bluuebunny/crossref_metadata_2025 huggingface dataset:
A "Unisex" Occupational Scale for the Strong- Campbell Interest Inventory
Authors: Johnson Richard W.
Published: March 2007

Previous research has shown that the female Pharmacist scale on the Strong-Campbell Interest Inventory (SCII) was more valid than the male Pharmacist scale for both male and female college students. The female scale was not as valid for men as it was for women, however, because of the sex differences reflected in its item content. In an attempt to develop a "unisex" occupational scale which would be equally effective for men and women, all items which differentiated between males and females by 10 percentage points or more were eliminated from the female scale. The re maining items (20 of 39 original items) formed a short unisex scale that was nearly as reliable and valid as the original scale over short time periods. The unisex version did not require separate norms or different interpretations of the scores for men and women. The possibility of constructing an abbreviated form of the SCII that contains only sex-balanced items merits further consideration.
Test Length and Validity
Authors: Bell Richard , Lumsden James
Published: March 2007

The effect of test length on predictive validity is examined empirically by successively omitting the poorest items and by calculating the correlations between the reduced test scores and the criterion. It was found, for four tests, that the curve of validity against test length had a very gentle slope for the longer tests and that all tests could be reduced by more than 60% without appreciable decreases in validity.
A Regression Solution to the Problem of Criterion Score Comparability
Authors: Pugh William M.
Published: March 2007

When the criterion measure in a study is the accumulation of responses or behaviors for an indi vidual over time, there may be a problem in obtain ing comparable scores if all individuals cannot be observed for the same amount of time. Past solu tions to this problem have included prorating the criterion score and deleting individuals lacking a portion of the criterion information. In the present paper the problem of criterion score comparability is viewed as a missing data problem, and a solution based upon linear regression is proposed. The re gression solution was evaluated by comparing it to the prorating and deletion methods in a monte car lo analysis. The population data were an actual data set collected during a study of illness aboard U.S. Navy ships, and a series of samples were created by randomly deleting individuals' records and portions of records. Results of the analyses suggested that the regression method is more ef ficient than the alternative methods. Application of the regression method and the results obtained to other research settings is discussed.
Using Simulation Results to Choose a Latent Trait Model
Authors: Yen Wendy M.
Published: March 2007

A latent trait model goodness-of-fit statistic was defined, and its relationships to several other com monly used fit statistics were described. Simulation data were used to examine the behavior of these fit statistics under conditions similar to those found with real data. The simulation data were generated for 36 pseudo-items and 1,000 simulees using three-, two-, and one-parameter logistic latent trait models. The data were analyzed using three-, two-, and one-parameter models. Between-model comparisons were made of the fit statistics, trait es timates, and item parameter estimates. The three generating models produced clearly different pat terns of results. The simulation results were com pared to results for real data involving seventh- and eighth-grade students' performance on eight achievement tests. The achievement test results ap peared most similar to the simulation results based on data generated with the three-parameter model. Some practical problems that can result from using an inappropriate model with multiple-choice tests are discussed.
Scaling Interpersonal Checklist Items to a Circular Model
Authors: McCormick Clarence C. , Kavanagh Jack A.
Published: March 2007

The items of the Interpersonal Checklist (ICL) were scaled to a circular model by two different procedures: (1) the items were sorted by two differ ent samples into categories corresponding to the la bels of the eight ICL octants and (2) each item was scaled twice by a third sample, first on the 9-point bipolar scale Hate-Love, and second on the 9-point bipolar scale Dominance-Submissiveness. The two sets of ratings were found to correlate -.09, indicat ing that the two postulated dimensions presumed to underly the circular order are orthogonal. The items were then plotted into the plane formed by using the two scales as axes. The circular scale values calculated for the two sorting procedures correlated .95. The scale values obtained from the sorting procedure and those from the two-dimen sional procedure correlated .89. In general, the plotted items followed a circular order from close synonymity to antonymity and back. Several gaps on the circle were found, indicating an inadequate sampling of items. Scale values were calculated for each of the eight ICL scales using the circular scale values as item weights. When these values were plotted and compared with a factor plot of the eight ICL scales, the plots were remarkably similar. Many items were found to be displaced by the scal ing procedures from the placements given by the authors of the ICL. Most of these displacements were found to be related to an intensity dimension postulated by the authors of the ICL. In general, the mild/moderate items were scaled toward the Love and Dominance poles, and the strong/extreme items were scaled toward the Hate and Submissive poles, thus pulling the items away from the scales they were intended to represent. Some of the major implications of the use of these procedures in the construction of personality instruments are dis cussed.
Factors Defined by Negatively Keyed Items: The Result of Careless Respondents?
Authors: Schmitt Neal , Stuits Daniel M.
Published: March 2007

