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Ronald M. Epstein, Elaine F. Dannefer, Anne C. Nofziger, John T. Hansen, Stephen H. Schultz, Nicholas Jospe, Laura W. Connard, Sean C. Medrum, Lindsey C. Henson. Comprehensive Assessment of Professional Competence: The Rochester Experiment: Teaching and Learning in Medicine 16(2), 186-196. Reviewed by Sherilyn Smith, University of Washington


 

Ronald M. Epstein, Elaine F. Dannefer, Anne C. Nofziger, John T. Hansen, Stephen H. Schultz, Nicholas Jospe, Laura W. Connard, Sean C. Medrum, Lindsey C. Henson. Comprehensive Assessment of Professional Competence: The Rochester Experiment: Teaching and Learning in Medicine 16(2), 186-196.

Reviewed by Sherilyn Smith, University of Washington

This article provides an in depth description of a comprehensive evaluation of the clinical skills of 2nd year medical students. The authors provide an overview of the double helix curriculum at Rochester (which integrates early clinical experiences with basic science and then provides an opportunity for students to revisit the basic sciences later in their training). They then describe their comprehensive assessment of skills, knowledge and attitudes that occurs at the end of the 2nd year of training. This assessment uses multiple modalities including standardized patient exercises, multiple choices tests, structured evidence based medicine exercises, team work assessment and take home essays. Built into the exercise are evaluations from standardized patients, faculty preceptors and peers. The authors provide data on test question performance, distribution of student per-formance on each of the items and correlations between different tests in specific skills domains (such as communication skills and items of professionalism). The product of the assessment was an individual learning plan reflected areas that needed work (identified through the anonymous feedback & test results). The authors also provide students' evaluations of this exercise. Highlights in the article include the 19-item Rochester Communication rating scale developed to assess four domains of patient centered communication and the peer assessment form.

This article is worth reading to see how a comprehensive evaluation test could be constructed and how one might use different testing modalities to test skills. I particularly liked the two rating scales because these could be directly imported into clerkship training evaluations. A similar comprehensive test at the end of 3rd year/beginning of 4th year would be equally interesting. What was missing and would also be interesting is how these evaluations predict performance on other more traditional measures such as NMBE test scores and clerkship performance. This will most likely be presented in follow up papers.

(Do you use peer evaluations as part of your evaluation program in the third year? Steve Miller)

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