The authors review the methods by which U.S. medical schools have evaluated student achievement during the twentieth century, especially for the assessment of noncognitive abilities, including clinical skills and behaviors. With particular reference to the current decade, information collected by the Liaison Committee on Medical Education (LCME) is used to examine the congruence of assessment methods with the rising tide of understanding--and accreditation requirements--that knowledge, competence, and behavioral objectives require different methods of assessment to measure the extent of students' learning in each domain. Amongst 97 medical schools having accreditation surveys between July 1993 and June 1998, only 186 of 751 basic science courses tested students' noncognitive achievements in things such as the preparation for and participation in small-group conferences, the quality of case-based discussion, library research and literature reviews, and research projects, despite staking out scholarship, habits of life-long learning, and reasoned thinking as educational objectives. In the clerkships of these schools, structured and observed assessments of clinical skills--with standardized patients and/or OSCEs--contributed 7.4-23.1% to a student's grade (depending on the clerkship discipline), while the predominant contribution (50-70% across the clerkships) was made by resident and faculty ratings that were based largely on recollections of case presentations and discussions having little relationship to interpersonal skills, rapport with patients, and logical and sequenced history taking and physical examination. On a more optimistic note, the results show that the number of schools using standardized patients in one or more clerkships increased between 1993 and 1998 from 34.1% to 50.4% of the 125 schools in the United States, and the number of schools using standardized patients in comprehensive fourth-year examinations increased from 19.1% to 48% of the total. Despite such progress, this study shows that too many medical schools still fail to employ evaluation methods that specifically assess students' achievement of the skills and behaviors they need to learn to practice medicine. The findings of this article explain why accreditors are paying closer attention to how well schools provide measured assurances that students learn what the faculties set out to teach.

Allometric relationships between incisor size and body size were determined for 26 species of New World primates. While previous studies have suggested that the incisors of Old World primates, and anthropoids in general, scale isometrically with body size, the data presented here indicate a negative allometric relationship between incisor size and body size among New World species. This negative allometry was exhibited by platyrrhines when either upper or lower incisor row length was regressed against body weight, and when either least-squares or bivariate principal axis equations were used. When upper incisor length was plotted against skull length, negative allometry could be sustained using both statistical techniques only when the full sample of 26 species was plotted. The choice of variables to represent incisor size and body size, and the choice of a statistical technique to effect the allometric equation, had a more pronounced impact on the location of individual species with regard to lines of best fit. Platyrrhines as a group have smaller incisors relative to body size than do catarrhines, regardless of diet. Among New World primates, small incisors represent a plausible primitive condition; species with relatively large incisors manifest a phyletic change associated with a dietary shift to foods that require increased incisal preparation. The opposite trend characterizes Old World primates. In spite of the taxonomic differences in relative incisor size between platyrrhine and catarrhine primates, inferences about diet derived from an allometric equation for all anthropoids should prove reliable as long as the species with unknown diet does not lie at the upper end of the body size range for platyrrhines or catarrhines.

Observations on the sequence and timing of gingival tooth eruption are reported for six species of Madagascar lemurs. Complete sequences of eruption were obtained for the deciduous dentition, and partial to complete sequences were recorded for the permanent dentition. In CheirogaZeus medius and in four species of the genus Lemur, the deciduous teeth erupt in front-to-back sequence, with the toothcomb emerging near birth as an integrated complex. In Propithecus verreauxi the same pattern is exhibited, but the small peglike lower canine and dp3 erupt last. Eruption of the permanent dentition in Lemur species takes place in two distinct stages. In the first stage the upper incisors, toothcomb, and first two molars penetrate the gingiva.After an interval of 3 to 4 months, the remaining permanent teeth erupt.Deciduous premolars erupt when young animals are being weaned. The eruption of the deciduous toothcomb appears unrelated to feeding or grooming behavior. In L. catta and L. fulvus, the first stage of permanent tooth eruption occurs at approximately 6 months of age, when the growth rate slows down and (in wild populations) the rainy season is ending. This suggests that eruption of the anterior molars is timed to coincide with a shift from a more frugivorous to a more folivorous dietary regime, which occurs during the dry season. No further tooth eruption occurs until approximately 1 year of age, when the growth rate increases and the rainy season returns for wild populations. Thus, the second wave of permanent tooth eruption in these species again appears linked to changing climatic conditions which lead to a shift in dietary preferences.

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Size variations in the anterior dentition were analyzed for 26 species of strepsirhine primates. The upper and lower incisor rows of strepsirhines, like those of anthropoid primates, scale isometrically with body size. Within the order Primates, strepsirhines exhibit the smallest incisors relative to body size, followed in increasing size by tarsiers, platyrrhines, and catarrhines. If the lateral teeth of the indriid toothcomb are interpreted as incisors and not canines, correlations between mandibular tooth size variables and body weight are maximized. The upper incisors of strepsirhines are extremely small and frequently widely separated, most likely to minimize occlusion with the toothcomb. Species deviations for assorted size variables of the anterior dentition generally fail to reflect functional variations in the use of the anterior teeth; some of the variables, however, do reflect taxonomic differences within the Strepsirhini. Although toothcomb size variations among extant strepsirhines are more readily interpreted in terms of gum feeding and bark scraping than they are in terms of grooming, anterior dental morphology as a whole is more easily explained by a grooming hypothesis when existing models of toothcomb origins are considered.