PURPOSE The purpose of this study is to judge the quality of clinical skills assessment in Busan-Gyeongnam Consortium.
METHODS Fourth grade medical school students (n=350 in 2012 and n=419 in 2013) in the Busan-Gyeongnam Consortium were included in the study. The examination was consisted of 6 clinical performance examination (CPX) and 6 objective structured clinical examination (OSCE) stations. The students were divided into groups to take the exam in 4 sites during 3 days. The overall reliability was estimated by Cronbach alpha coefficient across the stations and the case reliability was by alpha across checklist items.
Analysis of variance and between-group variation were used to evaluate the variation of examinee performance across different days and sites.
RESULTS The mean total CPX/OSCE score was 67.0 points. The overall alpha across-stations was 0.66 in 2012 and 0.61 in 2013. The alpha across-items within a station was 0.54 to 0.86 in CPX, 0.51 to 0.92 in OSCE. There was no significant increase in scores between the different days. The mean scores over sites were different in 30 out of 48 stations but between-group variances were under 30%, except 2 cases.
CONCLUSION The overall reliability was below 0.70 and standardization of exam sites was unclear. To improve the quality of exam, case development, item design, training of standardized patients and assessors, and standardization of sites are necessary. Above of all, we need to develop the well-organized matrix to measure the quality of the exam.
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PURPOSE We developed an objective structured oral examination (OSOE) case to assess the medical ethics of students. The aim of this study was to assess the reliability of OSOE with generalizability theory.
METHODS One 10-minute OSOE that contained key questions was developed. The evaluation sheet consisted of 4 domains: moral sensitivity, moral reasoning, decision making, and attitude. The total number of items was 13. The numbers of checklist items and global rating items were 11 and 2, respectively. Items and key questions were validated by 6 professionals. Standardization of the raters and the pilot study was performed before the OSOE. Fifty-four third-year medical students participated in the OSOE. The OSOE was duplicated, and 2 professors assessed 1 student independently. Each station lasted 8 minutes and was followed by a 2-minute interval,during which raters completed the checklist forms. We analyzed the reliability of the OSOE with the GENOVA program.
RESULTS The reliability (generalizability coefficient) was 0.945, and the interrater agreement was 0.867. The type of item, checklist or global rating, was the largest variance component. The reliability of the checklist alone was 0.668 and that of the global rating alone was 0.363.
CONCLUSION The OSOE is reliable and can be used to assess ethics. More research should focus on achieving validity.
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PURPOSE To draw attention to patient safety and increase its awareness among medical students, we developed a program that teaches patient safety based on common medical error cases. The aim of this study is to introduce this program and improve student receptivity to it. METHODS: As part of the "Patient, Doctor, and Society" course, third-year medical students participated in 8 hours of a medical error education program. Students discussed recent, typical medical lawsuits that were generated from internal medicine, surgery, pediatrics, obstetrics and gynecology, neurosurgery, medication, anesthesia, and blood transfusion cases. Students weighed these issues in small groups, using various discussion methods. After finishing the program, students completed a course evaluation questionnaire.
RESULTS The students rated this program as satisfactory, highly motivating, and helpful in preparing their future practices. They responded that although the cases were interesting, some were difficult. They stated that the small group discussion techniques encouraged them to take active part in the discussion and to consider the cases more deeply. CONCLUSION: Small group discussion of medical error cases is an effective method for students to study patient safety.
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PURPOSE Ethics objective structured clinical examination (OSCE) scenarios was developed and were applied to medical students to see whether it would be suitable for assessing the students' ethical behaviors. METHODS: The data for this study were gathered from the end-of-clerkship patient-doctor-society OSCE, involving third-year medical students along the academic year of 2006. 54 students who participated in the ethics OSCE, which consisted of three stations, responded. Nine standardized patients (SPs) participated in the evaluation. The SPs were trained for 4 hours to conduct the medical interview and for 2 hours for evaluating students' performance using the checklist for each station. RESULTS: The consistency (Cronbach's alpha) of the SPs was 0.796. Mean score was 57.33. There was no difference among circuits and gender. CONCLUSION: We found that the ethics OSCE was adequate for evaluating students' performances.
