J J Veloski

Thomas Jefferson University, Philadelphia, PA, United States

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Publications (125)609.09 Total impact

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    ABSTRACT: Untimed examinations are popular with students because there is a perception that first impressions may be incorrect, and that difficult questions require more time for reflection. In this report, we tested the hypothesis that timed anatomy practical examinations are inherently more difficult than untimed examinations. Students in the Doctor of Physical Therapy program at Thomas Jefferson University were assessed on their understanding of anatomic relationships using multiple-choice questions. For the class of 2012 (n = 46), students were allowed to circulate freely among 40 testing stations during the 40-minute testing session. For the class of 2013 (n = 46), students were required to move sequentially through the 40 testing stations (one minute per item). Students in both years were given three practical examinations covering the back/upper limb, lower limb, and trunk. An identical set of questions was used for both groups of students (untimed and timed examinations). Our results indicate that there is no significant difference between student performance on untimed and timed examinations (final percent scores of 87.3 and 88.9, respectively). This result also held true for students in the top and bottom 20th percentiles of the class. Moreover, time limits did not lead to errors on even the most difficult, higher-order questions (i.e., items with P-values < 0.70). Thus, limiting time at testing stations during an anatomy practical examination does not adversely affect student performance. Anat Sci Educ. © 2013 American Association of Anatomists.
    Anatomical Sciences Education 03/2013;
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    ABSTRACT: To examine the contribution of students' gender and ethnicity to assessments by simulated patients (SPs) of medical students' empathy, and to compare the results with students' self-assessments of their own empathy. In 2008, the authors used three different tools to assess the empathy of 248 third-year medical students. Students completed the Jefferson Scale of Physician Empathy (JSPE), and SPs completed the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) and a global rating of empathy (GRE) in 10 objective structured clinical examination (OSCE) encounters. Of the 248 students who completed an end-of-third-year OSCE, 176 (71%) also completed the JSPE. Results showed that women scored higher than men on all three measures of empathy. The authors detected no significant difference between white and Asian American students on their self-report JSPE scores. However, the SPs' assessments on the JSPPPE and on the GRE were significantly lower, indicating less empathy, for Asian American students. A tool for SPs to assess students' empathy during an OSCE could be helpful for unmasking some deficits in empathy in students during the third year of medical school. Because the authors found no significant differences on self-reported empathy, the differences they observed in the SPs' assessments of white and Asian American students were unexpected and need further exploration. These findings call for investigation into the reasons for such differences so that OSCEs and other examinations comply with the guidelines for fairness in educational and psychological testing as recommended by professional testing organizations.
    Academic medicine: journal of the Association of American Medical Colleges 06/2011; 86(8):984-8. · 2.34 Impact Factor
  • Academic medicine: journal of the Association of American Medical Colleges 03/2011; 86(3):404. · 2.34 Impact Factor
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    ABSTRACT: Empathy is necessary for communication between patients and physicians to achieve optimal clinical outcomes. To examine associations between Simulated Patients' (SPs) assessment of medical students' empathy and the students' self-reported empathy. A total of 248 third-year medical students completed the Jefferson Scale of Physician Empathy (JSPE). SPs completed the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a global rating of empathy in 10 objective clinical skills examination encounters during a comprehensive end of third-year clinical skills examination. High correlation was found between the scores on the JSPPPE and the global ratings of empathy completed by the SPs (r = 0.87, p < 0.01). A moderate but statistically significant correlation was observed between scores of the JSPE and the JSPPPE (r = 0.19, p < 0.05). Significant differences were observed on the JSPE and global ratings of empathy among top, middle and low scorers on the JSPPPE in the expected direction. While significant associations exist between students' self-reported scores on the JSPE and SPs' evaluations of students' empathy, the associations are not large enough to conclude that the two evaluations are redundant.
    Medical Teacher 01/2011; 33(5):388-91. · 1.82 Impact Factor
  • Academic medicine: journal of the Association of American Medical Colleges 12/2010; 85(12):1812; author reply 1813-4. · 2.34 Impact Factor
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    ABSTRACT: The principle of lifelong learning is pervasive in regulations governing medical education and medical practice; yet, tools to measure lifelong learning are lagging in development. This study evaluates the Jefferson Scale of Physician Lifelong Learning (JeffSPLL) adapted for administration to medical students. The Jefferson Scale of Physician Lifelong Learning-Medical Students (JeffSPLL-MS) was administered to 732 medical students in four classes. Factor analysis and t tests were performed to investigate its construct validity. Maximum likelihood factor analysis identified a three-factor solution explaining 46% of total variance. Mean scores of clinical and preclinical students were compared; clinical students scored significantly higher in orientation toward lifelong learning (P < .001). The JeffSPLL-MS presents findings consistent with key concepts of lifelong learning. Results from use of the JeffSPLL-MS may reliably inform curriculum design and education policy decisions that shape the careers of physicians.
