Measuring Integrity for Selection into Medical School : Development of a Situational Judgement Test

This thesis examines the use of a Situational Judgement Test (SJT) for the selection into medical school based on the noncognitive attribute of integrity. Specifically, this thesis describes five studies that investigate how several test characteristics influence a number of quality criteria of an SJT in measuring integrity among medical school applicants

Integrity situational judgement test for medical school selection

Context: Despite their widespread use in medical school selection, there remains a lack of clarity on exactly what situational judgement tests (SJTs) measure. Objectives: We aimed to develop an SJT that measures integrity by combining critical incident interviews (inductive approach) with an innovative deductive approach. The deductive approach guided the development of the SJT according to two established theoretical models, of which one was positively related to integrity (honesty–humility [HH]) and one was negatively related to integrity (cognitive distortions [CD]). The Integrity SJT covered desirable (HH-based) and undesirable (CD-based) response options. We examined the convergent and discriminant validity of the Integrity SJT and compared the validity of the HH-based and CD-based subscores. Methods: The Integrity SJT was administered to 402 prospective applicants at a Dutch medical school. The Integrity SJT consisted of 57 scenarios, each followed by four response options, of which two represented HH facets and two represented CD categories. Three SJT scores were computed, including a total, an HH-based and a CD-based score. The validity of these scores was examined according to their relationships with external integrity-related measures (convergent validity) and self-efficacy (discriminant validity). Results: The three SJT scores correlated significantly with all integrity-related measures and not with self-efficacy, indicating convergent and discriminant validity. In addition, the CD-based SJT score correlated significantly more strongly than the HH-based SJT score with two of the four integrity-related measures. Conclusions: An SJT that assesses the ability to correctly recognise CD-based response options as inappropriate (i.e. what one should not do) seems to have stronger convergent validity than an SJT that assesses the ability to correctly recognise HH-based response options as appropriate (i.e. what one should do). This finding might be explained by the larger consensus on what is considered inappropriate than on what is considered appropriate in a challenging situation. It may be promising to focus an SJT on the ability to recognise what one should not do

Social competence at the playground: Preschoolers during recess

Social interactions at the playground have been represented as a rich learning opportunity to hone and master social skills at pre- school years. Specifically, all forms of social play (fantasy, role, ex- ercise or rough-and-tumble) have been related to children’s social competence. The main goal of this study was to examine whether it is a certain kind of social play which facilitates the development of social competence, or if it is just the opportunity for interacting during recess that provides children with an optimal environment for social learning. A total of 73 preschoolers (4–6 years old) were videotaped at the school’s playground. Teachers provided assess- ments of children’s social competence. Children’s interactions at the playground were assessed through an innovative measuring method, based on radio-frequency identification devices. The results showed a positive association between exercise play and children’s social competence. In contrast with the literature, both forms of pretend play, fantasy and role play were unrelated to children’s social competence. Smaller peer groups and longer interactions also demonstrated a positive association with these preschoolers’ social competence. The study shows the importance of outdoor physical play for preschoolers’ social success. More- over, the study suggests that the environment in which children play has an important effect on the adaptive nature of their play

MUM effect in medical education: taking into account the recipient and training setting

진남포 전경. 평양 모란대 “Town of Chinnampo. Botandai, Heijyo”. This image is posted publicly for non-profit educational use, excluding print publication. For additional information, please see http://digital.lafayette.edu/copyright for our Reproduction, Use, and Copyright Guidelines. Banque d’images : East Asia Image collection (EAIC)   The East Asia Image Collection is an open-access archive of digitized photographs, negatives, postcards, and slides of imperial Japan (1868-1945), its Asian empire (18..

Influence of response instructions and response format on applicant perceptions of a Situational Judgement Test for medical school selection

