Abstract
BACKGROUND
There is poor interrater reliability in the assessment of a medical student's ability to generate a differential diagnosis list using Likert-based scales in the surgical clerkship. This important clinical skill is tested on the United States Medical Licensing Examination Step 2 Clinical Skills Examination.
OBJECTIVE
We hypothesize that third-year medical students in the surgical clerkship will be able to accurately diagnose adult patients with acute abdominal pain after performing a focused history and physical examination in a 3-station Objective Structured Clinical Examination (OSCE). Second, we want to test our hypothesis that service assessments of a student's ability to analyze data will not correspond with OSCE performance.
METHODS
In this retrospective study, third-year medical student differential diagnosis lists from a 3-station OSCE and medical student clerkship assessments were collected from the 2009-2010 academic year. Differential diagnosis lists were scored for accuracy. Differences between groups were compared with nonparametric statistics, using an α = 0.05.
RESULTS
Seventy-eight third-year medical students (56.4% female) were evaluated. For 2 stations, more than half of the medical students had the correct diagnosis on the differential diagnosis list (p < 0.0001). For 1 station, less than half of the medical students had the correct diagnosis on the differential diagnosis list (p = 0.0001). There were no differences in the service evaluation scores and the number of correct differential diagnosis lists for the students (p = 0.91).
CONCLUSIONS
Third-year medical students are generally accurate with the ability to diagnosis adult patients with acute abdominal pain after performing a history and physical examination. Additionally, surgical service faculty and resident assessments of a student's ability to analyze data do not correspond with OSCE performance. We recommend some changes that might lead to improved grading for third-year medical students in the surgical clerkship.
TY - JOUR
T1 - Differential diagnosis in a 3-station acute abdominal pain objective structured clinical examination (OSCE): a needs assessment in third-year medical student performance and summative evaluation in the surgical clerkship.
AU - Falcone,John L,
AU - Watson,Gregory A,
Y1 - 2011/04/16/
PY - 2010/12/09/received
PY - 2011/01/24/revised
PY - 2011/02/28/accepted
PY - 2011/6/29/entrez
PY - 2011/6/29/pubmed
PY - 2011/12/13/medline
SP - 266
EP - 9
JF - Journal of surgical education
JO - J Surg Educ
VL - 68
IS - 4
N2 - BACKGROUND: There is poor interrater reliability in the assessment of a medical student's ability to generate a differential diagnosis list using Likert-based scales in the surgical clerkship. This important clinical skill is tested on the United States Medical Licensing Examination Step 2 Clinical Skills Examination. OBJECTIVE: We hypothesize that third-year medical students in the surgical clerkship will be able to accurately diagnose adult patients with acute abdominal pain after performing a focused history and physical examination in a 3-station Objective Structured Clinical Examination (OSCE). Second, we want to test our hypothesis that service assessments of a student's ability to analyze data will not correspond with OSCE performance. METHODS: In this retrospective study, third-year medical student differential diagnosis lists from a 3-station OSCE and medical student clerkship assessments were collected from the 2009-2010 academic year. Differential diagnosis lists were scored for accuracy. Differences between groups were compared with nonparametric statistics, using an α = 0.05. RESULTS: Seventy-eight third-year medical students (56.4% female) were evaluated. For 2 stations, more than half of the medical students had the correct diagnosis on the differential diagnosis list (p < 0.0001). For 1 station, less than half of the medical students had the correct diagnosis on the differential diagnosis list (p = 0.0001). There were no differences in the service evaluation scores and the number of correct differential diagnosis lists for the students (p = 0.91). CONCLUSIONS: Third-year medical students are generally accurate with the ability to diagnosis adult patients with acute abdominal pain after performing a history and physical examination. Additionally, surgical service faculty and resident assessments of a student's ability to analyze data do not correspond with OSCE performance. We recommend some changes that might lead to improved grading for third-year medical students in the surgical clerkship.
SN - 1878-7452
UR - https://www.unboundmedicine.com/medline/citation/21708362/Differential_diagnosis_in_a_3_station_acute_abdominal_pain_objective_structured_clinical_examination__OSCE_:_a_needs_assessment_in_third_year_medical_student_performance_and_summative_evaluation_in_the_surgical_clerkship_
L2 - https://linkinghub.elsevier.com/retrieve/pii/S1931-7204(11)00064-X
DB - PRIME
DP - Unbound Medicine
ER -