    Academic medicine: journal of the Association of American Medical Colleges 10/2010; 85(10 Suppl):S41-4. · 2.34 Impact Factor
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    ABSTRACT: The Medical College Admission Test (MCAT) has undergone several revisions for content and validity since its inception. With another comprehensive review pending, this study examines changes in the predictive validity of the MCAT's three recent versions. Study participants were 7,859 matriculants in 36 classes entering Jefferson Medical College between 1970 and 2005; 1,728 took the pre-1978 version of the MCAT; 3,032 took the 1978-1991 version, and 3,099 took the post-1991 version. MCAT subtest scores were the predictors, and performance in medical school, attrition, scores on the medical licensing examinations, and ratings of clinical competence in the first year of residency were the criterion measures. No significant improvement in validity coefficients was observed for performance in medical school or residency. Validity coefficients for all three versions of the MCAT in predicting Part I/Step 1 remained stable (in the mid-0.40s, P < .01). A systematic decline was observed in the validity coefficients of the MCAT versions in predicting Part II/Step 2. It started at 0.47 for the pre-1978 version, decreased to between 0.42 and 0.40 for the 1978-1991 versions, and to 0.37 for the post-1991 version. Validity coefficients for the MCAT versions in predicting Part III/Step 3 remained near 0.30. These were generally larger for women than men. Although the findings support the short- and long-term predictive validity of the MCAT, opportunities to strengthen it remain. Subsequent revisions should increase the test's ability to predict performance on United States Medical Licensing Examination Step 2 and must minimize the differential validity for gender.
    Academic medicine: journal of the Association of American Medical Colleges 06/2010; 85(6):980-7. · 2.34 Impact Factor
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    01/2010;
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    ABSTRACT: Background/Rational Chronic illness in the rapidly aging population of the US is an important healthcare concern. As a result of the increase of chronic illness, several health organizations have expressed the need to redesign health care education. One such reorganization is to use a team approach to healthcare education called Interprofessional Health Education (IPHE). IPHE has become a priority for many universities; however, its introduction is seen as problematic because many factors can impede implementation. Further, student attitudes can impact the successful implementation of IPHE. Therefore it is important to determine whether programs have an impact on improving student attitudes towards working in teams. Methods 700 students in medicine, nursing, occupational therapy, physical therapy, pharmacy and public health were administered two survey instruments, RIPLS and IEPS at the beginning of a year long IPHE experience. This experience was created to address the lack of health care information held by individuals with chronic illness, and it required the interprofessional teams to work with an older individual living in the community with a chronic illness. At the conclusion of the year, the IEPS was again administered to students to determine if there was a change in attitudes towards interprofessional care. Results An ANOVA with appropriate post hoc analyses found some significant difference among the professions in attitudes toward IPHE at the conclusion of the experience. A correlation analysis found some significant relationships between readiness and attitudes toward IPHE. This presentation will describe and discuss the differences and its implications.
    137st APHA Annual Meeting and Exposition 2009; 11/2009
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    ABSTRACT: Interprofessional education has been recognized as an important strategy to improve care of the rising epidemic of chronic illness (Institute of Medicine, 2001). The purpose of this study was to assess attitudes toward chronic illness care prior to and after one year of an interprofessional curriculum. The Jefferson Health Mentors Program (JHMP) is a 2-year longitudinal required curriculum for all entering medical, BSN nursing, occupational therapy, physical therapy, pharmacy, and family and couples therapy students matriculating at Thomas Jefferson University. Begun in 2007, JHMP creates teams of 4-5 students from 3-4 disciplines, partnered with volunteer adult Health Mentors, primarily older adults living with one or more chronic conditions. Teams and Health Mentors complete a series of activities with the goals of preparing students to work in highly functioning teams and understanding patients' perspectives of chronic illness care. Activities include the patient/client as individual; obtaining an interdisciplinary health history; access to care; professionalism; medication usage; patient safety; and wellness planning. An interprofessional team of nearly 30 faculty and students are implementing and evaluating JHMP. Qualitative and quantitative analyses examined attitudes and understanding of chronic illness prior to as compared to after one year of the program, as well as differences among the students' attitudes compared by professions.
