Purpose The revised Clinical Skills Test (CST) of the Korean Medical Licensing Exam aims to provide a better assessment of physicians’ clinical competence and ability to interact with patients. This study examined the impact of the revised CST on medical education curricula and resources nationwide, while also identifying areas for improvement within the revised CST.
Methods This study surveyed faculty responsible for clinical clerkships at 40 medical schools throughout Korea to evaluate the status and changes in clinical skills education, assessment, and resources related to the CST. The researchers distributed the survey via email through regional consortia between December 7, 2023 and January 19, 2024.
Results Nearly all schools implemented preliminary student–patient encounters during core clinical rotations. Schools primarily conducted clinical skills assessments in the third and fourth years, with a simplified form introduced in the first and second years. Remedial education was conducted through various methods, including one-on-one feedback from faculty after the assessment. All schools established clinical skills centers and made ongoing improvements. Faculty members did not perceive the CST revisions as significantly altering clinical clerkship or skills assessments. They suggested several improvements, including assessing patient records to improve accuracy and increasing the objectivity of standardized patient assessments to ensure fairness.
Conclusion During the CST, students’ involvement in patient encounters and clinical skills education increased, improving the assessment and feedback processes for clinical skills within the curriculum. To enhance students’ clinical competencies and readiness, strengthening the validity and reliability of the CST is essential.
Purpose This study aimed to detect relationships between undergraduate students’ attitudes toward communication skills learning and demographic variables (such as age, academic year, and gender). Understanding these relationships could provide information for communication skills facilitators and curriculum planners on structuring course delivery and integrating communication skills training into the medical curriculum.
Methods The descriptive study involved a survey of 369 undergraduate students from 2 medical schools in Zambia who participated in communication skills training stratified by academic year using the Communication Skills Attitude Scale. Data were collected between October and December 2021 and analyzed using IBM SPSS for Windows version 28.0.
Results One-way analysis of variance revealed a significant difference in attitude between at least 5 academic years. There was a significant difference in attitudes between the 2nd and 5th academic years (t=5.95, P˂0.001). No significant difference in attitudes existed among the academic years on the negative subscale; the 2nd and 3rd (t=3.82, P=0.004), 4th (t=3.61, P=0.011), 5th (t=8.36, P˂0.001), and 6th (t=4.20, P=0.001) academic years showed significant differences on the positive subscale. Age showed no correlation with attitudes. There was a more favorable attitude to learning communication skills among the women participants than among the men participants (P=0.006).
Conclusion Despite positive general attitudes toward learning communication skills, the difference in attitude between the genders, academic years 2 and 5, and the subsequent classes suggest a re-evaluation of the curriculum and teaching methods to facilitate appropriate course structure according to the academic years and a learning process that addressees gender differences.
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Purpose It aims to find students’ performance of and perspectives on an objective structured practical examination (OSPE) for assessment of laboratory and preclinical skills in biomedical laboratory science (BLS). It also aims to investigate the perception, acceptability, and usefulness of OSPE from the students’ and examiners’ point of view.
Methods This was a longitudinal study to implement an OSPE in BLS. The student group consisted of 198 BLS students enrolled in semester 4, 2015–2019 at Karolinska University Hospital Huddinge, Sweden. Fourteen teachers evaluated the performance by completing a checklist and global rating scales. A student survey questionnaire was administered to the participants to evaluate the student perspective. To assess quality, 4 independent observers were included to monitor the examiners.
Results Almost 50% of the students passed the initial OSPE. During the repeat OSPE, 73% of the students passed the OSPE. There was a statistically significant difference between the first and the second repeat OSPE (P<0.01) but not between the first and the third attempt (P=0.09). The student survey questionnaire was completed by 99 of the 198 students (50%) and only 63 students responded to the free-text questions (32%). According to these responses, some stations were perceived as more difficult, albeit they considered the assessment to be valid. The observers found the assessment protocols and examiner’s instructions assured the objectivity of the examination.
Conclusion The introduction of an OSPE in the education of biomedical laboratory scientists was a reliable, and useful examination of practical skills.
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Purpose This study aims to apply the yes/no Angoff and Hofstee methods to actual Korean Medical Licensing Examination (KMLE) 2022 written examination data to estimate cut scores for the written KMLE.
