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[Evaluation of medical teaching of clinical medicine in 6th year internship-Medical School of USP].

The authors analyzed the performance of student's during their stay at the University Hospital of São Paulo. The study was based on: theoretical evaluation (tests), number of hours dispensed on standard textbook study, and participation in seminars and/or classes. The opinion of the students about the quality of the study of the internal medicine was also analyzed. The average number of hours designated to study the textbook's was 5.8 +/- hours/week. There was an increase in the presence at seminars from 10% to 72%.

Clinical Medicine↗
PubMed1993

Use of an Objective Structured Clinical Examination (OSCE) to measure improvement in clinical competence during the surgical internship.

BACKGROUND: Traditional ward ratings and multiple-choice tests do not reliably assess clinical competence. This study determined the reliability of the Objective Structured Clinical Examination (OSCE) and its sensitivity in detecting the performance gains and deficits in surgical interns. METHODS: A comprehensive 35-station OSCE was administered to 23 incoming interns and seven outgoing interns. The OSCE comprised 17 two-part clinical problems, relying primarily on actual or simulated patients. The reliability of the examination was assessed by coefficient alpha. Significant differences in performance between the two intern groups, between parts A and B, and among the 17 problems were determined by a three-way ANOVA: OSCE performance was also correlated with National Board of Medical Examiners Part II scores. RESULTS: The reliabilities of part A, part B, and parts A and B combined were 0.72, 0.70, and 0.82, respectively. Overall, the outgoing interns performed significantly better than the incoming interns: 58% +/- 1% mean OSCE score versus 47% +/- 1% (p = 0.0001). The 17 clinical problems differed significantly in difficulty; major performance deficits were seen in both groups of trainees. The correlation of OSCE scores with National Board of Medical Examiners Part II scores was not significant (r = 0.11, p = 0.633). CONCLUSIONS: We conclude that the OSCE is an innovative, reliable tool for evaluating resident competence. Although outgoing interns performed better than did incoming interns, the OSCE scores clearly indicated major performance deficits in all interns.

Clinical Competence↗