Elsevier

Surgery

Volume 140, Issue 4, October 2006, Pages 633-639
Surgery

Central Surgical Association
Utilization of standardized patients to evaluate clinical and interpersonal skills of surgical residents

Presented at the 63rd Annual Meeting of the Central Surgical Association, Louisville, Kentucky, March 9-11, 2006.
https://doi.org/10.1016/j.surg.2006.07.014Get rights and content

Background

This project was designed to determine the growth of interpersonal skills during the first year of a surgical residency.

Methods

All categorical surgical residents were given a clinical skills examination of abdominal pain using standardized patients during their orientation (T1). The categorical residents were retested after 11 months (T2). The assessment tool was based on a 12-item modified version of the 5-point Likert Interpersonal Scale (IP) used on the National Board of Medical Examiners prototype Clinical Skills Examination and a 24-item, done-or-not-done, history-taking checklist. Residents’ self-evaluation scores were compared to standardized patients’ assessment scores. Data were analyzed using the Pearson correlation coefficient, Wilcoxon signed rank test, Student t test, and Cronbach alpha.

Results

Thirty-eight categorical residents were evaluated at T1 and T2. At T1, in the history-taking exercise, the scores of the standardized patients and residents correlated (Pearson = .541, P = .000). In the interpersonal skills exercise, the scores of the standardized patients and residents did not correlate (Pearson = −0.238, P = .150). At T2, there was a significant improvement in the residents’ self-evaluation scores in both the history-taking exercise (t = −3.280, P = .002) and the interpersonal skills exercise (t = 2.506, P = 0.017). In the history-taking exercise, the standardized patients’ assessment scores correlated with the residents’ self-evaluation scores (Pearson = 0.561, P = .000). In the interpersonal skills exercise, the standardized patients’ assessment scores did not correlate with the residents’ self-evaluation scores (Pearson = 0.078, P = .646).

Conclusions

Surgical residents demonstrate a consistently low level of self-awareness regarding their interpersonal skills. Observed improvement in resident self-evaluation may be a function of growth in self-confidence.

Section snippets

Methods

All categorical residents of a general surgery training program participated in an exercise using a standardized patient assessment tool during their orientation (T1). The assessment tool was based on a 12-item modified version of the 5-point Likert Interpersonal Scale (IP) used on the National Board of Medical Examiners (NBME) prototype Clinical Skills Examination (CSE) (Table I) and a 24-item, done-or-not-done, history-taking checklist (Abd) (Table II). The standardized patient scenario was

Results

Thirty-eight residents were evaluated at T1 and T2. The scores for the standardized patients and residents are listed in Table III. Statistical evaluation is summarized in Table IVa, Table IVb, Table IVc.

There were 24 items in the done-or-not-done Abd. At T1 (Table III), the standardized patients (Spabd) noted a mean performance of 13.7 ± 3.5 (57%) items. The residents (Mdabd) claimed a mean performance of 14.3 ± 2.8 (60%) items (Table III).

There was no significant difference between the

Discussion

This was an observational study in which residents were studied twice. The study was designed to identify activity status at the entry point and determine the normal growth of the activity between 2 points during which clinical encounters were the only intervention.

The study was based on the concept that clinical experiences create a significant curriculum for skill acquisition. Intervention or modification of the naturally occurring curriculum should be based on an adequate study to determine

References (7)

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