Julie M. Noffsinger, MD, MD, University of Colorado Denver, Aurora, CO, Jennifer B. Soep, MD, University of Colorado Denver, Aurora, CO
Background: Observation is a crucial part of medical student education. As part of an initiative to increase the frequency and quality of feedback to students from direct observation, we implemented required formal observations during the clerkship. The Mini-Clinical Evaluation Exercise (mini-CEX) and the Structured Clinical Observation (SCO) are two tools available for observation of trainees.
Methods:In the 2010-2011 academic year, we required students get one mini-CEX filled out during the clerkship. In 2011-2012, we requested students complete 1-5 SCO forms. We compared data from end-of-block evaluations for the 2010-2011 (mini-CEX) year and the 2011-2012 (SCO) year using an independent t-test. Student comments were also reviewed from the evaluations. Students were asked if they received feedback as a result of the observations, rated on a 4 point Likert scale (1=Strongly Disagree and 4=Strongly Agree). They were also asked to rate the usefulness of the observations on a 5 point Likert scale (1=not at all useful and 5=essential).
Results:On average, students agreed that they received feedback as a result of the observations (mini-CEX=3.09 versus SCO=3.28, p=0.68). Students found the SCO significantly more useful with a mean rating of 3.28(SCO) versus 2.7(mini-CEX), t=4.2184, df=206, p<.0001. Comments, although rare, were mostly positive for both observation tools and included: “the structured clinical observations were an incredible resource unique to this block”, and “to get direct feedback on skills is invaluable, and to have them as a requirement provided a way to be observed without being perceived as a burden”. Although some students expressed concerned about extra paperwork, no faculty complaints were received regarding the new observation requirement for either tool.
Conclusions:Requiring brief formal observations during the pediatric clerkship is a simple way to increase preceptor feedback to students. In our cohort, the SCO was rated more useful than the mini-CEX, but both tools seemed to provide an opportunity for feedback. In the future, we could explore how these observations could improve the quality of competency-based student evaluations.