The use of this CEX app is feasible and it captures students' clinical performance data with a high rate of user satisfaction. Our embedded checklists had adequate interrater reliability and concurrent validity. The grades measured on this app, however, were not predictive of subsequent student performance.

Introduction:Many research reports revealed declining empathy in medical schools that continues in postgraduate years of training.Objective:The aim of this study is to examine the self-reported empathy levels of internal medicine (IM) residents in 3 community-based teaching hospitals.Methods:The Jefferson Scale of Physician Empathy, Health Professionals version, is an online, self-administered, questionnaire that was offered to 129 current and incoming residents at 1 osteopathic and 2 allopathic, IM training programs in Flint, Michigan.Results:Forty-five residents responded (35% response rate). Our residents’ cumulative mean empathy score was 112.5 with a SD of 12.72, which is comparable with the cumulative empathy scores for IM residents at university hospitals. There was an increase in empathy score from the beginning level of training, postgraduate year 0 (PGY0), to the PGY1 level, and a noticeable, although statistically non-significant, decrease in empathy score for both PGY2 and PGY3 residents. The graduating residents’ scores were higher compared with incoming residents.Conclusions:The cumulative mean empathy score in community-based IM residents showed an increase in the beginning of residents’ training and decrease in empathy score by the end of training. There were significant differences in empathy scores by level of training at individual hospitals. This might be related to different targeted curricula.

BackgroundFacilitating direct observation of medical students' clinical competencies is a pressing need.MethodsWe developed an electronic problem-specific Clinical Evaluation Exercise (eCEX) based on a national curriculum. We assessed its feasibility in monitoring and recording students' competencies and the impact of a grading incentive on the frequency of direct observations in an internal medicine clerkship. Students (n = 56) at three clinical sites used the eCEX and comparison students (n = 56) at three other clinical sites did not. Students in the eCEX group were required to arrange 10 evaluations with faculty preceptors. Students in the second group were required to document a single, faculty observed ‘Full History and Physical’ encounter with a patient. Students and preceptors were surveyed at the end of each rotation.ResultseCEX increased students' and evaluators' understanding of direct-observation objectives and had a positive impact on the evaluators' ability to provide feedback and assessments. The grading incentive increased the number of times a student reported direct observation by a resident preceptor.ConclusionseCEX appears to be an effective means of enhancing student evaluation.