BACKGROUND: This study examined the influence of two Situational Judgement Test (SJT) design features (response instructions and response format) on applicant perceptions. Additionally, we investigated demographic subgroup differences in applicant perceptions of an SJT. METHODS: Medical school applicants (N = 372) responded to an online survey on applicant perceptions, including a description and two example items of an SJT. Respondents randomly received one of four SJT versions (should do-rating, should do-pick-one, would do-rating, would do-pick-one). They rated overall favourability and items on four procedural justice factors (face validity, applicant differentiation, study relatedness and chance to perform) and ease-of-cheating. Additionally, applicant perceptions were compared for subgroups based on gender, ethnic background and first-generation university status. RESULTS: Applicants rated would-do instructions as easier to cheat than should-do instructions. Rating formats received more favourable judgements than pick-one formats on applicant differentiation, study-relatedness, chance to perform and ease of cheating. No significant main effect for demographic subgroup on applicant perceptions was found, but significant interaction effects showed that certain subgroups might have more pronounced preferences for certain SJT design features. Specifically, ethnic minority applicants - but not ethnic majority applicants - showed greater preference for should-do than would-do instructions. Additionally, first-generation university students - but not non-first-generation university students - were more favourable of rating formats than of pick-one formats. CONCLUSIONS: Findings indicate that changing SJT design features may positively affect applicant perceptions by promoting procedural justice factors and reducing perceived ease of cheating and that response instructions and response format can increase the attractiveness of SJTs for minority applicants

Clear cell chondrosarcoma in Von Hippel-Lindau disease

A diagnosis of clear cell chondrosarcoma of the ulna was made in a patient with Von Hippel-Lindau disease (VHL). After surgery, genetic analysis of the tumor tissue showed loss of heterozygosity at the VHL gene locus. Immunohistochemical analysis confirmed loss of expression of the VHL protein in the tumor cells. In addition, abundant Cyclin D1 expression in the tumor was observed. Chondrosarcoma has been described before in a VHL patient and VHL protein expression has been correlated to tumor grade in a series of sporadic chondrosarcomas. In this report, we show that clear cell chondrosarcoma may be a rare but canonical VHL manifestation through a cell-autonomous mechanism involving somatic loss-of-heterozygosity of the VHL tumor suppressor gene. We discuss the relevance of this observation with regard to the pathogenesis of clear cell chondrosarcoma in the context of VHL

Formalin-Fixed, Paraffin-Embedded–Targeted Locus Capture:A Next-Generation Sequencing Technology for Accurate DNA-Based Gene Fusion Detection in Bone and Soft Tissue Tumors

Chromosomal rearrangements are important drivers in cancer, and their robust detection is essential for diagnosis, prognosis, and treatment selection, particularly for bone and soft tissue tumors. Current diagnostic methods are hindered by limitations, including difficulties with multiplexing targets and poor quality of RNA. A novel targeted DNA-based next-generation sequencing method, formalin-fixed, paraffin-embedded–targeted locus capture (FFPE-TLC), has shown advantages over current diagnostic methods when applied on FFPE lymphomas, including the ability to detect novel rearrangements. We evaluated the utility of FFPE-TLC in bone and soft tissue tumor diagnostics. FFPE-TLC sequencing was successfully applied on noncalcified and decalcified FFPE samples (n = 44) and control samples (n = 19). In total, 58 rearrangements were identified in 40 FFPE tumor samples, including three previously negative samples, and none was identified in the FFPE control samples. In all five discordant cases, FFPE-TLC could identify gene fusions where other methods had failed due to either detection limits or poor sample quality. FFPE-TLC achieved a high specificity and sensitivity (no false positives and negatives). These results indicate that FFPE-TLC is applicable in cancer diagnostics to simultaneously analyze many genes for their involvement in gene fusions. Similar to the observation in lymphomas, FFPE-TLC is a good DNA-based alternative to the conventional methods for detection of rearrangements in bone and soft tissue tumors.</p

Nodular Fasciitis With Malignant Morphology and a COL6A2-USP6 Fusion: A Case Report (of a 10-Year-old Boy)

Nodular fasciitis is usually a benign lesion genetically characterized by ubiquitin-specific protease 6 (USP6) rearrangements. We present a case of a 10-year-old boy with a 1.5-week history of a painless mass on the right chest wall, which was excised. A histomorphologically malignant tumor with pronounced pleomorphism, atypical mitotic figures, and a myoid immunophenotype was observed. The methylation profile was consistent with nodular fasciitis and fluorescence in situ hybridization confirmed USP6 rearrangement. Using Archer Fusion Plex (Sarcoma Panel) and RNA sequencing, a collagen, type VI, alpha 2 (COL6A2)-USP6 gene fusion was subsequently identified. Furthermore, DNA clustering analysis also showed a match with nodular fasciitis. During the follow-up of 22 months, no recurrence or metastasis occurred. In conclusion, we describe a clinically benign, histomorphologically malignant mesenchymal neoplasm with a myoid immunophenotype, and a genetic and epigenetic profile consistent with nodular fasciitis. In such cases, molecular analysis is a useful adjunct to avoid unnecessary overtreatment