The medical licensing examination debate

National licensing examinations are typically large‐scale examinations taken early in a career or near the point of graduation, and, importantly, success is required to subsequently be able to practice. They are becoming increasingly popular as a method of quality assurance in the medical workforce, but debate about their contribution to patient safety and the improvement of healthcare outcomes continues. A systematic review of the national licensing examination literature demonstrates that there is disagreement between assessment experts about the strengths and challenges of licensing examinations. This is characterized by a trans‐Atlantic divide between the dominance of psychometric reliability assurance in North America and the wider interpretations of validity, to include consequences, in Europe. We conclude that the debate might benefit from refocusing to what a national licensing examination should assess: to achieve a balance between assessing a breadth of skills and the capacity for such skills in practice, and focusing less on reproducibility.     

Theorien als latente Quellen von Normativität und Verantwortung in der Hochschullehre: Die Bedeutung von didaktischen und fachspezifischen Theoriedebatten am Beispiel des politikwissenschaftlichen Teilgebiets „Internationale Beziehungen“

The article deals with normative aspects that are negotiated in didactic and subject-specific theoretical debates and thus gain relevance in teaching. It turns out that the didactic theories provide divergent answers to the question of what should be taught how and by whom. Similarly, the example of theoretical debates in International Relations shows that, from a subject-specific perspective, there can often be a lack of consensus on the essentials that are to be taught. Such conflicting requirements, however, demonstrate the instructors’ scope for action, which they should realize and use responsibly. Due to academic pluralism, it seems possible that the societal pluralism, which is sometimes perceived as crisis-laden, can be used productively for teaching.     

Book reviews

Music and Video Private Copying: An International Survey of the Problem and the Law Gillian Davies and Michèle E. Hung 1993 Sweet & Maxwell P. 280 £40.00 ISBN 0‐421‐48450‐0

Publishing and Multimedia Law Michael Henry 1994, London: Butterworths Pp. xxviii + 820 + diskette (hardback)

Blackstone's Guide to the Trade Marks Act 1991 Ruth Annand and Helen Norman Pp. 411 £19.95     

Interrogative suggestibility,self‐esteem,and the influence of negative life‐events

Purpose. Past research has frequently demonstrated the impact of life adversity on the behaviour and mindset of individuals. In terms of the formal police interview, the experience of negative life‐events may have an effect upon interviewee performance. This study, therefore, aims to investigate how negative life‐events may influence interviewee performance on the Gudjonsson suggestibility scale (GSS). Moreover, self‐esteem will also be investigated in relation to both the experience of negative life‐events and interrogative suggestibility. Method. Sixty participants were administered the GSS1. In between the immediate and delayed recall phases, interviewees were asked to complete the culture‐free self‐esteem inventory, the life‐events questionnaire and the Eysenck personality questionnaire. Results. Negative life‐events (NLEs) were significantly correlated with all of the GSS suggestibility scores (yield 1, yield 2, shift and total Suggestibility). Contrary to past research, however, self‐esteem scores were not significantly related to any of the GSS components or to NLE scores. Conclusion. This paper is the first to show a link between the experience of NLEs and GSS scores. The findings suggest that interviewees reporting a high number of NLEs are significantly more susceptible to the leading questions, as well as to negative feedback, administered during the GSS interview. Erroneous reports and false confessions may thus be more likely with such interviewees, potentially classifying them as vulnerable witnesses.     

Not everyone strongly supports the death penalty: Assessing weakly-held attitudes about capital punishment

Polls exploring attitudes toward the death penalty typically impose a simple, dichotomous response structure: respondents are asked whether or not they support or oppose capital punishment. This polling strategy deprives respondents of expressing an indication of the strength of their opinions. When asked whether they support (or oppose) the death penalty “strongly” or “not strongly,” significant proportions of respondents select the latter category. This suggests that many proponents and opponents of the death penalty have weakly-held views regarding the issue. These respondents are of great interest because they are the individuals most likely to change their views. This article analyzes responses to two national surveys in order to explore the variables that differentiate respondents with strongly-held and weakly-held views. A theoretical account is offered to explain why some people have weakly-held views on this critical social issue.     

Improving the Health Coverage of the Rural Poor: Does Contracting-Out Mobile Medical Teams Work?

Low population density in rural developing countries coupled with deficient infrastructure, weak state capacity and limited budgets makes increasing health care coverage difficult. Contracting-out mobile medical teams may be a helpful solution in this context. This article examines the impact of a large-scale programme of this type in Guatemala. We document large impacts on immunisation rates for children and prenatal care provider choices. The programme increased substantially the role of physician and nurses at the expense of traditional midwives. The results indicate that mobile medical teams substantially increased coverage of health care services in Guatemala, and could be effective in other developing countries.     

Application of Attachment Theory to Male Violence Toward Female Intimates

Ninety one men were interviewed regarding their intimate relationships and childhood experiences. A secondary analysis of an extant data set was conducted to explore the applicability of Bowlby's attachment theory in explaining the etiology of male intimate violence. Various attachment-related variables were hypothesized to be related to male intimate violence. Results of a hierarchical regression analysis indicated that the attachment cluster of variables served as unique predictors of male intimate violence. The male's perceived relationship support and recollection of maternal relationship were the two significant predictors of male intimate violence within the attachment cluster. Race and education were also found to be significant predictors of male violence toward a female intimate.