    137st APHA Annual Meeting and Exposition 2009; 11/2009
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    ABSTRACT: This longitudinal study was designed to examine changes in medical students' empathy during medical school and to determine when the most significant changes occur. Four hundred fifty-six students who entered Jefferson Medical College in 2002 (n = 227) and 2004 (n = 229) completed the Jefferson Scale of Physician Empathy at five different times: at entry into medical school on orientation day and subsequently at the end of each academic year. Statistical analyses were performed for the entire cohort, as well as for the "matched" cohort (participants who identified themselves at all five test administrations) and the "unmatched" cohort (participants who did not identify themselves in all five test administrations). Statistical analyses showed that empathy scores did not change significantly during the first two years of medical school. However, a significant decline in empathy scores was observed at the end of the third year which persisted until graduation. Findings were similar for the matched cohort (n = 121) and for the rest of the sample (unmatched cohort, n = 335). Patterns of decline in empathy scores were similar for men and women and across specialties. It is concluded that a significant decline in empathy occurs during the third year of medical school. It is ironic that the erosion of empathy occurs during a time when the curriculum is shifting toward patient-care activities; this is when empathy is most essential. Implications for retaining and enhancing empathy are discussed.
    Academic medicine: journal of the Association of American Medical Colleges 10/2009; 84(9):1182-91. · 2.34 Impact Factor
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    ABSTRACT: The most effective time to introduce formal tobacco use treatment training for physicians is during the medical school experience. However, few medical schools have adopted standardized curricula, missing an important opportunity to influence future physician behavior. The Pennsylvania Continuum of Tobacco Education pilot project was undertaken from spring 2003 through summer 2005 to evaluate a generalizable method of improving students' knowledge, attitudes, and behaviors related to tobacco use treatment. Intervention methods included a 1-day intensive multiformat seminar, followed by a reinforcement session 4 weeks later, within an internal medicine clerkship. Outcome measures included changes in students' attitudes, rates of "ask" and "advise" behaviors during clinical encounters, and performance on end-of-year clinical skills examinations. Short, intermediate, and long-term outcomes related to both smoking assessment and counseling improved as a result of the intervention. The percentage of students who obtained tobacco histories and counseled patients in clerkships increased following the seminar compared with the baseline. Nearly, all students demonstrated relevant skills during a clinical skills assessment at the end of the third year. The introduction of a standardized tobacco curriculum into medical school training is both feasible and effective. Results were sustained following the intervention, and the effects were reflected across several valid outcomes.
    Nicotine & Tobacco Research 05/2009; 11(4):387-93. · 2.48 Impact Factor
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    ABSTRACT: The conceptualisation and measurement of competence in patient care are critical to the design of medical education programmes and outcome assessment. We aimed to examine the major components and correlates of postgraduate competence in patient care. A 24-item rating form with additional questions about resident doctors' performance and future residency offers was used. Study participants comprised 4560 subjects who graduated from Jefferson Medical College between 1975 and 2004. They pursued their graduate medical education in 508 hospitals. We used a longitudinal study design in which the rating form was completed by programme directors to evaluate residents at the end of the first postgraduate year. Factor analysis was used to identify the underlying components of postgraduate ratings. Multiple regression, t-test and correlational analyses were used to study the validity of the components that emerged. Two major components emerged, which we labelled 'Knowledge and Clinical Capabilities' and 'Professionalism', and which addressed the science and art of medicine, respectively. Performance measures during medical school, scores on medical licensing examinations, and global assessment of Medical Knowledge, Clinical Judgement and Data-gathering Skills showed higher correlations with scores on the Knowledge and Clinical Capabilities component. Global assessments of Professional Attitudes and ratings of Empathic Behaviour showed higher correlations with scores on the Professionalism component. Offers of continued residency and evaluations of desirable qualities were associated with both components. Psychometric support for measuring the components of Knowledge and Clinical Capabilities, and Professionalism provides an instrument to empirically evaluate educational outcomes to medical educators who are in search of such a tool.
