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Background: National statistics reveal that efforts to reduce medical student mistreatment have been largely ineffective. Some hypothesize that as supervisors gain skills in professionalism, medical students become more sensitive. Aims: The purpose of this study was to determine if medical student perceptions of mistreatment are correlated with mistreatment sensitivity. Method: At the end of their third year, 175 medical students completed an Abuse Sensitivity Questionnaire, focused on student assessment of hypothetical scenarios which might be perceived as abusive, and the annual Well-Being Survey, which includes measurement of incident rates of mistreatment. It was hypothesized that those students who identified the scenarios as abusive would also be more likely to perceive that they had been mistreated. Results: Student perceptions of mistreatment were not statistically correlated with individual's responses to the scenarios or to a statistically derived abuse sensitivity variable. There were no differences in abuse sensitivity by student age or ethnicity. Women were more likely than men to consider it 'harsh' to be called incompetent during rounds ( p < 0.0005). Conclusion: This study provides preliminary evidence that challenges the hypothesis that medical students who perceive mistreatment by their superiors are simply more sensitive. [ABSTRACT FROM AUTHOR]

OBJECTIVES This study examined the construct validity of three commonly used clerkship performance assessments, including preceptors' evaluations, objective structured clinical examination (OSCE)-type clinical performance measures, and the National Board of Medical Examiners (NBME) medicine subject examination, in order to better understand their conceptual structures and utility in the explanation of clinical competence. METHODS A total of 686 students who took an in-patient medicine clerkship during the period 2003 to 2007 participated in the study. Exploratory and confirmatory factor analyses using structural equation modelling were adopted to examine the latent domains underlying various indicators assessed by these three measures and the pattern of indicator-domain relationships. RESULTS Factor analyses found three latent constructs, labelled Clinical Performance, Interpersonal Skills and Clinical Knowledge, underlying the observed measures. The three domains were modestly correlated with one another (inter-factor correlation coefficients ranged from 0.39 to 0.54). They also tapped a common higher-order construct, Clinical Competence, in varying degrees of magnitude (0.73, 0.74, 0.53, respectively). CONCLUSIONS The study demonstrated that although the three commonly used tools for assessing clerkship performance contributed uniquely to the understanding of clinical performance, they also attested to a shared domain of clinical competence in their assessment. The study confirmed the need for a multiple-methods approach to clinical performance assessment. Findings also revealed that clerkship preceptors need to differentiate their evaluation of students' performances, and that the OSCE did not assess a single domain of clinical competence. [ABSTRACT FROM AUTHOR]