Formative Assessment by Direct Observation of Clinical Skills on the OB/GYN Clerkship Rotation
Bibliographic record
Abstract
Local Mentor: Margaret Burnett, MD, FRCSC APGO Advisor: John Dalrymple, MD PURPOSE: To determine the impact of requiring that medical students be observed taking a history or performing a pelvic examination by a physician during their OB/GYN clerkship rotation. BACKGROUND: One of the LCME standards for accreditation of a medical school is having physicians directly observe medical students in their clinical activities in order to provide formative feedback. Since 2009, 29.7–52.9% of each class of Manitoba medical graduates report having been observed taking a history on their OB/GYN clerkship rotation; 45.2–70.4% for observed physical examination. METHOD: Clerks are surveyed on the last day of their OB/GYN rotation to determine the number of observed histories and/or pelvic examinations. In September 2015, observed histories and pelvic examinations became a rotation requirement. A mini-CEX tool was developed and included in the student's logbook to facilitate documentation and provide feedback. The reported number of observed histories and pelvic examinations are compared before and after implementation of this process. RESULTS: Thirty-five percent of 69 students surveyed before implementation report having been observed performing a history by a physician. This rose to 64% (of 28 students) following implementation. All of them report being observed performing a pelvic examination, before and after, however only 53% documented this on the assessment tool. DISCUSSION: The number of observed histories has increased however there is room for further improvement. This may require additional faculty education and/or scheduled assessment for some students. The number reporting an observed pelvic examination continues to be 100% but improved documentation of this must be encouraged.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.028 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".