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3. Validity assumptions for a multiple-choice test of medical knowledge with open-books and web access. A known groups comparison study.

Author

O’Neill, Lotte Dyhrberg, Simonsen, Eivind Ortind, Knudsen, Ulla Breth, Stentoft, Jesper, Jensen, Anders Bonde, Carlsen, Charlotte Green, Mørcke, Anne Mette, O’Neill, Lotte Dyhrberg, Simonsen, Eivind Ortind, Knudsen, Ulla Breth, Stentoft, Jesper, Jensen, Anders Bonde, Carlsen, Charlotte Green, and Mørcke, Anne Mette

Abstract

Relatively little evidence about the validity threats in open-book multiple-choice tests exist. The aim of this study was to examine validity aspects relating to gener-alization, extrapolation and decision of a multiple-choice test of medical knowledge with aids (open-book and internet access). The theoretical framework was modern validity theory, and the study was designed as a ‘known groups com-parison’ study. Test performances of three known groups of test takers hypothe-sized to have different knowledge levels of the test content were compared, and analysis of pass/fail decisions was used to examine implications of decisions based on test scores. Results indicated that it was possible to discriminate between expert and non-expert test taker groups even with the access to aids. In contrast, an inde-fensible passing score was found to be the largest potential threat to test validity. Relatively little evidence about the validity threats in open-book multiple-choice tests exist. The aim of this study was to examine validity aspects relating to gener-alization, extrapolation and decision of a multiple-choice test of medical knowledge with aids (open-book and internet access). The theoretical framework was modern validity theory, and the study was designed as a ‘known groups com-parison’ study. Test performances of three known groups of test takers hypothe-sized to have different knowledge levels of the test content were compared, and analysis of pass/fail decisions was used to examine implications of decisions based on test scores. Results indicated that it was possible to discriminate between expert and non-expert test taker groups even with the access to aids. In contrast, an inde-fensible passing score was found to be the largest potential threat to test validity.

Published
2018

6. Optagelsessamtaler på medicin-studiet ved Aarhus Universitet:En pilottest af et Multiple Mini Interview (MMI)

Author

Andreassen, Pernille, Pedersen, Kamilla, Jensen, Rune Dall, Møller, Jane Ege, Carlsen, Charlotte Green, and O'Neill, Lotte

Subjects
Optagelsessamtale, Medicinsk Uddannelse, pillottest, Multiple Mini Interviews
Abstract

I denne rapport præsenteres evalueringsresultaterne af en pilottest af et optagelsessamtale-format, som fra foråret 2016 vil være en del af kvote 2 optagelsesproceduren til medicinstudiet på Aarhus Universitet (AU). Multiple Mini Interview (MMI) er et optagelsessamtale-format, som bruges til at teste ikke-kognitive kompetencer. Den MMI vi pilottestede ved denne lejlighed bestod af otte på hinan-den følgende interviewstationer med fire overordnede indholdsdomæner (samarbejde, em-pati, kommunikation og robusthed). Hver station varede otte minutter, og på hver station fik testtageren en opgave, der skulle besvares. En bedømmer på hver station vurderede testtage-rens præstation ud fra fastlagte kriterier. D. 13. november 2015 gennemførtes en pilottest af en MMI-test i personalekantinen på Skejby Sygehus, AU. I alt deltog 32 bedømmere (uddannelsesansvarlige overlæger, postgraduate kliniske lektorer og kommunikationsundervisere) og 26 simulerede testtagere (medicinstuderende, 1.-6. semester). Desuden fungerede fire stationsopgave-udviklere som observatører under MMI’en. Rapporten fokuserer dels på planlægningen og organiseringen af pilottesten og dels på vali-dering af MMI’en. Den teoretiske ramme for rapporten er moderne validitetsteori, hvor eviden-sen oprinder fire kategorier af antagelser, der relaterer sig til scoringen, generaliserbarheden, extrapoleringerne og beslutningerne.Rapporten viser, at MMI pilottesten var praktisk gennemførlig med stor grad af aftagerinvolvering. Det skønnes dog nødvendigt fremover at have en vis ekstra bemanding klar under prøven, som kan træde til i tilfælde af uforudsete hændelser. Med hensyn til validiteten viste prøven gode takter i forhold til scoringsprocessen og acceptabiliteten. Generaliserbarheden af prøven var også høj på testdagen. Fremover kan der med fordel satses på uddybende dokumentation for, hvad vi kan ekstrapolere ud fra testens resultater, men også på yderligere undersøgelser af beslutninger og konsekvenser af testen. Begge dele gøres med fordel i større, ikke-simulerede testpopulationer og med prospektive og longitudinelle studiedesigns.

