Paula L. Stillman

Results of a survey on the use of standardized patients to teach and evaluate clinical skills

In 1989, a survey was sent to each U.S. and Canadian medical school requesting information about how standardized patients are used for teaching and evaluating clinical skills, and 95% of the schools responded. Although there was widespread use of standardized patients throughout the curricula, the role and training of these patients varied markedly within a given school as well as across schools. One outcome of this survey is the development of a network to share resources, protocols, and training material to enhance the development of this educational strategy.

Construct Validation of the Arizona Clinical Interview Rating Scale

The Arizona Clinical Interview Rating Scale is examined for construct validity as an instrument to evaluate the interviewing techniques of medical students. Evidence was gathered in the areas of convergent and discriminant validity, sensitivity to change, internal consistency, and objectivity.

Scoring and Standard Setting with Standardized Patients

The purpose of this study was to compare the continuous method of scoring a performance test composed of standardized patients with a derivative method that assigned each examinee a dichotomous score and to explore the use of Ang off s method at the case level with these two scoring methods. Both scoring systems produced reasonable means and distributions of scores. The continuous scores were somewhat more reproducible than the dichotomous scores although neither was very relay?ducible. Pass rates for both scoring systems were appropriately very high and thus the reproducibility of the pass/fail decisions was also high. Regardless of the scoring system, the application of Angoffs method reported in this article has the advantages of efficiency and enhanced credibility to the experts.

Examiner error in intelligence testing: Are you a source?

Four protocols and scripts were constructed for the WAIS (Wechsler, 1955) presenting a range of levels of intelligence and an assortment of behavioral patterns. A group of three practicing school psychologists edited the scripts and assessed the accuracy of point assignments to individual items. Unanimity was reached for scoring of each response. These “standard” responses appearing in the WAIS manual were memorized by clients who served as examinees. Thirty-three WAIS administrations were completed by practicing school psychologists and school psychology students eligible for state certification as psychometrists. These obtained score means were not significantly different from the “true scores” assigned to the standard responses for Verbal, Performance, or Full Scale indices. However, a number of examiner item scoring and administration errors were observed for numerous subtests, that could well result in misplacement or exclusion of an individual from a special program. Such examiner error suggests the need for a reexamination of training procedures and continuing education for school psychologists to facilitate proficiency with new and revised psychometric instruments (WAIS-R).

The use of live models in the teaching of gross anatomy

Live models were introduced into the first‐year gross anatomy course to provide medical students with an opportunity to apply to the living person what they learned from cadaver dissection. After each major segment of the cadaver dissection, clinical correlation sessions were presented for the students by clinicians, using live models for demonstration, examination and correlation. At the completion of the course, an evaluation questionnaire was given to students. Their response indicated that the new teaching technique made anatomy seem more relevant to clinical medicine than using cadavers alone. Live models were rated superior to using cadavers, especially in demonstrating superficial anatomical structures and landmarks.

The relationship of spoken-English proficiencies of foreign medical school graduates to their clinical competence

No abstract available.

Effect of Immediate Student Evaluations on a Multi-Instructor Course.

Immediate student feedback and peer evaluation by a single physician were used to evaluate and monitor an interdisciplinary multi-instructor course. Clinical Correlations with Pathology is taught during the second year of medical school by 50 instructors, each of whom has a limited exposure to sophomore medical students. The format of the course, in which the same students evaluate multiple lecturers in multiple content areas, provided a unique opportunity to demonstrate the reliability and validity of student evaluations. About one-half of the lectures were repeated by the same instructors the following year to the next class of medical students, who also evaluated all of the lectures. Comparison of two consecutive sophomore classes of medical students documented overall course improvement and showed higher ratings given to instructors who presented the same lecture both years. Student evaluation is a powerful technique that can result in positive changes leading toward course improvement.

Pilot study of the use of the ECFMG clinical competence assessment to provide profiles of clinical competencies of graduates of foreign medical schools for residency directors. Educational Commission for Foreign Medical Graduates

&NA; PURPOSE. To conduct the first of a series of pilot projects of the clinical competence assessment (CCA) of the Educational Commission for Foreign Medical Graduates (ECFMG) in order to provide profiles of clinical competencies of graduates of foreign medical schools for residency directors in the United States and for governments and institutions in other countries. METHOD AND RESULTS. In September 1992 the first pilot project of the ECFMG CCA was conducted for a program director who wanted to evaluate ten first‐year residents in a midwestern U.S. program. The CCA consists of integrated clinical encounters with ten standardized patients, 60 laser videodisc pictorials, and analysis of test items of previously completed ECFMG certification examinations. Profiles of the following clinical competencies were provided to the program director: data gathering (history and physical examination), interviewing and interpersonal skills, diagnosis and management skills, interpretation of diagnostic and laboratory procedures, written communication of information to the health care team, and spoken‐English proficiency. The profiles were provided as individual scores compared with mean scores of a reference group of 525 first‐year residents who took the CCA at four U.S. assessment centers, and as percentile scores with a range of one standard error of measurement. CONCLUSION. The individual performance data in this first pilot project were valuable to the program director, who used them to supplement scores on a written examination during the first residency year. The pilot project has shown the ECFMG CCA to be a useful tool for program directors to evaluate applicants and residents who are graduates of foreign medical schools.

The use of a patient note to evaluate clinical skills of first-year residents who are graduates of foreign medical schools.

No abstract available.

Using a Competency-Based Program to Assess Interviewing Skills of Pediatric House Staff.

A program has been initiated to assess objectively the interviewing skills of pediatric house staff. Each entering house staff member interviews and is evaluated by a nonphysician mother who presents the medical history of her child. Remedial instruction is provided for all who do not perform in accordance with established minimum criteria. As a result of this competency-based program, all house staff members are now known to have attained at least a minimum level of competence in interviewing technique.