Methods Fourteen panelists gathered to derive the cut score of the 86th KMLE written examination data using the yes/no Angoff method. The panel reviewed the items individually before the meeting and shared their respective understanding of the minimum-competency physician. The standard setting process was conducted in 5 rounds over a total of 800 minutes. In addition, 2 rounds of the Hofstee method were conducted before starting the standard setting process and after the second round of yes/no Angoff.
Results For yes/no Angoff, as each round progressed, the panel’s opinion gradually converged to a cut score of 198 points, and the final passing rate was 95.1%. The Hofstee cut score was 208 points out of a maximum 320 with a passing rate of 92.1% at the first round. It scored 204 points with a passing rate of 93.3% in the second round.
Conclusion The difference between the cut scores obtained through yes/no Angoff and Hofstee methods did not exceed 2% points, and they were within the range of cut scores from previous studies. In both methods, the difference between the panelists decreased as rounds were repeated. Overall, our findings suggest the acceptability of cut scores and the possibility of independent use of both methods.
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Purpose Undertaking a standard-setting exercise is a common method for setting pass/fail cut scores for high-stakes examinations. The recently introduced equal Z standard-setting method (EZ method) has been found to be a valid and effective alternative for the commonly used Angoff and Hofstee methods and their variants. The current study aims to estimate the minimum number of panelists required for obtaining acceptable and reliable cut scores using the EZ method.
Methods The primary data were extracted from 31 panelists who used the EZ method for setting cut scores for a 12-station of medical school’s final objective structured clinical examination (OSCE) in Taiwan. For this study, a new data set composed of 1,000 random samples of different panel sizes, ranging from 5 to 25 panelists, was established and analyzed. Analysis of variance was performed to measure the differences in the cut scores set by the sampled groups, across all sizes within each station.
Results On average, a panel of 10 experts or more yielded cut scores with confidence more than or equal to 90% and 15 experts yielded cut scores with confidence more than or equal to 95%. No significant differences in cut scores associated with panel size were identified for panels of 5 or more experts.
Conclusion The EZ method was found to be valid and feasible. Less than an hour was required for 12 panelists to assess 12 OSCE stations. Calculating the cut scores required only basic statistical skills.
Purpose This study examined how students’ academic performance changed after undergoing a transition to online learning during the coronavirus disease 2019 (COVID-19) pandemic, based on the test results of 16 integrated courses conducted in 3 semesters at Hanyang University College of Medicine in Korea.
Methods For the 16 required courses that formed an integrated system-based curriculum running for 3 semesters, the major examinations’ raw scores were collected for each student. Percent-correct scores were used in the subsequent analysis. We used the t-test to compare grades between 2019 and 2020, and the Cohen D was calculated as a measure of effect size. The correlation of scores between courses was calculated using Pearson correlation coefficients.
Results There was a significant decrease in scores in 2020 for 10 courses (62.5%). While most of the integrated system-based curriculum test scores showed strong correlations, with coefficients of 0.6 or higher in both 2019 and 2020, the correlation coefficients were generally higher in 2020. When students were divided into low, middle, and high achievement groups, low-achieving students consistently showed declining test scores in all 3 semesters.
Conclusion Our findings suggest that the transition to online classes due to COVID-19 has led to an overall decline in academic performance. This overall decline, which may occur when the curriculum is centered on recorded lectures, needs to be addressed. Further, medical schools need to consider establishing a support system for the academic development of low-achieving students.
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We aimed to determine whether it was feasible to assess medical students as they completed a virtual sub-internship. Six students (out of 31 who completed an in-person sub-internship) participated in a 2-week virtual sub-internship, caring for patients remotely. Residents and attendings assessed those 6 students in 15 domains using the same assessment measures from the in-person sub-internship. Raters marked “unable to assess” in 75/390 responses (19%) for the virtual sub-internship versus 88/3,405 (2.6%) for the in-person sub-internship (P=0.01), most frequently for the virtual sub-internship in the domains of the physical examination (21, 81%), rapport with patients (18, 69%), and compassion (11, 42%). Students received complete assessments in most areas. Scores were higher for the in-person than the virtual sub-internship (4.67 vs. 4.45, P<0.01) for students who completed both. Students uniformly rated the virtual clerkship positively. Students can be assessed in many domains in the context of a virtual sub-internship.
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Purpose This study was conducted to determine whether a computer simulation of practical exercises in undergraduate medical pharmacology led to the realization of the intended learning outcomes.
