Standardized patient outcomes trial (SPOT) in neurology.
BACKGROUND
The neurologic examination is a challenging component of the physical examination for medical students. In response, primarily based on expert consensus, medical schools have supplemented their curricula with standardized patient (SP) sessions that are focused on the neurologic examination. Hypothesis-driven quantitative data are needed to justify the further use of this resource-intensive educational modality, specifically regarding whether using SPs to teach the neurological examination effects a long-term benefit on the application of neurological examination skills.


METHODS
This study is a cross-sectional analysis of prospectively collected data from medical students at Weill Cornell Medical College. The control group (n=129) received the standard curriculum. The intervention group (n=58) received the standard curriculum and an additional SP session focused on the neurologic examination during the second year of medical school. Student performance on the neurologic examination was assessed in the control and intervention groups via an OSCE administered during the fourth year of medical school. A Neurologic Physical Exam (NPE) score of 0.0 to 6.0 was calculated for each student based on a neurologic examination checklist completed by the SPs during the OSCE. Composite NPE scores in the control and intervention groups were compared with the unpaired t-test.


RESULTS
In the fourth year OSCE, composite NPE scores in the intervention group (3.5±1.1) were statistically significantly greater than those in the control group (2.2±1.1) (p<0.0001).


CONCLUSIONS
SP sessions are an effective tool for teaching the neurologic examination. We determined that a single, structured SP session conducted as an adjunct to our traditional lectures and small groups is associated with a statistically significant improvement in student performance measured 2 years after the session.
Department of Neurology and Neuroscience, Weill Medical College of Cornell University, New York, NY 10021, USA. jos9046@med.cornell.edu
Joseph E
JE
Safdieh
Andrew L
AL
Lin
Juliet
J
Aizer
Peter M
PM
Marzuk
Bernice
B
Grafstein
Carol
C
Storey-Johnson
Yoon
Y
Kang
D002982:Clinical Clerkship; D032921:Consensus; D003430:Cross-Sectional Studies; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods; D004522:Educational Status; D006801:Humans; D007858:Learning; D009422:Nervous System Diseases / Q000175:diagnosis; D009460:Neurologic Examination / Q000379:methods; D009462:Neurology / Q000193:education*; D017063:Outcome Assessment, Health Care; D012577:Schools, Medical; D013337:Students, Medical / Q000523:psychology*; D013663:Teaching
Acad Med. 1993 Jun;68(6):443-51; discussion 451-3
8507309
Acad Med. 1994 Jul;69(7):567-70
8018268
Med Educ. 1992 Mar;26(2):99-104
1565039
Acad Med. 1995 Apr;70(4):313-7
7718064
Neurologist. 2004 Jul;10(4):216-20
15245587
Med Educ. 2004 Sep;38(9):969-73
15327678
Med Educ Online. 2009 Jun 29;14:7
20165521
Med Educ. 2001 Apr;35(4):371-3
11319001
Neurology. 2002 Mar 26;58(6):849-52
11914397
Acad Med. 1997 Oct;72(10 Suppl 1):S85-7
9347749
Acad Med. 1997 Jul;72(7):619-26
9236472
Acad Med. 1999 Jan;74(1):23-6
9934290
Am J Surg. 1997 Apr;173(4):320-5
9136788
Teach Learn Med. 2004 Spring;16(2):171-4
15276894