A frequently occurring phenomenon in factor and cluster analysis of personality or attitude scale items is that all or nearly all questionnaire items that are nega tively keyed will define a single factor. Although sub stantive interpretations of these negative factors are usually attempted, this study demonstrates that the negative factor could be produced by a relatively small portion of the respondents who fail to attend to the negative-positive wording of the items. Data were generated using three different correlation matrices, which demonstrated that regardless of data source, when only 10% of the respondents are careless in this fashion, a clearly definable negative factor is gener ated. Recommendations for instrument development and data editing are presented.
The Difficulty of Test Items That Measure More Than One Ability
Authors: Reckase Mark D.
Published: March 2007

Many test items require more than one ability to obtain a correct response. This article proposes a mul tidimensional index of item difficulty that can be used with items of this type. The proposed index describes multidimensional item difficulty as the direction in the multidimensional space in which the item provides the most information and the distance in that direction to the most informative point. The multidimensional dif ficulty is derived for a particular item response theory model and an example of its application is given using the ACT Mathematics Usage Test.
Grouped Versus Randomized Format: An Investigation of Scale Convergent and Discriminant Validity Using LISREL Confirmatory Factor Analysis
Authors: Schriesheim Chester A. , Solomon Esther , Kopelman Richard E.
Published: March 2007

LISREL maximum likelihood confirmatory factor analyses (Jöreskog & Sörbom, 1984) were conducted to explore the effects of two questionnaire formats (grouping versus randomizing items) on the conver gent and discriminant validity of two sets of question naire measures. The first set of measures consisted of satisfaction scales that had demonstrated acceptable psychometric properties in earlier studies; the second set of scales were job characteristics measures that had shown discriminant validity problems in previous re search. Correlational data were collected from two groups of employed business administration students (N = 80 in each group) concurrently (Study 1) and at two points in time (Study 2). The results of the anal yses showed that the grouped format was superior to the random format, particularly with respect to the weaker measures (the job characteristics scales). The results also illustrated and supported the usefulness of LISREL confirmatory factor analysis in studies of con vergent and discriminant validity. Index terms: con firmatory factor analysis, convergent validity, discrim inant validity, LISREL analysis, questionnaire formats, scale validity.
The Effects of Test Disclosure on Equated Scores and Pass Rates
Authors: Gilmer Jerry S.
Published: March 2007

This paper examines the effects of test item disclo sure on resulting examinee equated scores and popula tion passing rates. The equating model studied was the common-item nonequivalent-populations design under Tucker linear equating procedures. The research in volved simulating disclosure by placing correct an swers of "disclosed" items into response vectors of selected examinees. The degree of exposure the dis closed items received in the population was manipu lated by varying the number of items disclosed and the number of examinee records receiving the correct an swers. Other factors considered among the 10 experi mental conditions included the characteristics of the disclosed items (difficulty of disclosed items and whether they were anchor or nonanchor test items) and the ability level of the subgroup receiving the dis closed items. Results suggest that effects of disclosure depend on the nature of the released items. Specific effects of disclosure on particular examinees are also discussed.
A Comparison of Bivariate Smoothing Methods in Common-Item Equipercentile Equating
Authors: Hanson Bradley A.
Published: March 2007

The effectiveness of smoothing the bivariate distributions of common and noncommon item scores in the frequency estimation method of common-item equipercentile equating was exam ined. The mean squared error of equating was computed for several equating methods and sample sizes, for two sets of population bivariate distribu tions of equating and nonequating item scores defined using data from a professional licensure exam. Eight equating methods were compared: five equipercentile methods and three linear methods. One of the equipercentile methods was unsmoothed equipercentile equating. Four methods of smoothed equipercentile (SEP) equating were con sidered : two based on log-linear models, one based on the four-parameter beta binomial model, and one based on the four-parameter beta compound binomial model. The three linear equating methods were the Tucker method, the Levine Equally Reliable method, and the Levine Unequally Reliable method. The results indicated that smoothed distributions produced more accurate equating functions than the unsmoothed distributions, even for the largest sample size. Tucker linear equating produced more accurate results than SEP equating when the systematic error introduced by assuming a linear equating function was small relative to the random error of the methods of SEP equating.
A Method for Severely Constrained Item Selection in Adaptive Testing
Authors: Stocking Martha L. , Swanson Len
Published: March 2007

Previous attempts at incorporating expert test construction practices into computerized adaptive testing paradigms are described. A new method is presented for incorporating a large number of con straints on adaptive item selection. The meth odology emulates the test construction practices of expert test specialists, which is a necessity if com puterized adaptive testing is to compete with con ventional tests. Two examples—one for a verbal measure and the other for a quantitative measure— are provided of the successful use of the proposed method in designing adaptive tests.
Analysis of Differential Item Functioning in Translated Assessment Instruments
Authors: Budgell Glen R. , Raju Nambury S. , Quartetti Douglas A.
Published: March 2007

