KMID : 0381520080200010061
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Korean Journal of Medical Education 2008 Volume.20 No. 1 p.61 ~ p.72
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Inter-rater Reliability in a Clinical Performance Examination Using Multiple Standardized Patients for the Same Case
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Ko Jin-Kyung
Yoon Tai-Young Park Jae-Hyun
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Abstract
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Purpose: The ¡°standardization¡± of standardized patients (SP) is one of the most crucial factors for a successful clinical performance examination (CPX). This study aimed to examine the inter-rater reliability among SPs who portrayed the same case during a CPX.
Methods: The context was a CPX conducted under the supervision of CPX Seoul-Gyeonggi Consortium in K medical school in August 2007. K medical school ran 12 stations consisting of duplicated sets of 6 cases. In total, thirty SPs participated with 5 SPs acting each of the 6 cases. The SPs evaluated the student¡¯s performances in addition to portraying the cases. ANCOVA (analysis of covariance) was used to compare scores rated by the different SPs. The
dependent variables were the case scores and the 4 subcomponent (history taking, physical examination, Clinical courtesy, and Patient-physician interaction) scores for each case; the independent variable was the SPs; and the covariate was the CPX total score.
Results: The Headache and Cough stations showed an acceptable level of reliability. Otherwise, Weight Loss and Facial Flushing failed to show consistent scores in all 4 subcomponents. Diarrhea and Lt. hemiparesis showed partial consistency. In terms of the subcomponents, the physical exam scores were most consistent and the patient-physician
interaction scores were most inconsistent.
Conclusion: This study tested the level of ¡°standardization¡± of one set of CPX cases with mixed results. The authors hope that our results will contribute to quality assurance of CPX.
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KEYWORD
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CPX, Standardized Patient, Inter-rater Reliability, Analysis of Covariance, Assessment
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