AMEE Berlin 2002 Programme

ecoming more common. Here, it is imperative that
scores are reliable and valid. To accomplish this task,
great care must be taken in the training and monitoring
of SPs. For the Clinical Skills Assessment (CSA),
administered by the Educational Commission for
Foreign Medical Graduates (ECFMG), SP performance
is continually scrutinized. In addition, surveys are
administered to collect data on SP demographics and
opinions regarding exam logistics and training. The
purpose of this paper is to explore the relationship
between SP-related variables (e.g., work history,
training, conditions portrayed) and the adequacy of
candidate scores. Initial results suggest that some, albeit
small, variation in candidate scores can be attributed
to some characteristics of the SP. Fortunately,
continuous quality control, combined with periodic
training and re-training of SPs, ensures that decisions
regarding candidate competence are accurate, fair, and
unbiased.
2D6 Use of standardized patients to
assess medical response to a
natural disaster
Graceanne Adamo*, Marguerite Hawkins, Heidi Worth-
Dickstein, Eric Marks, Ralph Jones, Gilbert Muniz and
Richard E Hawkins
Uniformed Services University of the Health Sciences, National
Capital Area Medical Simulation Center, 4301 Jones Bridge
Road, Bethesda MD 20814, USA
We describe the feasibility and advantages of utilizing
Standardized Patients (SPs) to train and assess the
ability of military medical teams to provide
international health care following natural disasters.
The real-time simulation took place aboard ship after
a hurricane in Belize. Cases were based upon
geographic and natural disaster-related epidemiology.
Moulage, radiographs, computerized laboratory and
imaging reports were provided. Analytic methods
included surveys, structured medical record review, SP
- 4.8 -
checklists, and direct observation. Crew rated the
exercise as more realistic and significantly better than
a previous exercise without SPs in assessing and
preparing them to triage and care for casualties. Medical
record audits and SP checklists were complementary
in evaluating quality of care for individuals. Observers
yielded important data regarding patient flow,
communication, equipment function, supply use, and
ancillary support. The simulation and inclusion of a
variety of assessment measures allowed for high quality
evaluation of complex care delivery.
2D7 The weakest link? Performance
factors and degrees of influence in
an interactive long-station general
practice examination (VOICEs)
C M Wiskin*, T Allan and J Skelton
The Medical School, University of Birmingham, Edgbaston,
Birmingham B15 2TT, UK
Passing a six-station Primary Care OSCE examination
is compulsory. In 2 tasks students improvise
consultations with ‘patients’ portrayed by our role-play
team. Clinical performance is marked by a clinical
examiner. Communication scores (professionalism,
competence, attitude) are awarded by negotiation
between examiner and role-player. This paper is part
of a study evaluating reliability and bias across
examination variables. Data about role-players, students
and examiners; the dynamics and score-awards,
demographics and the logistics of exam days were
collected. Results from over 1,000 assessed
consultations were collated on SPSSv.10. Preliminary
data suggest variables such as question selection, order
in which students are seen, age/experience of examiners
and relationship between role-player and examiner
assessment are not significant. Despite the apparent
subjectivity of the format, interactive examinations are
an appropriate means of testing the communication
skills of medical students.
Session 2E Postgraduate education – the early years
2E1 New PRHO: “I am not sure what I
am supposed to do”. Can we
improve on PRHO induction? An
evaluation of a new induction
process
Dason Evans*, Mike Roberts and Diana Wood
St Bartholomew’s and the Royal London, Department of Medical
Educational Research & Innovation, Robin Brook Centre, School
of Medicine & Dentistry, West Smithfield, London EC1A 7BE,
UK
We conducted a controlled study involving 48 PRHOs.
We compared a traditional, one-day induction with a
newer process principally involving five days of
shadowing before the commencement of the PRHO
post. Clinical responsibility was taken in a safe
environment with full support from the outgoing teams.
Monday 3 September
We assessed feelings of anxiety, preparedness and
confidence in clinical skills via questionnaire, and
ability in clinical skills via an OSCE, before and after
induction and at one month. We audited prescribing
errors, radiology request errors, note keeping and
adverse events in both groups. Pre-induction levels of
anxiety and uncertainty were high, with almost half
having biological symptoms of anxiety. Clinical skills
improved during the longer induction, and 21/22 of
intervention PRHOs felt more prepared for their post
(cf 13/22 controls with 7/22 controls feeling less
prepared after a traditional induction). We will discuss
the induction process and statistical analysis of results
in depth.