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This study sought to determine the academic and professional outcomes of medical school graduates who failed the United States Licensing Examination Step 1 on the first attempt. This retrospective cohort study was based on pooled data from 2,003 graduates of six Midwestern medical schools in the classes of 1997-2002. Demographic, academic, and career characteristics of graduates who failed Step 1 on the first attempt were compared to graduates who initially passed. Fifty medical school graduates (2.5%) initially failed Step 1. Compared to graduates who initially passed Step 1, a higher proportion of graduates who initially failed Step 1 became primary care physicians (26/49 [53%] vs. 766/1,870 [40.9%]), were more likely at graduation to report intent to practice in underserved areas (28/50 [56%] vs. 419/1,939 [21.6%]), and more likely to take 5 or more years to graduate (11/50 [22.0%] vs. 79/1,953 [4.0%]). The relative risk of first attempt Step 1 failure for medical school graduates was 13.4 for African Americans, 7.4 for Latinos, 3.6 for matriculants greater than 22 years of age, 3.2 for women, and 2.3 for first generation college graduates. The relative risk of not being specialty board certified for those graduates who initially failed Step 1 was 2.2. Our observations regarding characteristics of graduates in our study cohort who initially failed Step 1 can inform efforts by medical schools to identify and assist students who are at particular risk of failing Step 1.

Discusses how one medical school modified its evaluation system to identify and frame the most important questions facing program planning, particularly those issues that go beyond traditional cognitive measures to address practice environment and curricular innovations. (EV)

Surveyed U.S. medical schools to determine the extent to which student assessments have broadened beyond multiple-choice question (MCQ) examinations and preceptor ratings. Found that a variety of competency assessments currently are used; MCQs remain a core assessment method. Year 3 had the greatest breadth of assessment strategies. (EV)

Compares three categories of staff at substance-abuse treatment facilities: recovering, nonrecovering, and having recovering or addicted family members. More staff with addicted or recovering family members were female, were similar to nonrecovering staff in their treatment approach, and fell between the other two groups on measures of roles within programs and backgrounds. Recovering staff reported a wider range of treatment goals and techniques. (MKA)

Discusses computer-mediated communications for linking educators conducting research and educational activities and describes the development and evaluation of the DR-ED listserv for medical education. Evaluation includes a subscriber demographic profile, a content analysis of the messages posted, and a subscriber survey. (Author/LRW)

Abstract This study documents medical students' opinions of the relative efficacy of PBL versus lectures. Second-year medical students exposed to both traditional lectures and PBL were surveyed regarding their attitudes [...]

Examined family practice residency directors' perspectives on the National Resident Matching Program and medical students' recruitment behavior. Analysis of questionnaire responses (n=351) found that while few directors felt it was ethically wrong for students to interview in more than one specialty, most indicated that knowledge of this behavior had a significant negative effect on the applicant's rank order. (DB)

The empirical literature on disclosing a lesbian sexual orientation has explored the circumstantial and demographic variables related to this act. This exploratory study utilized self-efficacy theory (Bandura, 1986) to investigate the extent to which each of the four sources of efficacy information (e.g., performance accomplishments, vicarious experience, verbal persuasion, or emotional arousal) contributed to the coming out self-efficacy of lesbians, that is, the sense of confidence possessed by a lesbian to disclose her sexual orientation to others. Anonymous survey packets were completed by 134 lesbians. Results of regression analyses indicated that emotional arousal was the most potent predictor of coming out self-efficacy. Verbal persuasion and vicarious experience also were significant. The most theoretically salient source of self-efficacy information, performance accomplishments (Bandura, 1986), was not a significant predictor of coming out self-efficacy. Further, significant correlations were found between coming out self-efficacy and outness and life-style satisfaction, which were also significantly correlated to measures of psychological adjustment. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworth.com]

The Addiction Severity Index (ASI) is a structured interview widely used by substance abuse clinicians and researchers for client screening, determining treatment needs, and assessing treatment outcomes. Previous researchers have evaluated inter-rater agreement, test-retest reliability, and concurrent validity. The present report describes the stability of ASI scores in longitudinal work. In the context of an ongoing treatment outcome evaluation study involving seven assessors, inter-rater agreement, inter-rater reliability, as well as intra- and inter-rater accuracy were assessed repeatedly during a 2-year period. The results show the scores derived from the ASI to be stable across assessors and over time. The relationship between stable scores and resources required for training are discussed.

Abstract Background This paper describes a pilot survey of faculty involved in medical education. The questionnaire focuses on their understanding of IRB policies at their institution, specifically in relation to the use of student assessment and curriculum evaluation information for scholarship. Methods An anonymous survey was distributed to medical educators in a variety of venues. Two brief scenarios of typical student assessment or curriculum evaluation activities were presented and respondents were asked to indicate their likely course of action related to IRB approval. The questionnaire also asked respondents about their knowledge of institutional policies related to IRB approval. Results A total of 121 completed surveys were obtained; 59 (50%) respondents identified themselves as from community-based medical schools. For the first scenario, 78 respondents (66%) would have contact with the IRB; this increased to 97 respondents (82%) for the second scenario. For both scenarios, contact with the IRB was less likely among respondents from research-intensive institutions. Sixty respondents (55%) were unsure if their institutions had policies addressing evaluation data used for scholarship. Fifty respondents (41%) indicated no prior discussions at their institutions regarding IRB requirements. Conclusion Many faculty members are unaware of IRB policies at their medical schools related to the use of medical student information. To the extent that policies are in place, they are highly variable across schools suggesting little standardization in faculty understanding and/or institutional implementation. Principles to guide faculty decision-making are provided.