively objective, standardized and consistent assessment of history-taking education. Ethnicity, previous academic performance and supportive communication skills independently influenced the students' history-taking level. Mature history-taking skills require not only solid theoretical knowledge but good communication skills.


Assuntos
Educação em Enfermagem , Estudantes de Enfermagem , Comunicação , Estudos Transversais , Educação em Enfermagem/métodos , Humanos , Autoeficácia
16.
Neuropsychol Rev ; 32(1): 20-50, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-33786797

RESUMO

Assessment of speech and language functions is an essential part of awake craniotomies. Although standardized and validated tests have several advantages compared to homemade (or mixed) batteries, in the literature it is unclear how such tests are used or whether they are used at all. In this study, we performed a scoping review in order to locate standardized and validated intraoperative language tests. Our inquiry included two databases (PubMED and MEDLINE), gray literature, and snowball referencing. We discovered 87 studies reporting use of mixed batteries, which consist of homemade tasks and tests borrowed from other settings. The tests we found to meet the validation and standardization criteria we set were ultimately three (n = 3) and each one has its own advantages and disadvantages. We argue that tests with high sensitivity and specificity not only can lead to better outcomes postoperatively, but they can also help us to gain a better understanding of the neuroanatomy of language.


Assuntos
Craniotomia , Vigília , Mapeamento Encefálico , Humanos , Idioma , Testes de Linguagem , Fala
17.
Environ Res ; 198: 111241, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33933487

RESUMO

BACKGROUND: Persistent disparities in academic performance may result from a confluence of adverse exposures accruing disproportionately to specific subpopulations. OBJECTIVE: Our overarching objective was to investigate how multiple exposures experienced over time affect early childhood educational outcomes. We were specifically interested in whether there were: racial/ethnic disparities in prevalence of adverse exposures; racial/ethnic disparities in associations observed between adverse exposures and early childhood educational outcomes; and interactions between exposures, suggesting that one exposure augments susceptibility to adverse effects of another exposure. METHODS: We link geocoded North Carolina birth data for non-Hispanic white (NHW) and non-Hispanic black (NHB) children to blood lead surveillance data and 4th grade end-of-grade (EOG) standardized test scores (n = 65,151). We construct a local, spatial index of racial isolation (RI) of NHB at the block group level. We fit race-stratified multi-level models of reading and mathematics EOG scores regressed on birthweight percentile for gestational age, blood lead level, maternal smoking, economic disadvantage, and RI, adjusting for maternal- and child-level covariates and median household income. RESULTS: There were marked racial/ethnic disparities in prevalence of adverse exposures. Specifically, NHB children were more likely than NHW children to be economically disadvantaged (80% vs. 40%), live in block groups with the highest quintile of RI (46% vs. 5%), have higher blood lead levels (4.6 vs. 3.7 µg/dL), and lower birthweight percentile for gestational age (mean: 39th percentile vs. 51st percentile). NHB children were less likely to have mothers who reported smoking during pregnancy (11% and 22%). We observed associations between key adverse exposures and reading and math EOG scores in 4th grade. Higher birthweight percentile for gestational age was associated with higher EOG scores, while economic disadvantage, maternal smoking, and elevated blood lead levels were associated with lower EOG scores. Associations observed for NHB and NHW children were generally not statistically different from one another, with the exception of neighborhood RI. NHB children residing in block groups in the highest RI quintile had reading and math scores 1.54 (0.74, 2.34) and 1.12 (0.38, 1.87) points lower, respectively, compared to those in the lowest RI quintile; statistically significant decrements in EOG scores associated with RI were not observed for NHW children. We did not find evidence of multiplicative interactions between exposures for NHB or NHW children. DISCUSSION: Key adverse host, environmental, and social exposures accrue disproportionately to NHB children. Decrements in test scores associated with key adverse exposures were often but not always larger for NHB children, but were not significantly different from those estimated for NHW children. While we did not observe interactive effects, NHB children on average experience more deleterious combined exposures, resulting in larger decrements to test scores compared to NHW children.


