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Biomedical subjects

B G Ferrell

Publications and source records attributed to B G Ferrell.

5 recordsLinked to original sources
PubMed1995

Clinical performance assessment using standardized patients: a primer.

The clinical performance assessment (CPA) exam using standardized patients is being used with increasing frequency in medical education. A standardized patient (SP) is an individual who has been taught to portray a patient problem in a way that does not vary from student to student. These exams usually take the format of the Objective Structured Clinical Examination (OSCE), comprised of short "stations" designed to assess a discrete skill, or the simulated clinical encounter (SCE), where stations are fewer in number but of longer duration. While both formats have a place in student assessment, they measure different skills. CPAs have been found to be both reliable and valid. Longer tests tend to be more reliable than short ones, and raters and case specificity are the most likely factors in lowering reliability in SP-based exams. Validity studies have found differences in performance in expected directions and correlations between scores on SP-based exams and other measures. Work on developing standard-setting procedures is being done. Both the OSCE and SCE formats have application for family medicine education. Basic skills and higher-level thinking can be assessed and learning prescriptions developed, but some concepts, such as continuity of care, are difficult to evaluate. Collaborative efforts among family medicine educators should be encouraged.

Education, Medical, Undergraduate↗
PubMed1993

Standardized patients: a long-station clinical examination format.

Data from the first 20 periods of a long-station clinical performance examination for a 4-week required clerkship in family medicine were examined in order to assess the reliability and validity of the examination. Data from 304 students were examined for station, case scenario and examiner effects and results compared to short-station formats. A significant examiner effect was found but there were no differences in student performance for station or case scenario. These findings reflect examiner specificity cited in the literature for short station examinations, but not case specificity. The source of variability for this examination appears to be primarily examiner effect. There was a significant correlation between student scores on the two cases, and raters tended to rank order students similarly in spite of variability in mean rater score. Scores on the CPE correlated with other measures of clinical performance as well as other methods of student evaluation for the clerkship providing some evidence for construct and criterion-related validity. CPE cases were developed from clerkship objectives but examination of the test blueprint revealed some gaps in the extent to which the CPE covers the course content. CPE developers are working to increase interrater reliability through examiner training and further standardize case scenarios through check-lists and patient training. Additional cases are being developed to increase the content validity of the examination.

Clinical Clerkship↗
PubMed1993

A clinical performance assessment for a third-year required clerkship in family medicine.

BACKGROUND: In planning a new family medicine clerkship, a clinical performance examination (CPE) using focused encounters was included in the student evaluation. This format was believed to best reflect the types of experiences that students would be exposed to during the primarily ambulatory care family medicine clerkship. METHODS: Testing scenarios were representative of either the problem-based cases on which the curriculum had been developed or the 20 common problems seen in family medicine. To date, 175 students have taken the CPE, each completing two cases. RESULTS: The first year of experience indicates that there are no differences in student performance between periods and that students do not perform differently on the first case than they do on the second. No significant effect for scenarios was found. Examiner effects have been found, however. CONCLUSION: These effects suggest a need for further work in standardizing the scoring of the examination.

Clinical Clerkship↗
PubMed1991

A profile of required third-year family medicine clerkships.

A survey was conducted of programs which reported requiring a third-year clerkship in family medicine in the 1988-89 AAMC Curriculum Directory to determine the characteristics of these 36 programs. The program characteristics were compared to those outlined by the STFM Task Force on Predoctoral Education in the 1981 monograph, Predoctoral Education in Family Medicine. Only one third of schools nationwide had a required family medicine clerkship; for 36 schools it was scheduled in the third year. Based on the information provided by the 25 (72%) of these 36 programs which responded, the third-year clerkship was likely to be a stand-alone, decentralized six- or eight-week rotation. The curricula were based on a set of "common problems" and emphasized those areas which separate family practice from other specialties. Students were most likely to be graded by faculty rating and a multiple choice examination. The curricula of the programs reviewed did reflect the recommendations of the Task Force, but there was great variability across programs.

Clinical Clerkship↗