Korean J Fam Med.  2014 Mar;35(2):56-64. 10.4082/kjfm.2014.35.2.56.

Impact of Clinical Performance Examination on Incoming Interns' Clinical Competency in Differential Diagnosis of Headache

• Park SM
• Song YM
• Kim BK
• Kim H

• KMID: 2304146
• DOI: http://doi.org/10.4082/kjfm.2014.35.2.56

Abstract

BACKGROUND
In Korea, clinical performance examination (CPX) has been included in license examination for medical doctors since 2009 in order to improve clinical performance of medical students. This study aimed to evaluate the contribution of CPX to medical education.
METHODS
Clinical competency in the differential diagnosis of secondary headache was compared between the incoming interns in 2009 unexposed to CPX and the incoming interns in 2010 exposed to CPX, using the data of patients who visited the emergency department due to headache (181 patients seen by 60 CPX non-exposed interns and 150 patients seen by 50 CPX-exposed interns). We obtained the data by reviewing electronic medical records and nominal lists of doctors. Clinical competency was assessed by sensitivity and specificity between the diagnostic impression by interns and the final diagnosis. The association between CPX exposure and clinical competency in secondary headache diagnosis was evaluated using multiple logistic regression analysis.
RESULTS
When we assessed clinical competency on the basis of all listed diagnostic impressions, sensitivity and specificity were 67.9% and 80.0%, respectively, for headaches seen by CPX-exposed interns, and 51.7%, and 71.7%, respectively, for headaches seen by CPX non-exposed interns. Multivariable adjusted logistic regression analysis showed exposure to CPX was not associated with increased competency for identifying secondary headache.
CONCLUSION
Exposure to CPX as a part of the medical license examination was not effective for the improvement of clinical competency of interns in identifying secondary headache.

Keyword

Competency-Based Education; Clinical Performance Examination; Headache; Internship and Residency; Medical Student

MeSH Terms

Competency-Based Education
Diagnosis
Diagnosis, Differential*
Education, Medical
Electronic Health Records
Emergency Service, Hospital
Headache*
Humans
Internship and Residency
Korea
Licensure
Logistic Models
Sensitivity and Specificity
Students, Medical