Effects of Case Type and Standardized Patient Gender on Student Performance in a Clinical Performance Examination

Abstract

The purpose of this study is to assess the effects of case type and gender of standardized patient on student performance in a clinical performance examination (CPX).Methods: During 2005, an eight-station CPX was administered to fourth-year students from 4 medical schools. A total of 306 students, of which 206 (67%) were male, participated in the exam.Station checklists, scored by the SPs, consisted of history taking (Hx), physical examination (PE), information sharing (IS), clinical courtesy (CC) and patient-physician interaction (PPI). A measurement of students' perceived difficulty was obtained through student questionnaires. The difference of CPX scores between male and female students were studied using Mann-Whitney's U.Results: Across the gender-neutral cases, female students scored better in Hx in 2 cases. In PE, IS and CC, the only difference seen was with CC in 1 case (female students scored higher). In PPI, female students performed better than male students in all female SP cases and one male SP case, but, there was a significant student gender-SP gender interaction when averaging all cases. For the gender sensitive case, there was no significant difference in all checklist categories in the male case when student gender was considered. In the female case, female students performed better than male students only in PPI. Student questionnaires revealed that there was no significant difference in perceived difficulty between male and female students. Conclusion:The standardized patients' ratings in gender sensitive cases are not affected by the gender of standardized patients and students, except in PPI with a female case where female students performed better than male students. 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

The Change of CPX Scores according to Repeated CPXs

“…본 연구에서는 총 21개 사례에서 표준화 환자에 의해 평정된 점수만을 사용하였는데, 각 사례별로 표준화 환자의 나이나 성별이 다르고, 이는 학생들을 평가하는 데 있어서 영향을 줄 수 있을 것이다. Kim et al [ 14 ]은 진료수행평가에 사용되는 증례의 특성과 표준화 환자의 성별은 평가 결과에 영향을 미칠 수 있다고 하였고, Lee et al[ 15 ]은 PPI 측면에서 학생들이 ‘잘하는 것’과 ‘취약한 점’은 CPX 사례에 따라 달라질 수 있다고 하였다. 또한 Park et al [ 16 ]은 시나리오와 평가표의 난이도가 문제에 따라 다를 수 있기 때문에 이러한 차이들이 채점 정확도에서 영향을 줄 수 있다고 하였다.…”