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  1. Article ; Online: Evaluating clinical reasoning in first year DPT students using a script concordance test.

    Kojich, Lindsey / Miller, Stephanie A / Axman, Katelyn / Eacret, Timothy / Koontz, J Atticus / Smith, Caroline

    BMC medical education

    2024  Volume 24, Issue 1, Page(s) 329

    Abstract: Background: A script concordance test (SCT) provides a series of clinical vignettes to assess clinical reasoning in uncertainty. Appraised throughout health education literature, SCTs are cognitive assessments of clinical reasoning, though their use in ... ...

    Abstract Background: A script concordance test (SCT) provides a series of clinical vignettes to assess clinical reasoning in uncertainty. Appraised throughout health education literature, SCTs are cognitive assessments of clinical reasoning, though their use in Doctor of Physical Therapy (DPT) entry-level education has not been investigated. The purpose of this study was to develop and explore the reliability and validity of a SCT for first year DPT students.
    Methods: The SCT was developed and implemented over four phases. During phases one and two, DPT program faculty consulted on course content from the first-year curriculum. Thirty clinical vignettes with three follow-up questions each were constructed. The SCT was pilot tested with five clinicians in phase three to assess question clarity. During phase four, the SCT was administered to students and a reference panel via Qualtrics. First year DPT students (n = 44) and reference panel physical therapists with at least two years of experience and advanced certification (n = 15) completed the SCT. Internal consistency was analyzed using Cronbach's Alpha. Differences between student and reference panel percent-correct scores were analyzed with a t-test. Relationships between student SCT scores and academic records were explored with Spearman's Rho.
    Results: The SCT had an internal consistency of 0.74. A significant difference in scores was found between the students [mean 58.5 (+/-5.31)] and reference panel [65.8 (+/-4.88), p < .01]. No significant correlations between student SCT scores and academic records were found.
    Conclusions: The developed SCT was reliable and demonstrated satisfactory internal consistency among test items. The SCT successfully differentiated between groups, with the reference panel demonstrating statistically significant higher percent-correct scores compared to students. SCTs may provide means to measure clinical reasoning in DPT students and lead to novel pedagogical approaches to enhance clinical reasoning.
    MeSH term(s) Humans ; Reproducibility of Results ; Educational Measurement ; Clinical Competence ; Students ; Clinical Reasoning
    Language English
    Publishing date 2024-03-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2044473-4
    ISSN 1472-6920 ; 1472-6920
    ISSN (online) 1472-6920
    ISSN 1472-6920
    DOI 10.1186/s12909-024-05281-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Racioethnic Differences in Human Posterior Scleral and Optic Nerve Stump Deformation.

    Tamimi, Ehab A / Pyne, Jeffrey D / Muli, Dominic K / Axman, Katelyn F / Howerton, Stephen J / Davis, Matthew R / Girkin, Christopher A / Vande Geest, Jonathan P

    Investigative ophthalmology & visual science

    2017  Volume 58, Issue 10, Page(s) 4235–4246

    Abstract: Purpose: The purpose of this study was to quantify the biomechanical response of human posterior ocular tissues from donors of various racioethnic groups to better understand how differences in these properties may play a role in the racioethnic health ... ...

    Abstract Purpose: The purpose of this study was to quantify the biomechanical response of human posterior ocular tissues from donors of various racioethnic groups to better understand how differences in these properties may play a role in the racioethnic health disparities known to exist in glaucoma.
    Methods: Sequential digital image correlation (S-DIC) was used to measure the pressure-induced surface deformations of 23 normal human posterior poles from three racioethnic groups: African descent (AD), European descent (ED), and Hispanic ethnicity (HIS). Regional in-plane principal strains were compared across three zones: the optic nerve stump (ONS), the peripapillary (PP) sclera, and non-PP sclera.
    Results: The PP scleral tensile strains were found to be lower for ED eyes compared with AD and HIS eyes at 15 mm Hg (P = 0.024 and 0.039, respectively). The mean compressive strains were significantly higher for AD eyes compared with ED eyes at 15 mm Hg (P = 0.018). We also found that the relationship between tensile strain and pressure was significant for those of ED and HIS eyes (P < 0.001 and P = 0.004, respectively), whereas it was not significant for those of AD (P = 0.392).
    Conclusions: Our results suggest that, assuming glaucomatous nerve loss is caused by mechanical strains in the vicinity of the optic nerve head, the mechanism of increased glaucoma prevalence may be different in those of AD versus HIS. Our ONS strain analysis also suggested that it may be important to account for ONS geometry and material properties in future scleral biomechanical analysis.
    MeSH term(s) African Continental Ancestry Group ; Aged ; Aged, 80 and over ; Axons/pathology ; European Continental Ancestry Group ; Female ; Glaucoma/ethnology ; Glaucoma/physiopathology ; Hispanic Americans ; Humans ; Intraocular Pressure/physiology ; Male ; Middle Aged ; Optic Disk/pathology ; Optic Nerve Diseases/ethnology ; Optic Nerve Diseases/physiopathology ; Sclera ; Tissue Donors
    Language English
    Publishing date 2017-08-01
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 391794-0
    ISSN 1552-5783 ; 0146-0404
    ISSN (online) 1552-5783
    ISSN 0146-0404
    DOI 10.1167/iovs.17-22141
    Database MEDical Literature Analysis and Retrieval System OnLINE

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