Advances in Medical Education Advances in Medical Education edited by A.l.J.A. Scherpbier C.P.M. van der Vleuten 1.1. Rethans A.F. W. van der Steeg Maastricht University, The Netherlands SPRINGER-SCIENCE+BUSINESS MEDIA, B.V. A C.I.P. Catalogue record for this book is available from the Library of Congress. ISBN 978-94-010-6048-6 ISBN 978-94-011-4886-3 (eBook) DOI 10.1007/978-94-011-4886-3 Printed an acid-free paper AII Rights Reserved © 1997 Springer Science+Business Media Dordrecht Originally published by Kluwer Academic Publishers in 1997 Softcover reprint of the hardcover 1s t edition 1997 No part of the material protected by this copyright notice may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from the copyright owner Preface About 550 registrants from 51 different countries attended the Seventh Ottawa Conference on Medical Education and Assessment in Maastricht. We received 525 abstracts for the conference, divided in thematic poster sessions and platform presentations. Organising the conference was an honour and we tried to meet the high standards of a friendly and relaxed atmosphere which has characterized previous Ottawa conferences. During and after the conference about 250 papers were submitted for publication in the conference proceedings, leaving us little time for a post-conference depression. Despite the large number of papers, the editors have attempted to review and edit the papers as care- fully as possible. Occasionally, however, correspondence exceeded reasonable deadlines, preventing careful editing of a small number of the papers. Although we felt that our editorial task was not quite finished, we nevertheless decided to include these papers. We thank the many authors for their enthusiastic and prompt response to - occasionally tedious - editorial suggestions and requests. We are sure that this collective effort has resulted in a book that will make an important contribution to the field of medical education. The editors want to thank Jocelyn Flippo-Berger whose expertise with desk top publishing and perseverance was a great help. Albert Scherpbier Cees van der Vleuten Jan-Joost Rethans Lideke van der Steeg Maastricht, September 1997 Table of Contents Key-Note Addresses A Student Evaluation of Community Based Education in General Practice S.L. Hartley, J.H.S. Fuller, A. Berlin 49 Assessment Truths that We Hold as Self-Evident and Their Implications Qualitative LEAP Project S.M. Case 2 A. Hatim Ricardo, R.S. Salas-Perea 53 Adult Learning Theory, Prizes and Motivation: The Implementation of a Multi-Institution, Multi- Fundamental Learning Issues T.J. David, L. Patel 7 Disciplinary Project to Develop Community Undergraduate Medical Education Summary of the Conference E.R. McLennan, M. Rickets, S.L. Hartley, K. Hoffmann, G.R. Norman 11 D. Gill, A. Berlin, J.H.S. Fuller 55 The Student as Quality Controller C.J.A.H. Prince, K. Visser 15 Continuing Medical Education Does Clinical Performance Correlate with Physicians' Scores on Written Examinations? Interactive Continuing-Education Sessions: P.G. Ramsey 19 An Effective Way to Change Strategies? E. Crone-Kraaijeveld, L.W.A. van Suijlekom-Smit, H.J. Dolder 60 Strategies for Effecting Change in Teaching Practices: A Review of Current Models Can the Effect of Continuing Medical Education on L.A. Wilkerson, D. Irby 23 Physician Performance Be