    Medical Education 11/2007; 41(10):982-9. · 3.55 Impact Factor
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    ABSTRACT: Monitoring the teaching effectiveness of attending physicians is important to enhancing the quality of graduate medical education. We used a critical incident technique with 35 residents representing a cross-section of programmes in a teaching hospital to develop a 23-item rating form. We obtained ratings of 11 attending physicians in internal medicine and general surgery from 54 residents. We performed linear and logistic regression analysis to relate the items on the form to the residents' overall ratings of the attending physicians and the programme directors' ratings of the attending physicians. The residents rated the attending physicians highly in most areas, but lower in provision of feedback, clarity of written communication and cost-effectiveness in making clinical decisions. When we used the residents' overall ratings as the criterion, the most important aspects of attending physicians' teaching were clarity of written communication, cost-effectiveness, commitment of time and energy and whether the resident would refer a family member or friend to the physician. When we used the programme directors' ratings as the criterion, the additional important aspects of performance were concern for the residents' professional well-being, knowledge of the literature and the delivery of clear verbal and written communication. The critical incident technique can be used to develop an instrument that demonstrates content and construct validity. We found that residents consider commitment of time to teaching and clinical effectiveness to be the most important dimensions of faculty teaching. Other important dimensions include written and verbal communication, cost-effectiveness and concern for residents' professional development.
    Medical Education 01/2007; 40(12):1201-8. · 3.55 Impact Factor
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    ABSTRACT: Despite the importance of lifelong learning as an element of professionalism, no psychometrically sound instrument is available for its assessment among physicians. To assess the validity and reliability of an instrument developed to measure physicians' orientation toward lifelong learning. Mail survey. Seven hundred and twenty-one physicians, of whom 444 (62%) responded. The Jefferson Scale of Physician Lifelong Learning (JSPLL), which includes 19 items answered on a 4-point Likert scale, was used with additional questions about respondents' professional activities related to continuous learning. Factor analysis of the JSPLL yielded 4 subscales entitled: "professional learning beliefs and motivation,"scholarly activities,"attention to learning opportunities," and "technical skills in seeking information," which are consistent with widely recognized features of lifelong learning. The validity of the scale and its subscales was supported by significant correlations with a set of criterion measures that presumably require continuous learning. The internal consistency reliability (coefficient alpha) of the JSPLL was 0.89, and the test-retest reliability was 0.91. Empirical evidence supports the validity and reliability of the JSPLL.
    Journal of General Internal Medicine 10/2006; 21(9):931-6. · 3.28 Impact Factor
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    ABSTRACT: There is a basis for the assumption that feedback can be used to enhance physicians' performance. Nevertheless, the findings of empirical studies of the impact of feedback on clinical performance have been equivocal. To summarize evidence related to the impact of assessment and feedback on physicians' clinical performance. The authors searched the literature from 1966 to 2003 using MEDLINE, HealthSTAR, the Science Citation Index and eight other electronic databases. A total of 3702 citations were identified. Empirical studies were selected involving the baseline measurement of physicians' performance and follow-up measurement after they received summaries of their performance. Data were extracted on research design, sample, dependent and independent variables using a written protocol. A group of 220 studies involving primary data collection was identified. However, only 41 met all selection criteria and evaluated the independent effect of feedback on physician performance. Of these, 32 (74%) demonstrated a positive impact. Feedback was more likely to be effective when provided by an authoritative source over an extended period of time. Another subset of 132 studies examined the effect of feedback combined with other interventions such as educational programmes, practice guidelines and reminders. Of these, 106 studies (77%) demonstrated a positive impact. Two additional subsets of 29 feedback studies involving resident physicians in training and 18 studies examining proxy measures of physician performance across clinical sites or groups of patients were reviewed. The majority of these two subsets also reported that feedback had positive effects on performance. HEADLINE RESULTS: Feedback can change physicians' clinical performance when provided systematically over multiple years by an authoritative, credible source. The effects of formal assessment and feedback on physician performance are influenced by the source and duration of feedback. Other factors, such as physicians' active involvement in the process, the amount of information reported, the timing and amount of feedback, and other concurrent interventions, such as education, guidelines, reminder systems and incentives, also appear to be important. However, the independent contributions of these interventions have not been well documented in controlled studies. It is recommended that the designers of future theoretical as well as practical studies of feedback separate the effects of feedback from other concurrent interventions.
