Abstract
BackgroundClinical skills tests have been added to the national medical licensure examinations in Canada, the U.S., Korea and Switzerland. Adding a clinical skills test to the Japanese national medical licensure examination should also be considered under the Medical Practitioners Act. On the other hand, such tests might be costly and represent an economic burden to the nation’s citizens. Thus, it is appropriate to obtain the opinion of the general public for the introduction of such tests. Although a clinical skills test can measure various competencies, it remains uncertain as to what should be measured. In this study, we aimed to ascertain public opinion regarding the clinical skills demanded of novice physicians.MethodsWe conducted an internet-based survey of the general public in Japan. We randomly selected 7,213 people aged 20 to 69 years. The main topics surveyed included: whether the Japanese government should add a skills test to the existing national medical licensure examination; what kind of skills should be included in this test; and who should pay for the examination.ResultsOf 3,093 (1,531 men and 1,562 women) people who completed the questionnaire (completion rate 42.9%), 90.5% (n = 2,800) responded that a clinical skills test should be part of the national medical licensure examination. The main skills which respondents thought should be included were “explaining and discussing medical issues in an appropriate manner to patients” (n = 2,176, 70.4%), “accurately diagnosing problems by conducting a physical examination” (n = 1,984, 64.1%), and “carefully interviewing patients to make a diagnosis” (n = 1,663; 53.8%). Three-fifths of the respondents (n = 1,900; 61.4%) responded that more than half of the cost of the examination should be paid by the Japanese government.ConclusionsThe majority of respondents indicated that a clinical skills test should be added to the national medical licensure examination. These respondents who represent the general public were requesting the verification of communication, diagnostic interview and diagnostic physical examination skills. Medical educators should incorporate these public requests, and teach and assess medical students accordingly.
Highlights
Clinical skills tests have been added to the national medical licensure examinations in Canada, the U.S, Korea and Switzerland
It is necessary to obtain the opinion of the general public when deciding the introduction of such tests, to the conduct of a U.S poll which supported the recent addition of skills tests to the United States Medical Licensing Examination [2]
We developed a 6-item questionnaire based on the results of our preceding qualitative study, including 9 individual interviews and 3 focus groups about lay people’s understanding of medical education, [4] a questionnaire survey among 521 patients of 10 Japanese teaching hospitals selected by a cluster sampling, [5] and a previous study about people’s level of skepticism toward medical care and health utilization [6]
Summary
Clinical skills tests have been added to the national medical licensure examinations in Canada, the U.S, Korea and Switzerland. Adding a clinical skills test to the Japanese national medical licensure examination should be considered under the Medical Practitioners Act. On the other hand, such tests might be costly and represent an economic burden to the nation’s citizens. Within the last 20 years, clinical skills tests have been added to the national medical licensure examinations in Canada, the U.S, Korea and Switzerland. Adding a clinical skills test to the Japanese national medical licensure examination should be considered to meet demand in order to assure novice physicians’ clinical competence under the Medical Practitioners Act. Japanese government and Japanese Society for Medical Education are considering when and how to start it. We had a hypothesis that most Japanese citizens agree to introduce skills test in Japan
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