Standardized Patients To Evaluate The Statistical Validity And Reliability Of Clinical Competence Of Medical Students Study

PrefaceClinical comprehensive ability is an important standard which should be achieved by medical graduates. There are many methods to test whether the medical graduates are qualified. Objective Structured Clinical Examination ( OSCE) has been paid close attention in the medical educational circles as a method to assess the clinical competence of medical students. In OSCE the number of the assessors is reduced and the Standardized Patients ( SPs) act as the assessors, so the objectivity of the scores increase. At the same time the more contents of examination than before make the evaluation more accurate. Recently more and more abroad educational organizations use the OSCE as a tool to assess the clinical ability. OSCE was used scarely by native Evaluation. There are some questions in OSCE such as whether the result is reliable or not, the cost questions of OSCE, the validity of the SPs' modeling, the training of SPs, the evaluation of the SPs and the confidentiality of OSCE. At present OSCE is on trial only in several (about 3or4) universities in our country. So it is necessary to discuss the method that evaluate clinical comprehensive ability to pay attention to some questions,it is significant to make it used widely in China. We invite the clinician to score the students with SPs and we get two sets of the scores in 2001 OSCE. It is the first time that the scores by clinicians are used to measure the accuracy of the ones by SPs in our country. The objective is to assess the accuracy, Validity and reliability of Sps and to supply the theoretic basis for thefurther extension of OSCE. This research will supply the proof that statistic methods were used in evaluation of medical education.SUBJECTS AND METHODSThe candidates are 182 clinical medical graduates of China Medical University in 2001. This OSCE consists of 16 stations and we just investigate 6 stations involving SPs. The examiners are 11 well -trained clinicians and SPs. Two clinicians score the students by turn with 19 SPs separately. We get 1088 effective portions and the 561 portions are the short stations including physical examination and the other is not. The reliability and validity are used to evaluate the exam. The difficulty and difference degree are used to evaluate the content of the exam. The data are analyzed statistically with variance a-nalysis, analysis of homogeneity of variance and Pearson correlation a-nalysis on the computer with SPSS8.0.RESULTSl.The reliability of this OSCE is indicated with reliability coefficients^) anda =0. 9033 in the first set of medical records, a =0. 8715 in the second set. The validity of this OSCE is indicated with Criterion ?related Validity.2.The total score by the clinicians is 1.6% more than the one by SP. Their correlation coefficient is 0.685(p < 0.01) in the short stations including physical examination and the one is0.815(p < 0.01) in the short stations not including physical examination. The correlation is notably significant and the correlation is obvious. The correla-tion coefficient of the item score is 0.408 ~0. 835 . It is analyzed with t test and the result (p < 0. 01) shows that the correlation is very notably significant. The coefficient of variation of scores by SPs is more than the one by clinicians in the short stations including physical examination, especially in the skill scores. The situation is not the same in the short stations not including physical examination and the difference is less than 1 percent.3. The correlation coefficient of the content scores by SP and clinicians in history taking technique is significantly more than the one of the technical skill scores and the conclusion in physical examination technique is the same. The each difference test of-correlation coefficients in both content scores and skill scores (p < 0. 05) shows that the difference is significant.4. The variance analysis of the scores by two clinicians and one SP in all short stations not including physical examination shows that p> 0. 05 and the differences a...