Clinical Skills Assessment

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Rationale:

In order to ensure that all students have obtained the skills necessary to progress to the next level of clinical training.

Scope and Applicability:

All students enrolled in the School of Medicine

Standard Practice Guideline:

All students are required to complete a formative mid year assessment and pass an end of year clinical skills assessment after completing all M3 clerkships. A non-anchored multi-station Objective Structured Clinical Exam (OSCE) is used for this assessment. The assessment is conducted in two stages. The first, the formative, “mid-year” clinical skills assessment, occurs approximately half way through the regularly scheduled M3 year. The second, the summative, “end-of-year” clinical skills assessment, occurs within 4-8 weeks of the completion of the M3 clerkships. Students on target to progress to the M4 year are considered eligible to participate in the above clinical skills assessments unless otherwise indicated by the Associate Dean for Undergraduate Clinical Education.

Procedures: 

Background

The clinical skills assessment customarily consists of a standardized patient (SP) based case or cases. The content and format of individual OSCE cases for the clinical skills exam mirrors those used for regular end-of-clerkship OSCEs. An OSCE “case” normally includes a patient encounter followed immediately by a post encounter note.  The cases are drawn from the M3 clerkship disciplines. The post-encounter note usually involves completing all or part of a simulated medical record chart, following the Subjective, Objective, Assessment, and Plan format. Additionally, clerkship directors may add or substitute components in the patient encounter and/or post encounter note including but not limited to procedural trainers, mannequins, and/or diagnostic study interpretations. Where practical, to minimize disruption, mid-year and end-of-year clinical skills exam are scheduled to coincide with regularly scheduled, end-of-clerkship OSCEs.

Formative Assessment

The mid-year clinical skills assessment is formative. Students who do not perform as expected on the mid-year clinical skills assessment will be contacted by the Clinical Optimization Specialist and encouraged to work with staff and faculty to improve their skills.

Summative Grading and Assessment

Performance on individual cases on the end of year summative exam is aggregated to provide a final evaluation on end-of-year the Clinical Skills Assessment. The Associate Dean for Undergraduate Clinical Education sets the passing grade. Students who do not successfully complete the end-of-year clinical skills assessment are required to meet with the Clinical Optimization Specialist and the Associate Dean for Undergraduate Clinical Education and/or their designate(s) to arrange remediation and/or retesting.

Retesting

Remediation and retest of the summative end-of-year clinical skills assessment failure normally occurs within three weeks of the original exam date. Successful completion of any and all prescribed remediation and retesting are required before a grade of “pass” will be awarded for the end-of-year clinical skills exam. Specifics of remediation and retesting are determined on an individual basis in consultation with the Clinical Optimization Specialist, Director Clinical Skills Training and Simulation Center, and the Associate Dean for Undergraduate Clinical Education or designee.

Students Unable to Participate in the Regularly Scheduled Exam or Retest

Students unable or ineligible to participate in the regularly scheduled end-of-year clinical skills assessment in June or students that need to retest a failed end-of-year clinical skills exam may be eligible to take the exam in August. Exceptions include, but are not limited to, those students who will not have completed the M3 curriculum by the scheduled end-of-year clinical skills exam date. Approval to take the August end-of-year clinical skills exam must be received in writing from the Associate Dean for Undergraduate Clinical Education.

Successful completion of the end-of-year clinical skills exam, while not necessarily required to begin the M4 year, is a requirement for graduation from the M.D. program. Students failing the end-of-year clinical skills assessment retest will be referred to the Student Performance Review Committee (SPRC).

Definitions:

Related Policies and Forms:

Good Academic Standing 

M3-M4 Graduation Requirements 

Standards for Graduation 

Student Performance Review Committee

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