Evaluating problem solving based on the use of history findings in a standardized-Patient examination

摘要: PURPOSE To evaluate a novel item format for assessing clinical problem solving in standardized-patient examination (SPE). METHOD In 1992-93 key-findings was included two versions of three stations an SPE (given the style objective structured examination) that taken by 198 third-year students at end their three-month internal medicine clerkship University Texas Medical Branch Galveston. Each involved extended matching question listed ten to 12 findings. The were told select as many or few findings they wished key leading them diagnosis standardized patient's (SP's) problem. fell into categories: (1) diagnosis, (2) provided SP but not and (3) SP. RESULTS A total 169 (85%) identified least one determined be each stations. Correctly identifying related correctly diagnosing SP's 145 (73%) indicated finding across cases given Selecting nonexistent found performance on SPE. It hypothesized once made, had difficulty differentiating led from other features cognitive model illness. CONCLUSION generally able obtain recognize some information needed formulate appropriate differential diagnoses, ability identify shown most diagnosis. has potential both assessment gaining better understanding problem-solving process.