Evaluating clinical knowledge across years of medical training

The evolution of clinical knowledge about the management of a common chronic disease was determined by applying analysis of variance and multiple discriminant analysis to responses on two patient management problems by groups of junior medical students and internal medicine residents. Differences between junior and resident groups were found on both problems for management decisions and therapeutic actions and on one problem for information-gathering. Discriminant analyses of original responses clearly identified patterns of choices contributing to group differences. The utility of patient management problems when analyzed under these two empirical models is discussed.