Linda R Tewksbury, MD 1, Colleen Gillespie, PhD 2, Chase Julianne, PhD 1 and Adina Kalet, MD,MPH 1. 1 NYU School of Medicine, New York, NY and 2 NYU Wagner Graduate School, New York, NY.
Background: In-house comprehensive clinical skills examinations are commonly used in medical schools and the passing of a standardized clinical examination (USMLE step 2 CS) is now a requirement for licensing. While the USMLE step 2 CS issues only a pass/fail grade, in-house clinical skill examinations provide the opportunity for providing more meaningful feedback to students and recommendations for remediation as needed.
Objective: To describe the development and implementation of individualized student report cards based on students' performance on a comprehensive clinical skills examination (CCSE) and a program for remediation.
Design/Methods: A 6 station CCSE for all 4th year medical students was designed, through collaborative effort of all core clerkship directors at our institution, to measure the following clinical skills: 1) communication 2) history taking 3) physical examination and 4) ability to write a coherent patient note. Standardized patients were trained to assess first 3 skills using carefully designed checklists using a 3-point scale for each behaviorally anchored item: not done, done minimally, well done. Faculty evaluated patient notes. All results were entered in a data bank allowing for calculation of individual and class results for all four-skill areas.
Results: 125/148(85%) of 4th year medical students who participated in the exam consented to have their data analyzed anonymously. Individual report cards were produced for each student comparing individual performance with class performance on each of four skill areas.. Based on poor performance (<10% across >2 skill areas), 7 students were recommended for remediation. Remediation included one-on-one in-depth analysis of performance with a trained faculty and review of videotaped patient session.
Conclusions: We are pleased to share our experience in developing individualized student report cards and program for remediation based on students' performance on an in-house comprehensive clinical skills examination.