Published
2016

9. One third of Danish doctors specializing in diagnostic radiology do not feel sufficiently equipped in terms of medical expertise

Author

Lange, Mine Benedicte, Carlsen, Charlotte Green, and Jurik, Anne Grethe

Abstract

An internet-based survey among Danish doctors specializing in diagnostic radiology revealed differences with respect to the length of internships at regional and university hospitals as well as the educational environment. The university hospitals were generally evaluated to have the best educational facilities except within practical skills. Therefore, it seems necessary to optimize the educational environment at regional hospitals, especially within medical expertise and scientific skills which are key elements regarding continuous development and quality assurance within radiology.

Published
2015

12. Hver tredje hoveduddannelseslæge i Diagnostisk Radiologi føler sig ikke rustede i rollen som medicinsk ekspert

Author

Lange, Benedicte, Carlsen, Charlotte Green, and Jurik, Anne Grethe

Subjects
education
Abstract

An internet-based survey among Danish doctors specializing in diagnostic radiology revealed differences with respect to the length of internships at regional and university hospitals as well as the educational environment. The university hospitals were generally evaluated to have the best educational facilities except within practical skills. Therefore, it seems necessary to optimize the educational environment at regional hospitals, especially within medical expertise and scientific skills which are key elements regarding continuous development and quality assurance within radiology.

Published
2014

14. Challenges in an educational RCT

Author

Carlsen, Charlotte Green, Lindorff Larsen, Karen, Funch-Jensen, Peter, Lund, Lars, Konge, Lars, and Charles, Peder

Published
2014

21. Initial experiences with laparoscopic incisional hernial repair

Author

Carlsen, Charlotte Green, Gaarden, Morten, Lundhus, Eskild, and Nielsen, Jørn

Subjects
Male, Questionnaires, Reoperation, Suture Techniques, Length of Stay, Surgical Mesh, Hernia, Ventral, Outcome Assessment (Health Care), Postoperative Complications, Patient Satisfaction, Recurrence, Risk Factors, Humans, Female, Laparoscopy
Abstract

INTRODUCTION: Incisional hernia following laparotomy remains an important problem. Laparoscopic repair has become the method of choice in recent years. The present article presents the outcome of laparoscopic incisional hernia mesh repair at Viborg Hospital in the years 2003-2006.MATERIAL AND METHODS: We retrospectively identified 114 patients who had undergone laparoscopic hernia repair during the relevant period. The patients received a questionnaire regarding satisfaction, pain and recurrence. Patients reporting any inconvenience were offered a consultation.RESULTS: Among the 114 included patients, ten procedures were converted to open laparotomy, six of which were converted due to recognized bowel injury. One case of bowel injury was managed laparoscopically. One case of bowel injury was recognized during reoperation the following day. Another four patients experienced reoperations for other reasons, mainly bleeding. The mean hospital stay was one day. A total of 12 patients had a recurrent hernia. The mean follow-up was 14 months.CONCLUSION: We conclude that laparoscopic incisional hernia repair is a useful surgical procedure with short hospital stay and high patient satisfaction. There is, however, a certain risk of bowel injury associated with this procedure.

Published
2009

22. Multiple tarmperforationer efter indtagelse af magnetisk legetøj

Author

Carlsen, Charlotte Green, Floyd, Andrea K, and Lundhus, Eskild

Subjects
Male, Radiography, Abdominal, digestive, oral, and skin physiology, Rectum, equipment and supplies, Foreign Bodies, Play and Playthings, Magnetics, Intestinal Perforation, Intestine, Small, Humans, Child, human activities, Colon, Transverse
Abstract

Ingestion of small foreign bodies is common in children, and usually does not cause any harm to the gastrointestinal tract. But ingestion of multiple magnets can be hazardous because of the strong attraction of the magnets through the bowel wall, which may lead to bowel wall necrosis and perforation. We describe the case of a 6-year-old autistic boy who swallowed 4 magnets which led to bowel obstruction and 8 small perforations. It is important to be aware of this potential risk if children ingest small magnetic toys.

