Factors associated with child development and differences in societal expectations and structures, along with the possible, albeit, differential impact of the Programme for International Student Assessment (PISA), may partially explain the differences and trends found in school pressure. School pressure increases alongside the onset of adolescence and the shift from elementary school to the higher demanding expectations of secondary education. Time-related increases in school pressure occurred in the years following the release of the PISA results, and were larger in those regions in which results were less positive.

The multiple mini-interview (MMI) has become an increasingly popular admissions method for selecting prospective students into professional programs (e.g., medical school). The MMI uses a series of short, labour intensive simulation stations and scenario interviews to more effectively assess applicants' non-cognitive qualities such as empathy, critical thinking, integrity, and communication. MMI data from 455 medical school applicants were analyzed using: (1) Generalizability Theory to estimate the generalizability of the MMI and identify sources of error; and (2) the Many-Facet Rasch Model, to identify misfitting examinees, items and raters. Consistent with previous research, our results support the reliability of MMI process. However, it appears that the non-cognitive qualities are not being measured as unique constructs across stations.

Examiner effects and content specificity are two well known sources of construct irrelevant variance that present great challenges in performance-based assessments. National medical organizations that are responsible for large-scale performance based assessments experience an additional challenge as they are responsible for administering qualification examinations to physician candidates at several locations and institutions. This study explores the impact of site location as a source of score variation in a large-scale national assessment used to measure the readiness of internationally educated physician candidates for residency programs. Data from the Medical Council of Canada's National Assessment Collaboration were analyzed using Hierarchical Linear Modeling and Rasch Analyses. Consistent with previous research, problematic variance due to examiner effects and content specificity was found. Additionally, site location was also identified as a potential source of construct irrelevant variance in examination scores.

BackgroundPatient safety (PS) receives limited attention in health professional curricula. We developed and pilot tested four Objective Structured Clinical Examination (OSCE) stations intended to reflect socio-cultural dimensions in the Canadian Patient Safety Institute's Safety Competency Framework.Setting and participants18 third year undergraduate medical and nursing students at a Canadian University.MethodsOSCE cases were developed by faculty with clinical and PS expertise with assistance from expert facilitators from the Medical Council of Canada. Stations reflect domains in the Safety Competency Framework (ie, managing safety risks, culture of safety, communication). Stations were assessed by two clinical faculty members. Inter-rater reliability was examined using weighted κ values. Additional aspects of reliability and OSCE performance are reported.ResultsAssessors exhibited excellent agreement (weighted κ scores ranged from 0.74 to 0.82 for the four OSCE stations). Learners’ scores varied across the four stations. Nursing students scored significantly lower (p<0.05) than medical students on three stations (nursing student mean scores=1.9, 1.9 and 2.7; medical student mean scores=2.8, 2.9 and 3.5 for stations 1, 2 and 3, respectively where 1=borderline unsatisfactory, 2=borderline satisfactory and 3=competence demonstrated). 7/18 students (39%) scored below ‘borderline satisfactory’ on one or more stations.ConclusionsResults show (1) four OSCE stations evaluating socio-cultural dimensions of PS achieved variation in scores and (2) performance on this OSCE can be evaluated with high reliability, suggesting a single assessor per station would be sufficient. Differences between nursing and medical student performance are interesting; however, it is unclear what factors explain these differences.

The MFRM and hierarchical clustering helped to explain some of the variability associated with raters in a way that other measurement models are unable to capture. These findings highlight that differences in ratings may result from raters possessing different interpretations of an observed performance. This study has implications for developing more purposeful rater selection and rater profiling in performance-based assessments.

BackgroundThis survey is part of a multi-year research study on informal and formal mental health support in northern Canada involving the use of qualitative and quantitative data collection and analysis methods in an effort to better understand mental health in a northern context.ObjectiveThe main objective of the 3-year study was to document the situation of formal and informal helpers in providing mental health support in isolated northern communities in northern British Columbia, northern Alberta, Yukon, Northwest Territories and Nunavut. The intent of developing a survey was to include more participants in the research and access those working in small communities who would be concerned regarding confidentiality and anonymity due to their high profile within smaller populations.DesignBased on the in-depth interviews from the qualitative phase of the project, the research team developed a survey that reflected the main themes found in the initial qualitative analysis. The on-line survey consisted of 26 questions, looking at basic demographic information and presenting lists of possible challenges, supports and client mental health issues for participants to prioritise.ResultsThirty-two participants identified various challenges, supports and client issues relevant to their mental health support work. A vast majority of the respondents felt prepared for northern practice and had some level of formal education. Supports for longevity included team collaboration, knowledgeable supervisors, managers, leaders and more opportunities for formal education, specific training and continuity of care to support clients.ConclusionFor northern-based research in small communities, the development of a survey allowed more participants to join the larger study in a way that protected their identity and confidentiality. The results from the survey emphasise the need for team collaboration, interdisciplinary practice and working with community strengths as a way to sustain mental health support workers in the North.

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