Measured? A.J. Finestone, R.R. Smedley, A.1. Meyer 63 Aims and Objectives Academic Skills Training for YOl,lng General Practitioners: the New London Academic Training Northerners and Southerners: Two Approaches to Scheme (LATS) G.K. Freeman, F. Smith, J.H.S. Fuller 65 Defining Core Content in Medical Education J.G. Bligh, D.J. Prideaux 32 Attendance at an Academic Meeting: Does It Change Core Clinical Content of Step 2 of the USMLE: Clinical Practice Using Surgery as an Example C.R. Hutchison, M.D. McKee, D. Yoo 68 A.G. Greenburg, S.M. Case, G.S. Golden, D.E. Melnick 34 Increasing Physician Involvement in Cholesterol- Determining Teaching Objectives for the Family Lowering Practices: the Role of Knowledge, Attitudes Medicine Clerkship in Medical School: A National and Perceptions Delphi Survey K.V. Mann, E.A. Lindsay, R.W. Putnam, D.A. Davis 71 U. Milman, M. Alperin, R. van Raalte, S. Reis 37 Continuing Medical Education in University Hospital Core Skills in Administering and Prescribing Drugs Centers Becomes Strategic P.A. O'Neill, T. Dornan 40 C. Segouin, E. Rusch, M. Reninger 75 Cross-Section of the Utrecht Medical Curriculum Continuous Built-in Evaluation of Participants' J.A. Smal 43 Motivation in PME and CME S. Wilm, M. Erbe 78 Community Based Programmes Curriculum Development Community Health Issues of the New PBL Undergraduate Medical Curriculum at the University of Geneva: A Description Design of an Integrative Course and Assessment P. Chastonay, H. Stalder, F. Mottu, A. Rougemont, T. Perneger, Method The CIP (Comprehensive Integrative Puzzle) A. Morabia, P. Huber, N.V. Vu 46 R. Ber 84 iv Advances in Medical Education A Universal Scheme of Analysis of the Educational Examining Examinations Processes and its Application to Health Sciences: Initial Premises and Hypotheses Maintaining and Enhancing Key Decision-Making A. Boczkowski, J.A. Indulski 87 Skills from Graduation into Practice: An Exploratory Study Experience with the Process of Curriculum G. Bordage, C.A. Brailovsky, T. Cohen, G. Page 128 Innovatiori D.A. Cook, A.H. Walji 91 Detection of Gender Differences in High-Stakes Performance SP-Based Examinations in Family Development of a Longitudinal Behavioural Medicine Medicine Continuity Curriculum for Third Year Medical C.A. Brailovsky, P. Grand'Maison, F. Miller, P. Rainsberry 131 Students R.A. Edelstein, V.M. Ranganath 94 Preliminary Descriptive Analyses of the Performance Curriculum Information Management System: of US Citizens Attending Foreign Medical Schools on Structure and Process of Analysis with CATs USMLE Steps 1 and 2 P.K. Fullagar, E.R. Petrusa 97 S.M. Case, D.B. Swanson, D.R. Ripkey, L.T. Bowles, D.E. Melnick 135 Problem-Based Learning: Always Small or Applying Learning Taxonomies to Test Items: Is a Sometimes Large? Fact an Artifact? A.J. Gercama, R.O.B. Gans 101 J.P.w. Cunnington, G.R. Norman, J.M. Blake, W.D. Dauphinee, D.E. Blackmore 139 Developing a Curriculum for Personal and Professional Development The Risks of Thoroughness: Reliability and Validity J. Gordon, S. Dunn 104 of Global Ratings and Checklists in an OSCE J.P.W. Cunnington, A.J. Neville, G.R. Norman 143 A Cross-Cultural Curriculum for Medical Students M. Hanson, M.L. Russell, A. Robb 106 The Impact of Postgraduate Training on an Examination for Medical Licensure Innovations in Medical Education: A Comparison of