Context, Conflict, and Management: The Assessment of Professionalism

In recent years, with the advent of competency-based medical school and residency curricula, there has been much more attention focused on the teaching and assessment of professionalism. Professionalism as a competency is considered paramount because of the trust that the public places in physicians. This construct has evolved over time from being value-based, to being behavioral-based, and is now also considered an important aspect of professional identity formation. The assessment of professionalism has also evolved with the development of newer and more innovative ways of ascertaining the professionalism of a physician. Modern assessments of professionalism are able to take into account the context, conflict in values, and techniques used to resolve the professional dilemma. This thesis is a compilation of research studies that were designed to gather validity evidence for the assessment of professionalism in a residency admissions process. The purpose of this work is to determine if it is possible to screen residency applicants for professionalism deficiencies in order to ensure that those applicants that are ultimately chosen are a good fit for the residency program and will ultimately become high quality pediatricians. </p

La fiabilité et validité du processus de sélection des internes en pédiatrie en relation avec l'évaluation du professionnalisme

La sélection des internes en formation post-graduée est un processus dont l'enjeu est élevé et qui exige une approche rigoureuse pour être fiable et valide. Dans cette thèse, le processus actuel de sélection des internes pour le Programme de Formation Post-Graduée à l'Hôpital des Enfants des Hôpitaux Universitaires de Genève (HUG) est analysé en le comparant aux méthodes d'évaluation les plus modernes de sélection des post-gradués. Le processus de transformation systématique de la sélection des internes de Genève par rapport aux cadres conceptuels de sélection et de professionnalisme est décrit. Les résultats obtenus sur la fiabilité et la validité de la nouvelle procédure sont présentés. En particulier, l'analyse de l'intégration de l'Exercice de mini-évaluation du professionnalisme, fondée sur la théorie de la généralisation, sera incluse

Case report : uncommon cause of limp in the 21st century

Scurvy results from a deficiency of ascorbic acid. This disease first appeared in children during the 19th century with the emergence of new dietary habits; in particular, heating milk that leads to a loss of ascorbic acid. Even though scurvy has become a rare condition in western countries, many cases are still reported in pediatric patients, especially in those who lack proper nutrition due to neurological or psychiatric illnesses. Symptoms include bleeding and swollen gums, loosening of teeth, bone abnormalities, arthralgia, delayed wound healing, anemia, petechiae, and purpura. Bone lesions are mainly irregularities of long bones metaphyses. We report the case of a five-year-old boy who presented with arthralgia and limb deformation (genu valgum). The patient was investigated for vitamin deficiencies to exclude rickets. The radiologic investigations revealed metaphyseal signs compatible with scurvy. During the hospitalization, the patient was observed to have abnormal eating patterns and the scurvy was attributed to malnutrition. Although the occurrence of scurvy is rare, it remains essential to detect this disease in children at risk of developing vitamin deficiencies. Without targeted treatment, the complications of scurvy can be serious and potentially fatal

Population based age stratified morbidities of premature infants in Switzerland

To provide population-based, gestational age (GA) stratified incidence of mortality and morbidities

Validity Evidence of A Screening Tool for Early Detection of Clinical Crisis-Related Anxiety Amongst Medical Students

Construct: Psychological distress among students is a growing concern in medical education, even more so with the advent of COVID-19 pandemic. Anxiety is among students’ mental health issues. High and persistent anxiety has many negative impacts on students’ academic and personal life. Early detection is essential for timely intervention. Background: Currently, medical student anxiety is assessed using tools primarily designed for psychiatric purposes. Despite their excellent validity evidence, these tools contain sensitive items and do not explore stressors related to clinical activities. There is a need for contextualized tools to better identify anxiety-provoking factors specific to the medical education environment. Approach: We previously developed the Crisis Experience Rating Scale (CERS-7), a short screening tool to identify early on anxious students participating in clinical activities during the first wave of the COVID-19 pandemic. The present study sought to produce further validity evidence for the CERS-7. Medical students in their clinical years at two Swiss and one French medical school, all involved in COVID-19 clinical activity during the second wave of the pandemic, completed the CERS-7 and the State Anxiety Inventory (STAI-A), the best known and widely used tool to measure for general anxiety. We evaluated internal structure using confirmatory factor analysis (CFA) and relation to other variables using linear regression (LR) and receiver operating characteristic (ROC) curves with thresholds defined using the Youden index. Findings: There were 372 participants. CFA confirmed the two-factor structure of the CERS-7 scale from first-wave dataset. The CERS-7 total scale and subscales demonstrated validity evidence in relationship to the STAI-A scores and categories. A CERS-7 total scale score &lt; 27.5 identified 93% of severely anxious students. Conclusion: The CERS-7 produces reliable scores to use for monitoring anxiety status when assigning students to clinical settings as well as for improving training conditions during clinical crisis.</p

Motivational factors influencing student intentions to practise in underserved areas

Exploring student intentions to practise in underserved areas (UAs) is necessary to inform the planning and training of the future medical workforce in order to increase effectiveness and fulfil societal needs. However, little is known about the motivational factors influencing these intentions. This paper explores medical students' intentions to practise in UAs and the motivational factors predicting these intentions