BACKGROUND The Objective Structured Clinical Examination (OSCE) has been used in pediatrics since the 1980s. Its main drawback is that large numbers of children are needed to make up for the fatigue factor inherent in prolonged testing periods. Also, examinations mainly include children between 7 and 16 years old. We describe the summative examination used in our institution to evaluate medical students' clinical competencies in pediatrics with realistic available resources and for a wider age-range. We also evaluated different factors known to influence medical students' performances. METHODS This retrospective, descriptive, observational study evaluated the 740 distinct pediatric examination results of fourth-year medical students over 5 years. Their summative examination combined two different assessment methods: a structured real-patient examination (SRPE) using standardized assessment grids for the most frequent pediatric diagnoses, and a computer-based written examination (CBWE). RESULTS Our approach defined an appropriate setting for some key elements of the educational objectives of pediatrics training, such as balancing the child-parent-pediatrician triangle and the ability to interact with pediatric patients, from newborns to 16-year-old adolescents, in a child-friendly fashion in realistic scenarios. SRPE scores showed no associations with students' degrees of exposure to specific lecture topics, vignettes, or bedside teaching. The impacts of clinical setting, topic, and individual examiners on SRPE scores was quite limited. Setting explained 1.6%, topic explained 4.5%, and examiner explained 4.7% of the overall variability in SRPE scores. CONCLUSIONS By combining two different assessment methods, we were able to provide a best-practice approach for assessing clinical skills in Pediatrics over a wide range of real patients.

中文翻译：

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“评估儿科本科临床技能的最佳实践方法的评估”。


背景 客观结构化临床检查 (OSCE) 自 20 世纪 80 年代以来一直用于儿科。其主要缺点是需要大量儿童来弥补长时间测试带来的疲劳因素。另外，考试对象主要是7岁至16岁的儿童。我们描述了我们机构使用的总结性考试，以利用现实的可用资源和更广泛的年龄范围来评估医学生在儿科方面的临床能力。我们还评估了已知影响医学生表现的不同因素。方法 这项回顾性、描述性、观察性研究评估了 5 年来 740 名四年级医学生的不同儿科检查结果。他们的总结性检查结合了两种不同的评估方法：使用标准化评估网格进行最常见儿科诊断的结构化真实患者检查（SRPE）和基于计算机的笔试（CBWE）。结果 我们的方法为儿科培训教育目标的一些关键要素定义了适当的环境，例如平衡儿童-家长-儿科医生三角关系以及与从新生儿到 16 岁青少年的儿科患者互动的能力。现实场景中的儿童友好时尚。 SRPE 分数显示与学生接触特定讲座主题、小插曲或床边教学的程度没有关联。临床环境、主题和个别检查者对 SRPE 评分的影响相当有限。 SRPE 分数总体变异性的设置解释了 1.6%，主题解释了 4.5%，考官解释了 4.7%。 结论 通过结合两种不同的评估方法，我们能够提供一种最佳实践方法来评估广泛的真实患者的儿科临床技能。