Claudio Violato

Wake Forest School of Medicine · Section of General Internal Medicine / Medical Education

Background How effective have lockdowns been at reducing the covid-19 infection and mortality rates? Lockdowns influence contact among persons within or between populations including restricting travel, closing schools, prohibiting public gatherings, requiring workplace closures, all designed to slow the contagion of the virus. The purpose of the p...

Objectives: The main objective of the study was to examine clinical, occupational and psychosocial outcomes of systematic psycho-education in depressed patients. Method: 80 patients with confirmed diagnosis of major depression were randomly assigned to either an intervention group or to standard care group. The intervention group received systemati...

Background: Physician professionalism, including anaesthesiologists and intensive care doctors, should be continuously assessed during training and subsequent clinical practice. Multi-source feedback (MSF) is an assessment system in which healthcare professionals are assessed on several constructs (e.g., communication, professionalism, etc.) by mu...

PURPOSE Physicians rarely receive formal training in leadership skills. Çitaku and colleagues have identified a set of leadership competencies (LCs) providing validity evidence in North American (NA) and European Union (EU) medical education institutions. We aim to apply this same survey to a sample of Latin American (LA) medical leaders from the o...

The distinction between basic sciences and clinical knowledge which has led to a theoretical debate on how medical expertise is developed has implications for medical school and lifelong medical education. This longitudinal, population based observational study was conducted to test the fit of three theories-knowledge encapsulation, independent inf...

Proceedings of the Conference : Medical science and health paradigm change 13-14-15 October 2017.Milan,Italy

This is a longitudinal study of first year medical students that investigates the relationship between the pattern change of the learning preferences and academic performance. Using the visual, auditory, reading-writing, and kinesthetic inventory at the beginning of the first and second year for the same class, it was found that within the first ye...

Objectives This study was conducted to adduce evidence of validity for admissions tests and processes and for identifying a parsimonious model that predicts students’ academic achievement in Medical College. Methods Psychometric study done on admission data and assessment scores for five years of medical studies at Aga Khan University Medical Coll...

Purpose The main purpose of the present study was to evaluate the predictive validity of medical school admissions data, preclinical and clinical achievement data, postgraduate evaluations, and the United States Medical Licensing Exam Step 1 and 2 data for performance on Step 3. Methods A total of 321 physicians (178 men, 55.4 %; 143 women, 44.6 %)...

Introduction: Physicians identify teaching as a factor that enhances performance, although existing data to support this relationship is limited. Purpose: To determine whether there were differences in clinical performance scores as assessed through multisource feedback (MSF) data based on clinical teaching. Methods: MSF data for 1831 family p...

This chapter reviews a decade’s effort by the International Society of Addiction Medicine to develop a multiple choice test of knowledge in the field. The process of establishing a pool of questions as well as criteria for eligibility to challenge such an examination is described. Lessons derived from the repeated administration of the exam are rev...

CGEA 2015 CONFERENCE ABSTRACT (EDITED) A Novel Approach to Assessing Professionalism in Preclinical Medical Students Using Paired Self- and Peer Evaluations. Amanda R. Emke, Steven Cheng, and Carolyn Dufault Construct: This study sought to assess the professionalism of 2nd-year medical students in the context of team-based learning. Background: Pro...

Construct: Authentic standard setting methods will demonstrate high convergent validity evidence of their outcomes, that is, cutoff scores and pass/fail decisions, with most other methods when compared with each other. The objective structured clinical examination (OSCE) was established for valid, reliable, and objective assessment of clinical skil...

Objectives: The purpose of the present study was to test the fit of three models – knowledge encapsulation, independent influence, distinct domains – of the development of medical expertise, and diagnostic or clinical reasoning skills based on aptitude for medical school, basic science knowledge, and clinical competency measures. Method: A total of...

Background: Weight loss and reduction in co-morbidities can be achieved by longitudinal sleeve gastrectomy (LSG). Existing evidence suggests that LSG resolves or improves hyperlipidemia in morbidly obese patients. The aim of this study was to systematically review the effect of LSG on hyperlipidemia. Methods: A systematic literature search was con...

Many medical graduates are deficient in anatomy knowledge and perhaps below the standards for safe medical practice. Three-dimensional visualization technology (3DVT) has been advanced as a promising tool to enhance anatomy knowledge. The purpose of this review is to conduct a meta-analysis of the effectiveness of 3DVT in teaching and learning anat...

In human medicine, standardised patients (SP) have been shown to reliably and accurately assess learners' communication performance in high-stakes certification Objective Structured Clinical Examinations (OSCE), offering a feasible way to reduce the need for recruitment, time commitment and coordination of faculty assessors. In this study, we evalu...

