의과대학생의 임상수행능력에 대한 표준화 환자의 서술형 평가내용 분석
Content Analysis of Standardized-Patients' Descriptive Feedback on Student Performance on the CPX
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초록
Purpose: The goal of this study was to explore what kind of additional information is provided by the descriptive comments other than the rating scales, on the physician-patient interaction (PPI) in the clinical performance examination (CPX) and its feedback role in identifying students' strengths and weaknesses in communication skills. Methods: The data were collected from 18 medical schools in Seoul and Gyeonggi region, which participated in the CPX for fourth-year medical students in 2006 and 2007. In total 12,650 examination cases in 2006 and 12,814 cases in 2007 were analyzed. Descriptive comments from the standardized patients (SPs) were analyzed by content analysis, which includes a 4-step process:coding, conceptualizing, categorizing and explanation. Results: Ten categories (41 concepts) for 'strength' and 11 for 'weakness' (40 concepts) in the PPI were extracted. Among them,10 categories were the same in both strength and weakness: providing adequate interview atmosphere, attentive listening, providing emotional support, non-verbal behaviors, professional attitude, questioning, explanation, reaching agreement, counseling & education and conducting adequate physical examination. For the 'structured and organized interview', only weakness was described. In 'providing emotional support' and 'adequate interview atmosphere', comments on strengths were more frequently mentioned than weaknesses. However, communication skills that were related to non-verbal behaviors were more frequently considered weaknesses rather than strengths. The numbers and content of the SP's comments on students' strengths and weaknesses in the PPI varied depending on the case specificities. Conclusion: The results suggest that the SPs' descriptive comments on student' performance on the CPX can provide additional information versus structured quantitative assessment tools such as performance checklists and rating scales. In particular, this information can be used as valuable feedback to identify the advantages and dicadvantages of the PPI and to enhance students'communication skills
Abstract
Purpose: The goal of this study was to explore what kind of additional information is provided by the descriptive comments other than the rating scales, on the physician-patient interaction (PPI) in the clinical performance examination (CPX) and its feedback role in identifying students' strengths and weaknesses in communication skills. Methods: The data were collected from 18 medical schools in Seoul and Gyeonggi region, which participated in the CPX for fourth-year medical students in 2006 and 2007. In total 12,650 examination cases in 2006 and 12,814 cases in 2007 were analyzed. Descriptive comments from the standardized patients (SPs) were analyzed by content analysis, which includes a 4-step process:coding, conceptualizing, categorizing and explanation. Results: Ten categories (41 concepts) for 'strength' and 11 for 'weakness' (40 concepts) in the PPI were extracted. Among them,10 categories were the same in both strength and weakness: providing adequate interview atmosphere, attentive listening, providing emotional support, non-verbal behaviors, professional attitude, questioning, explanation, reaching agreement, counseling & education and conducting adequate physical examination. For the 'structured and organized interview', only weakness was described. In 'providing emotional support' and 'adequate interview atmosphere', comments on strengths were more frequently mentioned than weaknesses. However, communication skills that were related to non-verbal behaviors were more frequently considered weaknesses rather than strengths. The numbers and content of the SP's comments on students' strengths and weaknesses in the PPI varied depending on the case specificities. Conclusion: The results suggest that the SPs' descriptive comments on student' performance on the CPX can provide additional information versus structured quantitative assessment tools such as performance checklists and rating scales. In particular, this information can be used as valuable feedback to identify the advantages and dicadvantages of the PPI and to enhance students'communication skills
참고문헌 (18)
- Norman GR, "Measuring physicians' performances by using simulated patients", J Med Educ, 60, pp.925~934 (1985)
- Hodges B, "Evaluating communication skills in the OSCE format:reliability and generalizability", Med Educ, 30, pp.38~43 (1996)
- Wallace J, "Simulated patients and objective structured clinical examinations: review of their use in medical education", Adv Psychiatr Treat, 8, pp.342~348 (2002)
- Ladyshewsky R, "Simulated patients and assessment", Med Teach, 21, pp.266~269 (1999)
- Klamen DL, "Using standardized patients for formative feedback in an introduction to psychotherapy course", Acad Psychiatry, 26, pp.168~172 (2002)
- 김 선, "진료수행시험 평가자로서 표준화 환자 활용의 타당성", 한국의학교육, 17(2), pp.163~172 (2005), 한국의학교육학회
- 권복규, "표준화 환자를 이용한 임상수행능력평가시험 (CPX)에서 교수와 표준화 환자의 평가 결과 비교", 한국의학교육, 17(2), pp.173~184 (2005), 한국의학교육학회
- 한재진, "시험 시기에 따른 임상수행능력평가 점수 비교", 한국의학교육, 19(1), pp.31~38 (2007), 한국의학교육학회
- Creswell JW, "Qualitative inquiry and research design: choosing among five traditions" (1997), Sage Publications
- Creswell JW, "Research design: qualitative, quantitative, and mixed methods approaches" (2003), Sage Publications
- Krippendorff K, "Content analysis: an introduction to its methodology. 2nd ed" (2004), Sage Publications
- Kim YC, "Methods and processes of qualitative research for inquiring educational phenomenon in school", Korean J Educ Res, 35, pp.135~170 (1997)
- Berelson B, "Content analysis in communication research" (1952), Hafner
- Nicol DJ, "Formative assessment and self-regulated learning: a model and seven principles of good feedback practice", Stud High Educ, 31, pp.199~218 (2006)
- Sadler DR, "Formative assessment: revisiting the territory", Assess Educ, 5, pp.77~84 (1998)
- Bose J, "A model formative assessment strategy to promote student-centered self-regulated learning in higher education", US-China Educ Rev, 6, pp.29~35 (2009)
- Cole SA, "The medical interview: the three-function approach" (2000), CV Mosby
- Platt FW, "Field guide to the difficult patient interview. 2nd ed" (2004), Lippincott Williams & Wilkins