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Objective: The authors examine associations of personality characteristics, National Board of Medical Examiners subject examination performance, and Objective Structured Clinical Examination performance with clinical evaluations of third-year medical students in a psychiatry clerkship. Methods: Students completed the Revised NEO Personality Inventory, which measures personality domains of neuroticism, extraversion, openness, agreeableness, and conscientiousness and associated personality traits. At clerkship completion, students completed the National Board of Medical Examiners subject examination and a psychiatry Objective Structured Clinical Examination, and were evaluated by attending physicians (using a standardized evaluation form) regarding their clinical "knowledge and skill" and "interpersonal behavior." Data were analyzed using Pearson correlation and canonical correlation. Results: National Board of Medical Examiners subject examination and Objective Structured Clinical Examination scores were uncorrelated with clinical evaluations of "knowledge and skill" and "interpersonal behavior." Personality variables explained a moderate amount of variance in clinical evaluations. "Knowledge and skill" was positively associated with the domain of conscientiousness, the extraversion trait of warmth, and the conscientiousness traits of competence and achievement striving. "Interpersonal behavior" was negatively associated with the neuroticism trait of angry hostility and positively associated with the domain of agreeableness; the extraversion traits of warmth, gregariousness, and positive emotions; and the agreeableness traits of trust, altruism, compliance, and tender-mindedness. Conclusion: Clinical evaluations of medical students may favor personality styles that reflect positive elements of extraversion, agreeableness, and conscientiousness. The present findings raise questions regarding the validity of clinical evaluation elements in clerkship performance appraisal.

Interpretation of positive response distortion (socially desirable responding) in employment evaluations is an important validity issue. This study of police officer applicants examined the construct validity of the Paulhus Deception Scales (PDS)--Moralistic Bias (MB; exaggerated adjustment/agreeableness) and Egoistic Bias (EB; exaggerated power/status)--in relation to validity scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; L, K, and S) and Inwald Personality Inventory (IPI; Guardedness). In regression analyses, MB was significantly associated with each validity scale (particularly L and Guardedness), whereas EB was significantly, but weakly, associated with L only. MB is consistent with response distortion as reflected in L ("perfect" adjustment/personality) and Guardedness (denial of shortcomings/faults). EB is a unique form of response distortion that is not reflected in MMPI-2 or IPI validity scales. The relevance of EB to self-assessment among police officer applicants is an important practical concern in personnel selection and an important theoretical question for future response distortion research. (Contains 3 tables.)

Objective: The authors investigated the association between psychiatry clerkship timing and pattern of student performance. Student rotation timing preference and specialty choice were explored as potential moderators. Methods: Archival data from six classes of third-year medical students were analyzed. Performance indicators included the National Board of Medical Examiners (NBME) psychiatry subject examination, Objective Structured Clinical Examination (OSCE), and attending evaluation. Cluster analysis grouped students into homogeneous subsets based on performance. Cluster membership was examined as a function of timing, with and without timing preference and specialty choice as covariates. Results: The association between performance, as indicated by cluster membership, and rotation timing was not significant. There were no significant relationships between performance trends and student preference for rotation order or specialty choice. Conclusion: The clerkship timing effect was not apparent for the psychiatry clerkship when the full pattern of student performance was examined. Student preference and specialty choice did not moderate performance.

Objective: The construct validity of checklist and global process scores for an objective structured clinical examination (OSCE) in psychiatry was assessed. Multiple regression analysis was used to predict psychiatry OSCE scores from the clinical skills examination, an obstetrics/gynecology (OB/GYN) OSCE, and the National Board of Medical Examiners (NBME) psychiatry subject examination. Methods: Archival data from two successive classes of third-year medical students (1999-2000, N = 142; 2000-2001, N = 144) were aggregated and analyzed. Results: The pattern and magnitude of convergence and discrimination were indicative of adequate construct validity for both the psychiatry checklist scores and the global process score. Clinical skills examination scores for history taking, interpersonal skills, and physical examination were related to psychiatry OSCE scores that reflected the same skill set. Construct validity was fairly higher for the global process rating. Conclusion: Evidence of construct validity of a psychiatry OSCE was obtained from multiple measures of performance, including the clinical skills examination. Findings lend support to the continued use of checklist and global process evaluations as part of OSCEs in psychiatry.

Background. Patients with delirium, compared with those without, are at increased risk for loss of function, longer hospital stays, and increased mortality. We studied the effect that an Acute Care of the Elderly Unit, which includes a delirium room, has on patients with delirium. Methods. Retrospective observational study. Charts of 148 patients ([greater than or equal to] 65 years) admitted to an Acute Care of the Elderly Unit with a delirium room during a 4-month period were reviewed. Delirium on admission (prevalence) was based on physician-performed Confusion Assessment Method; delirium during hospital stay (incidence) was based on nurse- performed Confusion Assessment Method. Patients with delirium were compared with those without delirium regarding change in function between admission and discharge (activities of daily living), hospital length of stay, and mortality. Results. The prevalence of delirium was 16.2% (24/148), and the incidence was 16.1% (20/124). There were no significant differences between delirious and non-delirious patients in demographics or comorbidity scores. A significant interaction effect (p < .001) indicated improved activities of daily living (mean [+ or -] SD; scale 0-12) between admission and discharge among delirious patients (4.1 [+ or -] 4.6 and 6.1 [+ or -] 3.9) compared with non-delirious patients (7.4 [+ or -] 4.7 and 6.9 [+ or -] 4.5). There were no differences between delirious and non-delirious patients with reference to mean length of stay (6.4 [+ or -] 3.1 vs 5.9 [+ or -] 3.6 days, respectively; p = .461) and mortality (2 [4.5%] versus 2 [1.9%], respectively; p = .582). Conclusions. Although this study sample was small, the results suggest that an Acute Care of the Elderly Unit with a delirium room may improve function among delirious patients and may equalize other outcomes compared with nondelirious patients. Key Words: Delirium--ACE Unit--Delirium Room. doi: 10.1093/gerona/glq136

Pain is the medical symptom that most often propels people to seek medical care. Because psychosocial problems often complicate treatment, patients in pain frequently require psychological care as well. Recent evidence demonstrates that the standard of care for racial--ethnic minorities is inferior to that for Caucasians. This article reviews the literature regarding disparities in pain treatment from patient, provider, and public health perspectives. Psychologists, both academic and clinical, are uniquely positioned to clarify factors that underlie disparities and to offset inequities in clinical settings. If racial-ethnic disparities in pain treatment are to be eliminated, psychologists must take an active role. Keywords: pain, disparities, race, ethnicity

The authors examined the associations of 3 types of psychological coping (task-based, emotion-based, avoidance), 2 types of religious coping (positive, negative), and their interactions with grief of 57 mothers bereaved by the sudden death of a child. Results indicated that mothers who use emotion-based coping report significantly higher levels of grief, whereas mothers who use avoidance coping report lower levels of grief The interaction of task coping and positive religious coping was also associated with lower self-reported grief The findings support the differential utility of various coping styles on mothers' grief reactions to the sudden death of a child.