Kissela Brett, Harris Steven, Kleindorfer Dawn, Lindsell Christopher, Pascuzzi Robert, Woo Daniel, Szaflarski Jerzy, Kanter Daniel, Schneider Alex, Sostok Michael, Broderick Joseph
Department of Neurology, University of Cincinnati, Cincinnati, OH 45267-0525, USA.
BMC Med Educ. 2006 Apr 25;6:22. doi: 10.1186/1472-6920-6-22.
Mock oral board exams, fashioned after the live patient hour of the American Board of Psychiatry and Neurology exam, are commonly part of resident assessment during residency training. Exams using real patients selected from clinics or hospitals are not standardized and do not allow comparisons of resident performance across the residency program. We sought to create a standardized patient mock oral board exam that would allow comparison of residents' clinical performance.
Three cases were created and then used for this mock oral boards exercise utilizing trained standardized patients. Residents from the University of Cincinnati and Indiana University participated in the exam. Residents were scored by attending physician examiners who directly observed the encounter with the standardized patient. The standardized patient also assessed each resident. A post-test survey was administered to ascertain participant's satisfaction with the examination process.
Resident scores were grouped within one standard deviation of the mean, with the exception of one resident who was also subjectively felt to "fail" the exam. In exams with two faculty "evaluators", scores were highly correlated. The survey showed satisfaction with the examination process in general.
Standardized patients can be used for mock oral boards in the live patient format. Our initial experience with this examination process was positive. Further testing is needed to determine if this examination format is more reliable and valid than traditional methods of assessing resident competency.
模拟口试是仿照美国精神病学与神经病学委员会考试的真人患者问诊环节设计的，通常是住院医师培训期间住院医师评估的一部分。使用从诊所或医院挑选的真实患者进行的考试不具有标准化，也无法对不同住院医师培训项目中的住院医师表现进行比较。我们试图创建一种标准化患者模拟口试，以便能够比较住院医师的临床能力表现。
创建了三个病例，然后利用经过培训的标准化患者开展此次模拟口试练习。来自辛辛那提大学和印第安纳大学的住院医师参加了考试。由主治医师考官对住院医师进行评分，这些考官直接观察住院医师与标准化患者的问诊过程。标准化患者也对每位住院医师进行评估。进行了一项考后调查，以确定参与者对考试过程的满意度。
住院医师的分数集中在均值的一个标准差范围内，但有一名住院医师主观上也被认为考试“不及格”。在由两名教员“评估员”进行的考试中，分数高度相关。调查显示，总体上对考试过程感到满意。
标准化患者可用于真人患者形式的模拟口试。我们对这一考试过程的初步体验是积极的。需要进一步测试，以确定这种考试形式是否比评估住院医师能力的传统方法更可靠、更有效。
