Correlations of Information Gathering Scores between Checklists and Interstation Works in a Clinical Performance Examination

Abstract

Purpose: Until now, students wrote only differential diagnoses and plans during the interstation work (IW) portion of clinical performance examinations (CPX). The contents of history taking (Hx) and the physical examination (PE) were only evaluated using checklists. This study addressed the correlations of Hx and PE scores from the checklists and the subsequent IW to research the necessity of adding Hx and PE sections in to the IW. Methods: One hundred and thrity-three students participated in a ten case CPX, and eight cases were used in this study. Immediately following the 12 minute patient encounter, students were given 6 minutes to write the IW. For the Hx and PE section, students were instructed to write the findings that they considered key information in approaching the patient’s problem. The Hx and PE sections of the IW were scored using the same items that appeared on the SP checklist. Calculations of Spearman’s rho were performed to find the relationship between the checklist scores and IW scores of Hx and PE sections. Results: Correlations of Hx and PE scores between the SP checklists and IW were low to moderate. Across the eight cases, the median Spearman’s rho was 0.37 with a range of 0.14 to 0.54. Conclusion: We suggest that, because SP checklist scores measure only what information the students gather, but not their reasons for doing so (e.g.: relative importance), students tend gather very specific information from the patients. By analyzing of their IW, we were able to explore how students prioritize the important information they have obtained from the patients.