Applying a validated scoring rubric to pre-clerkship medical students’ standardized patient notes: a pilot study

BMC Medical Education

Research

Michael L. Green¹  Benjamin D. Gallagher¹  Jaideep S. Talwalkar² 

[1] Department of Internal Medicine, Yale School of Medicine, 789 Howard Avenue, New Haven, CT, USA;Department of Internal Medicine, Yale School of Medicine, 789 Howard Avenue, New Haven, CT, USA;Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA;

关键词: Undergraduate medical education;    Clinical reasoning;    Clinical assessment;    OSCE;    Scoring rubric;   

DOI  :  10.1186/s12909-023-04424-9

 received in 2022-12-16, accepted in 2023-06-05,  发布年份 2023

来源: Springer

【 摘 要 】

ndWith the elimination in 2021 of the United States Medical Licensing Examination Step 2 Clinical Skills test, it is incumbent upon U.S. medical schools to develop local validated assessments of clinical reasoning. While much attention has been paid to summative exams for graduating students, formative exams for pre-clerkship students have not been well studied.MethodsWe applied the University of Illinois at Chicago College of Medicine (UIC-COM) Patient Note (PN) Scoring Rubric to templated PNs written by 103 pre-clerkship students for two cases in an objective structured clinical examination (OSCE) at the Yale School of Medicine. The rubric consists of four section scores (Documentation, Differential Diagnosis, Justification, and Workup, each scored 1 to 4) and a composite score (scaled 23 to 100). We calculated item discrimination for each section score and Cronbach’s alpha for each case. We surveyed students about their experience writing the templated PN.ResultsMean Documentation, Differential Diagnosis, Justification, Workup, and composite scores for case A were 2.16, 1.80, 1.65, 2.29, and 47.67, respectively. For case B, the scores were 2.13, 1.21, 1.60, 1.67, and 40.54, respectively. Item discrimination ranged from 0.41 to 0.80. Cronbach’s alpha for cases A and B was 0.48 and 0.25, respectively. A majority of the students felt that the exercise was useful and appropriate to their level of training.ConclusionsDespite performing poorly, pre-clerkship students found the note-writing task beneficial. Reliability of the scoring rubric was suboptimal, and modifications are needed to make this exercise a suitable measure of clinical reasoning.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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