The usefulness of three IRT-based methods and the Mantel-Haenszel technique in evaluating the measure ment equivalence of translated assessment instruments was investigated. A 15-item numerical test and an 18- item reasoning test that were originally developed in English and then translated to French were used. The analyses were based on four groups, each containing 1,000 examinees. Two groups of English-speaking ex aminees were administered the English version of the tests; the other two were French-speaking examinees who were administered the French version of the tests. The percent of items identified with significant differ ential item functioning (DIF) in this study was similar to findings in previous large-sample studies. The four DIF methods showed substantial consistency in identi fying items with significant DIF when replicated. Sug gestions for future research are provided.
Trait Level Estimation for Nonfitting Response Vectors
Authors: Meijer Rob R. , Nering Michael L.
Published: March 2007

Item responses that do not fit an item response theory model may cause the latent trait value, 0, to be inaccurately estimated. Although in many studies the proportion of nonmodel-fitting response vectors (NRvs) identified (i.e., the detection rate) has been investigated, less is known about the severity of the inaccuracy of the estimated 0 (0) in relation to the rate at which response patterns are classified as not fitting a model using person-fit statistics. In the present study, three scoring methods-maximum likelihood estimation (MLE), expected a posterior (EAP) estimation, and biweight estimation (BIw)-were used to estimate 0 when NRVS were present. The detection rate of the lz person-fit statistic (Drasgow, Levine, & Williams, 1985) was also investigated. It was found that NRVS influenced the value of 8, and this depended heavily on the type of misfit and the 8 level. It was also found that the BIW scoring method reduced the bias in 0 and improved the detection rate compared to MLE and EAP for examinees located at the extreme ends of the 8 continuum. Results of this study extended the results obtained by Reise (1995) and showed that the low detection rates found in his study were due to the particular kind of procedure used to generate NRVS.
Testing the Equality of Two Independent αCoefficients Adjusted by the Spearman-Brown Formula
Authors: Alsawalmeh Yousef M. , Feldt Leonard S.
Published: March 2007

An approximate statistical test is developed for the hypothesis of equality between the Spearman-Brown extrapolations of two independent values of Cronbach’s alpha reliability coefficient (α). This test assumes that the units added to or deleted from each instrument are classically parallel to the units included in the original version of each instrument. The projections for Tests 1 and 2 are based on lengthening or shortening factors of K1 and K2, which may or may not be equal. Special cases of this test include applications in which the projected values are intraclass coefficients or only one of the instruments is presumed to be altered in length. Monte carlo simulations demonstrated that the procedure effectively controls Type I error even when the original αs are based on as few as two test parts or two raters.
A Critical Examination of the Internalization, Identification, and Compliance Commitment Measures
Authors: Vandenberg Robert J. , Self Robin M. , Jai Hyun Seo
Published: March 2007

The objectives of this study were to examine O'Reilly and Chatman's ( 1986) compliance, identification, and internalization scales, and to compare the latter measures to the OCQ. Two studies were completed. Findings from Study 1 indicated that: ( 1) Although reliable, the identification measure was redundant with the OCQ; ( 2) the internalization measure was reliable and valid in that most items strongly loaded upon a different factor than did items of all other measures; and ( 3) the compliance measure obtained some validity only after the removal of two of its items, but possessed weak reliability throughout the analysis. Study 2 examined the applicability of the reconstituted ( based upon findings from Study 1) OCQ, internaliza tion and compliance measures in a longitudinal model of the turnover process. Of the three measures, only the OCQ had a significant causal effect within the model. Implications of these findings are examined.
The Changing Demographic and Economic Structure of Nonmetropolitan Areas in the United States
Authors: McCarthy Kevin F. , Morrison Peter A.
Published: March 2007

The forces underlying contemporary nonmetropolitan popula tion trends differ substantially from those that operated during the 1960s. Multivariate analyses of county-level population change between 1960-1970 and 1970-1974 support two major conclusions: (1) Migration into entirely rural nonmetropolitan counties has accelerated, evidently signaling the emergence in the 1970s of a new (or at least more complex) spatial pattern of settlement; and (2) previous growth advantages associated with manufacturing and gov ernment related activity appear to have diminished, and retirement and recre ation have emerged as important growth-inducing activities.

