Design of a structured objective clinical examination to assess neurological clinicalskills in fifth-year students

Abstract

Introduction: The clinical skills learned by students during their training are the main tools forthe diagnosis, prevention and treatment of neurological diseases. Assessment is essential in theteaching-learning process. A Structured Objective Clinical Examination (SOCE) is a method forassessing clinical skills that can be used both as summative and formative assessment. It consistsof stations that form a circuit. In each station the student faces a scenario that evaluates theclinical skills domain in three areas: cognitive, attitudinal, and psychomotor. Its implementationis 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 neurologicalclinical skills in medical internship students.

Method: A committee was formed including 12 experts in neurology, who were trained to designan 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, physicalexamination, diagnosis, treatment, interpretation of studies, decision making, and prevention.In each test station, its contents and checklists were validated by the review committee. A pilottest was applied to 14 medical internship students. The mean, and overall, Cronbach alpha wasobtained 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 logisticsof the test stations.