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Results for “Clinical Competence”

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PubMed1980

The assessment of clinical competence on the emergency medicine specialty certification examination: the validity of clinically relevant multiple-choice items.

This study investigated the effect of clinically relevant multiple-choice item content on the valid discrimination or statistical separation of groups with known and different levels of experience and training in emergency medicine. Items for a high-clinical-relevance (HCR) subscale were chosen for their highest correlation with independent ratings of clinical performance on 12 simulated patient encounters relevant to emergency medicine. Low-clinical-relevance (LCR) subscale items were selected for their lowest correlation with the same criterion ratings. HCR was significantly more statistically discriminating of candidate groups which differed with respect to years of training and experience in emergency medicine. Additionally, the HCR subscale was more reliable and less difficult than the LCR subscale.

Adult↗

PubMed1988

Evaluation of clinical competence in hematology training programs.

The American Board of Internal Medicine (ABIM) has called on directors of hematology training programs to establish systems to evaluate, document, and substantiate those components of overall clinical competence considered essential for certification in the subspecialty. Many of these can be assessed only by repeated direct observations. In particular, proficiency is now required in the preparation of blood smears, bone marrow aspiration and biopsy, administration of chemotherapy, management of indwelling vascular access, lumbar puncture with chemotherapy, bleeding time, phlebotomy, and exchange transfusion. The goal of this expanded evaluation program is to ensure that the public and the profession can identify, through certification, physicians with demonstrated excellence in hematology.

Certification↗

PubMed2026

Addressing racism as a clinical competence: Robert Wilson, Jr. (1867-1946).

Addressing health inequity is now recognized as a clinical competency in medical education. We examined the career and writings of Robert Wilson Jr. (1867-1946), longtime dean of the Medical College of the State of South Carolina during the Jim Crow Era, using primary and secondary sources within the context of systemic and structural racism, particularly in South Carolina. Wilson used public health data to refute the "Black Extinction Hypothesis" rooted in social Darwinism. He challenged assumptions of inherent Black susceptibility to tuberculosis, linking disease instead to social determinants of health. He also identified disproportionate mortality from kidney and cardiovascular disease among Black populations, anticipating modern health disparities research. Wilson further acknowledged systemic injustice and implicated structural conditions, including housing, in shaping outcomes. In an era of continuing health inequity and racial health disparities, Wilson applied empirical evidence to reject biological determinism, identify outcomes disparities, and advocate for racial justice.

History, 20th Century↗

PubMedDate not supplied

Gender differences in the clinical competence of residents in internal medicine.

OBJECTIVE: To study the differences between cognitive and noncognitive skills of men and those of women entering internal medicine. DESIGN: Comparison of program directors' ratings of overall clinical competence and its specific components and pass rates for men and women taking the Certifying Examinations in Internal Medicine in 1984-1987. PARTICIPANTS: 14,340 U.S. and Canadian graduates taking the Certifying Examinations of the American Board of Internal Medicine for the first time in 1984-1987. MEASUREMENTS/RESULTS: Average program directors' ratings of overall competence were 6.70-6.78 for men and 6.60-6.71 for women. The greatest differences in ratings of specific components of competence were in the areas of medical knowledge and procedural skills, where men were rated higher than women, and humanistic qualities, where women were rated higher than men. Pass rates were stable over the four years of the study, and ranged from 85 to 86% for men and from 79 to 81% for women. Men consistently performed slightly better than women regardless of the type of residency or quality of medical school attended. CONCLUSIONS: Small but consistent differences were found in the performances of men and those of women completing training in Internal Medicine as measured by program directors' ratings and ABIM Certifying Examination performances.

Certification↗

PubMed2006

Standard setting for clinical competence at graduation from medical school: a comparison of passing scores across five medical schools.

While Objective Structured Clinical Examinations (OSCEs) have become widely used to assess clinical competence at the end of undergraduate medical courses, the method of setting the passing score varies greatly, and there is no agreed best methodology. While there is an assumption that the passing standard at graduation is the same at all medical schools, there is very little quantitative evidence in the field. In the United Kingdom, there is no national licensing examination; each medical school sets its own graduating assessment and successful completion by candidates leads to the licensed right to practice by the General Medical Council. Academics at five UK medical school were asked to set passing scores for six OSCE stations using the Angoff method, following a briefing session on this technique. The results were collated and analysed. The passing scores set for the each of the stations varied widely across the five medical schools. The implication for individual students at the different medical schools is that a student with the same level of competency may pass at one medical school but would fail at another even when the test is identical. Postulated reasons for this difference include different conceptions of the minimal level of competence acceptable for graduating students and the possible unsuitability of the Angoff method for performance based clinical tests.