Published
2007

23. Prevalence of low serum estradiol levels in male osteoporosis

Author

Carlsen, Charlotte Green, Soerensen, T H, and Eriksen, E F

Subjects
Adult, Male, Estradiol, Reference Values, Androgens, Humans, Osteoporosis, Biological Markers, Middle Aged, Life Style, Aged
Abstract

Estrogen deficiency has recently been implicated in the pathogenesis of male osteoporosis. We therefore investigated estrogen and androgen status in 63 men admitted to our clinic with the diagnosis of osteoporosis over a period of 2 years. The diagnosis was based on the presence of either low-energy fractures of the spine or a BMD T-score

Published
2000

24. Perioperative oxygen fraction - effect on surgical site infection and pulmonary complications after abdominal surgery: a randomized clinical trial. Rationale and design of the PROXI-Trial

Author

Meyhoff, Christian Sylvest, Wetterslev, Jørn, Jorgensen, Lars N, Henneberg, Steen W, Simonsen, Inger, Pulawska, Therese, Walker, Line R, Skovgaard, Nina, Heltø, Kim, Gocht-Jensen, Peter, Carlsson, Palle Steen, Rask, Henrik Johannes, Karim, Sharaf, Carlsen, Charlotte Green, Jensen, Frank S, Rasmussen, Lars S, Meyhoff, Christian Sylvest, Wetterslev, Jørn, Jorgensen, Lars N, Henneberg, Steen W, Simonsen, Inger, Pulawska, Therese, Walker, Line R, Skovgaard, Nina, Heltø, Kim, Gocht-Jensen, Peter, Carlsson, Palle Steen, Rask, Henrik Johannes, Karim, Sharaf, Carlsen, Charlotte Green, Jensen, Frank S, and Rasmussen, Lars S

Abstract

A high perioperative inspiratory oxygen fraction may reduce the risk of surgical site infections, as bacterial eradication by neutrophils depends on wound oxygen tension. Two trials have shown that a high perioperative inspiratory oxygen fraction (FiO(2) = 0.80) significantly reduced risk of surgical site infections after elective colorectal surgery, but a third trial was stopped early because the frequency of surgical site infections was more than doubled in the group receiving FiO(2) = 0.80. It has not been settled if a high inspiratory oxygen fraction increases the risk of pulmonary complications, such as atelectasis, pneumonia and respiratory failure. The aim of our trial is to assess the potential benefits and harms of a high perioperative oxygen fraction in patients undergoing abdominal surgery.

Published
2008

25. Improving colonoscopy quality through individualised training programmes.

Author

Pedersen L, Bernstein I, Lindorff-Larsen K, Carlsen CG, and Torp-Pedersen C

Subjects
Colonic Polyps surgery, Colonoscopy standards, Denmark, Employee Performance Appraisal, Female, Gastroenterology standards, Humans, Male, Medical Staff, Hospital education, Middle Aged, Pilot Projects, Program Evaluation, Clinical Competence standards, Colonoscopy education, Education methods, Gastroenterology education, Quality Improvement
Abstract

Introduction: In Denmark, quality-improvement initiatives aimed at providing a better colonoscopy service are few. The primary objective of this study was to improve colonoscopy quality at Aalborg University Hospital, Denmark, using structured training programmes. The secondary aim was to introduce a system for individual colonoscopist performance monitoring., Methods: We conducted a colonoscopy-quality pilot study covering two major quality performance indicators: caecum intubation rate (CIR) and polyp detection rate (PDR). The pilot study was followed by colonoscopy training programmes offering experienced colonoscopists colonoscopy skills upgrading, polypectomy and train-the-trainers courses taught by English experts. Junior doctors completed a 20-day module-based colonoscopy-training programme. A regional individual colonoscopy quality-reporting system was developed as a supplementary file within the electronic health records., Results: The CIR increased from 87.1% to 92.1% (p less-than 0.001) and the PDR from 33.7% to 41.7% (p less-than 0.001) in the course of the structured training programme. Multivariable analysis adjusting for patient sex, patient age and colonoscopy indication showed a significant increase in CIR (p less-than 0.001), but not in PDR (p = 0.19). The colonoscopy quality reporting system was introduced and now provides biannual feedback to all colonoscopists., Conclusions: Quality-improvement initiatives may lead to an improved CIR and possibly PDR. Nationwide training programmes and performance monitoring should be implemented to further improve and monitor colonoscopy quality., Funding: none., Trial Registration: not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

