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Acad Med. 2009 Oct;84(10 Suppl):S94-6. doi: 10.1097/ACM.0b013e3181b38e8c.

Setting defensible standards for cardiac auscultation skills in medical students.

Author information

1
Department of Medicine, Northwestern University Feinberg School of Medicine, Galter 3-150, 251 East Huron Street, Chicago, IL 60611, USA. dwayne@northwestern.edu

Abstract

BACKGROUND:

Cardiac auscultation is a critical clinical skill for physicians, but minimum performance standards do not exist.

METHOD:

One hundred third-year medical students from three schools completed a case-based computerized examination that assessed their ability to identify 12 major cardiac findings. Cohort performance was reviewed by a panel of expert judges who provided item-based (Angoff method) and group-based (Hofstee method) judgments on two occasions. Judges' ratings were used to calculate a minimum passing standard (MPS) for cardiac auscultation skills. Interrater reliabilities and test-retest reliability (stability) were calculated.

RESULTS:

Both methods produced reliable and stable data. Use of the Angoff method yielded a more lenient MPS than the Hofstee method. Two thirds of the students (66%) did not achieve the MPS.

CONCLUSIONS:

Use of a defensible standard allows for reliable evaluation of cardiac auscultation skills. Further work is needed to improve the performance of this important clinical skill by medical students.

PMID:
19907398
DOI:
10.1097/ACM.0b013e3181b38e8c
[Indexed for MEDLINE]

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