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PURPOSE The aim of this study is to evaluate the students' clinical competency from the patient safety perspective.
METHODS We conducted this evaluation in 2006 at College of Medicine, Kangwon National University. We surveyed 50 fourth-year medical students after finishing all clinical clerkships. 49 Students evaluated their achievement with 5-Likert score scale. The questionnaires were composed 6 domains: communication skills, prevention & management of adverse events, using evidence and information techniques, teamwork & leadership, medical ethical behaviors, and procedural skills. The each domains were constituted several items. Total 53 items was evaluated.
RESULTS The students' preparedness was relatively low in 28 items of the total 53(difficult communication, detecting and managing medical errors, using evidence and information technique, understanding of complex systems, autonomy, and procedural skills).
CONCLUSION The items with low achievement were closely related with medical errors and patient safety. These findings suggest that the clinical education is insufficient for preventing medical errors by students. For patient safety, we should understand the importance of achievement of competency related with patient safety and establish a systematic clinical curriculum with explicit learning outcomes.
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PURPOSE The purpose of this paper was to assess if there is a relationship between Kolb learning styles and learner variables including age, gender, and grade retention among medical students.
METHODS The Kolb Learning Style Inventory(LSI) is used at many educational levels to determine the learning preferences of medical students and clinicians. The students' learning styles were analyzed for associations with learner variables. The Kolb LSI was administered to 164 Kangwon medical students. They were categorized based on learner variables.
RESULTS Kolb's 'assimilator' was the preferred learning style type of the study group(55.2%). 'Accommodator'(17.8%) and 'diverger'(16.0%) were next, followed by 'converger'(11.0%). Learning style preferences of medical students did not vary significantly according to age, gender, and grade retention.
CONCLUSION No statistically significant relationships were identified between the Kolb learning styles and learner variables. The assessment of medical students' learning styles categorized based on Kolb LSI is expected to provide educators with skills to plan teaching strategies, employ a variety of teaching methods, and facilitate academic performance.
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PURPOSE The aim of the study is to evaluate the possibility of giving student interns intern- level responsibilities and to discuss the various obstacles.
METHODS Modifications were made to the student internship program, including rotations through major departments, for 4th-year medical students and was conducted at the College of Medicine, Kangwon National University. We surveyed 49 students for the evaluation of the program, administered a checklist evaluation for their performance, and interviewed two focus groups of faculties and residents to find out the obstacles of the program.
RESULTS Most of the students answered that the program was satisfactory and necessary. Of the students, 71.4% performed as an acting intern. The mean score of the students' performance was 84.1. The students had the most difficulty with time management and making diagnostic and management decisions. Initially, at the start of the program, both students and residents were somewhat confused about the student interns' duties. They suggested that definite learning objectives, legal and institutional support to students' clinical practice, and announcements to patients and hospital staff should be put in place prior to the implementation of such a program.
CONCLUSION We discovered that it was possible for student interns to perform at the level of interns. We suggest that systemic improvements continue for the establishment of such student internship program.
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PURPOSE To evaluate the educational effectiveness of practice-based program for procedural skills at Kangwon National University College of Medicine.
METHODS In 2005, we conducted the training program composed of 19 procedural skills for third-year medical students during their first semester clerkship. The 14-week training used simulation models and was held for 3 hours per week, one hour for didactic session and 2 hours for practical exercise. A lecture was given only for wound dressing. OSCE, consisting of four 5-minute stations, was administered to analyze the students' achievement. 53 third-year students were given a survey following skills training and OSCE.
RESULTS Most students reported that the practice-based program was interesting and helpful in learning procedural skills. Students preferred practice to didactic medium.
Students were satisfied with the faculty's instruction, but suggested that the training should be providedprior to clerkship. OSCE had an overall reliability coefficient (Cronbach's alpha) of 0.78. The mean score in the dressing case was lower than those in other cases.
CONCLUSION The practice-based program for procedural skills was effective in motivating students' learning as well as improving theirtechnical skills. Self-directed exercises and appropriate feedback are more effective training tools than lectures.
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