Fenton G W, O'Gorman E C
Med Educ. 1984 Sep;18(5):355-9. doi: 10.1111/j.1365-2923.1984.tb01282.x.
Sixty final-year medical students had their clinical performance in psychiatry assessed by the following three methods: a multiple choice questionnaire based on a series of short videotaped interviews with psychiatric patients; the examination of a traditional long 'case' with presentation of the history, mental state findings and formulation about diagnosis and management to a panel of three examiners; and a conventional oral examination about the principles and practice of psychiatry with a different trio of examiners. The total mark on the videotape session correlated significantly with the combined clinical and oral marks. There was also a significant positive correlation between the total video marks and the individual clinical marks, but none between the marks obtained during the video and oral components of the examination. However, the significant positive correlations between the video marks and those of the clinical examination were modest and only accounted for not more than 14% of the variance. Inspection of the distribution of correct answers to the videotape questions shows that students do best in identifying mental state symptoms and signs and in choosing the correct diagnosis. They do less well in the areas of aetiology and treatment. Indeed, optimal performance in the latter distinguishes those who do well in the clinical/oral examination from those whose performance is mediocre. The significance of these findings to the teaching and assessment of psychiatric skills in medical students is discussed.
六十名医学专业最后一年的学生，通过以下三种方法对他们在精神病学方面的临床表现进行评估：基于一系列与精神病患者的简短录像访谈的多项选择题问卷；对一个传统的长“病例”进行检查，向由三名考官组成的小组展示病史、精神状态检查结果以及关于诊断和管理的阐述；以及与另一组三名考官进行关于精神病学原理和实践的传统口试。录像环节的总分与临床和口试的综合分数显著相关。录像总分与各个临床分数之间也存在显著的正相关，但在考试的录像部分和口试部分所得分数之间不存在相关性。然而，录像分数与临床考试分数之间的显著正相关程度适中，仅占方差的不超过14%。对录像问题正确答案分布的检查表明，学生在识别精神状态症状和体征以及选择正确诊断方面表现最佳。他们在病因学和治疗方面表现较差。事实上，在后者方面的最佳表现区分了在临床/口试中表现出色的学生和表现一般的学生。本文讨论了这些发现对医学生精神病学技能教学和评估的意义。