G.F. Dillon, T.R. Henzel, W.P. Walsh 146 Canadian and European Medical Schools B. Klemenz, D. McSherry 109 A Comparison of Conjoint Analysis with Other Approaches to Model Physician Policies in Scoring The Teaching of Anatomy in the Integrated Medical Complex Performance-Based Assessment Curriculum as Practised at the School of Medical Y.V. Fan, S.G. Clyman, B.E. Clauser, T.W. Piemme, Sciences, Universiti Sains Malaysia L. Chang, J. EI-Bayoumi, G.L. Malakoff 149 M. Othman 111 A Comparison of Diagnostic Pattern Recognition A Patient-Based Workshop in Anatomy for First Year Skills to Performance on a "High Stakes" OSCE Medical Students P.H. Harasym, N.G. Mohtadi, H. Henningsmoen 152 M.C.E.O'Driscoll 114 Knowledge on Skills: What is in the Name? Responses of Female and Male Medical Students to A.W.M. Kramer, J.C.M. Bloem en, J.J.M. Jansen 156 Case-Based Learning Programme in Anatomy P.V. Peplow 118 The Swiss Way to Score Multiple True-False Items: Theoretical and Empirical Evidence The Use of Novel Educational Techniques in the R. Krebs 158 Teaching of Molecular Cell Biology J. Szeberenyi, N. Nusser, G. BoglElri, L. Komaromy, M. Pap, Retention and Forgetting of Biological Facts and A. Sebok, G. Setal6 jr., A. Tigyi 121 Concepts, Learnt for the First Basic Science Exam, over a Two Year Period A New Approach to the Teaching of Clinically R. Krebs, J.J. Guilbert, R. Hofer, R. Bloch 162 Relevant Anatomical Sciences and Compassionate Medicine "Clinical Anatomy - The Structure of the Spatial Abilities and Learning Modes in Anatomy Human Body" Beginners A.H. Walji, D. Begg, G. Buzzell, B. Stevenson 124 M. Lischka, G. Gittler 166 Examiner Differences in the Mini-CEX J.J. Norcini, L.L. Blank, G.K. Arnold, H.R. Kimball 170 Repeated Assessment of Medical Knowledge During the Two Years of Clerkships M.J. Quaak, JA Smal 173 Table of Contents v Performance of Examinees from Foreign Schools on A Qualitative Study of Faculty Techniques for Giving the Clinical Science Component of the United States Feedback to Interns Following an Observed Medical Licensing Examination Standardized Patient Encounter D.R. Ripkey, S.M. Case, D.B. Swanson, D.E. Melnick, A.w. Frye, M.A. Hollingsworth, A. Wymer, A. Hinds 216 L.T. Bowles, N.E. Gary 175 Improving Clinical Teaching Skills Using Interaction Item Analysis in Clinical Encounter Scoring Analysis J. Roma, R. Gispert 179 J.H. George 220 The Use of Global Ratings in OSCE Station Scores Assessment of Needs and Perceived Competence of A.I. Rothman, D.E. Blackmore, W.D. Dauphinee, R.K. Reznick 181 Novice Clinical Teachers D. Gill, M. Rickets, E.R. McLennan 223 An Investigation of the Properties of Computer- Based Case Simulations Multiple Station Exams and Teaching Exercises J.D. Scheuneman, S.G. Clyman, Y.V. Fan 184 (MSEs) for Teaching about Teaching E. Krajic Kachur 226 Performance of Examinees from Foreign Schools on the Basic Science Component of United States Development of a Medical Education Journal Club Medical Licensing Examination E. Krajic Kachur 228 D.B. Swanson, S.M. Case, D.R. Ripkey, D.E. Melnick, L.T. Bowles, N.E. Gary 187 Assessing the Implementation of Teaching Portfolios in the Academic Medical Center Analysis of the Use of Global Ratings by L.S. Lee, R.C. Froh, E.R. Petrusa 231 Standardized Patients and Physicians M. Tann, G.E. Amiel, A. Bitterman, R. Ber, R. Cohen 191 Faculty Development and