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Measuring the instructional validity of clinical simulation problems.

E Feinstein, L P Gustavson, H G Levine

    Evaluation & the Health Professions
    |February 10, 1983
    PubMed
    Summary

    Clinical simulation problems did not consistently measure medical student learning gains. Essay-based simulations showed some improvement, unlike forced-choice formats, indicating limitations in assessing clinical problem-solving skills.

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    Area of Science:

    • Medical Education
    • Clinical Simulation
    • Pediatric Training

    Background:

    • Assessing clinical problem-solving skills in medical trainees is crucial for patient care.
    • Clinical simulation offers a method to evaluate these skills in a controlled environment.
    • Understanding how different simulation formats impact assessment of learning is important.

    Purpose of the Study:

    • To evaluate the effectiveness of written clinical simulation problems in assessing medical student learning.
    • To compare the performance of junior and senior medical students using two simulation formats.
    • To determine if clinical simulation problems reflect developmental changes in problem-solving skills.

    Main Methods:

    • Junior and senior medical students were tested using forced-choice and essay-based clinical simulation problems.

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  • Assessments were conducted at the conclusion of pediatric rotations.
  • Student performance was compared based on academic level and instructional time.

    • Main Results:

    • No consistent improvement was observed in forced-choice simulation performance with increased instructional time.
    • Junior students showed improvement in essay simulation performance over time.
    • Essay simulations appeared to better reflect the problem-solving and organizational skills of senior students.

    Conclusions:

    • Written clinical simulation problems, particularly forced-choice formats, showed limited responsiveness to learning and maturation.
    • Essay-based simulations demonstrated some potential in reflecting skill development compared to forced-choice.
    • Further research is needed to enhance the reliability and validity of clinical simulation for assessing patient care problem-solving.