RESUMEN
OBJECTIVE: Does use of the pediatric shelf examination affect students' performance on the United States Medical Licensure Examination (USMLE) Step 2 pediatric subtest? METHODS: The National Board of Medical Examiners Pediatrics Subject Examination (NBMEPSE) was used as the pediatric clerkship final examination at Brown Medical School through the 1996-97 academic year. The NBMEPSE was dropped in July 1997. Students' mean scores for the pediatric subtest of the USMLE Step 2 were compared for the years before and after the NBMEPSE was dropped. Performance on the internal medicine subtest of the USMLE Step 2 examination was used as a control because the National Board of Medical Examiners Internal Medicine Subject Examination (NBMEIMSE) remained the final examination in the internal-medicine clerkship. RESULTS: USMLE Step 2 scores trended upward from 1993 to 2003. From 1993 to 1997, Brown medical students performed above the US/Canadian mean on both the USMLE Step 2 pediatrics and internal medicine subtests as well as on the overall examination. Students performed at or just below the mean on both the USMLE Step 2 pediatrics and internal medicine subtests from 1998 to 2001. CONCLUSIONS: Dropping the shelf examination coincided with a decrease in performance on the USMLE Step 2 pediatric subtest in comparison with the US/Canadian mean. Similar decreases in performance in overall and USMLE Step 2 internal medicine subtest scores also occurred. Numerous confounding variables make it difficult to determine the effect of the shelf exam on Step 2 performance.
Asunto(s)
Prácticas Clínicas/normas , Evaluación Educacional , Medicina Interna/educación , Licencia Médica , Pediatría/educación , Consejos de Especialidades , Adulto , Canadá , Curriculum , Humanos , Medicina Interna/normas , Pediatría/normas , Rhode Island , Facultades de Medicina , Estados UnidosRESUMEN
Enuresis is a symptom that is frequently encountered in child psychiatric evaluations. Careful assessment is required to identify specific urologic, developmental, psychosocial, and sleep-related etiologies. For most children with enuresis, however, a specific etiology cannot be determined. Treatment then involves supportive approaches, conditioning with a urine alarm, or medications-imipramine or desmopressin acetate. The psychosocial consequences of the symptom must be recognized and addressed with sensitivity during the evaluation and treatment of enuresis.
Asunto(s)
Enuresis/diagnóstico , Enuresis/terapia , Adolescente , Niño , Preescolar , Enuresis/etiología , Humanos , Guías de Práctica Clínica como AsuntoRESUMEN
Enuresis is a symptom that is frequently encountered in child psychiatric evaluations. Careful assessment is required to identify specific urologic, developmental, psychosocial, and sleep-related etiologies. For most children with enuresis, however, a specific etiology cannot be determined. Treatment then involves supportive approaches, conditioning with a urine alarm, or medications--imipramine or desmopressin acetate. The psychosocial consequences of the symptom must be recognized and addressed with sensitivity during the evaluation and treatment of enuresis.