Primary Health Care Education in China Comparing Reliabilities of True/False and Short- H. Liu, D.H. Zhou, D.L. Fink, J.E. Rodnick, H.Z. Yuan, Answer Questions in Written Problem Solving Tests K. Lin, L.Y. Wang, F. Lu, A.I. Sutnick 234 Th.J. ten Cate 193 Long-Term Impact of Faculty Development Overcoming Difficulties in the Introduction of a Workshops: A Pilot Study Summative Assessment of Clinical Competence in a L. Nasmith, A. Saroyan, Y. Steinert, N. Daigle, E.D. Franco 237 Brazilian Medical School L.EA Troncori, M.L.V. Rodrigues, C.E. Piccinato, Tutor Training for Problem-Based Learning: J.F.C. Figueiredo, L.C. Peres, A.R.L. Cianflone 197 The Experience of a Large Medical School D.A. Price 241 Medical Student Perceptions of the Accuracy of Various New Clinical Evaluation Methods Planning Frameworks and Staff Participation: R.P. Usatine, R.A. Edelstein, A. Yajima, S.J. Slavin, M.S. Wilkes 200 Changing to a Graduate Entry, Problem-Based Medical Course D.J. Prideaux 244 Faculty Development Determining the Change in Staff Attitudes during Training in Preparation for Radical Change from a Re-engineering the Specialty Consult Paradigm: Traditional Curriculum to Problem-Based Learning Extending the Generalist and Maximizing the D.C.M. Taylor, E.A. Jump 247 Specialist Through Educational Reform B.A. Chernof, J.J. Guterman, M. Heckman, A Prospective Analysis Instrument for a Medical M. Esquivel, C.S. Hodgson 204 Education Centre Y. Urdaneta 249 Developing Staff: Developing Stations A Dental Objective Structured Clinical Examination (OSCE) Activity Day Family Medicine J.E.C. Davis, H. Fry, A. Jones 207 The Training and Education of Osteopathic A Treasure Discovered by Dutch Students in Practitioners to Become External Examiners in Canada; Results of a Student Exchange Program in Clinical Competence Family Medicine D.R. Edwards 210 R.J.M. Boot, S.E.M. Houben, M. Wijma, G.J. Dinant 252 Educational Training of Medical Teachers: Recent The Family Medicine Clerkship: Comparison of Two Developments in the Netherlands Programs in Different Continents C.R.M.G. Fluit, A.J.J.A. Scherpbier, J.C.M. Metz 213 R.J.M. Boot, M. Tarrant, J.M.H. Op 't Root 256 vi Advances in Medical Education Defensibility of Competency Assessments of Is There a Difference in the Clinical Experience of Practising Family Physicians Students with Diverse Career Interests? J.P.w. Cunnington, E. Hanna, J. Turnbull, T. Kaigas, G.R. Norman 259 A Comparison Study within a Family Medicine Clerkship Innovations in Physician Performance M. Tarrant, W. Woloschuk, H. Mandin 302 Enhancement-Communication Skills T. De Cloedt, G. Schnabl 263 Use of Immediate Video Debriefing During Practice Teaching Visits Training of GP Trainers in Flanders (Belgium) CA Thompson 305 A.G.M. Derese, D.R. Leroy 265 Gaining an Appreciation of Differing Ethnic Influences on General Practice in Western Australia How Students Learn from Ambulatory Preceptors: C.A. Thompson, Training Program, RACGP 308 Critical Incidents R.M. Epstein, D. Cole, B. Gawinski, N. Ruddy, S. Lee 268 Final-Year Students' Experiential Learnings in Family Medicine at the University of Cape Town Alternative Routes to Vocational Training for General D. Whittaker 311 Practitioners in Australia G. Holsgrove, B. Jolly, A. Jones, L. Southgate 272 Perceived Learning Opportunities: Students' Expectations of a Family Medicine