Educational Measurement↗

PubMed1995

European certification of clinical competence in adult echocardiography issued in Belgium. The Steering Committee of the Belgian Working Group on Echocardiography and Cardiac Doppler.

In accordance with the European proposals, adapted guidelines are proposed for a certification of clinical competence in adult echocardiography, with transoesophageal echocardiography as a special option. The conditions required to be candidate to the certification, the exemptions of practical training for long-term echocardiographers and the organisation of the training itself are successively considered. Standards for training, site accreditation, official logbook characteristics, minimal numbers of examinations and minimal stage duration are defined. Content of theoretical training, as well as organisation of formal and informal education and of final examination, are described.

Adult↗

PubMed1976

Relationships between clinical competence ratings and examination performance.

Relationships between faculty ratings and performance on components of the National Board of Medical Examiners Certifying Examination for Primary Care Physician's Assistants were investigated. A factor analysis of the clinical competence rating form yielded three discrete factors. Results of tests of simple relationships between each rating factor and examination component indicated that four of the six examination components correlated significantly though modestly with at least one of the rating scale factors. The results of multiple regression analyses indicated complex relationships between each of two examination components and the set of rating factors. One implication is that faculty members are able to make discrete judgments about students on more than one dimension.

Certification↗

PubMedDate not supplied

Internationally educated nurses' perceptions of their clinical competence.

Excelsior College, an educational institution with a strong background in nursing education assessment, partnered with the Commission on Graduates of Foreign Nursing Schools to conduct a study that assessed self-perceptions of nursing knowledge and the clinical needs of international nurses. The Clinical Competency Survey developed for this study was used to measure perceived proficiency in activities related to safe and effective nursing practice. These included conducting physical assessments, planning nursing care, administering medications, performing treatments, managing specific disease conditions, and using technology. Analyses indicate that international nurses perceived themselves to be less proficient in cardiac assessment and interventions and the use of technology and more proficient in wound and skin management and general physical assessments.

Adult↗

PubMedDate not supplied

Assessment of clinical competence of undergraduate medical students.

The assessment is a key determinant of learning by the students. Validity, reliability, objectivity and practicability are the fundamental attributes of assessment. It is important to understand how a given tool of assessment fares on these criteria. The conventional practical clinical examination consisting of "long"/"short" cases lacks objectivity and reliability. It also has a limited validity because sufficient sampling is not possible. Objective Structured Clinical Examination (OSCE), on the other hand, is a comprehensive, reliable and objective test, but does not take a holistic view of the patient. Viva-voce often revolves around theory and is highly subjective. Since no single tool of assessment of clinical competence is ideal, a combination of "long"/"short" case (s) with OSCE is suggested as a more rational examination.

Clinical Competence↗

PubMed2001

[The Cusum score. A tool for evaluation of clinical competence].

INTRODUCTION: The cusum analysis (cummulative summation) is a statistical technique used to assess the competence of medical trainees. We wanted to re-examine the validity of the test as a technique for qualitative assessment of competence, as well as a technique for monitoring the level of specialists' competence. METHODS: Doctors in two anaesthetic departments were asked to plot the cusum as they performed the following procedures: epidural and spinal analgesia, insertion of central venous and arterial cannulae. RESULTS: Data were collected over a year. Thirty-five doctors were asked to plot the cusum. The plots were returned by 75% (9/12) of the first year trainees, 50% (4/8) of the second- and third-year trainees, and 20% (1/5) of the four- and five-year trainees. From the specialists and consultants on the staff, we received 66% (4/6) and 50% (2/4). The correlation, according to the level of competence respecting spinal and epidural techniques, is shown in Figures 1 and 2. DISCUSSION: We found, that the cusum analysis is a valid and practical technique for the qualitative assessment of clinical competence as well as a tool for monitoring continuous professional development. The technique can be used in a number of settings. With the increasing demand in health care for continuous quality assurance, the analysis can be used both in personal professional monitoring and in monitoring of performance during training.

Anesthesia, Epidural↗

PubMed1988

Evaluation of clinical competence in rheumatology training programs.

To ensure that members of the public and the medical profession can identify physicians who have demonstrated excellence in the field of rheumatology, the American Board of Internal Medicine has called upon directors of rheumatology training programs to establish systems to evaluate, document, and substantiate those components of overall clinical competence that are considered essential for certification. Many of these abilities can be assessed only by repeated, direct observations.

Certification↗

PubMedDate not supplied