Methods The study was a descriptive analysis of laboratory classes carried out using computer simulation programs. Five programs were used to teach practical pharmacology to undergraduate medical students at the Mulungushi University School of Medicine and Health Sciences. The study period was January 2018 to December 2019. The computer programs included a pharmacokinetics simulator (CyberPatient), organ bath simulator (OBSim), AutonomiCAL for simulating autonomic pharmacology, and Virtual Cat and Virtual Rat (RatCVS) for simulating cardiovascular pharmacology. Students utilized these programs during their pharmacology laboratory classes, wrote reports, and answered relevant clinical questions.
Results The 5 programs provided easy and precise platforms for students to explore concepts and demonstrate knowledge of pharmacokinetics, pharmacodynamics, autonomic and cardiovascular pharmacology, and their clinical applications.
Conclusion The programs were effective learning tools. Students’ learning was easily assessed based on their laboratory reports. Although the computer programs met medical students’ learning needs, wet laboratory exercises are also needed to meet the needs of students who require practical laboratory skills.
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Purpose Acceptance of a learning technology affects students’ intention to use that technology, but the influence of the acceptance of a learning technology on learning approaches has not been investigated in the literature. A deep learning approach is important in the field of health, where links must be created between skills, knowledge, and habits. Our hypothesis was that acceptance of a hybrid learning model would affect students’ way of learning.
Methods We analysed these concepts, and their correlations, in the context of a flipped classroom method using a local learning management system. In a sample of all students within a single year of study in the midwifery program (n= 38), we used 3 validated scales to evaluate these concepts (the Study Process Questionnaire, My Intellectual Work Tools, and the Hybrid E-Learning Acceptance Model: Learner Perceptions).
Results Our sample had a positive acceptance of the learning model, but a neutral intention to use it. Students reported that they were distractible during distance learning. They presented a better mean score for the deep approach than for the superficial approach (P< 0.001), which is consistent with their declared learning strategies (personal reorganization of information; search and use of examples). There was no correlation between poor acceptance of the learning model and inadequate learning approaches. The strategy of using deep learning techniques was moderately correlated with acceptance of the learning model (rs= 0.42, P= 0.03).
Conclusion Learning approaches were not affected by acceptance of a hybrid learning model, due to the flexibility of the tool. However, we identified problems in the students’ time utilization, which explains their neutral intention to use the system.
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Purpose College of Medicine, Gulf Medical University, United Arab Emirates, underwent a major curriculum change from a discipline-based to an organ system-based integrated curriculum. However, it was not known how the faculty perceived the changes in the educational environment as experienced by the students. In this context, we aimed to compare the faculty perceptions of the student experiences in the discipline-based curriculum with those in the organ system-based integrated curriculum.
Methods The Dundee Ready Education Environment Measure (DREEM) questionnaire was modified to assess faculty perceptions of the student experiences, pilot-tested, and administered to all faculty members (n=28) involved in the discipline-based curriculum (FDC) in January 2009. In the subsequent year, data were collected from the same faculty involved in the new integrated curriculum (FIC). Collected data were transferred to Predictive Analytics Software version 18. Total, domain, and individual statement scores were assessed with the Wilcoxon signed rank test. Percentage agreement, disagreement, and uncertainty were assessed by the McNemar’s test for proportion.
Results The mean total DREEM score was significantly higher (P<0.001) for FIC (139/200) as compared to FDC (119/200). The FIC perceived significantly more positive student experiences with the educational environment as indicated by the domain scores and statement scores. The differences in proportions of agreement between FIC and FDC also reinforced that the FIC perceived more positive student experiences with the educational environment.
Conclusion The study showed that the faculty perceived the organ system-based integrated curriculum as providing a better educational environment for the students than the discipline based curriculum.
KIST Medical College is a new medical school in Lalitpur, Nepal. In Nepal, six basic science subjects are taught together in an integrated organ system-based manner with early clinical exposure and community medicine. Correlation seminars are conducted at the end of covering each organ system. The topics are decided by the core academic group (consisting of members from each basic science department, the Department of Community Medicine, the academic director, and the clinical and program coordinators) considering the public health importance of the condition and its ability to include learning objectives from a maximum number of subjects. The learning objectives are decided by individual departments and finalized after the meeting of the core group. There are two student coordinators for each seminar and an evaluation group evaluates each seminar and presenter. Correlation seminars help students revise the organ system covered and understand its clinical importance, promote teamwork and organization, and supports active learning. Correlation seminars should be considered as a learning modality by other medical schools.
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