Clerkship A Tool for Assessing the Readiness of Family W. Woloschuk, M. Tarrant, H. Mandin 313 Physician Practices to Adopt Prevention Strategies PA Jennett, K. Premkumar, W.R. Elford, L. Meadows, R. Renger 275 Competence of Trainees for GP at the Start of Their Information Technology Training P. Ket, H. DOsman, L.H.C. Tan, E. Schade, R.P.T.M. Grol, Knowledge and Attitudes towards Computers among C.P.M. van der Vleuten 278 Graduates from Developing Countries A.M. Ahmed, G. Guerra, J. Glaconi, F. Piccinno 318 Undergraduate Medical Education in Family Medicine in Slovenia The Effectiveness of Interactive Multimedia as an M. Kolsek 282 Instructional Aid for Learning Basic Clinical Skills and Knowledge Educational Objectives and Requirements of an M. Broudo, M. White, D. Rodenburg, R. Arseneau, A. Chalmers, Undergraduate Clerkship in General Practice: J. Wright, H. Mizgala, D. Lirenman 321 To Which Extent do General Practice Teachers Computer Based Simulations as Adjuncts for Achieve These? Teaching and Evaluating Complex Clinical Skills F.M.J.G. Martens, C.P.M. van der Vleuten, R.P.T.M. Grol, J.M.H. op 't Root, H.F.J.M. Crebolder, J.J. Rethans 284 RA Edelstein, S.G. Clyman 327 On-Line Evaluation of Teaching and Courses: The Comprehensive Assessment Project in The Methods, Practice, and Politics Continuing Medical Education of GPs D.A. Lloyd 330 P. Ram, J.J. Rethans, R.P.T.M. Grol, C.P.M. van der Vleuten 287 Disease-Class Specific, Computer Adaptive Testing Hospital Clinicians and General Practitioners on the World Wide Web Working Together to Teach Medical Students F.J. Papa, D.G. Aldrich, R.C. Stone, R.E. Schumacker 333 M. Rickets, E.R. McLennan, P.G. Kopelman 290 The Effects of Visual Genetics on the Learning of Constructing a Congruent Curriculum for the Students in a Problem Based Curriculum Vocational Training of GPs B. Schutte, T de Goeij, W. de Grave, A.M. Koehorst 336 E. Runia 292 The Internet as a Cross-Disciplinary Learning Improving the Quality of Tutorials in General Practice Environment by Means of Instruction and Quality Assessment M.L. Walker 339 W. Siort, M. de Haan, G. van Staveren, P.L. Schoonheim 295 Teaching Skills for Accessing and Interpreting Evaluation of the Impact of Clinical Skills Teaching Information from Systematic Reviews/Meta- on General Practice analyses, Practice Guidelines, and the Internet JA Spencer, A.L. Robinson, A. Corradine, D.D. Smith 299 F.M. Wolf, J.G. Miller, L.D. Gruppen, W.D. Ensminger 342 Table of Contents vii Innovations in Assessment Medical Students' Ability to Self Assess Knowledge and Skill levels: Findings from One Class of Seniors C. White, J.T. Fitzgerald, W.K. Davis, L.D. Gruppen, Testing Psychiatric Diagnostic Recognition Skills G. Regehr, M.A. McQuillan, M.L. Barclay, T.J. Bergstrom, with Video Vignettes K.R. Chamberlain, A.J. Zweifler 395 J.B. Battles, D.J. Crowder, D.A. Miller, JA Sadler, P.C. Mohl, D.D. Mcintire 348 Clinical Skills Assessment at NEOUCOM: A Description A Method for Developing Interdisciplinary L.F. Wilkinson, L.P. Pethtel 397 Examinations to Test Application of Knowledge by Students in a PBl Curriculum M.G. Camp 351 oseE The Diagnostic Schema Questionnaire: A New Tool to Assess a Specific Dimension of Clinical A Combined Structured Oral Examination (SOE) and Competence OSCE for the Assessment of Clinical Competence B. Charlin, C. Leduc, C.A. Brailovsky, D. Blouin, R. Hivon 