Comparison of the Evaluation Results of Faculty with Those of Standardized Patients in a Clinical Performance Examination Experience

Abstract

Purpose: To compare the evaluation results of faculties to those of Standardized Patients (SP) participating in a Clinical Performance Examination (CPX) administered at Ewha Womans University College of Medicine. Methods: The CPX was taken by 77 fourth year medical students. Cases and checklist were developed by the medical school consortium in capital area. Six cases were used and 24 SPs participated and evaluated the students’ performances. The whole session was recorded on videotapes so that 6 medical school faculties could analyze and evaluate the students´ performances as well. The results were compared and analyzed by SPSS package. Results: The agreement between the faculties and the SPs was relatively good (r=0.79), but not good enough. In every case, SPs gave higher marks than did the faculties. Clear disease entity cases like 'hepatitis' and 'anemia' showed better agreement than obscure clinical contexts such as 'bad news delivery'. Better agreement was seen in the items of physical exam category (r=0.91), but the agreement was very poor in the items of doctor-patient (Dr-Pt) relationship category (r=0.54). The construction of checklist and the character of each evaluation item should influence the differences. Conclusion: More detailed guidelines and clear/specific evaluating items are necessary to improve the agreement rate. In certain categories like physical exam and brief history taking, the SP´s evaluation can replace the faculties´, but for complex contexts like Dr-Pt relationship.