USE OF STANDARDIZED PATIENTS TO IDENTIFY DEFICITS IN STUDENT PERFORMANCE AND CURRICULUM EFFECTIVENESS

Much literature supports the value of performance-based tests for obta ining an overall assessment of clinical skills; however, these tests c an also identify specific deficits in medical curriculum and student l earning. This study, conducted over a period of 2.5 years, used standa rdized patients to identify deficiencies in medical students' evaluati on of a patient with ''hoarseness and cough.'' Each of 230 students pe rformed a physical examination and took a medical history, and each wa s evaluated on 29 items according to predetermined criteria. We conclu de the following: (1) When examining a patient complaining of hoarsene ss and cough, students frequently did not screen for hemoptysis, thyro id problems, and otalgia; (2) Overall test performance correlated posi tively with the time of year of the rotation, but screening for certai n items (including hemoptysis, thyroid problems, and otalgia) appeared not to depend on rotation; (3) Several important items significantly differentiated the more knowledgeable student from the less knowledgea ble student.