354 G.E. Amiel, M. Tann, M. Krausz, A. Bitterman, R. Cohen 402 The Contribution to Final Clinical Competence of An OSCE Trial in Japan: Feasibility and Correlation Preparing and Presenting a Dissertation within an with a Written Test Undergraduate Course in Osteopathy N. Ban, M. Hatao, J. Ohtaki, T. Saito, K. Matsueda, Y. Izumi, D.R. Edwards 357 M. Kusumoto, S. Hosoda 404 The Use of a Neural Net to Reproduce and Assess a OSCE Stations for the longitudinal Assessment of Physician's Clinical Diagnostic Skills Cancer Screening and Detection P.H. Harasym, F.J. Papa, R. Stone, D. Aldrich 359 J.B. Battles, S.J. Sprankell, L. Baker, M. Becker, G. Camp, C. Browne, S. Morell, J.R. Bowling, J. Shores, E. Buck, C.O. Frates, J.B. Green, G. Smith, B.C. Pence, A. Weinberg, Developing Written Assessments for Use in L. Laufman, B.U. Philips 407 Advanced Life Support Courses G. Holsgrove, G. Bowler, M. Elzubeir 363 Assessing the Adequacy of the Post-Encounter Written Scores in Standardized Patient Exams Maintaining Content Validity in Computerized J. Boulet, M. Friedman Ben-David, R. Hambleton, Adaptive Testing W.P. Burdick, A. Ziv 410 R.M. Luecht, A: De Champlain, R.J. Nungester 366 Reproducibility of Emergency Medicine Assessment of Self Directed learning Standardized Patient Cases from Philadelphia to P. McCrorie 370 Barcelona W.P. Burdick, R Pujol-Farriols, J.M. Martinez-Carretero, Developing In-Course and Final Assessments in a R Descarrega, M Friedman Ben-David, J. Boulet 413 New Dental Curriculum c. Mercer, G. Holsgrove 374 Using the Rasch Model to Equate Alternate Forms for Performance Assessments of Physician's Clinical Development of Clinical Reasoning Exercises in a Skills Problem-Based Curriculum B.E. Clauser, L.P. Ross, R.M. Luecht, R.J. Nungester, A.J. Neville, J.P.W. Cunnington, G.R. Norman 377 S.G. Clyman 416 'Disease Class-Specific, Typicality-Graded' Test Regression-Based Weighting of Items on Case Vignettes: Towards 'Construct-Referenced' Standardized Patient Checklists Assessments of Diagnostic Performance B.E. Clauser, M.J. Margolis, L.P. Ross, R.J. Nungester, D.J. Klass 420 F.J. Papa, R.C. Stone, D.G. Aldrich, R.E. Schumacker, P.H. Harasym 380 A large-Scale Study of the Reliabilities of Checklist Scores and Ratings of Components of Interpersonal Fair Reliable Essay Examinations for a Problem and Communication Skills Evaluated on a SP Based Curriculum Examination J.R. Philp, A.W. Frye, L.D. Cariaga-Lo, B. Richards, E. Bradley 383 D.S. Cohen, J.A. Colliver, R.S. Robbs, M.H. Swartz 424 Critical Thinking in Medical School Exams Clinical Assessment in an Academic Environment: T.M. Scott, L.L. Chafe 387 To Do or Not To Do? D.H. Davis, B. Hill 427 The Assessment of Higher level Cognitive Objectives in Undergraduate Medical Students Using Academic Assessment of Clinical Skills Inferences of a Clinical Audit Project Predictive Validity F. Sullivan, J. Morrison 390 D.H. Davis, B. Hill 430 viii Advances in Medical Education The Effect of Formal Feedback Sessions on Test The Comprehensive Objective Examination (COE) Security for a Clinical Practice Examination using D. Massey, L. Papineau 480 Standardized Patients G.E. Furman, J.A. Colliver, A. Galofre, M.A. Reaka, Improving Reliability and Validity of the Clinical R.S. Robbs, A. King 433 Examination for Fellowship of the Royal Australasian