While significant associations exist between students' self-reported scores on the JSPE and SPs' evaluations of students' empathy, the associations are not large enough to conclude that the two evaluations are redundant.
A tool for SPs to assess students' empathy during an OSCE could be helpful for unmasking some deficits in empathy in students during the third year of medical school. Because the authors found no significant differences on self-reported empathy, the differences they observed in the SPs' assessments of white and Asian American students were unexpected and need further exploration. These findings call for investigation into the reasons for such differences so that OSCEs and other examinations comply with the guidelines for fairness in educational and psychological testing as recommended by professional testing organizations.
Purpose: Despite standard instruction, medical students cannot reliably identify common heart sounds and murmurs. The authors developed a novel approach to teach cardiac auscultation that uses process-based techniques to increase the diagnostic ability and confidence of physicians in training.Methods: 64 medical students were initially presented with a random selection of 10 heart sounds from Harvey, The Cardiopulmonary Patient Simulator, and graded on how many they could successfully recognize on a scale from 1-10. All students were then taught the novel approach to cardiac auscultation (the lesson). One day following the lesson, students were presented with another random selection of 10 heart sounds from Harvey, and graded on how many sounds they could correctly identify. Students then completed a survey regarding their confidence levels.Results: Students correctly identified more heart sounds after undergoing the lesson (prior to lesson: 4.1 (1.05); after lesson: 6.7 (1.00); p<0.001). Following the lesson, students also reported increased confidence in their ability to listen to heart sounds (prior: 1.70 (0.46); after: 3.13 (0.33); p<0.001).
Conclusion:The novel approach to teaching cardiac auscultation is an effective means of instruction that increases diagnostic ability and confidence among medical students.
Background and Objectives: New standards announced in 2017 could increase the failure rate for Step 2 Clinical Skills (CS). The purpose of this study was to identify student performance metrics associated with risk of failing.
Methods: Data for 1,041 graduates of one medical school from 2014 through 2017 were analyzed, including 30 (2.9%) failures. Metrics included Medical College Admission Test, United States Medical Licensing Examination Step 1, and clerkship National Board of Medical Examiners (NBME) Subject Examination scores; faculty ratings in six clerkships; and scores on an objective structured clinical examination (OSCE). Bivariate statistics and regression were used to estimate risk of failing.
Results: Those failing had lower Step 1 scores, NBME scores, faculty ratings, and OSCE scores (P<.02). Students with four or more low ratings were more likely to fail compared to those with fewer low ratings (relative risk [RR], 12.76, P<.0001). Logistic regression revealed other risks: low surgery NBME scores (RR 3.75, P=.02), low pediatrics NBME scores (RR 3.67, P=.02), low ratings in internal medicine (RR 3.42, P=.004), and low OSCE Communication/Interpersonal Skills (RR 2.55, P=.02).
Conclusions: Certain medical student performance metrics are associated with risk of failing Step 2 CS. It is important to clarify these and advise students accordingly.
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