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Using systematically observed clinical encounters (SOCEs) to assess medical students' skills in clinical settings.

Bergus GR, Woodhead JC, Kreiter CD - Adv Med Educ Pract (2010)

Bottom Line: The calculated reliability of the SOCE scores, using generalizability theory, from 10 observed patient encounters was 0.81.Students reported receiving helpful feedback from faculty after 97% of their observed clinical encounters.The SOCE is an attractive addition to the other methods utilizing real patient encounters for assessing the skills of learners.

View Article: PubMed Central - PubMed

Affiliation: Performance Based Assessment Program, Office of Student Affairs and Curriculum, The University of Iowa, Iowa City, IA, USA ; Department of Family Medicine, The University of Iowa, Iowa City, IA, USA ; Department of Psychiatry, The University of Iowa, Iowa City, IA, USA.

ABSTRACT

Introduction: The Objective Structured Clinical Examination (OSCE) is widely used to assess the clinical performance of medical students. However, concerns related to cost, availability, and validity, have led educators to investigate alternatives to the OSCE. Some alternatives involve assessing students while they provide care to patients - the mini-CEX (mini-Clinical Evaluation Exercise) and the Long Case are examples. We investigated the psychometrics of systematically observed clinical encounters (SOCEs), in which physicians are supplemented by lay trained observers, as a means of assessing the clinical performances of medical students.

Methods: During the pediatrics clerkship at the University of Iowa, trained lay observers assessed the communication skills of third-year medical students using a communication checklist while the students interviewed and examined pediatric patients. Students then verbally presented their findings to faculty, who assessed students' clinical skills using a standardized form. The reliability of the combined communication and clinical skills scores was calculated using generalizability theory.

Results: Fifty-one medical students completed 199 observed patient encounters. The mean combined clinical and communication skills score (out of a maximum 45 points) was 40.8 (standard deviation 3.3). The calculated reliability of the SOCE scores, using generalizability theory, from 10 observed patient encounters was 0.81. Students reported receiving helpful feedback from faculty after 97% of their observed clinical encounters.

Conclusion: The SOCE can reliably assess the clinical performances of third-year medical students on their pediatrics clerkship. The SOCE is an attractive addition to the other methods utilizing real patient encounters for assessing the skills of learners.

No MeSH data available.


A schematic of the two-step systematically observed clinical encounter (SOCE) process. The student first interviews and examines a patient while being observed by a standardized observer (SO). The student then presents their findings to a faculty physician who is supervising learners in the General Pediatrics Clinic.
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f1-amep-1-067: A schematic of the two-step systematically observed clinical encounter (SOCE) process. The student first interviews and examines a patient while being observed by a standardized observer (SO). The student then presents their findings to a faculty physician who is supervising learners in the General Pediatrics Clinic.

Mentions: At the start of each half-day clinic session, a standardized observer met with the third-year medical student assigned to the clinic. If the student consented to participate, the standardized observer went into the clinic waiting room to find the patient the student was scheduled to see next. If the patient and his/her parent consented, the standardized observer then accompanied the patient and his/her parent into an exam room. When the student entered the exam room the standardized observer took a position outside of the student’s line of sight and completed the communication checklist while observing the student. The standardized observer remained in the exam room for the entire encounter (Figure 1).


Using systematically observed clinical encounters (SOCEs) to assess medical students' skills in clinical settings.

Bergus GR, Woodhead JC, Kreiter CD - Adv Med Educ Pract (2010)

A schematic of the two-step systematically observed clinical encounter (SOCE) process. The student first interviews and examines a patient while being observed by a standardized observer (SO). The student then presents their findings to a faculty physician who is supervising learners in the General Pediatrics Clinic.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3643132&req=5

f1-amep-1-067: A schematic of the two-step systematically observed clinical encounter (SOCE) process. The student first interviews and examines a patient while being observed by a standardized observer (SO). The student then presents their findings to a faculty physician who is supervising learners in the General Pediatrics Clinic.
Mentions: At the start of each half-day clinic session, a standardized observer met with the third-year medical student assigned to the clinic. If the student consented to participate, the standardized observer went into the clinic waiting room to find the patient the student was scheduled to see next. If the patient and his/her parent consented, the standardized observer then accompanied the patient and his/her parent into an exam room. When the student entered the exam room the standardized observer took a position outside of the student’s line of sight and completed the communication checklist while observing the student. The standardized observer remained in the exam room for the entire encounter (Figure 1).

Bottom Line: The calculated reliability of the SOCE scores, using generalizability theory, from 10 observed patient encounters was 0.81.Students reported receiving helpful feedback from faculty after 97% of their observed clinical encounters.The SOCE is an attractive addition to the other methods utilizing real patient encounters for assessing the skills of learners.

View Article: PubMed Central - PubMed

Affiliation: Performance Based Assessment Program, Office of Student Affairs and Curriculum, The University of Iowa, Iowa City, IA, USA ; Department of Family Medicine, The University of Iowa, Iowa City, IA, USA ; Department of Psychiatry, The University of Iowa, Iowa City, IA, USA.

ABSTRACT

Introduction: The Objective Structured Clinical Examination (OSCE) is widely used to assess the clinical performance of medical students. However, concerns related to cost, availability, and validity, have led educators to investigate alternatives to the OSCE. Some alternatives involve assessing students while they provide care to patients - the mini-CEX (mini-Clinical Evaluation Exercise) and the Long Case are examples. We investigated the psychometrics of systematically observed clinical encounters (SOCEs), in which physicians are supplemented by lay trained observers, as a means of assessing the clinical performances of medical students.

Methods: During the pediatrics clerkship at the University of Iowa, trained lay observers assessed the communication skills of third-year medical students using a communication checklist while the students interviewed and examined pediatric patients. Students then verbally presented their findings to faculty, who assessed students' clinical skills using a standardized form. The reliability of the combined communication and clinical skills scores was calculated using generalizability theory.

Results: Fifty-one medical students completed 199 observed patient encounters. The mean combined clinical and communication skills score (out of a maximum 45 points) was 40.8 (standard deviation 3.3). The calculated reliability of the SOCE scores, using generalizability theory, from 10 observed patient encounters was 0.81. Students reported receiving helpful feedback from faculty after 97% of their observed clinical encounters.

Conclusion: The SOCE can reliably assess the clinical performances of third-year medical students on their pediatrics clerkship. The SOCE is an attractive addition to the other methods utilizing real patient encounters for assessing the skills of learners.

No MeSH data available.