The Relationship Between the National Board of Medical Examiners??? Prototype of the Step 2 Clinical Skills Exam and Interns??? Performance

Department of Family Medicine, Medical University of South Carolina, Charleston, 29425, USA.
Academic Medicine (Impact Factor: 2.93). 06/2005; 80(5):496-501. DOI: 10.1097/00001888-200505000-00019
Source: PubMed


To examine the relationship between graduates' performances on a prototype of the National Board of Medical Examiners' Step 2 CS and other undergraduate measures with their residency directors' ratings of their performances as interns.
Data were collected for the 2001 and 2002 graduates from the study institution. Checklist and interpersonal scores from the prototype Step 2 CS, along with United States Medical Licensing Examination (USMLE) Step 1 and 2 scores and undergraduate grade-point average (GPA), were correlated with residency directors' ratings (average score for six competencies, quartile ranking, and isolated interpersonal communication competency score). Stepwise linear regression was used to identify the best outcome predictors.
Quartile ranking was more highly correlated with GPA than Step 2 CS prototype interpersonal score, USMLE Step 2 score, USMLE Step 1 score, and Step 2 CS prototype checklist score. The average score on the residency director's survey was more highly correlated with GPA than USMLE Step 2 score, USMLE Step 1 score, Step 2 CS prototype interpersonal score, and Step 2 CS prototype checklist score. The best predictors for both quartile ranking and average competency score were GPA and Step 2 CS prototype interpersonal score (R(2) = 0.26 and 0.28).
Both scores from the Step 2 CS prototype significantly correlated with the interns' quartile ranking and average competency score. Only GPA and Step 2 CS prototype interpersonal score accounted for most of the variance of performance in the regression model.

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    • "A study by Clauser et al.26) showed that significant inconsistency may exist regarding the assessment of examinees in the USMLE step 2 CS. In addition, the USMLE step 2 score reflected residency directors' rating for interns less accurately than undergraduate grades did.27) Therefore, further studies evaluating the effect of CPX on clinical competency of medical students and doctors need to be conducted. "
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    ABSTRACT: In Korea, clinical performance examination (CPX) has been included in license examination for medical doctors since 2009 in order to improve clinical performance of medical students. This study aimed to evaluate the contribution of CPX to medical education. Clinical competency in the differential diagnosis of secondary headache was compared between the incoming interns in 2009 unexposed to CPX and the incoming interns in 2010 exposed to CPX, using the data of patients who visited the emergency department due to headache (181 patients seen by 60 CPX non-exposed interns and 150 patients seen by 50 CPX-exposed interns). We obtained the data by reviewing electronic medical records and nominal lists of doctors. Clinical competency was assessed by sensitivity and specificity between the diagnostic impression by interns and the final diagnosis. The association between CPX exposure and clinical competency in secondary headache diagnosis was evaluated using multiple logistic regression analysis. When we assessed clinical competency on the basis of all listed diagnostic impressions, sensitivity and specificity were 67.9% and 80.0%, respectively, for headaches seen by CPX-exposed interns, and 51.7%, and 71.7%, respectively, for headaches seen by CPX non-exposed interns. Multivariable adjusted logistic regression analysis showed exposure to CPX was not associated with increased competency for identifying secondary headache. Exposure to CPX as a part of the medical license examination was not effective for the improvement of clinical competency of interns in identifying secondary headache.
    Korean Journal of Family Medicine 03/2014; 35(2):56-64. DOI:10.4082/kjfm.2014.35.2.56
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    ABSTRACT: or those who have not been in the Charleston area for several years, 2005 has marked the opening of a fabulous new span that links Charleston with Mount Pleasant. In mid July, the entire region turned out to stroll over the new bridges and celebrate their completion with a monumental fireworks display. The two dilapidated structures that had offered an aging and sometimes perilous connection between these Charleston and communities east of the Cooper River are now in the process of being torn apart, destined to be sunk somewhere off the South Carolina coast where they will serve as breeding grounds for fish. The new bridge is a beautiful structure that towers over the old rusty bridges and is visible from just about anywhere on the Charleston Peninsula. The eight-lane structure, with an additional 12 foot wide lane for walkers and bikers, makes the drive over the upper Charleston harbor a breeze. When accidents do occur (and there have been a few already), remaining drivers simply maneuver around the problem with little effect on the overall flow of traffic. What a pleasant change from the past when one disabled vehicle could easily bog down flow over the bridge for an hour or more. The new bridge to Mount Pleasant reminds me that connectivity have as much to do with efficient and safe health care as it does vehicular traffic. The cornerstone of effective patient care is the exchange of information between the patient and her or his physician. Likewise, communicating information about the patient to others on the health care team such as nurses, consulting physicians, and hospitals, is just as valuable to assuring that patients get the best and safest care possible. Yet, for much of the past eighty years our communication in health care has been on par with the old Cooper River bridges. Communication systems usually worked, but in places they were rusty, in other places a break-down could jam up the entire system, and in other places communication could be so faulty that it created dangerous conditions. Just like a new Cooper River bridge to bring commuters to Charleston more efficiently and safely, we need to figure out how we can do the same thing to improve patient communication with the health care system. In our own offices, we have been pioneers with electronic medical record systems. Family Medicine has had a computerized medical record since the early 1970's. The Department started out on a home-grown system housed on a massive mainframe computer located in two large offices in our Calhoun Street building. Faculty and residents in our office connected to this mainframe via dummy terminals situated throughout the building. Over time as computer systems shrunk in size, we were able to retire the mainframe and run our system off computers that are now linked throughout Charleston so that the same record serves our office downtown, our North Charleston office, and our East Cooper office. In addition, faculty members have tapped into the record from the nursing home or remote clinic sites on Johns Island. This connectivity assures that the latest information about patients is available to all our doctors all the time. In addition, we have been working
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