COMSEP 2008 Atlanta Meeting
Simulated Cases as a Predictor for Structured Oral Examination Results
Gary L. Beck & Sharon R. Stoolman
University of Nebraska Medical Center, Omaha, Nebraska
Objective: The use of standardized patients in clinical diagnosis is being challenged in the computer age. Rising costs require new innovations in education. However, few studies have been done to determine if use of simulations prepare students for real patient encounters or standardized patients. Hypothesis: Increased use of CLIPP cases does not indicate better performance on a structured oral examination.
Methods: As part of the pediatrics clerkship, approximately a third of the students are assigned to a private clinic in locations throughout the state of Nebraska (CP). The other students rotate through various services at the University of Nebraska Medical Center (UNMC). During the 2006/2007 year, junior medical students (n=119) were required to maintain a core experience log documenting either direct patient experiences or a corresponding CLIPP case during their 8-week pediatrics clerkship. Students conduct a structured patient interview on the last day of the clerkship, which is graded for content as well as professionalism. Correlation analyses were conducted to determine what measured variables provide the best predictor for oral exam results.
Results: Average minutes spent per CLIPP case and average number of patients encounters were not statistically significant predictors for either content or professionalism components on the structured patient interview. Interestingly, total number of cases completed demonstrated positive correlation for the first rotation for UNMC students (r=0.667, p<0.05) and the last rotation for CP students (r=0.928, p<0.05).
Conclusions: Although a useful means of ensuring students receive similar patient care knowledge, the CLIPP cases did not impact demonstrated clinical history-taking skills.