Assuntos
Chumbo , População Branca , Negro ou Afro-Americano , Peso ao Nascer , Criança , Pré-Escolar , Feminino , Humanos , North Carolina/epidemiologia , Gravidez
18.
Cureus ; 13(2): e13567, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33815979

RESUMO

Background Combined Internal Medicine/Pediatrics (Med/Peds) residencies rely on categorical program data to predict pass rates for the American Board of Internal Medicine Certifying Exam (ABIM-CE) and the American Board of Pediatrics Certifying Exam (ABP-CE). There is insufficient literature describing what best predicts a Med/Peds resident passing board exams. In this study, we aimed to determine how standardized test scores predict performance on ABIM-CE and ABP-CE for Med/Peds residents. Methodology We analyzed prior exam scores for 91/96 (95%) residents in a Med/Peds program from 2008 to 2017. Scores from the United States Medical Licensing Examination (USMLE) Steps 1 and 2 Clinical Knowledge (CK) and In-Training Exams in Internal Medicine (ITE-IM) and Pediatrics (ITE-P) were analyzed with the corresponding ABIM-CE and ABP-CE first-time scores. Linear and logistic regression were applied to predict board scores/passage. Results USMLE 1 and 2 CK, ITE-IM, and ITE-P scores had a linear relationship with both ABIM-CE and ABP-CE scores. In the linear regression, adjusted R2 values showed low-to-moderate predictive ability (R2 = 0.11-0.35), with the highest predictor of ABIM-CE and ABP-CE being USMLE Step 1 (0.35) and Postgraduate Year 1 (PGY-1) ITE-IM (0.33), respectively. Logistic regression showed odds ratios of passing board certifications ranging from 1.05 to 1.53 per point increase on the prior exam score. The PGY-3 ITE-IM was the best predictor of passing both certifying exams. Conclusions In one Med/Peds program, USMLE Steps 1 and 2 and all ITE-IM and ITE-P scores predicted certifying exam scores and passage. This provides Med/Peds-specific data to allow individualized resident counseling and guide programmatic improvements targeted to board performance.

19.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-882165

RESUMO

@#PURPOSE: This study examined the predictive ability of Assessment Technologies Institute (ATI) standardized tests on Fundamentals of Nursing (FON), Pharmacology (PHARM), Medical-Surgical Nursing (MSN), and RN Comprehensive Predictor (RNCP) on the National Council Licensure Examination-Registered Nurses (NCLEX-RN) performance of nursing graduates. BACKGROUND: Various assessment tools in nursing education are used to predict the success of students in nursing licensure examinations. There are inconsistent findings on the predictive ability of course-specific standardized tests on NCLEX-RN success. METHODS: A retrospective correlation research design was used to determine the association between ATI standardized tests and NCLEX-RN success. Secondary data analysis of 141 ATI student scores from 2017 to 2018 from a Southeastern university in the United States were analyzed using descriptive and inferential statistics, set at 0.05 level of significance. Three models of logistic regression were used to determine the predictive ability of ATI standardized exams on NCLEX-RN success. RESULTS: ATI MSN standardized test is the strongest predictor of NCLEX-RN success, followed by ATI FON and ATI RNCP tests. ATI PHARM standardized test is not predictive of NCLEX-RN success. CONCLUSION: Standardized tests can help in identifying students who are at-risk for failing the NCLEX-RN prior to taking the examination. Understanding the impact of standardized testing on NCLEX-RN performance is essential in addressing the students' ability to become successful in the nursing program and NCLEX-RN.


Assuntos
Estudantes de Enfermagem , Educação em Enfermagem , Escolaridade , Capacitação de Professores
20.
Gastroenterol Clin North Am ; 49(3): 411-426, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32718561

RESUMO

High-resolution manometry evaluates esophageal motor function using 10 supine water swallows. Superimposing impedance over high-resolution manometry pressure topography assesses the relationship between contraction and bolus propulsion and identifies inadequate clearance. Ancillary techniques and maneuvers augment the standard supine high-resolution manometry evaluation by challenging peristaltic function. Increasing bolus volume (rapid drink challenge) and altering bolus consistency (standardized test meal, solid swallows) enhance identification of esophageal outflow obstruction syndromes. Physiologic maneuvers (multiple rapid swallows, abdominal compression) address the ability of the esophageal smooth muscle to augment contraction vigor. Pharmacologic challenge is less commonly used clinically, and elucidates pathophysiology of esophageal motor disorders.


Assuntos
Deglutição/fisiologia , Técnicas de Diagnóstico do Sistema Digestório , Transtornos da Motilidade Esofágica/diagnóstico , Transtornos da Motilidade Esofágica/fisiopatologia , Esôfago/fisiopatologia , Aumento da Imagem/métodos , Manometria/métodos , Humanos , Período Pós-Prandial
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