The first finding has important implications for the rationale underlying U.S. regional development policy, in which urban nodes designated as "growth centers" figure as a necessary element for a region's takeoff or reversal of its economic decline. Under present circumstances, that rationale may define the prospects for nonmetropolitan development too narrowly by purporting that only areas with an identifiable urban node will grow, since alternatives to this model have spontaneously emerged. The second finding suggests that if opportunities for growth are to be exploited, regional develop ment policy with respect to public infrastructure and business development will need to identify exactly where these possibilities are emerging and build more specifically on them.
Migration and Urban Change
Authors: Korcelli Piotr
Published: March 2007

This paper examines the population development of large urban regions. Several hypotheses about patterns of settlement change in highly urbanized countries are discussed using empirical material derived from IIASA's Comparative Migration and Settlement Study. These hypotheses refer to interrelations between population growth and urban size, the role of migration and natural increase as components of urban population change, overall spatial mobility, hierarchical migration, and the age distribution of migrants moving between, out of, and into large urban areas.
Regional Multipliers: WAIO vs. RIMS
Authors: Bourque Philip J.
Published: March 2007

This article outlines the survey approach as it is used in building the Washington Input-Output Models (WAIO), and compares its multiplier estimates for Washington state with those of the Regional Input-Output Modeling System (RIMS) as developed by the U.S. Department of Commerce. The author finds that RIMS multipliers differ—often substantially—from those of WAIO.
Dimensions of Citation Analysis
Authors: Leydesdorff Loet , Amsterdamska Olga
Published: March 2007

An analytical scheme that differentiates among the various types of cognitive and social functions of citations is used as the basis for an analysis of the results of a questionnaire designed to probe the citing behavior of a group of scientists who had cited one of four papers originating from a single biochemical laboratory. Even when papers fall within a relatively well-defined research area and are based on research conducted within a single lab, groups of scientists to which a given paper is of relevance can have quite distinct internal structures. We argue that the scientists'subjective reasons for citing a given work do not correspond with the actual argumentative uses of cited articles in citing texts. Scientists appear to regard the papers they cite as having a rather generalized significance even if in their citations they refer to very specific claims made in the original texts. The consequences of these findings for a theory of citation and for the use of citations in science studies are discussed.
The Qualitative Arms Race: Pluralism Gone Mad?
Authors: Lewis Eugene
Published: March 2007

Large-scale weapons systems have increasingly become part of a patronage system justified by claims about national defense. American politics tends to proceed by distribution, redistribution, and compromise. The disjunction between the "virtually" autonomous processes of worldwide weapons innovation and American incrementalism lead to a potentially disastrous situation. This situation is characterized by potential chaos in the integration of complex, interdependent combat and communication systems as well as a mindless arms race that seems to defy political control. A modest proposal is made to suggest a potential bureaucratic change agent.
Textbook Portrayals of Science and Technology Issues in a Television Age
Authors: Hamm Mary
Published: March 2007

This article examines the role of middle-school science textbooks in dealing with sensitive social and scientific issues. Education specialists compared the ten most widely used sixth- and seventh-grade textbooks to determine the amount and depth of content presented on five major global issues, including the issue of nuclear weapons. Differences between grade levels were also explored. Implications stemming from the content analysis are discussed within the context of a television culture.
The Rhetorical Construction of Novelty: Presenting Claims in a Letters Forum
Authors: Blakeslee Ann M.
Published: March 2007

Physical Review Letters has become the primary forum for the dissemination of innovative work in physics. Physicists' acceptance of this journal, and their adaptation to its requirements, show their ability to present their work in a variety of institutionally sanctioned but evolving frameworks. However, such a forum, because of its constraints on space and its emphasis on innovation, poses special problems to authors in relation to constructing their novel claims and reconstructing the consensus of their fields. In addition, itsprestige has caused the journal to acquire archivalfeatures that have slowed publication and resulted in other unintended consequences. Through an analysis of three letters published in Physical Review Letters and of a follow-up article published in Physical Review, the rhetorical features of this forum are examined as well as the problems its poses for the contextualization of novelty within relevant frameworks of accepted belief.
A Translation Analysis of the Green Revolution in Bali
Authors: Bardini Thierry
Published: March 2007

This article uses the translation approach to analyze the Green Revolution in Bali, Indonesia. The translation approach reopens the controversy about a classical topic in development studies: the failure or success of the Green Revolution. The translation method helps us to understand how the previous explanations of the failure or success of the Green Revolution in Bali were socially constructed and how the presence and the identity of social groups involved in agriculture on Bali were negotiated during the controversy. J. Stephen Lansing's recent computer model of Balinese agriculture is examined as a new component of the Green Revolution technological package. The analysis shows that the success of Lansing's model is better understood as a result of his communication strategy than as a scientific achievement.
Riddle Me This: The Craft and Concept of Animal Mind
Authors: Cox Graham , Ashford Tony
Published: March 2007

