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The "Patient management problem" as a formative evaluation during the internship.

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    La Tunisie Medicale
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    Formative evaluation using Patient Management Problems (PMP) improved pediatric orthopedic interns' clinical reasoning. This method offers a more effective assessment than traditional exams for surgical internships.

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    Area of Science:

    • Medical Education
    • Orthopedic Surgery
    • Pediatric Traumatology

    Background:

    • Traditional end-of-rotation clinical exams (ECOS) in pediatric orthopedics may not fully reflect intern learning objectives.
    • A discrepancy exists between summative evaluation methods and the practical skills required during surgical internships.

    Purpose of the Study:

    • To investigate the efficacy of a formative evaluation method during pediatric orthopedic surgery internships.
    • To assess the utility of the Patient Management Problem (PMP) for evaluating clinical and therapeutic reasoning in interns.

    Main Methods:

    • A prospective, evaluative, longitudinal study conducted from October 2019 to September 2020.
    • Formative evaluation using Patient Management Problems (PMP) with pre-tests and post-tests on acute osteomyelitis and malignant bone tumors.
    • Study involved 18 interns in the pediatric orthopedics and traumatology department.

    Main Results:

    • Post-test scores showed statistically significant improvement compared to pre-test scores for both osteomyelitis and bone tumor PMPs.
    • Average post-test scores were 18.11 for osteomyelitis and 16.45 for bone tumors.
    • Osteomyelitis PMP scores were significantly higher than bone tumor PMP scores (p = 0.04).

    Conclusions:

    • The Patient Management Problem (PMP) method shows promise for continuous, formative evaluation in pediatric orthopedic surgery internships.
    • This approach effectively assesses and enhances interns' clinical and therapeutic reasoning skills.
    • Results support the implementation of PMP for ongoing learner assessment in surgical training.