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…

In a pilot project, computer-assisted bibliographic retrieval from MEDLINE was taught to an entire entering medical school class (n=112), followed by incorporation of a MEDLINE searching exercise into an early phase of the curriculum and monitoring of subsequent spontaneous use. The method was seen as useful and effective. (Author/MSE)

Studies in five senior medical school classes at Southern Illinois University investigated whether using multiple standardized patients to simulate the same case in postclerkship medical student evaluation affects the measure's reliability. Results of three studies show little or no effect on reliability of total, checklist, or written test…

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 method for training physicians in a simple, efficient, and effective smoking cessation counseling strategy consisted of lunchtime seminar, follow-up reinforcement session, and prompt sheet for use during counseling. The counseling strategy emphasizes individual motivation, assessing and addressing obstacles to quitting, drug therapy, contracting…

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)

A study using five Southern Illinois University senior medical school classes (n=350 students) investigated whether having a standardized patient simulate a case repeatedly in postclerkship medical student evaluation affects the measure's reliability. Results suggest that repeated simulation had little or no effect on intercase reliability of…

A discussion of multifacet Rasch model analysis describes the Rasch model and its assumptions, then presents an extension of the model to include a facet for the influence of examiner severity. The model is illustrated with an application to an oral examination administered by a medical specialty board. (Author/MSE)

Analysis of 61 inpatient medical writeups by 23 third year medicine clerks found smoking history notations in 74 percent but quantification of exposure much less commonly. None detailed patient addiction or willingness to quit, or included smoking cessation in the patient plan. Students' smoking assessment and cessation skills are seen as poorly…

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 review (HE 528 450) of large-scale studies of the psychometric characteristics of standardized-patient clinical examinations is commended for its clarity, thoroughness, and relevance. Issues of reliability, validity, scoring, reporting, and use of the tests are discussed further. (MSE)

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.…