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Glossary of Medical Terms
Reflective Learning Process
An important model of learning that is based on the principle of gaining from the learner's own experience; this is significantly different from the traditional model of undergraduate medical education. It has very clear links with the model of self-directed learning based on a portfolio which gives evidence of activity, reflection and the outcomes of learning. Students use their knowledge, skills and attitudes to solve problems in the workplace. However, many problems are ambiguous and create surprises. Recognition of these surprises causes the student to review problems and create alternative hypotheses, which is termed "reflection in action". This leads to a search for more information, seeking help from colleagues or experts, reading texts or searching on-line to solve the problem. In order to turn the new information into new learning, a further step is required, which takes place after the problem has been solved: Reflecting on action' involves looking back critically over the initial 'surprise' and the resolution of the problem. The process of reviewing and evaluating information leads to learning and this in turn adds to expertise. The process of learning itself tends to generate new questions and motivates the professional to undertake further inquiry, which results in the learning process being determined more by the learner than by the person who designed the activity. This process of reflection provides a stimulus for learning and helps learners to derive maximum benefit from their own experiences.
Trust in the accuracy or provision of one's results; in the case of tests, it is an expression of the precision, consistency and reproducibility of measurements. Ideally, measurements should be the same when repeated by the same person or made by different assessors. In tests, contributing factors to reliability are the consistency of marking, the quality of test and test items, and the type and size of the sample. Satisfactory reliability of objective tests can be achieved by having large numbers of well-constructed test items marked by computer. Reliability is characterized by the stability, equivalence, and homogeneity of test.
Stability or test-retest reliability is the degree to which the same test produces the same results when repeated under the same conditions;
Equivalence or alternate-form reliability is the degree to which alternate forms of the same measurement instrument produce the same result
Homogeneity is the extent to which various items legitimately team together to measure a single characteristic, such as a desired attitude.
In a clinical examination, obtaining
reliability depends on three variables: the students, the examiners and
the patients. Such complexity makes it difficult to reproduce a comparable
situation for tests of clinical skill and clinical problem-solving. In a
reliable assessment procedure, the variability due to the patient and the
examiner should be removed. Wherever possible, a subjective approach to
marking should be replaced by a more objective one and students should be
tested by a number of examiners. It is important to note that students are
usually examined using different patients, which may enhance the
performance of some students and harm the performance of others.
Therefore, tests which aim to assess clinical skills and clinical
problem-solving have to contain many samples of student performance if
they are to achieve adequate levels of reliability. The development of the
multi-station objective structured clinical examination (OSCE) represents
an effort to do so.
Reproducibility of Assessment
Consistency in producing the same results if a test is repeated is a vital attribute of any test. It is important to know that if the same examinees were given the same test after some time and learned nothing in the interim, the same scores would result. Reproducibility is especially important in making licensure and certification decisions.
Scientific inquiry or an organized quest for new knowledge and better understanding, such as of the natural world or determinants of health and disease. Research can take several forms: empiric (observational), analytic, experimental, theoretical and applied.
The period of training in a specific medical specialty. It occurs after graduation from medical school and its length varies from three to seven years, depending upon the specialty.
Resident or Resident Physician
An individual at any level in a Graduate Medical Education program, including subspecialty programs. Other terms used to refer to these individuals include interns, house officers, house staff, trainees, or fellows. The term "intern" is often used to denote physicians in their first year of training. The term "fellow" is frequently used to denote physicians in subspecialty programs (versus residents in specialty programs) or in Graduate Medical Education programs that are beyond the eligibility requirements for first board certification in the discipline.
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which on the basis of epidemiological evidence is known to be associated with an unfavorable health-related condition and considered important to prevent, if possible. It is used as an indication of increased probability of a specified health outcome such as the occurrence of a disease but is not necessarily a causal factor. The term risk factor is further used to mean a determinant that can be modified by intervention, thereby reducing the probability of occurrence of disease or other specified outcomes.