Background: Emotional Intelligence (EI) is the ability to deal with your own and others emotions. Medical students are inducted into medical schools on the basis of their academic achievement. Professionally, however, their success rate is variable and may depend on their interpersonal relationships. EI is thought to be significant in achieving go...

The purpose of this study was to conduct a meta-analysis on the construct and criterion validity of multi-source feedback (MSF) to assess physicians and surgeons in practice. In this study, we followed the guidelines for the reporting of observational studies included in a meta-analysis. In addition to PubMed and MEDLINE databases, the CINAHL, EMBA...

The use of multisource feedback (MSF) or 360-degree evaluation has become a recognized method of assessing physician performance in practice. The purpose of the present systematic review was to investigate the reliability, generalizability, validity, and feasibility of MSF for the assessment of physicians. The authors searched the EMBASE, PsycINFO,...

We determined the Web-based configurations that are applied to teach medical and veterinary communication skills, evaluated their effectiveness, and suggested future educational directions for Web-based communication teaching in veterinary education. We performed a systematic search of CAB Abstracts, MEDLINE, Scopus, and ERIC limited to articles pu...

Background: Although many studies have made efforts to define and assess medical professionalism, few have addressed issues of construct validity. Purposes: The purpose of this article is to explore further construct validity of medical professionalism employing exploratory and confirmatory factor analysis. Methods: The 32-item instrument by t...

Obesity and its related illnesses are pan-endemic health problems which require intervention. Laparoscopic Adjustable Gastric Banding (LAGB) is seen as a safe surgical procedure with satisfactory results on weight reduction and improvement in obesity related illness. Data were collected in a repeated-measures longitudinal five year study for 143 mo...

Background. Weight loss and reduction in comorbidities can be achieved by longitudinal sleeve gastrectomy (LSG). Existing evidence suggests that LSG resolves or improves hyperlipidemia in morbidly obese patients. The aim of this study was to systematically review the effect of LSG on hyperlipidemia. Methods. A systematic literature search was condu...

Objective: To conduct a needs assessment for a research curriculum development for PGME programs in Saudi Arabia. Methods: Two questionnaires (one for trainees and the other for educators) were employed. A total of 70 trainees out of 117 participated, for a response rate of 59.8%. Fifty two percent of participants were females. The majority of trai...

Current teaching approaches in human and veterinary medicine across North America, Europe, and Australia include lectures, group discussions, feedback, role-play, and web-based training. Increasing class sizes, changing learning preferences, and economic and logistical challenges are influencing the design and delivery of communication skills in ve...

Background: The assessment, maintenance of competence, and recertification for surgeons have recently received increased attention from many health organizations. Assessment of physicians' competencies with multisource feedback (MSF) has become widespread in recent years. The aim of the present study was to investigate further the use of MSF for a...

The purpose of this study was to examine and compare diagnostic success and its relationship with the diagnostic reasoning process between novices and experts in psychiatry. Nine volunteers, comprising five expert psychiatrists and four clinical clerks, completed a think-aloud protocol while attempting to make a DSM-IV (Diagnostic and Statistical M...

Background: The objective structure clinical examination (OSCE) has been used since the early 1970s for assessing clinical competence. There are very few studies that have examined the psychometric stability of the stations that are used repeatedly with different samples. The purpose of the present study was to assess the stability of objective st...

New approaches are needed to ensure that surgical trainees attain competence in a timely way. Traditional solutions have focused on the years spent in surgic al training. We sought to examine the outcomes of graduates from 3-year versus 4-year medical schools for differences in surgeon performance based on multisource feedback data. We used data fr...

The purpose of this study was to examine the career decision-making process of International Medical Graduates (IMGs). There are two main types of IMGs who apply for licensure in Canada. Canadian International Medical Graduates (CIMGs) were Canadian citizens before leaving to study medicine in a foreign country, in comparison to those non-CIMGs who...

The purpose of this study was to investigate the predictive and construct validity of a high-stakes objective structured clinical examination (OSCE) used to select candidates for a 3-month clinical rotation to assess practice-readiness status. Analyses were undertaken to establish the reliability and validity of the OSCE. The generalizability coeff...

To identify and empirically investigate the dimensions of leadership in medical education and healthcare professions. A population-based design with a focus group and a survey were used to identify the perceived competencies for effective leadership in medical education. The focus group, consisting of five experts from three countries (Austria n=1;...

The number of Multiple Mini Interview (MMI) stations and the type and number of interviewers required for an acceptable level of reliability for veterinary admissions requires investigation. The goal is to investigate the reliability of the 2009 MMI admission process at the University of Calgary. Each applicant (n = 103; female = 80.6%; M age = 23....

