Use of standardized patients to identify deficits in student performance and curriculum effectiveness.
Much literature supports the value of performance-based tests for obtaining an overall assessment of clinical skills; however, these tests can also identify specific deficits in medical curriculum and student learning. This study, conducted over a period of 2.5 years, used standardized patients to identify deficiencies in medical students' evaluation of a patient with "hoarseness and cough." Each of 230 students performed a physical examination and took a medical history, and each was evaluated on 29 items according to predetermined criteria. We conclude the following: (1) When examining a patient complaining of hoarseness and cough, students frequently did not screen for hemoptysis, thyroid problems, and otalgia; (2) Overall test performance correlated positively with the time of year of the rotation, but screening for certain items (including hemoptysis, thyroid problems, and otalgia) appeared not to depend on rotation; (3) Several important items significantly differentiated the more knowledgeable student from the less knowledgeable student.
Department of Surgery, University of Kentucky College of Medicine, Lexington.
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Haydon
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Donnelly
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Schwartz
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Strodel
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Jones
D002982:Clinical Clerkship; D002983:Clinical Competence / Q000592:standards*; D003371:Cough / Q000175:diagnosis; D003479:Curriculum; D003937:Diagnosis, Differential; D004504:Education, Medical, Undergraduate / Q000592:standards*; D004521:Educational Measurement / Q000379:methods*; D005069:Evaluation Studies as Topic; D013502:General Surgery / Q000193:education*; D006685:Hoarseness / Q000175:diagnosis; D006801:Humans; D008403:Mass Screening / Q000592:standards; D008487:Medical History Taking / Q000592:standards; D010361:Patients; D010808:Physical Examination / Q000592:standards; D015397:Program Evaluation / Q000379:methods*; D012381:Role Playing