Simulation-based teaching to improve cardiovascular exam skills performance among third-year medical students.

BACKGROUND: Evidence supports the need for improvement in cardiac physical examination skills training. PURPOSE: This study evaluates whether the addition of simulation offers added benefit over training utilizing standardized patients only. METHODS: All 124 third-year students who completed the required clerkship in one academic year received cardiac examination skills training utilizing a standardized patient and a cardiac simulator. The control group, comprising 281 students from 2 previous academic years, received training utilizing a standardized patient only. All students' physical exam skills were assessed in an objective structured clinical examination. RESULTS: Students trained with cardiac simulation performed significantly better than the control group in all 5 cardiac skills. The number of students who correctly performed all 5 cardiac exam skills increased significantly (p=.004). Pulmonary exam skills were unchanged. CONCLUSION: The use of simulation in addition to standardized patient teaching can improve students' performance of cardiac examination skills.

Assessing students' communication and interpersonal skills across evaluation settings.

BACKGROUND AND OBJECTIVES: Medical students' interpersonal and communication skills are a fundamental dimension of their clinical competence and will be measured on the anticipated US Medical Licensure Examination (USMLE) standardized patient (SP) exam. We compared students' performance on measures of SP satisfaction on a third-year family medicine Objective Structured Clinical Examination (OSCE) with measures of SP satisfaction on a fourth-year Clinical Practice Examination (CPX). METHODS: A total of 127 students completed both the clerkship OSCE and a CPX. The CPX was a pilot of the National Board of Medical Examiners Standardized Patient Exam. To assess students' interpersonal skills, both exams used modified versions of the American Board of Internal Medicine Patient Satisfaction Questionnaire. Students' scores were standardized, and correlations were calculated. A logistic regression model examined the ability of the OSCE to predict poor performance on the CPX. RESULTS: The correlation between the OSCE and CPX patient satisfaction scores was.08. There was no significant predictive ability of the OSCE for poor performance on the CPX. CONCLUSIONS: Our study calls into question the ability of a routine end-of-clerkship OSCE to identify students' interpersonal skills abilities on fourth-year clinical performance exams and potentially that component of the anticipated USMLE SP exam.

Medical school application interview score has limited predictive validity for performance on a fourth year clinical practice examination.

BACKGROUND AND PURPOSE: : Data supporting the predictive validity of the medical school admission interview are mixed. This study tested the hypothesis that the admission interview is predictive of interpersonal interactions between medical students and standardized patients. METHOD: : We determined correlations between admission interview scores and performance on a senior-year Clinical Practice Examination piloting US National Board of Medical Examiners stations. We also completed regression analyses controlling for undergraduate academic performance, gender and ethnicity. Outcome measures included an Interpersonal Skills score and a separate Overall Checklist performance score, completed by standardized patients. RESULTS: : The applicant interview had limited but statistically significant correlation with the Interpersonal Skills (r = 0.15; p < 0.05) score. The applicant interview had a correlation of 0.13 with the Overall Checklist score (p = .056). In linear regression models, the applicant interview had limited but statistically significant correlations with the Interpersonal Skills score and the Overall Checklist score. CONCLUSION: : As practiced at this medical school, the admission interview has limited predictive validity for future interactions with standardized patients. More comprehensive assessment of interpersonal skills during the medical school selection process will be needed in order to better select matriculants with desirable interpersonal skills.