The purpose of this study was to investigate the reliability and validity of a performance assessment of communication, professionalism, and surgical skills competencies for surgery residents. Fourteen residents from the general surgery program of the University of Calgary were assessed in 7 surgical simulation stations that included communication...

To examine changes in partially responsive anxiety symptoms utilizing adjunctive treatment with atomoxetine in the treatment of adult ADHD patients with comorbid partially responsive anxiety symptoms. Consenting adult patients (n=29) with confirmed diagnosis of generalized anxiety and comorbid attention deficit hyperactivity disorder (ADHD) partici...

To develop and psychometrically assess a short instrument that can be easily used in clinical practice to measure knowledge-seeking behavior in patients suffering from depression. We developed the knowledge seeking instrument (KSI), a self-report scale of three items to assess the number of hours spent in knowledge seeking behavior such as reading...

Assessment of clinical teaching by learners is of value to teachers, department heads, and program directors, and must be comprehensive and feasible. To review published evaluation instruments with psychometric evaluations and to develop and psychometrically evaluate an instrument for assessing clinical teaching with linkages to the CanMEDS roles....

A total of 205 high school students (grades 10,11,12) with approximately equal numbers of males (N=104; 50.7 percent) and females (N=101; 49.3 percent) responded to the Learning Process Questionnaire. The resulting data were fit to a three-factor model of learning motives and strategies that was theoretically derived from Biggs' learning process mo...

The experience of the International Society of Addiction Medicine in setting up the first international certification of clinical knowledge is reported. The steps followed and the results of a psychometric analysis of the tests from the first 65 candidates are reported. Lessons learned in the first 5 years and challenges for the future are identifi...

In this article we provide an overview of the nature and scope of multisource feedback (MSF) and provide empirical evidence of its reliability, validity, and feasibility in one of the health professions. The overall internal consistency reliability (Cronbach alpha) of MSF instruments is generally greater than .96 for self and informants such as pat...

Non-adherence to treatment can result from forgetting, carelessness, stopping the drug when feeling worse, or stopping the drug when feeling better. To develop and psychometrically assess a brief instrument that can be easily used in clinical practice to measure adherence to antidepressants. We developed the Antidepressants Adherence Scale (AAS); a...

Structural equation modeling (SEM) is a set of statistical techniques used to measure and analyze the relationships of observed and latent variables. Similar but more powerful than regression analyses, it examines linear causal relationships among variables, while simultaneously accounting for measurement error. The purpose of the present paper is...

The purpose of the study was to adduce evidence for estimating the construct validity of clinical competence measured through assessment instruments used for high-stakes examinations. Thirty-nine international physicians (mean age = 41 + 6.5 y) participated in high-stakes examination and 3-month supervised clinical practice to determine the practic...

The reliability and validity of using essays for veterinary medical school admissions requires investigation. We explored the reliability and construct validity of a structured essay station in the 2009 admission process at the University of Calgary Faculty of Veterinary Medicine. One hundred three applicants (female=80.6%, male=19.4%; mean age=23....

Background: To assess the efficacy of a 16 week, intensive, full-time medical communication and clinical skills educational program – Medical Communication Assessment Project (M-CAP) – at the Universities of Calgary and Alberta for improving medical communication, clinical skills and professionalism of international medical graduates (IMGs). There...

Characteristics of university courses and student engagement were examined in relation to student ratings of instruction. The Universal Student Ratings of Instruction instrument was administered to students at the end of every course at a major Canadian university over a three-year period. Using a two-step analytic procedure, a latent variable path...

Objective: To conduct a literature review of patient-and population-based research on depression literacy and determine the implications of the findings for patient psycho-education. Method: The authors searched PubMed for articles published between January 1995 and January 2007; they chose English-language articles of studies based on samples draw...

A primary goal of education is to promote long-term knowledge storage and retrieval. A prospective interventional study design was used to investigate our research question: Does a dispersed curriculum promote better short- and long-term retention over a massed course? Participants included 20 gastroenterology residents from the University of Calga...

The objective was to develop and psychometrically evaluate (feasibility, reliability, validity) a questionnaire-based multisource feedback (MSF) system for quality improvement (QI) for occupational therapists (OTs). Surveys were developed for assessment of OTs by clients, co-workers, and themselves, respectively, using 5-point scales with an "unabl...

To develop and psychometrically assess an instrument to measure patients' attitudes towards depression, to its treatments, and aspects of professional help in patients suffering from depression. A 27 item Likert type instrument was developed and written based on an evidence from a literature review and in consultation with experts in depression. Ps...

Although measures of student ratings of instruction have been developed and examined empirically, students' attitudes about the utility of these ratings have yet to be meaningfully quantified. Using survey responses from 1229 students at a major Canadian university, we developed a psychometrically sound measure of the usefulness of student ratings....

