Gretchen Dickson

Publications (2)2.66 Total impact

• Article: Are students less likely to report pertinent negatives in post-encounter notes?

  Anne Walling, Scott E Moser, Gretchen Dickson, Rosalee E Zackula
  [show abstract] [hide abstract]
  ABSTRACT: BACKGROUND AND OBJECTIVES: In completing post-encounter notes (PENs), students are believed to under-report about 30% of the important information obtained in the medical history. The resulting incomplete clinical notes can contribute to adverse patient care and medicolegal outcomes. We hypothesized that pertinent negative items would be more likely to be under-reported than positive items. We compared reporting rates for pertinent positive and negative items on two cases in a clinical skills assessment (CSA) taken by all 55 third-year students. Based on standardized patient (SP) checklists, students obtained 87% of both positive and negative items. Scoring of PENs found significant differences in the reporting rates for positive (75%) and negative (52%) items. These results were consistent for each case. Students appear to be able to elicit pertinent negative information from patients but, although these items may be crucial in the medical history, they are significantly more likely than positive items to be omitted from the clinical note.
  Family medicine 01/2012; 44(1):22-5. · 1.33 Impact Factor
• Article: Do students falsify information in clinical notes?

  Anne Walling, Scott E Moser, Gretchen Dickson, Rosalee E Zackula, Holly Fussell
  [show abstract] [hide abstract]
  ABSTRACT: BACKGROUND: If students report information in a post-encounter note that was allegedly not obtained from the patient, they may be suspected of serious professional misconduct, ie, deliberate falsification of patient data. Over-reporting during a clinical assessment may result in accusations of cheating and even lead to failure of a high-stakes examination. Despite these serious implications, the prevalence and reasons for over-reporting are not clear. We investigated every detected incident of false reporting during our high-stakes clinical skills assessment (CSA) at the end of the third year. Of 73 alleged incidents, 69 were attributed to errors in standardized patient (SP) performance, note scoring, data management, or the design of cases or scoring instruments. The four instances of over-reporting by students were more compatible with mistakes and lack of specificity than deliberate falsification. We conclude that all potential sources of error must be excluded before over-reporting incidents are attributed to deliberate falsification of data by students.
  Family medicine 06/2011; 43(6):418-21. · 1.33 Impact Factor