지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2016.1
- 수록면
- 35 - 47 (13page)
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Purpose: The purpose of this study is to investigate the reliability and validity of new clinical performance examination (CPX) for assessing clinical reasoning skills and evaluating clinical reasoning ability of the students.
Methods: Third-year medical school students (n=313) in Busan-Gyeongnam consortium in 2014 were included in the study. One of 12 stations was developed to assess clinical reasoning abilities. The scenario and checklists of the station were revised by six experts. Chief complaint of the case was rhinorrhea, accompanied by fever, headache, and vomiting. Checklists focused on identifying of the main problem and systematic approach to the problem. Students interviewed the patient and recorded subjective and objective findings, assessments, plans (SOAP) note for 15 minutes. Two professors assessed students simultaneously. We performed statistical analysis on their scores and survey.
Results: The Cronbach α of subject station was 0.878 and Cohen κ coefficient between graders was 0.785. Students agreed on CPX as an adequate tool to evaluate students’ performance, but some graders argued that the CPX failed to secure its validity due to their lack of understanding the case. One hundred eight students (34.5%) identified essential problem early and only 58 (18.5%) performed systematic history taking and physical examination. One hundred seventy-three of them (55.3%) communicated correct diagnosis with the patient. Most of them had trouble in writing SOAP notes.
Conclusion: To gain reliability and validity, interrater agreement should be secured. Students' clinical reasoning skills were not enough. Students need to be trained on problem identification, reasoning skills and accurate record-keeping.
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참고문헌 (21)
참고문헌 신청
Hrynchak P / 2014 / Key-feature questions for assessment of clinical reasoning: a literature review / Med Educ 48:870~883
Groves M / 2003 / Clinical reasoning: the relative contribution of identification, interpretation and hypothesis errors to misdiagnosis / Med Teach 25:621~625
Mauksch LB / 2008 / Relationship, communication, and efficiency in the medical encounter: creating a clinical model from a literature review / Arch Intern Med 168:1387~1395
Beasley JW / 2004 / How many problems do family physicians manage at each encounter? A WReN study / Ann Fam Med 2:405~410
Baker LH / 2005 / "What else?" Setting the agenda for the clinical interview / Ann Intern Med 143:766~770
Groves M / 2003 / Clinical reasoning: the relative contribution of identification, interpretation and hypothesis errors to misdiagnosis / Med Teach 25:621~625
Mauksch LB / 2008 / Relationship, communication, and efficiency in the medical encounter: creating a clinical model from a literature review / Arch Intern Med 168:1387~1395
Beasley JW / 2004 / How many problems do family physicians manage at each encounter? A WReN study / Ann Fam Med 2:405~410
Baker LH / 2005 / "What else?" Setting the agenda for the clinical interview / Ann Intern Med 143:766~770
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