FACTORS INFLUENCING FAILURE IN THE LONG-CASE EXAMINATION OF 6TH-YEAR MEDICAL STUDENTS IN THE DEPARTMENT OF MEDICINE CHIANGRAI PRACHANUKROH HOSPITAL
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Abstract
BACKGROUND: Long-case examination tests the student's clinical skills, clinical reasoning, and interaction with a patient. Some students failed the test, so there is a need to re-evaluate the causes of failure in the current long-case examination in Thai medical education.
OBJECTIVE: To determine factors associated with long-case assessment failure.
METHODS: This study is a retrospective case-control study from 1st May to 31st December 2019. The data was recorded in the case record form. The factors of interest were analyzed by Student t-test, Wilcoxon rank sum test and Exact probability test. The association factors were determined by the univariable and multivariable logistic regression methods. A P-value of less than 0.05 was defined as significant.
RESULTS: 30 medical students were included in this study with 6 (20%) failures. In univariate analysis, the variables such as age, gender, previous GPA, previous medical grades, rotation between wards and the long-case examination experience was not related to the outcome. Interestingly, if the students took an exam that related to the medical teacher 's sub-specialty, the chances of failing the exam would be increased with OR 9.99, 95%CI 0.99-100.61, p=0.051. Thus, the failures were significantly associated with a student taking the test with a medical teacher, whose subspecialty was associated with a case. This remained statistically significant after adjustment for other variables (adjusted OR 14.9, 95%CI 1.08-205.01, p-value 0.043).
CONCLUSIONS AND RECOMMENDATION: The examiners' subspecialties affect the failure in long-case examinations. This study underlines the importance of patient selections and defining criteria for a long case evaluation, which are appropriate for the level of knowledge of 6th-year medical students. Besides, medical education for medical teachers should be provided for improving the quality of assessment.
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