    Medical Teacher 04/2006; 28(2):117-28. · 1.82 Impact Factor
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    ABSTRACT: Clinical vignette-based surveys have been used for more than 30 years to measure variation in physicians' approaches to the diagnosis and treatment of patients with similar health problems. Vignettes offer advantages over medical record reviews, analysis of claims data, and standardized patients. A vignette-based survey can be completed more quickly than a record review or standardized patient program. Research has shown that vignette-based surveys produce better measures of quality of care than medical record reviews when used to measure differential diagnosis, selection of tests, and treatment decisions. Although standardized patients are preferred when measuring communication and physical examination skills, vignettes are more cost-effective than standardized patients when assessing clinical physicians' decision making. Vignettes offer better opportunities to isolate physicians' decision making and to control case-mix variation than do analyses of claims data sets. Clinical vignette-based surveys are simple and economical tools that can be used to characterize physicians' practice variation.
    American Journal of Medical Quality 01/2005; 20(3):151-7. · 1.47 Impact Factor
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    ABSTRACT: To determine whether the time interval between completing the third-year curriculum and test administration affects a student's USMLE Step 2 score. Scores for 846 students in the classes of 2000-2004 were grouped in ten time periods depending on test date. A linear regression model to predict performance on Step 2 using gender, Step 1, and grades in medicine, pediatrics and obstetrics-gynecology was developed based on the class of 1999. Analysis of covariance was used to test the effect of time on scores, adjusting for predicted performance. Step 2 scores decreased significantly (p <.001) across time. Students' mean scores were four points higher than predicted in the early months and five to eight points lower near the end of the senior year. Students who scheduled Step 2 early in the senior year achieved higher scores, on average, than those who waited until later in the year.
    Academic Medicine 11/2004; 79(10 Suppl):S49-51. · 3.29 Impact Factor
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    ABSTRACT: Empathy is a major component of a satisfactory doctor-patient relationship and the cultivation of empathy is a learning objective proposed by the Association of American Medical Colleges (AAMC) for all American medical schools. Therefore, it is important to address the measurement of empathy, its development and its correlates in medical schools. We designed this study to test two hypotheses: firstly, that medical students with higher empathy scores would obtain higher ratings of clinical competence in core clinical clerkships; and secondly, that women would obtain higher empathy scores than men. A 20-item empathy scale developed by the authors (Jefferson Scale of Physician Empathy) was completed by 371 third-year medical students (198 men, 173 women). Associations between empathy scores and ratings of clinical competence in six core clerkships, gender, and performance on objective examinations were studied by using t-test, analysis of variance, chi-square and correlation coefficients. Both research hypotheses were confirmed. Empathy scores were associated with ratings of clinical competence and gender, but not with performance in objective examinations such as the Medical College Admission Test (MCAT), and Steps 1 and 2 of the US Medical Licensing Examinations (USMLE). Empathy scores are associated with ratings of clinical competence and gender. The operational measure of empathy used in this study provides opportunities to further examine educational and clinical correlates of empathy, as well as stability and changes in empathy at different stages of undergraduate and graduate medical education.
    Medical Education 07/2002; 36(6):522-7. · 3.55 Impact Factor
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    ABSTRACT: Conceptualization and measurement of clinical competence of residents are of interest to medical educators. Yet there is a scarcity of operational tools with satisfactory psychometric support for measuring clinical competence. In this study, we investigated the underlying structure, criterion-related validity and alpha reliability of a brief rating form (20 items) developed to assess clinical competence of residents. The study sample consisted of 882 physicians (654 men, 228 women) in postgraduate training at Thomas Jefferson University Hospital between 1998 and 2000. Construct validity of the form was supported by factor analysis. Two relevant factors emerged: 'Knowledge, Data-Gathering and Processing Skills', and 'Interpersonal Skills and Attitudes'. Criterion-related validity was supported by significant linear associations between factor scores and performance on the medical licensing examinations. Alpha reliability coefficients for the two factors were 0.98 and 0.97, respectively. This brief rating form can be employed as one measure to evaluate clinical competence of residents with reasonable confidence in its measurement properties.
    Medical Teacher 06/2002; 24(3):299-303. · 1.82 Impact Factor

Publication Stats

2k Citations
609.09 Total Impact Points

Institutions

  • 1992–2013
    • Thomas Jefferson University
      • • Department of Pathology, Anatomy & Cell Biology
      • • Center for Research in Medical Education and Health Care
      • • Department of Radiology
      Philadelphia, PA, United States
  • 1988–2011
    • Thomas Jefferson University Hospitals
      Philadelphia, Pennsylvania, United States
  • 2001
    • Christiana Care Health System
      Wilmington, Delaware, United States
  • 1998–2000
    • Northeast Ohio Medical University
      Ravenna, Ohio, United States