Analysis of the Evaluation for Clinical Performance Examination using Standardized Patients in one Medical School

일개 의과대학에서 실시한 표준화환자(SP)를 이용한임상수행능력평가시험(CPX) 결과 분석

Kim, Ju-Ja;Lee, Gyeong-Jae;Choe, Gyu-Yeon;Lee, Dong-Hwan
김주자;이경재;최규연;이동환

  • Published : 20040000

Abstract

Purpose: Analysis of the evaluation for clinical performance examination(CPX) using standardized patient(SP) in one medical school was done to compare the evaluations between the staffs and SPs, among the staffs, and among the SPs, and to investigate the correlation between the evaluation scores and the school record. Methods: Clinical performance examination was done to seventy-nine 4th grade medical students. Checklist was modified from the existing reference and added more items. Three SPs who were non-physician volunteers were trained by authors about what is the disease and how to act the patient and how to evaluate the students. Three staffs and three SPs both filled up the checklist at the same time right after each student's performance. Results: Agreements between the staffs and the SPs were relatively high enough in the items of physical examination and management but low in the history taking related items although they were statistically significant. In the evaluation between the staffs and the SPs, the mean scores in the management and overall attitude were not significantly different, but, mean scores in the history taking, physical examination and overall skill were significantly different. Among the staffs there were no significant differences in history taking, physical examination, overall attitude, and there were significant differences in patient management and overall skill. Among the SPs there were no significant differences in physical exam, patient management and overall skill, and there were significant differences in history taking and overall attitude. The correlation coefficients between the evaluation scores and school records, between the evaluation scores and written report were relatively low respectively. Conclusion: To increase the agreement rates between the staffs and SPs, more training for the staffs and SPs are necessary

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References

  1. 김경한(2001). 임상실습시 선택과목제 시행 경험. 한국의학교육, 13(2), 221-230
  2. 김병수, 이영미, 안덕선, 박정률(2001). 임상의학입문(Introduction to Clinical Medicine) 평가를 위한 객관적 임상실기시험(Objective Structured Clinical Examination) 경험. 한국의학교육, 13(2), 289-298
  3. 안덕선(1997). The medical Council of Canada Qualifying Examination Part II 연구. 한국의학교육, 9, 65-72
  4. 이병국(2000). 임상수행평가의 세계적 추세에 따른 표준화환자 프로그램의 토착화 방안 연구. 한국의학교육, 12(2), 377-392
  5. 이병국(2001). 우리나라 표준화환자 프로그램 활용 현황과 개선 방안 - 관련 문헌 고찰 및 현장 연구를 중심으로. 한국의학교육, 13(1), 27-39
  6. 이영미, 황 건, 백상호, 홍명호, 최윤선, 김수현(2001). 의사국가시험에 임상수행능력측정의 도입을 위한 객관적 임상실기시험(Objective Structured Clinical Examination) 경험. 한국의학교육, 13(1), 47-57
  7. 박훈기, 김동원, 김덕언, 최호순, 김경태(1998). 의학과 4학년 종합평가로서의 객관적-구조적 임상능력 평가 (OSCE)의 경험. 한국의학교육, 1, 43-57
  8. 서보양, 이두진, 권굉보, 강복수(1998). 객관적으로 구조화된 임상시험의 시행 경험. 한국의학교육, 2, 363-381
  9. 최윤호, 손희정, 이준혁, 정진상, 홍경표, 안병헌, 채수응, 서정돈(2000). 임상실습 교육을 위한 표준화환자 프로그램의 개발 및 적용. 한국의학교육, 12(2), 353-361
  10. 황건, 이영미, 백상호(2001). 의사시험에 임상수기수행평가를 도입하기 위한 예비연구. 한국의학교육, 13(2), 277-287
  11. Abrahamson, S(1998). 표준화 환자를 이용한 임상실기능력평가 워크샵 I. How to assess clinical competence. 한국의학교육, 10(1), 153-164
  12. Barrows H, Abrahamson S(1964). The programmed patient. J. of Med Ed, 39, 802-805
  13. Elliot DL, Hickam DH(1987). Evaluation of physical examination skills: Reliability of faculty observers and patient instructors. JAMA, 258, 3405-3408 https://doi.org/10.1001/jama.258.23.3405
  14. Fleiss JL(1981). Statistical methods for rates and proportions. John Wiley & Sons: New York
  15. Garman(1998). 표준화 환자를 이용한 임상실기능력평가 워크샵. V. 1. How are rating scales are deloped? 2. Statistical scoring. 한국의학교육, 10(1), 235-253
  16. Harden RM, Stevenson M, Downie WW, Wilson GM(1975). Assessment of clinical competence using objective structured examination. British Medical Journal, 1, 447-451 https://doi.org/10.1136/bmj.1.5955.447
  17. Kachur EK, Lischka M, Das M, Ahn DS, Ban N, Swartz M(1996). Notes from the 7th Ottawa International Conference on Medical Education and Assessment. Medical Encounter, 12, 9-12
  18. Reteguiz JA, Cornel-Avendano B(1996). Mastering the OSCE/CSA. McGraw-Hill Co: Health Professions Division
  19. Sutnick AL(1993). ECFMG Assessment of clinical competence of graduates of fireign medical schools. JAMA, 270, 1041 https://doi.org/10.1001/jama.270.9.1041
  20. Tamblyn1 RM, Klass DJ, Schnabl GK, Kopelow ML(1991). Sources of unreliability and bias in standardized patients rating. Teaching and Learning in Medicine, 3, 74-85 https://doi.org/10.1080/10401339109539486
  21. Tamblyn2 RM, Klass DJ, Schnabl GK, Kopelow ML(1991). The accuracy of standardized-patient presentations. Medical Education, 25, 100-109 https://doi.org/10.1111/j.1365-2923.1991.tb00035.x
  22. Vu NV, Steward DE, Marcy ML(1987). An assessment of the consistency and accuracy of standardized patients' simulations. J. of Medcial Education, 62, 65-57
  23. Vu NV, Marcy ML, Colliver JA, Verhulst SJ, Travis TA, Barrows HS(1992). Standardized patients' accuracy in recording clinical performance checklist items. Medical Education, 26, 99-104 https://doi.org/10.1111/j.1365-2923.1992.tb00133.x
  24. Ziv Am Ben-David MF, Sutnick AI, Gary NE(1998). Lessons learned form six years of international administrations of the ECFMG's SP-based clinical skills assessment. Aca Med, 73, 84 https://doi.org/10.1097/00001888-199801000-00017