Effect of formative assessment on documentation of pediatric physical examination by undergraduate medical students

Dr Arun Kumar T,Dr Sangeeta A,Dr Jyothi S,Dr Rashmi R

doi:10.17511/ijpr.2017.i10.04

Abstract

Introduction: Medical educators have serious concern about the decline in physical examination skills of undergraduate medical students. Though formative assessments act as an educational tool to improve students’ performance, data to establish their educational benefits in recording pediatric physical examination skills are lacking. This study was conducted to analyse the competency gaps in documentation of the physical examination skills and to assess the effect of formative assessment on case sheet documentation. Methodology: This comparative study was conducted on fifty undergraduate students of sixth semester undergoing paediatric clinical posting. During the first session students’ examined a standardized patient and documented the findings in a case sheet. Marks were awarded based on checklist. Feedback was provided based on the case record. The same teaching learning program was conducted in the second session and results were compared. Results: Documentation regarding Central nervous system (4.22+0.932) examination was the area of concern noted in our study. The perception of the students’ about their proficiency in various components of physical examination assessed with the questionnaire was statistically significant (p<0.001). Formative assessment had a statistically significant effect on the performance and marks of students’ (p<0.001). Conclusion: Our findings indicate that formative assessment helps identify the competency gaps and increases the proficiency in documentation of pediatric physical examination skills. Adequate frequency of formative evaluation with immediate feedback has a beneficial effect on the students’ performance.

Highlights

Medical educators have serious concern about the decline in physical examination skills of undergraduate medical students
The current assessment of clinical skills is through summative Direct Observation Clinical Encounter Exam (DOCEE) and summative Objective Structured Clinical Examination (OSCE)
They are conducted at the end of the clinical posting with no feedback provided to the students’

Summary

Introduction

The physical examination is recognized as fundamental to the practice of medicine as critical decisions regarding management emerge from clinical findings [1]. Medical educators emphasize more on physical examination skills of undergraduate students and document the findings comprehensively in the case records. They struggle to find methods to augment documentation and structure of students’ skills. Formative assessment (FA) provide feedback to orient the learner and reinforce students’ intrinsic motivation to learn and inspire them to achieve set goals [19]. The current assessment of clinical skills is through summative Direct Observation Clinical Encounter Exam (DOCEE) and summative Objective Structured Clinical Examination (OSCE) They are conducted at the end of the clinical posting with no feedback provided to the students’. The current study was done to assess the effect of formative evaluation on the documentation of physical examination skills among undergraduate students’. Greater emphasis should be placed on training in basic clinical skills and its precise documentation in real patient setting

Methodology

The time given to document was adequate

Results

Discussion

Conclusion