Purpose Information gathering ability had been evaluated mainly via checklists in clinical performance examinations (CPX). But, it is not proved yet if students write the information correctly in postencounter note (PN), although they asked questions or performed physical examinations (PE) about the information when they interacted with standardized patients in CPX. This study addressed the necessity of introducing PN to evaluate the ability in CPX.
Methods After patient encounters, students were instructed to write the findings of history taking and physical examination that they considered as important information in approaching the patient’s problems in PN. PNs were scored using answer keys selected from checklist items, which were considered to be recorded in PN by CPX experts.
Results PNs of six CPX cases from 54 students were analyzed. Correlation coefficients between the key-checklist scores and PN scores of six cases were moderate to high (0.52 to 0.79). However, students frequently neglected some cardinal features of chief complains, pertinent findings of past/social history and PE, and pertinent negative findings of associated symptoms in PNs, which were checked as ‘done’ in the keys of checklists.
Conclusion It is necessary to introduce PN in CPX to evaluate the students’ ability of synthesis and integration of patient information.
Citations
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Deliberate practice of diagnostic clinical reasoning reveals low performance and improvement of diagnostic justification in pre-clerkship students Justine Staal, Jason Waechter, Jon Allen, Chel Hee Lee, Laura Zwaan BMC Medical Education.2023;[Epub] CrossRef
Restoring force of medical school Eun Kyung Chung Korean Journal of Medical Education.2014; 26(2): 81. CrossRef
PURPOSE The purpose of this study is to assess the effects of case type and gender of standardized patient on student performance in a clinical performance examination(CPX).
METHODS During 2005, an eight-station CPX was administered to fourth-year students from 4 medical schools. A total of 306 students, of which 206(67%) were male, participated in the exam. Station checklists, scored by the SPs, consisted of history taking(Hx), physical examination(PE), information sharing(IS), clinical courtesy(CC) and patient-physician interaction(PPI). A measurement of students' perceived difficulty was obtained through student questionnaires. The difference of CPX scores between male and female students were studied using Mann-Whitney's U.
RESULTS Across the gender-neutral cases, female students scored better in Hx in 2 cases. In PE, IS and CC, the only difference seen was with CC in 1 case(female students scored higher). In PPI, female students performed better than male students in all female SP cases and one male SP case, but, there was a significant student gender-SP gender interaction when averaging all cases. For the gender sensitive case, there was no significant difference in all checklist categories in the male case when student gender was considered. In the female case, female students performed better than male students only in PPI. Student questionnaires revealed that there was no significant difference in perceived difficulty between male and female students.
RESULTS The standardized patients' ratings in gender sensitive cases are not affected by the gender of standardized patients and students, except in PPI with a female case where female students performed better than male students.
Citations
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The Relationship between Medical Students’ Assessment of Standardized Patients and Patient‐Physician Interaction Score Eui-Ryoung Han, Sun Kim, Eun-Kyung Chung Korean Medical Education Review.2019; 21(3): 150. CrossRef
The Change of CPX Scores according to Repeated CPXs Yoon Hee Lee, Jae Hyun Park, Jin Kyung Ko, Hyo Bin Yoo Korean Journal of Medical Education.2011; 23(3): 193. CrossRef
Comprehension of Patient-Physician Interaction through Analysis of Relationships between Domains in Clinical Performance Examination Jae Jin Han, Myoung Jin Lee, Hyun-jung Im Korean Journal of Medical Education.2010; 22(3): 177. CrossRef
The Correlation between CPX and Written Examination Scores in Medical Students Yera Hur, Sun Kim, Sung-Whan Park Korean Journal of Medical Education.2007; 19(4): 335. CrossRef
PURPOSE This study was designed to investigate the effects of information sharing between students on results of clinical performance examination (CPX).
METHODS 143 third-year students, who completed their core clinical clerkship, were randomly assigned to one day of a 3-day, 6 station CPX. Station checklists, scored by the SP(s), consisted of history taking, physical examination, information sharing, clinical courtesy and patient-physician interaction. We compared the CPX station scores, CPX domain scores, self assessment scores and GPA of the three groups tested on different days with ANOVA, and analyzed the differences in CPX scores, after controlling for GPA, with ANCOVA. The correlations among the CPX total and domain scores, self assessment and the GPA of the 3rd year students were calculated. Data regarding information sharing between students and self-assessment were obtained through student questionnaires.
RESULTS CPX total scores, self assessment scores and GPA of 3rd year students from day-2 were significantly higher than scores from day-1 or day-3. Checklist analysis showed that PE, CC and PPI scores were significantly higher on day-2, but Hx and IS scores were not significantly different.
Results from questionnaires showed that 43% of students shared evaluation information. And CPX total scores had little correlation with self assessment scores. GPA of 3rd year students showed a similar pattern with the CPX totalscore.
CONCLUSION There is information sharing occurring between students during clinical performance examinations. Although there are significant differences in CPXscores for the treatment group, it seemed that CPX scores are not affected by information sharing between students. Reliability of information sharing from other students is low. The generalization of this study should be interpreted carefully.
Citations
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Necessity of introducing postencounter note describing history and physical examination at clinical performance examination in Korea Jonghoon Kim Korean Journal of Medical Education.2014; 26(2): 107. CrossRef
Comprehension of Patient-Physician Interaction through Analysis of Relationships between Domains in Clinical Performance Examination Jae Jin Han, Myoung Jin Lee, Hyun-jung Im Korean Journal of Medical Education.2010; 22(3): 177. CrossRef
Does sharing information before a clinical skills examination impact student performance? Jong Hoon Kim Medical Teacher.2010; 32(9): 747. CrossRef
Correlations of Information Gathering Scores between Checklists and Interstation Works in a Clinical Performance Examination Jong Hoon Kim Korean Medical Education Review.2010; 12(2): 19. CrossRef
Effects of Case Type and Standardized Patient Gender on Student Performance in a Clinical Performance Examination Jonghoon Kim, Kiyoung Lee, Dongmi Yoo, Eunbae Yang Korean Journal of Medical Education.2007; 19(1): 23. CrossRef
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