This article examines the relations between methods used in both animal work and study and concepts of animal mind. By "animal work" the authors mean humans and animals working together, and by "animal study" they mean the discipline of ethology, especially the emerging area of cognitive ethology. Within these areas the wide range of conceptions of animal mind includes varying emphases on intelligence, forms of rationality and language, cognition, consciousness, and intentionality. The authors' central concern is to elucidate the vocabulary and the concepts which seem necessary to establishing successful working relationships with sheepdogs and gundogs. Their argument moves toward an emphasis on the appreciation of particular intentional states and recognizes that they invariably deploy elements of a moral vocabulary in achieving creative teamwork performances with dogs and other animals. The article concludes by consid enng the relevance of accounts of work with animals for associated considerations of intentionality.
Trainee Characteristics and Perceptions of HIV/AIDS Training Quality
Authors: Panter A. T. , Huba G. J. , Melchior Lisa A. , Anderson Donna , Driscoll Mary , German Victor F. , Henderson Harold , Henderson Ron , Lalonde Bernadette , Uldall Karina K. , Zalumas Jacqueline
Published: March 2007

HIV/AIDS education and training have played a vital role in keeping health providers up to date on emerging developments and approaches. This study reports findings from seven HIV/AIDS education and training projects. Participants in more than 600 training sessions described themselves, their professional background, and their general reasons for taking the training. Immediately following the training, they also rated the quality of their educational experience along several dimensions. Trainee characteristics were related to assessments of training quality, using a regression decision-tree analytic approach. Although effect sizes were generally small, quality ratings of the HIV/AIDS training experiences were associated with certain projects, basic trainee demographic characteristics, professional background, and experience in the HIV field. Greater understanding about participant characteristics can provide clues about how these training experiences are perceived and processed and may inform decision making about instructional HIV/AIDS curricula.
Methods for Exploring Heterogeneity in Meta-Analysis
Authors: Song Fujian , Sheldon Trevor A. , Sutton Alex J. , Abrams Keith R. , Jones David R.
Published: March 2007

In meta-analysis, when the difference in results between studies is greater than would be expected by chance, one needs to investigate whether the observed variation in results across studies is associated with clinical and/or methodological differences between studies. This article reviews methods used in meta-analysis for exploring heterogeneity, including statistical tests for homogeneity, methods for visually displaying results of primary studies, methods for reducing heterogeneity, methods for investigating sources of heterogeneity, and identification of moderator variables or effect modifiers. The investigation of sources of heterogeneity in meta-analysis is by nature exploratory, and therefore its results should always be interpreted with caution. However, careful investigation of heterogeneity may provide an important second level of evidence that can be useful in suggesting direction of future research. Sometimes, it may provide clinically important results by indicating who might benefit more or less from a treatment or how an intervention should be applied.
"Evaluating the Evaluators"
Authors: Barkdoll Gerald L.
Published: March 2007

Critical impediments to successful evalu ation are (1) a lack of organization and support of evaluation, (2) an imbalance between the expectations of top management and the capacity of the evaluation staff, and (3) an inability to develop a satisfactory conceptual framework for planning and managing evaluation activities. One organizatron's (The Food and Drug Administration) successful solutions to these problems are discussed.
Evaluating Emergency Medical Services
Authors: Bergner Lawrence , Eisenberg Mickey , Hallstrom Alfred
Published: March 2007

The need to evaluate expensive, dramatic, and politically sensitive emergency medical services programs when classical controlled trials are neither ethically nor practically possible can be satisfied by quasi-experimental designs. The sequential implemen tation of paramedic services in several suburban areas provided a natural experimental situation in which to evaluate whether addition of the service could significantly alter the outcome of cardiac emergencies compared to the basic emergency medical technician program previously available. Before measurements and after measurements were made in a study area plus two control areas: one with paramedic services in both time periods and the other with emergency medical technican service throughout. Preliminary results indicate successful resuscitation increased from 20% to 32% (p < .05) and discharge from the hospital went from 8% to 18% (p<.01). The implications for program and policy decisions are noted. Development of studies that evolved from this work are outlined
Behavioral Child-Management Cost-Effectiveness
Authors: Siegert Frederick E. , Yates Brian T.
Published: March 2007

This experiment contrasted the effectiveness and cost of three systems for training parents to use social learning techniques for child-management. Thirty self-referred parents of problem children were assigned randomly to either: (1)individual in-office, (2) individual in-home, (3)group in-office, or (4) measurement and contact control delivery systems. Two weeks of baseline data recording preceded five weeks of training and continued data collection and a four-month follow-up. From the parent perspective, effectiveness was measured by observation of target children's problem behavior frequencies , the number and in tensity of parent-child issues, and follow-up ratings. From the therapist's perspective, effectiveness was assessed by ratings of parenting improvement and adherence to training procedures. The value of resources used by each delivery system was assessed from operations, opportunity, and client costing perspectives. All experimental delivery systems produced strongly significant improvements over the control system: a mean 86% reduction in problem behavior frequencies compared to a mean 38% reduction in the control condition. The three experimental delivery systems did not differ in effectiveness on any measure. Non- behavioral measures showed no significant differences between the experimental and control delivery systems. Although operations costs favored group delivery, the more comprehensive opportunity and client costs favored individual in-home delivery.
Health Education Evaluation
Authors: Gebhardt Mary E.
Published: March 2007

