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2008 Annual Meeting Abstracts

Medical Student Performance in Surgical Patient Simulation Correlates With End-Of-Clerkship Oral Examination Performance
Gladys L. Fernandez, MD, Neal E. Seymour, MD, David W. Page, MD.
Baystate Medical Center, Springfield, MA, USA.

Objective: The study purpose was to demonstrate that medical student performance in simulated surgical patient care correlates with performance in verbally-expressed patient care as measured during the end-of-clerkship oral examination (OE), using a uniform performance measurement instrument.
Design: Subject-controlled trial
Setting: University affiliated community hospital
Participants: Forty-six Tufts 3rd year medical students (MS3s)
Interventions: MS3s received patient simulation training during the surgical clerkship from January 2006 to September 2007. This consisted of 5 scheduled simulations per student, drawn from a core of simulated patient experiences. All students had the same didactic exposure over the 12-week rotation. An end-of-clerkship oral examination patterned on the ABS certifying exam was given, testing verbally-expressed patient management on randomly selected cases. Examiners were blinded to student simulation experiences.
Main Outcome Measures: Simulation and OE performance were measured using an 8-item instrument assessing diagnostic, therapeutic, and presentation skills (5-point scale), with a final score comprised of the mean of assessed items. Performance trend in successive simulations was tested by repeated measures ANOVA. Pearson correlation test was performed for simulation and OE performance.
Results: MS3s received 5.89 ± 0.91(SD) hours simulation training (median = 6 hours) and all finished at least 4 simulations (range 4-8). A significant improvement in simulation performance was observed over 4 successive simulations (p < 0.0001). Simulation performance correlated well with OE performance (r = 0.415; p = 0.0041).
Conclusions: Performance in simulation during the surgical clerkship correlates well with end-of-rotation OE performance, and suggests that the skill sets employed during these two activities are similar. This suggests a means of discovering performance issues during formative training that might impact subsequent summative assessment.


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