PURPOSE Recently, the clinical practice examination (CPX) using standardized patients has been introduced into several specialty certifying examinations in Korea. The purpose of this paper was to determine the correlation of a resident's performance on the CPX with the comprehensive written multiple-choice question (MCQ) examination on the certifying examination for family medicine.
METHODS The subjects of this study were 1,023 residents who completed the 1st and 2nd certifying examination for family medicine between 2009 and 2011. We determined the correlation between the total scores and 4 domain scores (history taking, physical examination, patient education, and patient-physician interaction) on the CPX with the MCQ scores of the 1st written test and 2nd slide examination and the correlation between the total CPX score and scores on the CPX domains.
RESULTS The correlation between CPX score with each MCQ examination (0.21~0.45 with 1st written MCQ, 0.15~0.33 with 2nd slide MCQ) was lower than that between each MCQ examination (0.46~0.59). The CPX score on patient education did not correlate with the 1st written and 2nd MCQ scores.
The CPX scores on history taking and physical examination correlated slightly with the 1st written MCQ scores. The global ratings of preceptor examiners had the highest correlation (r=0.68~0.82) with the total CPX scores.
CONCLUSION Considering the mild correlation of CPX scores with each MCQ examination, the CPX is more likely to measure other qualities, such as critical thinking and communication skills.
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BACKGROUND There has been widespread use of in-training examination for the evaluation of clinical competence of residents. The result of in-training examination seems to be helpful for improving the quality of residency programs using feedback system, further. We evaluated the relationship between residency program and the result of in-training examination.
METHODS Reports on the contents of residency program(82 programs) which were submitted in 1999 and in-training examination scores of 516 family medicine residents in 1998 were linked each other through the name of resident.
Correlation analysis, t test, ANOVA analysis, and the multiple linear regression analysis were used.
RESULTS Mean score acquired by residents of tertiary hospital residency program(59.4+/-7.79) was significantly higher than that of secondary hospital(56.4+/-8.45) among all three residency years. Residents who have seen their own patients in ambulatory care clinic(58.5+/-8.14) and were given feedback by peer review of teaching faculty(60.2+/-7.71) acquired significantly better results compared to those who have not(56.1+/-8.35, 57.5+/-8.27).
Residents in programs with moderate ratio of the number of residents to teaching faculty acquired significantly better results compared to those with smaller or larger ratio; the score were 56.2+/-6.90, 59.2+/-8.64, 58.7+/-7.90, 57.1+/-8.82 for the ratio of < or =3, 4-6, 7-9, and 9 <, respectively. Statistically significant but low correlation coefficients(less than 0.25) were observed between in-training examination score and the period of rotation to learn family medicine, general medicine, dermatology, musculo- skeletal problem, and the neuro-sensory problem.
After controlling probable confounders, third year of residency, residency program in tertiary hospital, and the moderate ratio of residents to teaching faculty were significantly associated with the better result of in-training examination.
CONCLUSION For improving clinical competence of residents in family practice, limiting the ratio between residents and teaching faculty in residency program to appropriate level and substantiality in contents of hospital teaching rotation program should be needed.
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