A major disappointment with educational evaluative research in general, and health education evaluation in particular, is all too often outcome of "no significant differ ence" or " no effect." Reviewing the evaluation literature one finds experienced investigators such as Donald Campbell, Marcia Guttentag, and Carol Weiss lamenting the fact that educational programs persistently fail to uncover statistical differences . This problem continues to plague evaluators whose experiential evidence indicates that the program may have produced some very desirable results. Thus, the traditional methods of evaluation are increas ingly being called into question. Evaluators are presenting theories to explain the "no effects" phenomenon and alternate methodologies are being proposed in the literature. This article suggests that health educators not only acknowledge the existence of this dilemma, but develop a working knowledge of alternate or qualitative data methodologies , theirpossibilities, and their limitations, thus encouraging the evalua tion of those health programs which have traditionally been classified as undoable.
Market and Evaluation Roles in Quality Assurance
Authors: Getzen Thomas E.
Published: March 2007

Competitive markets and formal evaluations offer distinctly different mechanisms for controlling the quality of care based on patients'choices as consumers and applied scientific methods, respectively. As the difficulty of acquiring relevant information and its skewness towardproviders becomes greater, the needfor evaluations increases. Thus the complexities of medical care tend to limit the range of the market. Markets, however, provide information on value, accommodating differences in patient preferences and cost conditions not readily obtained withformal evaluations. Through incentives, markets integrate the evaluation and controlfunctions and may create greater efficiency and responsiveness. A variety of organizational structures for quality assurance are available, andformal evaluations are often incorporated within a market context. The policy task addressed here is to specify how, as conditions vary, greater reliance should be placed on market competition or on formal evaluations and external regulation.
Medical Care in Developing Countries
Authors: Walker Godfrey J. A.
Published: March 2007

In recent years attention in developing countries has concentrated upon strategies to improve the equitable provision of essential health care-the primary health care approach. Very little work has been reported in connection with the quality of medical care, and yetfor the successful outcome of care it is necessary that adequate health care processes be carried out. Conceptual, methodological, data, and organizational issues related to quality assessment and assurance are presented. Thefew examples of reported work concerned with these important aspects of medical care in developing countries are reviewed. Suggestions are made as to how measures to ensure reasonable quality might be further developed and refined.
Measuring Patient Perceptions of the Patient-Doctor Interaction
Authors: Smith Jana Kay , Falvo Donna , McKillip Jack , Pitz Gordon
Published: March 2007

Patient satisfaction has been related to patient compliance, doctor-patient information exchange, and continuity of care. However, the construct of patient satisfaction is not well defined; its measurement has typically consisted of the anecdotal generation of questions that may not tap issues of concern to patients. Generally, neither reliability nor validity of the measurement instruments are considered. The present study investigated the construct of patient satisfaction and developed the Smith-Falvo Patient-Doctor Interaction Scale (PDIS), a patient satisfaction scale based on empirically derived dimensions of patient satisfaction. The project consisted of three studies. The first study involved the generation of physician behavior descriptions by 22 family practice center patients. The resultant 1540 descriptions were grouped into 80 reliable categories. In Study 2, a sample of 30 patients rated the behavior descriptions on a 9-point scale from most preferred to least preferred. Multidimensional scaling techniques were applied to the preference ratings, resulting in the identification of two dimensions: general health care delivery and inappropriate interpersonal interactions. The PDIS was then constructed from items salient to these two dimensions. Outcome of the investigation ofthe reliability and validity of the PDIS in a third study was quite positive.
A Deterministic Theory of Clinical Performance Rating
Authors: Cason Gerald J. , Cason Carolyn L.
Published: March 2007

The proposed theory provides a basis for both measuring and correcting rater stringency error in some grossly incomplete rating data matrices. The theoretical model fit (R = .92, .85, .82; joint p <.000001) ratings made byfaculty and resident physicians (n = 47, 31, and 29) of student clinical performance in each of three junior year medical student cohorts (n = 29, 30, and 35) better than alternative models. In these data the percentage of variation attributable to stringency and ability was about 35 and 40, respectively. Three-month test-retest reliability for rater stringencies was .16 < r < .29 (joint p < .04). Cross-validation supported the proposed model (r = .61) over the conventional alternative (r = .41; z = 2.62, p < .004). Both reliability and convergent validity of the ability construct were .20 greater for one corrected rating than for one observed (uncorrected) rating.
Students as Evaluators
Authors: McCollister Robert J.
Published: March 2007

