Diseño de un ECOE para evaluar habilidades clínicas en neurología en estudiantes del quinto año


Design of a structured objective clinical examination to assess neurological clinical skills in fifth-year students
Laura S. Hernández Gutiérrezaa, Juan Andrés Trejob, Yolanda Marín Camposcc

a Posgrado de Educación en Ciencias de la Salud, Facultad de Medicina, UNAM, Ciudad de México, México
b Coordinación de Ciencias Básicas, Departamento de Evaluación Educativa, Secretaría de Educación Médica, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
c Coordinación de Ciencias Básicas, Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México

Recibido 18 octubre 2016, Aceptado 05 enero 2017

Palabras Clave

Habilidades clínicas, Neurología, Examen Clínico Objetivo Estructurado

Keywords

Clinical skills, Neurology, Structures Objective Clinical Examination


Abstract

Introduction: The clinical skills learned by students during their training are the main tools for the diagnosis, prevention and treatment of neurological diseases. Assessment is essential in the teaching-learning process. A Structured Objective Clinical Examination (SOCE) is a method for assessing clinical skills that can be used both as summative and formative assessment. It consists of stations that form a circuit. In each station the student faces a scenario that evaluates the clinical skills domain in three areas: cognitive, attitudinal, and psychomotor. Its implementation is helpful in evaluating professional skills of a curriculum with clinical qualities.

Objective: The objective of this study was to design and pilot an SOCE to assess neurological clinical skills in medical internship students.

Method: A committee was formed including 12 experts in neurology, who were trained to design an SOCE. A clinical skills specification table was constructed in order to assess clinical cases. This was followed by designing an SOCE with 7 clinical skills that included: history, physical examination, diagnosis, treatment, interpretation of studies, decision making, and prevention. In each test station, its contents and checklists were validated by the review committee. A pilot test was applied to 14 medical internship students. The mean, and overall, Cronbach alpha was obtained for each station.

Results: An SOCE of 18 stations was designed and pilot tested. A mean of 6.53 was obtained, with an overall Cronbach alpha of 0.62 in the examination.

Conclusions: An SOCE allows clinical skills to be evaluated in a planned manner. The key elements for design are: the examination committee, table specifications, and design and logistics of the test stations.