College of Physicians The Quebec Licensing OSCE: Modifications and N.S. Paget 482 Improvements over 6 Years of Experience P. Grand'Maison, C.A. Brailovsky, J. Lescop 437 Development of the Catalan OSCE of Internal Medicine Reliability, Number of Stations, and Examination R. Pujol-Farriols, A. Nogueras-Rimblas, M. Vilardell-Tarres, Length in an Objective Structured Clinical C. Blay-Pueyo, J. Roma-Millan, J.M. Martinez-Carretero 485 Examination L.D. Gruppen, W.K. Davis, J.T. Fitzgerald, M.A. McQuillan 441 Using Peer Comparisons to Evaluate Combined Residency Training in Pediatrics, Psychiatry, and Construct Validity of "High Stakes" OSCE Scores Child and Adolescent Psychiatry P.H. Harasym, N.G. Mohtadi, H. Henningsmoen 443 J. Schowalter, C.P. Friedman, S.C. Scheiber, D. Juul 488 OSCA: Assessing to Unite Theory and Practice The Relationship Between Age of Candidates and J.M. Kelly 446 Performance in the FRACGP Examination N.A. Spike, P.C. Veitch 490 An Evaluation of OSCEs for Final-year Students E.M. Long, J.A. Martin 448 Remediation for the Intern with Deficiencies in Clinical Competence Implementing a Multiple Station Clinical S. Willcock, J. Gordon 494 Examination: An International Collaboration J.M. Martinez-Carretero, J. Roma-Millan, R. Pujol-Farriols, C. Blay-Pueyo, A. Nogueras-Rimblas, C.A. Brailovsky, P. Grand'Maison 452 Problem Based Learning Clinical Skills Assessment (CSA) in Undergraduate The New Preclinical Medical Curriculum at the Medical Education in Catalonia, 1995 J.M. Martinez-Carretero, F. Borrell-Carri6, C. Blay-Pueyo, University of Geneva: Processes of Selecting Basic J. Roma-Millan, R. Pujol-Farriols, J.M. Gomez-Saez, Medical Concepts and Problems for the PBL L. Masana-Marin, J. Sanchis-Aldas 454 Learning Units A. Baroffio, J.P. Giacobino, B. Vermeulen, N.V. Vu 498 An OSCE for Licensure: The Canadian Experience R.K. Reznick, D.E. Blackmore, W.D. Dauphinee, S.M. Smee, Implementation of an Integrated Educational A.1. Rothman 458 Curriculum at the Medical Faculty of Lausanne R. Bonvin, B. Waeber, C. Perret, J.P. Wauters 501 Preparing PhYSician Examiners for a High Stakes, MUlti-Site OSCE An Introduction of Certain Basic Principles in S.M. Smee, D.E. Blackmore 462 Kinesiology: Incorporation into a Problem-Based Setup M. Chakravarty, F.N.L. Engmann 503 Postgraduate Training and Assessment The Rome Parallel Track (CPR) M. Fioravanti, P. Gazzaniga, A. Marcheggiano, J. Osborn, A Self-Assessment Study of Competency Levels in T. Renda, A. Torsoli, V. Ziparo and CPR Group 506 the Postgraduate School of Public Health A. Boczkowski 466 Macroanalysis of Integration of the Basic Sciences in a Problem-Based Learning Curriculum An Innovative CME Cardiology Program for General P.G. latridls, W.M. Anderson, D. Gupta, N.W. Hudson, Practitioners v. Hoftiezer, P. Bankston, J.C. Vanden Berge, S.F. Echtenkamp, D. Feldman, J. Sirkin, M.K. O'Brien, D. Cohen, D.H. Novack 470 B.G. Kennedy, S.P. Sivam, C.F. Marfurt, R. Dziarski, W. Baldwin, S.D. Vaughn 509 Assessment of Junior Doctors' Clinical Competence: A Feedback Loop The Source of Final Exams (Internal versus External) J. Gordon, I. Rolfe, S. Pearson, S. Willcock 474 and their Impact on Learning in Biochemistry in a PBL Curriculum Can You Teach an Old Doc New Tricks? P.G. latridis, S.D. Vaughn, W.M. Anderson, D. Gupta, E. Hanna, J. Premi, J. Turnbull 477 N.W. Hudson 513