title: How we developed and piloted an electronic key features examination for the internal medicine clerkship based on a US national curriculum.
abstract: BACKGROUND
  Key features examinations (KFEs) have been used to assess clinical decision making in medical education, yet there are no reports of an online KFE-based on a national curriculum for the internal medicine clerkship. What we did: The authors developed and pilot tested an electronic KFE based on the US Clerkship Directors in Internal Medicine core curriculum. Teams, with expert oversight and peer review, developed key features (KFs) and cases.
  
  
  RESULTS
  The exam was pilot tested at eight medical schools with 162 third and fourth year medical students, of whom 96 (59.3%) responded to a survey. While most students reported that the exam was more difficult than a multiple choice question exam, 61 (83.3%) students agreed that it reflected problems seen in clinical practice and 51 (69.9%) students reported that it more accurately assessed the ability to make clinical decisions.
  
  
  CONCLUSIONS
  The development of an electronic KFs exam is a time-intensive process. A team approach offers built-in peer review and accountability. Students, although not familiar with this format in the US, recognized it as authentically assessing clinical decision-making for problems commonly seen in the clerkship.
authors.affiliation: a University of Nevada School of Medicine , USA .
authors.forename: Kirk A
authors.initials: KA
authors.lastname: Bronander
authors.affiliation: b University of Rochester School of Medicine , USA .
authors.forename: Valerie J
authors.initials: VJ
authors.lastname: Lang
authors.affiliation: c University of Minnesota College of Medicine , USA .
authors.forename: L James
authors.initials: LJ
authors.lastname: Nixon
authors.affiliation: d University of Florida College of Medicine , USA .
authors.forename: Heather E
authors.initials: HE
authors.lastname: Harrell
authors.affiliation: e Southern Illinois University School of Medicine , USA .
authors.forename: Regina
authors.initials: R
authors.lastname: Kovach
authors.affiliation: e Southern Illinois University School of Medicine , USA .
authors.forename: Susan
authors.initials: S
authors.lastname: Hingle
authors.affiliation: f Geisel School of Medicine at Darmouth , USA.
authors.forename: Norman
authors.initials: N
authors.lastname: Berman
mesh_terms: D002982:Clinical Clerkship / Q000379:methods*; D002983:Clinical Competence; D000066491:Clinical Decision-Making; D003258:Consumer Behavior; D003479:Curriculum; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D020407:Internet; D014584:User-Computer Interface