Published
2020

26. [One third of Danish doctors specializing in diagnostic radiology do not feel sufficiently equipped in terms of medical expertise].

Author

Lange B, Carlsen CG, and Jurik AG

Subjects
Attitude of Health Personnel, Denmark, Diagnostic Imaging standards, Hospitals, County standards, Hospitals, University standards, Humans, Internship and Residency standards, Physician's Role, Surveys and Questionnaires, Clinical Competence standards, Physicians standards, Radiology education, Radiology standards
Abstract

An internet-based survey among Danish doctors specializing in diagnostic radiology revealed differences with respect to the length of internships at regional and university hospitals as well as the educational environment. The university hospitals were generally evaluated to have the best educational facilities except within practical skills. Therefore, it seems necessary to optimize the educational environment at regional hospitals, especially within medical expertise and scientific skills which are key elements regarding continuous development and quality assurance within radiology.

Published
2014

27. [Initial experiences with laparoscopic incisional hernial repair].

Author

Carlsen CG, Gaarden M, Lundhus E, and Nielsen J

Subjects
Female, Humans, Laparoscopy adverse effects, Length of Stay, Male, Outcome Assessment, Health Care, Patient Satisfaction, Postoperative Complications etiology, Recurrence, Reoperation, Risk Factors, Surgical Mesh, Surveys and Questionnaires, Suture Techniques, Hernia, Ventral surgery
Abstract

Introduction: Incisional hernia following laparotomy remains an important problem. Laparoscopic repair has become the method of choice in recent years. The present article presents the outcome of laparoscopic incisional hernia mesh repair at Viborg Hospital in the years 2003-2006., Material and Methods: We retrospectively identified 114 patients who had undergone laparoscopic hernia repair during the relevant period. The patients received a questionnaire regarding satisfaction, pain and recurrence. Patients reporting any inconvenience were offered a consultation., Results: Among the 114 included patients, ten procedures were converted to open laparotomy, six of which were converted due to recognized bowel injury. One case of bowel injury was managed laparoscopically. One case of bowel injury was recognized during reoperation the following day. Another four patients experienced reoperations for other reasons, mainly bleeding. The mean hospital stay was one day. A total of 12 patients had a recurrent hernia. The mean follow-up was 14 months., Conclusion: We conclude that laparoscopic incisional hernia repair is a useful surgical procedure with short hospital stay and high patient satisfaction. There is, however, a certain risk of bowel injury associated with this procedure.

Published
2009

28. [Multiple bowel perforations after swallowing magnetic toys].

Author

Carlsen CG, Floyd AK, and Lundhus E

Subjects
Child, Colon, Transverse injuries, Colon, Transverse surgery, Humans, Intestinal Perforation surgery, Intestine, Small injuries, Intestine, Small surgery, Male, Radiography, Abdominal, Rectum injuries, Rectum surgery, Foreign Bodies diagnostic imaging, Foreign Bodies surgery, Intestinal Perforation etiology, Magnetics adverse effects, Play and Playthings injuries
Abstract

Ingestion of small foreign bodies is common in children, and usually does not cause any harm to the gastrointestinal tract. But ingestion of multiple magnets can be hazardous because of the strong attraction of the magnets through the bowel wall, which may lead to bowel wall necrosis and perforation. We describe the case of a 6-year-old autistic boy who swallowed 4 magnets which led to bowel obstruction and 8 small perforations. It is important to be aware of this potential risk if children ingest small magnetic toys.

Published
2007

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