Evaluating clinical skills of radiation oncology residents: Parts I and II

The purposes of this article are to: (1) underscore both the importance and the difficulty of assessing clinical skills at the graduate level, (2) rev iew both old and new assessment methods of clinical skills in an attempt to familiarize educators with current views on evaluation modalities, and (3) assess the state of clinical-skills assessment specifically in radiation o ncology. A series of articles published in The Lancet in 1995, entitled "Ex amining the Examiner," was used as a starting point. We then conducted an e xtensive literature search (using MEDLINE) to find publications that examin ed different examination methods, old and new, that apply to the education of radiation oncology residents. Concepts critical to understanding any dis cussion of clinical skills evaluation methods are also reviewed. Results: P art I of the article provides an introduction critical to understanding the objectives of clinical-skills evaluation. Also, three older, well-establis hed methods of clinical skills evaluation (ward evaluation, oral examinatio n, and multiple-choice questions) are assessed. In Part II, the objective s tructured clinical examination (OSCE), the standardized patient (SP), and t he patient management problem (PMP), all born of recent innovations in the field, are discussed. Part II concludes with a review of how the issues pre sented in both parts are relevant to the assessment of the radiation oncolo gy resident. All evaluation methods that can be applied to the education of radiation oncology residents have perceived advantages and shortcomings. W ith the proper administration of many of these (save, perhaps, the PMP), an y perceived difficulties in evaluating the clinical skills of radiation onc ology residents may be addressed and diminished. Suggestions offered that a re worthy of further discussion, debate, and study include establishment of a standardized "ward" examination, a formative oral examination to accompa ny the ACR In-Training examination, and the possible revision of the Americ an Board of Radiology oral examination. An in-depth appraisal on the feasib ility of using newer evaluation methods (OSCE, SP, etc.) is also needed. (C ) 2000 Wiley-Liss, Inc.