Park Kyong-Min, Park Kye-Yeung, Kim Nam-Eun, Seo Bong-Kyung, Park Hoon-Ki, Hwang Hwan-Sik
Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea.
Korean J Fam Med. 2018 Jan;39(1):23-28. doi: 10.4082/kjfm.2018.39.1.23. Epub 2018 Jan 23.
After introduction of clinical skills assessment in the Korean Medical Licensing Examination, medical schools have reinforced both experiential learning with real patients and preparatory programs. This study was conducted to investigate whether a clinical practice examination (CPX) preparation program improves students' CPX score in terms of case specificity.
One hundred and thirteen senior students in a medical school participated in this study. During the fourth-year clerkship, 28 students (24.8%) from three rotation groups took a 3-day CPX preparation course consisting of module development, role play, and comprehensive physical exam skills training. Eleven rotation groups (n=85) were compared as control. Both the intervention and control group took two comprehensive CPXs before and after the clerkship was completed.
There was no significant difference in age, sex, and school type between the two groups. On pre-test CPX, there was no significant difference in total and sectional scores between the two groups. On post-test CPX, total scores of the intervention group were higher than those of the control groups (69.5±4.3 vs. 67.5±4.4, P<0.05). History taking scores were higher in intervention groups (70.0±6.0 vs. 66.0±6.6, P=0.01). The station scores of vaginal discharge with case similarity were higher in the intervention groups (73.0±6.3 vs. 68.9±9.3, P=0.03).
A short CPX preparation course improved history taking ability, but its effect was greater only in a specific case, similar to the pre-course case. Whether this effect was due to the test experience or true improvement in competency requires further investigation.
韩国医师执照考试引入临床技能评估后，医学院校加强了与真实患者的体验式学习和备考项目。本研究旨在调查临床实践考试（CPX）备考项目是否能在病例特异性方面提高学生的CPX成绩。
一所医学院的113名高年级学生参与了本研究。在四年级临床实习期间，来自三个轮转组的28名学生（24.8%）参加了为期3天的CPX备考课程，包括模块开发、角色扮演和综合体格检查技能培训。将11个轮转组（n = 85）作为对照组。干预组和对照组在临床实习结束前后都参加了两次综合CPX考试。
两组在年龄、性别和学校类型方面无显著差异。在CPX预测试中，两组的总分和各部分分数无显著差异。在CPX后测试中，干预组的总分高于对照组（69.5±4.3对67.5±4.4，P<0.05）。干预组的病史采集分数更高（70.0±6.0对66.0±6.6，P = 0.01）。干预组中病例相似的白带检查站分数更高（73.0±6.3对68.9±9.3，P = 0.03）。
短期CPX备考课程提高了病史采集能力，但其效果仅在与课程前病例相似的特定病例中更为显著。这种效果是由于考试经验还是能力的真正提高需要进一步研究。