Rating of teachers by students is a commonly sought, important component of the evaluation of teaching. Whether student raters should be identified is controversial. Student evaluation of medical faculty is done with the knowledge that students may well need to return to these faculty for letters of recommendation for graduate program application. This subjects the rating process to a bias of recall that may result in leniency or inhibition. The special circumstance of medical student rating was studied by interviewing a sample (n = 50) of senior medical students. Nearly 40% of students felt that they would have been inhibited in responding to questions on quality of teaching and personal rating of their medical teachers. Fewer students would have been inhibited in commenting on the organization and operation of courses, but even in this area an element of inhibition would have been felt. The findings support continued protection of the identity of student raters.
The Cost-Effectiveness of Randomized Incentive and Follow-Up Contacts in a National Mail Survey of Family Physicians
Authors: Mullen Patricia D. , Easling Irene , Nixon Sam A. , Koester Donald R. , Biddle Andrea K.
Published: March 2007

As part of a national mail survey of family physicians, we tested the individual and combined effects on initial response rates of a small nonmonetary incentive and an invitation to withdraw from the survey (2 X 2 fully crossedfactorial design). The effectiveness and efficiency of threefollowup contacts based on Dillman's Total Design Method were also examined in a timeseries design. Neither the incentive, a sticker, or the withdrawal provision alone nor the two treatments in combination with one another affected initial or final response significantly. The withdrawalprovision appeared to save a small amount in follow-up costs, although it was also associated with a decrease in the rates offinal response that approached signif icance. The threefollow-up mailings (postcard reminder, second questionnaire, and third questionnaire sent by certified mail) increased the initial response of 40.6% by 6.0, 11.3, and 15.0 percentage points respectively. Nonlabor costs associated with the postcard were $2.01 per returned questionnaire; for the secondfollow-up they were $7.34; and for the certified mailing, $6.25.
A Benefit-Cost Analysis of Family Planning Services in Iowa
Authors: Levey Linda M. , Nyman John A. , Haugaard John
Published: March 2007

An analysis ofpubliclyfundedfamilyplanning services in Iowa was undertaken to provide tangible estimates based on local data of the value of these services in averting unplanned and unwanted births to women who voluntarily use them. The study reports methods that can be applied by other states in evaluating their own family planning programs. Benefits were measured as the cost savings in public expenditures avoided by providing family planning services to lowand marginal-income women. Iowa data for AFDC, food stamps, and Medicaid payments were used to calculate benefits. The total benefit savings were adjusted to reflect the impact of family planning services on preventing births. The adjusted savings were accrued over one-year and five-year time frames and for four age groups (14-19, 20-29, 30-34, and 35-44). lin the base year, the cost of providing family planning services in Iowa to the more than 56,000 women who used them was $3.1 million, or $59 per user. Results showed that the benefits of family planning services were highest for teenagers who would become eligible for public assistance programs upon the birth of a child.
An Analysis of Decision Making in Discharge Planning
Authors: Weaver Frances M. , Bryant Fred B.
Published: March 2007

A repeated-measures design was used to examine medicalprofessionals'discharge planning strategies. Physicians, residents, nurses, and social workers were presented with 16 hypothetical case scenarios and asked to: (1) rate the appropriateness of four discharge options (nursing home, community nursing, adult day, and outpatient clinic care), and (2) select the most appropriate discharge plan for each case. Four within-group variables were included in the scenarios: physical impairment, caregiver availability, follow-up required, and patient compliance. Decisions were greatly influenced by caregiver availability. When a caregiver was available, respondents preferred community-based options (i.e., community nursing care or outpatient clinic); if the case involved complications (i.e., severe physical impairment, heavy follow-up, noncompliant patient), they considered community nursing care more appropriate than outpatient clinic. When a caregiver was unavailable, respondents preferred institution-based options (i.e., nursing home or adult daycare); if there were complications, they considered nursing home more appropriate that adult daycare.
Using Fourth-Generation Evaluation in Nursing
Authors: Swenson Melinda M.
Published: March 2007

