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Abstract

This study identified dimensions of clinical competence underlying faculty ratings of fourth-year student performance in a standardizedpatient examination and assessed the impact of these dimensions onfaculty pass/fail decisions. Content review coupled with exploratoryfactor analysis was used to group 17 of 25 specific behavioral rating categories intofourhomogeneous clusters. Confirmatory factor analysis refined the clusters into four unidimensional scales that included 14 of the original ratings. The dimensions reflected relating to the patient, problem-solving skills, medical history skills, and physical examination skills. The factor structure was crossvalidated in a separate data set. Logistic regression indicated problem solving was the only independent predictor of a student passing the exercise.

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References

Anderson, J. C. , & Gerbing, D. W. (1988). Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103, 411-423.

Arnold, L. , Willoughby, T. L. , & Calkins, E. V. (1984). Understanding the clinical performance of physicians: A factor analysis approach. Journal of Medical Education, 59, 591-594.

Bentler, P. M. (1989). EQS structural equations program manual. Los Angeles: BMDP Statistical Software.

Bridgeman, B. , & Rock, D. A. (1993). Relationships among multiple-choice and open-ended analytical questions. Journal of Educational Measurement, 30, 313-329.

Byrne, B. M. (1994). Structural equation modeling withEQS and EQSIWindows: Basicconcepts, applications and programming. Thousand Oaks, CA: Sage.

Hassard, T. H. , Campbell, C. , Kass, D. , Kopelow, M. , & Schnabl, G. (1990). An examination of the factor structure of clinical competence. In Proceedings of Current Developments in Assessing Clinical Competence (pp. 352-356). Ottawa: The Canadian Association for Medical Education.

Hunter, J. E. , & Gerbing, D. W. (1982). Unidimensional measurement, second order factor analysis, and causal models. Research in Organizational Behavior, 4, 267-320.

Joreskog, K. G. (1969). Ageneral approach to confirmatory maximum likelihood factor analysis. Psychometrika, 34, 183-202.

Maatsch, J. L , & Huang, R. (1986). An evaluation of the construct validity of four alternative theories of clinical competence. In Proceedings of the 7henty-Fifth Annual Conference Research in Medical Education (pp. 69-74). Washington, DC: The Association of American Medical Colleges.

10.

van der Vleuten, C.P.M. , & Swanson, D. B. (1990). Assessment of clinical skills with standardized patients: State of the art. Teaching and Learning in Medicine, 2, 58-76.

11.

Verhulst, S. J. , Colliver, J. A. , Paiva, R.E.A. , & Williams, R. G. (1986). A factor analysis study of performance of first-year residents. Journal of Medical Education, 61, 132-134.

12.

Vu, N. V. , Colliver, J. A. , & Verhulst, S. J. (1990). Factor structure of clinical competence as assessed in a performance-based exainaon using stanrdzed patients. In Proceedings of Current Developments in Assessing Clinical Competence (pp. 411-415). Ottawa: The Canadian Association for Medical Education.

Dimensions of Clinical Competence as Conceptualized by Medical School Faculty

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