Medical Students Progress in the Practice Assessment of Knowledge, Skills, and Attitudes

Abstract

We have developed an alternate instrument of evaluation named ACHA- Avalia??o de Conhecimento, Habilidades e Atitude (Assessment of Knowledge, Skills and Attitude) in our institution. We feel that the construct of this tool is more comprehensive than OSCE (Objective Structured Clinical Examination), as it includes two other domains; knowledge and attitude. This study aims to present results of ACHA in medical students during internship as a tool of monitoring their progress. We selected students enrolled in Medicine course from 2007 to 2011. We included in the analysis only 5th and 6th year students, and only those who participated in four consecutive assessments in this period of time. There was a linear progression during the four assessments. The lowest averages were found in the first tests, during the fifth and sixth year (I5Y and I6Y). The scores were separated by stations (Surgery, Internal Medicine, Obstetrics/Gynecology, and Pediatrics) to evaluate student progress. There was a significant difference between assessments in all specialties (the highest value in the II5Y assessment for Surgery (Mean = 7.43 SD = 1.59), and the lowest in the I5Y for Pediatrics (Mean = 4.49, SD = 2.33). The best correlation of improvement progression (score over time) was observed in the Internal Medicine (R2 = 0,678), while the poorest was seen in Gynecology/Obstetrics (R2 = 0.144). We felt that ACHA went beyond being only an assessment tool for evaluating student performance, but also it involved other domains of education and learning process. Perhaps the key element would be the acceptance by everyone involved (teachers and students) in the process which forced a reflection and developed actions to improve the quality of the course and the evaluation itself. We understand that it is essential for the evaluation process to be dynamic and for such the motivation of those involved is vital.