Evaluation is disciplined inquiry undertaken to determine the value, including merit and worth, of some entity: a curriculum program, a clinical intervention, an academic course, a care plan. An evaluation is conducted to improve or refine the thing being evaluated (evaluand) or to assess its impactand effectiveness. Evaluation in nursing has been designed using various positivistic and postpositivistic models in the first three "generations" in the evolution of evaluation practice. This article describes a new model of nursing evaluation more consistent with a nursing paradigm than with a traditional, scientific, medical paradigm. Responsive nursing evaluation informs and empowers all those involved in its outcomes (the stakeholders) when framed within the research stance called naturalistic or constructivist inquiry. The fourth-generationevaluation approach of Guba and Lincoln (1989) is consistent with a nursing paradigm and a constructivist approach. Fourth-generation evaluation is presented with specific application to nursing evaluation.
Medical Treatment Effectiveness Research
Authors: Raskin Ira E. , Maklan Claire W.
Published: March 2007

The Medical Treatment Effectiveness Program (MEDTEP) is an intradepartmental federal program of the Department of Health and Human Services, for which the Agency for Health Care Policy and Research (AHCPR) has lead responsibility. This article presents a staff perspective on the conceptual framework for the MEDTEP research agenda and on the opportunity to address empirically the relationships between particular health care services and patient outcomes. It reviews programmatic priorities and identifies active MEDTEP research projects, with descriptions of 11 patient outcomes research team projects. Finally, it addresses the need to produce useful research findings in the short term and the implications of a dual concern for the quality and cost of health care.
Physician Recertification and Outcomes Assessment
Authors: Kremer Barbara K.
Published: March 2007

Physician recertification poses a unique challenge to member boards of theAmerican Board of Medical Specialties (ABMS) charged with the responsibility of credentialing physicians. The key issue that emerges in recertification programs is how to evaluate performance in practice. Although some test of knowledge may be appropriate, an evaluation of clinical performance has become essential in recertification programs. To meet this challenge, ABMS boards have adopted methods to evaluate performance in practice. However, regardless of the methods chosen, criteria are needed to serve as standards. This article considers the application of outcomes assessment in the definition of standards for recertification. When direct outcome assessment may not be possible, outcome-validated process measures may provide a suitable alternative.
Two Scales for Measuring International Health Status
Authors: Larson James S.
Published: March 2007

This article develops two scales for measuring international health status, which are proposed as alternatives to the most popular current measure, the infant mortality rate. The first scale is derived from the Physical Quality of Life Index and is called Health Status I (HSI). It is an interval scale combining infant mortality, life expectancy, and the literacy rate. The second scale is called Health Status 2 (HS2), and is composed of HSI plus two other indicators -death rate for persons aged 65 and older and mental hospital admissions. The virtues of HSI and HS2 are discussed in relation to the current practice of using the infant mortality rate.
Graduate Nursing Students' Attitudes Toward Gay and Hemophiliac Men with AIDS
Authors: Strasser Judith A. , Damrosch Shirley
Published: March 2007

Subjects were 180 registered nurses enrolled in a master's nursing program. By random assignment, each read one of six versions of a vignette about a male patient. Vignettes differed in terms of patient's diagnosis (AIDS of unspecified origin, AIDS in a hemophiliac infected by blood transfusion, and leukemia) and sexual preference (gay or heterosexual). Nurses evaluated the patient on two scales, one involving judgments of patients and the other concerning willingness to interact socially with them. The hemophiliac/AIDS and leukemia patients were judged significantly less responsible for and less deserving of their illnesses than was the patient with AIDS of unspecified origin (p < .001). However, all three diagnostic categories were considered equally deserving of the best possible care. Both categories of AIDS patients were stigmatized in terms of certain social interactions. There was also some weak evidence of antigay bias. Implications for theory and practice are discussed.
Reliability and Accuracy of Resident Evaluations of Surgical Faculty
Authors: Risucci Donald A. , Lutsky Larry , Rosati Robert J. , Tortolani Anthony J.
Published: March 2007

This study examines the reliability and accuracy of ratings by general surgery residents of surgical faculty. Twenty-three of 33 residents anonymously and voluntarily evaluated 62 surgeons in June, 1988; 24 of 28 residents evaluated 64 surgeons in June, 1989. Each resident rated each surgeon on a 5-point scale for each of 10 areas ofperformance: technical ability, basic science knowledge, clinical knowledge, judgment, peer relations, patient relations, reliability, industry, personal appearance, and reaction to pressure. Reliability analyses evaluated internal consistency and interrater correlation. Accuracy analyses evaluated halo error, leniency/severity, central tendency, and range restriction. Ratings had high internal consistency (coefficient alpha = 0. 97). Interrater correlations were moderately high (average Pearson correlation = 0.63 among raters). Ratings were generally accurate, with halo error most prevalent and some evidence of leniency. Ratings by chief residents had the least halo. Results were generally replicable across the two academic years. We conclude that anonymous ratings of surgical faculty by groups of residents can provide a reliable and accurate evaluation method, ratings by chief residents are most accurate, and halo error may pose the greatest threat to accuracy, pointing to the needfor greater definition of evaluation items and scale points.