Do coursework summative assessments predict clinical performance? A systematic review

BACKGROUND: Two goals of summative assessment in health profession education programs are to ensure the robustness of high stakes decisions such as progression and licensing, and predict future performance. This systematic and critical review aims to investigate the ability of specific modes of summative assessment to predict the clinical performance of health profession education students. METHODS: PubMed, CINAHL, SPORTDiscus, ERIC and EMBASE databases were searched using key terms with articles collected subjected to dedicated inclusion criteria. Rigorous exclusion criteria were applied to ensure a consistent interpretation of ‘summative assessment’ and ‘clinical performance’. Data were extracted using a pre-determined format and papers were critically appraised by two independent reviewers using a modified Downs and Black checklist with level of agreement between reviewers determined through a Kappa analysis. RESULTS: Of the 4783 studies retrieved from the search strategy, 18 studies were included in the final review. Twelve were from the medical profession and there was one from each of physiotherapy, pharmacy, dietetics, speech pathology, dentistry and dental hygiene. Objective Structured Clinical Examinations featured in 15 papers, written assessments in four and problem based learning evaluations, case based learning evaluations and student portfolios each featured in one paper. Sixteen different measures of clinical performance were used. Two papers were identified as ‘poor’ quality and the remainder categorised as ‘fair’ with an almost perfect (k = 0.852) level of agreement between raters. Objective Structured Clinical Examination scores accounted for 1.4–39.7% of the variance in student performance; multiple choice/extended matching questions and short answer written examinations accounted for 3.2–29.2%; problem based or case based learning evaluations accounted for 4.4–16.6%; and student portfolios accounted for 12.1%. CONCLUSIONS: Objective structured clinical examinations and written examinations consisting of multiple choice/extended matching questions and short answer questions do have significant relationships with the clinical performance of health professional students. However, caution should be applied if using these assessments as predictive measures for clinical performance due to a small body of evidence and large variations in the predictive strength of the relationships identified. Based on the current evidence, the Objective Structured Clinical Examination may be the most appropriate summative assessment for educators to use to identify students that may be at risk of poor performance in a clinical workplace environment. Further research on this topic is needed to improve the strength of the predictive relationship. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12909-017-0878-3) contains supplementary material, which is available to authorized users

Water Quality Trading and Offset Initiatives in the U.S.: A Comprehensive Survey

This document summarizes water quality trading and offset initiatives in the United States, including state-wide policies and recent proposals. The following format was used to present information on each program. We attempted to have each program summary reviewed by at least one contact person for program accuracy. In the cases where this review occurred, we added the statement "Reviewed by.." at the end of the case summary

Effectiveness of Yoga for Hypertension: Systematic Review and Meta-Analysis

Objectives. To systematically review and meta-analyze the effectiveness of yoga for reducing blood pressure in adults with hypertension and to assess the modifying influences of type and length of yoga intervention and type of comparison group. Methods. Academic Search Premier, AltHealthWatch, BIOSIS/Biological Abstracts, CINAHL, Cochrane Library, Embase, MEDLINE, PsycINFO, PsycARTICLES, Natural Standard, and Web of Science databases were screened for controlled studies from 1966 to March 2013. Two authors independently assessed risk of bias using the Cochrane Risk of Bias Tool. Results. All 17 studies included in the review had unclear or high risk of bias. Yoga had a modest but significant effect on systolic blood pressure (SBP) (4.17 [6.35, 1.99], ) and diastolic blood pressure (DBP) (3.62 [4.92, 1.60], ). Subgroup analyses demonstrated significant reductions in blood pressure for (1) interventions incorporating 3 basic elements of yoga practice (postures, meditation, and breathing) (SBP: 8.17 mmHg [12.45, 3.89]; DBP: 6.14 mmHg [9.39, 2.89]) but not for more limited yoga interventions; (2) yoga compared to no treatment (SBP: 7.96 mmHg [10.65, 5.27]) but not for exercise. Conclusion. Yoga can be preliminarily recommended as an effective intervention for reducing blood pressure. Additional rigorous controlled trials are warranted to further investigate the potential benefits of yoga

The importance of adequate referrals for chronic kidney disease

DISCUSSION: Regional Australia remains a district of workforce shortage for nephrology. Thus, it is imperative that patients who have the greatest need for nephrologist services are effectively identified upon referral. The aim of this study was to assess referrals to a regional nephrology service against Australian guidelines by assessing the patient’s renal function and the information contained in the referral document at the time of first consultation. We conducted a retrospective study of all referrals to a regional Australian nephrology service between 2013 and 2015. The 582 referrals that met the inclusion criteria were compared with Australian nephrology referral guidelines. Less than half of the referral documents (n = 253; 43.5%) described a clinical situation that met referral guidelines, typically due to insufficient pathology investigation. However, after consideration of renal functional test results performed at the initial consultation, an additional 82 cases met referral guidelines (n = 335; 57.6%). More than 40% of nephrology referrals to a regional Australian service did not meet Australian nephrology referral guidelines. This has implications for a regional nephrology service that is experiencing workforce pressures, in addition to the health system more broadly, and for patients. Many referrals contained insufficient information to allow differentiation of patients who would benefit most from nephrology care from patients who could be appropriately managed within primary care

First Records of the Adventive Pseudoanthidium nanum (Mocsáry) (Hymenoptera: Megachilidae) in Illinois and Minnesota, with Notes on its Identification and Taxonomy

We report the first records of Pseudoanthidium nanum (Mocsáry) in Illinois and Minnesota in 2016 and 2018, respectively. This represents a relatively rapid expansion since P. nanum was first detected in New Jersey in 2008. In order to help monitor the spread of this bee, we provide information on how to identify P. nanum and provide images of the general habitus, diagnostic features, and male genitalia. Finally, we confirm the taxonomic identity of P. nanum in the United States and highlight potential impacts on native anthidiines