Third year medical students (n=26) participated in a pilot program of an entirely outpatient multispecialty clinic experience. Overall, 61 percent of outpatient encounters involved a surgical diagnosis currently managed entirely on an outpatient basis, illustrating the importance of this setting in broad student exposure to surgery and surgical…

A University of Adelaide (Australia) study investigated the effect of administering identical stations to different classes over a 12-year period within the objective structured clinical examination component of a final-year medical school examination. Repeat administrations correlated with improved student performance over time. (Author/MSE)

A study evaluated a teaching model in which contact between medical students, patients, and physicians was maximized. Each student (n=96) learned the physical examination of the abdomen and genitourinary system through contact with four patients, a plastic model, and five physicians. Students appreciated the interaction and physician role models.…

Four years of experience with an objective structured clinical examination (OSCE) following an eight-week surgical clerkship (n=356 students) are reported, including data on mean student performance across years, reliability coefficients, and generalizability. Implications for improvement and development of OSCE are discussed. (Author/MSE)

Large scale studies of the psychometric characteristics of standardized-patient clinical examinations are reviewed, and recommendations for test improvement are offered, including (1) assessment of history taking, physical examination, and communication skills separately from diagnostic and management skills; (2) a mastery-testing framework for…

A discussion of research needs on physicians' choice of specialty looks at methodological problems identified in the literature and suggests six areas for further development: distinction between career preference and career attainment; multiple predictors; larger samples; more specific specialty subdivisions; longitudinal approach; and testing of…

Evaluators in six objective structured clinical examinations were encouraged to add written comments to the traditional checklist rating forms. The 1,283 comments were categorized as trainee performance (technique, content, summary) and organizational comments. Analysis found that the comments were relevant and useful, and provided substantial…

A study compared the use of free-form alternative-choice (AC) test items, offering two response options, and both complex and single-best-answer multiple-choice items for use of information in making clinical judgments. Although the AC items' reliability was less than other types, students felt they tested knowledge application, not just recall.…

The University of New Mexico hospital supported development and implementation of a brief course for medical students in medical dictation. Dictations of hospital discharge summaries prepared by the participants were compared with those done by prior graduates of the institution. Results found better completeness, clarity, and brevity in…

The theoretical model of medical student performance begins with 38 measures, reduced to 18 without loss of information. These measures are shown to reflect five underlying theoretical interrelated variables: medical knowledge; clinical performance; science aptitude; college achievement; and attitudes and values. Results should be useful in…

A study identified variables perceived by clinical medical faculty (n=20) to influence the ease or difficulty of teaching in the ambulatory care setting. Characteristics affecting the teaching situation included teacher, student, and patient characteristics. Implications for faculty development on teaching in the clinical setting are discussed.…

The authors propose that the present system of medical education has not kept pace with changes in medical services and financing and is contributing to high health care costs. Academic medical centers are urged to assume a leadership role in finding solutions to problems in medical education and health care reform. (Author/MSE)

Literature on general, fellowship, and short-term faculty development activities for family medicine educators is reviewed. Suggestions for future activities include initiation of training during residency, fourth year clinical fellow positions and two-year research fellowships supported by clinic revenue and grants, and more rigorous fellowship…

General practice medical residents (n=18) evaluated their performance in videotaped consultations at the beginning and end of a three-month residency. Results indicate self-awareness was increased. A major benefit of this method, in addition to feedback, may be training in self-evaluation, useful throughout a demanding career. (Author/MSE)

Extended matching, a test item format used currently in medical licensing examinations, is described. Procedures for writing and reviewing such test items are outlined, test development and psychometric advantages are discussed, and issues in test administration and scoring are examined. The extended matching form is also seen as having uses for…