Designing a search strategy to identify and retrieve articles onevidence-based health care using MEDLINE

Thepractice of evidence-based health care requires that information on methodology be identifiedfrom databases such as MEDLINE. Up until this year there have been no designated medicalsubject headings (MeSH) for evidence-based health care. ‘EVIDENCE-BASEDMEDICINE’ appears as a MeSH term from 1997. The absence of designated MeSH forthis concept prior to 1997 provides a challenge to the searcher. This paper describes the creationof a MEDLINE search strategy to retrieve articles on the methods of evidence-based health carepublished prior to the introduction of the new term, where an optimal combination of free-textand MeSH terms is required to identify relevant material. The study examines both free-text andsubject heading searching and attempts an optimal balance of sensitivity and specificity. It beginsby examining separate free-text and subject heading searches. Sensitivity of the subject headingsearch was 33% and specificity 80%, while the free-text search produced asensitivity of 50% and a specificity of 67%. The final strategy, combining bothapproaches, was more successful with sensitivity reaching between 82 and 90% andspecificity 83%. It is therefore possible to devise a search strategy to retrieve articles on themethods of evidence-based health care with relatively successful rates of sensitivity andspecificity. The limitations of MEDLINE, however, necessitate the use of additional approachesin identifying articles on the methods of evidence-based health care.     

Science at Harvard University, 1846-47: a case study of the character and functions of written documents

This paper explores surviving documentation and what it reveals about the underlying social structure and relations in a historic time and place. The mid-nineteenth century is chosen as a period prior to modern bureaucracies so that documents are not found in defining filing systems. Some six hundred documents are studied individually and characterized collectively. They are examined not to tell a story, however, but for evidence of their creation and maintenance and of their physical types, functional characteristics, and relations between authors and recipients. The study reveals the fruitfulness of such an orientation to documents, which complements traditional historical uses that emphasize document content.     

The relationship between individual instructional characteristics and the overall assessment of teaching effectiveness across different instructional contexts

There is an ongoing debate in the student evaluation of teaching literature about whether an overall rating or factorial dimensions of teaching effectiveness should be used in personnel decisions. Marsh and his colleagues have advocated the use of a weighted average approach to computing overall evaluations. A policy-capturing experiment was carried out where students in three different instructional contexts made overall evaluations of hypothetical instructors based on a manipulation of the teaching factors in Marsh's SEEQ. The results indicated (1) amount learned was consistently the most important factor affecting overall evaluations; (2) course difficulty was consistently the least important factor affecting overall evaluations; and (3) there was a strong similarity among the three groups in the relative importance of the various teaching factors in arriving at an overall evaluation. The implications of this research are discussed, as well as directions for future research.     

Emerging Attributes of Pedagogy and Curriculum for the “New World Order”

This article is a conceptual one designed to start dialogue on educational issues that are unfolding amidst the changes in other sectors of our society such as production, services, and recreation. We first present an overview of the fundamental but profound changes evidenced in our society and then discuss the nature of these changes and their impact on human ability to function effectively within such an environment. In light of the complexities such as uncertainties and dualistic/multiple perspectives and incongruities, we propose that a model for pedagogy and curriculum development should adopt critical thinking as the key attribute—because it has the potential to deliver an education system for the new world order.     

Differential Grading Standards Revisited

The differential grading standards described by Goldman and Widawski (1976) exist in the same magnitude and in roughly the same order a decade later in a different kind of institution. Major fields that attract as majors students who score higher on SATs employ stricter grading standards. These differential grading standards serve to attenuate the correlation between SAT scores and grades, which is, even in highly selective institutions, substantial.     

Factors underlying students' decisions to use mobile devices in clinical settings

University policies prohibiting use of mobile devices by medical students during clinical placements are contradicted by regular use by physicians. Consequently, many students use their mobile devices, which can be beneficial for learning but may put patient privacy at risk. This study explores the reasons underlying students' decisions about using mobile devices in clinical settings. We used a mixed-methods sequential explanatory design involving a questionnaire and focus groups. Qualitative data from the questionnaire and focus groups was analysed through thematic analysis. We found students were aware of the risks mobile devices posed to professionalism and medical practice. Despite prohibitions, many made individual decisions to use mobile devices because the benefits outweighed the risks. These students were influenced by an organised, strategic approach to learning and a motivation to comply with the beliefs and behaviours of their medical teams and conform to physicians' directives in order to participate in their community of practice. Many students appear to be transferring everyday use of mobile devices to clinical settings. There is a need to understand and promote aspects of learning that are enhanced by mobile devices in clinical settings, while articulating clear guidelines and boundaries compatible with the professional behaviour expected of students.