Despite the impartiality implied in its title, the objective structured clinical examination (OSCE) is vulnerable to systematic biases, particularly those affecting raters' performance. In this study our aim was to examine OSCE ratings for evidence of differential rater function over time (DRIFT), and to explore potential causes of DRIFT. We studie...

To determine the long-term effects of curriculum length on physician competence, the authors compared the performance of graduates from the University of Calgary (U of C; a school with a three-year curriculum) with matched samples from the University of Alberta (U of A) and from other Canadian schools with a four-year curriculum. The authors used d...

To develop and psychometrically assess a multiple choice question (MCQ) instrument to test knowledge of depression and its treatments in patients suffering from depression. A total of 63 depressed patients and twelve psychiatric experts participated. Based on empirical evidence from an extensive review, theoretical knowledge and in consultations wi...

In this article, we provide an introduction to and overview of issues of validity, reliability, and defensibility related to measurement of student performance in veterinary medical education. Validity has to do with the extent to which the instrument measures whatever it is supposed to measure, reliability has to do with the consistency of measure...

There is increasing interest in ensuring that physicians demonstrate the full range of Accreditation Council for Graduate Medical Education competencies. To determine whether it is possible to develop a feasible and reliable multisource feedback instrument for pathologists and laboratory medicine physicians. Surveys with 39, 30, and 22 items were d...

Context.—There is increasing interest in ensuring that physicians demonstrate the full range of Accreditation Council for Graduate Medical Education competencies. Objective.—To determine whether it is possible to develop a feasible and reliable multisource feedback instrument for pathologists and laboratory medicine physicians. Design.—Surveys with...

US medical school curricula continually undergo reform. The effect of formal curricular approaches (course organization and pedagogical techniques) on competence in medicine as measured by the United States Medical Licensing Examinations (USMLE) Step 1, 2, and 3 is not fully understood. The purpose of this study was to investigate the effects of fo...

Communication skills are essential for physicians to practice Medicine. Evidence for the validity and domain specificity of communication skills in physicians is equivocal and requires further research. This research was conducted to adduce evidence for content and context specificity of communication skills and to assess the usefulness of a generi...

Many people are afflicted with chronic diseases, in which nutrition plays a key role. The need for greater nutrition training among physicians, particularly gastroenterologists, is becoming increasingly evident. To determine the nutritional knowledge and perceived nutrition knowledge of gastroenterology fellows. Thirty-two gastrointestinal (GI) fel...

The admissions interview still remains the most common approach used to describe candidates' noncognitive attributes for medical school. In this prospective study, we have investigated the predictive validity of a semi-structured interview for admissions to medical school based on medical judgment vignettes: (1) ethical decision-making (moral), (2)...

As society's expectations of physicians change, so must the objectives of training. Professional organizations involved in training now emphasize multiplicity of roles. But how well do we evaluate these multiple roles? Aims: To investigate the principal components of evaluation in the Internal Medicine clerkship rotation at the University of Calgar...

Multi-source feedback (MSF) enables performance data to be provided to doctors from patients, co-workers and medical colleagues. This study examined the evidence for the validity of MSF instruments for general practice, investigated changes in performance for doctors who participated twice, 5 years apart, and determined the association between chan...

The University of Calgary offers a palliative care course that involves both classroom- and web-based learning for rural-based family medicine residents. This study assessed the impact of the course on palliative care-related competencies for two classes: 2004 and 2005. Instruments were developed to evaluate pre- versus post-course changes in knowl...

To assess the feasibility and evidence for the reliability and validity of a set of questionnaires for psychiatrists, given that multisource feedback (MSF) or 360 degrees evaluation allows medical colleagues, coworkers, and patients to provide feedback about competencies to enhance physician improvement in intended directions. Surveys with 40, 22,...

The authors studied a representative Canadian cohort from the National Longitudinal Study of Children and Youth at 3 points in time, when the participants were aged 10-11 years (n = 2,147), 12-13 years (n = 1,976), and 14-15 years (n = 1,762). The presence of parent-related adversity appeared detrimental to young people's emotional and behavioral c...

To determine whether it is possible to develop a feasible, valid, and reliable multisource feedback program for radiologists. Materials and Surveys with 38, 29, and 20 items were developed to assess individual radiologists by eight radiologic colleagues (peers), eight referring physicians, and eight co-workers (eg, technicians), respectively, by us...

To develop and test a latent variable path model of general achievement, aptitude for medicine and competence in medicine employing data from the Medical College Admission Test (MCAT), pre-medical undergraduate grade point average (UGPA) and demographic characteristics for competence in pre-clinical and measures of competence (United States Licensu...