Document Detail


Evaluation of medical student performance on objective structured clinical exams with standardized patients with and without disabilities.
MedLine Citation:
PMID:  20881817     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate whether medical students' performance on a family medicine clerkship objective structured clinical exam (OSCE) differed when the standardized patient (SP) had a disability versus when the SP did not have a disability.
METHOD: SPs with spinal cord injury (SP-SCI), SPs with intellectual disability (SP-ID), and SPs without a disability participated separately in two OSCE scenarios that were administered by the University of South Carolina School of Medicine's Department of Family and Preventive Medicine from 2007 to 2009. OSCE scores were determined based on the number of critical actions completed by the student, and scores were analyzed to determine differences among scenarios.
RESULTS: Students scored lower in history, physical exam, lab tests, and interpersonal skills with an SP-SCI, and lower in history, physical exam, and lab tests with an SP-ID than did students interacting with SPs without a disability. The odds ratio for ordering a hemoglobin A1c in one scenario was 4.16 times higher in cases when the SP did not have a disability (95% confidence interval [CI] 1.78-9.17, P = .001). In the second scenario, the odds ratio was 3.08 times higher for ordering a urinalysis (95% CI 1.34-7.08, P = .006) and was 2.15 times higher for providing lifestyle counseling (95% CI 1.04-4.44, P = .038) in students interacting with SPs without a disability.
CONCLUSIONS: Students performed better when the SP did not have a disability. This suggests that greater emphasis should be placed on teaching appropriate care of patients with a disability.
Authors:
Rachel S Brown; Catherine Leigh Graham; Nancy Richeson; Junlong Wu; Suzanne McDermott
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Academic medicine : journal of the Association of American Medical Colleges     Volume:  85     ISSN:  1938-808X     ISO Abbreviation:  Acad Med     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-28     Completed Date:  2010-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904605     Medline TA:  Acad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1766-71     Citation Subset:  AIM; IM    
Affiliation:
Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, South Carolina, USA. rachel.brown@uscmed.sc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Clinical Competence*
Disability Evaluation
Educational Measurement / methods*
Family Practice / education*
Female
Humans
Logistic Models
Male
Medical History Taking / standards
Mental Retardation / complications*
Patient Simulation
Physical Examination / standards
Spinal Cord Injuries / complications*
Grant Support
ID/Acronym/Agency:
1U59DD000268-01/DD/NCBDD CDC HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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