Using clinical skills exams to evaluate medical student skills in prevention

In 2006, the Brody School of Medicine Regional Medicine-Public Health Education Center integrated the teaching of prevention into the curriculum for first-, second-, and third-year medical students.

The purpose of this article is to report on the use of clinical skills exams (CSEs) in the evaluation of prevention health instruction for the period 2006-2010.

Two CSEs were employed to measure preventive skills at the end of the third year of medical school. CSE-1 was a woman aged 56 years with knee pain. The outcome measure is the percentage of students asking three or more prevention history items. CSE-2 was a boy, aged 15 years, undergoing a sports physical/preventive screening. The outcome measure is the number of prevention items queried.

For CSE-1, the percentage of students who met the outcome measure increased to 83% in 2010 as compared to 62% in both 2009 and 2007. The improvement between 2007 and 2010 was significant with a p=0.0080 (Fisher's exact test). Of the 64 students taking the third-year medical student objective structured clinical examination-2 in June 2009, the greatest number queried the following preventive items: exercise (98%), alcohol misuse (98%), drug use (98%), school and grades (98%), sexual activity (98%), and tobacco use (97%).

By integrating prevention elements into CSE cases, the results are useful for student assessment and may be a powerful influence on curricular design, leading to an increase in prevention content.