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Purpose: To assess the feasibility of Direct Observation of Clinical Skills (DOCS), a program for formative assessment of students' clinical skills during a medicine clerkship and to determine relationships between DOCS measures and other clinical performance measures. Method: From August, 2004 through June, 2005, Medicine Clerks assigned to the primary on-campus clinical site were asked to participate in the pilot phase of the DOCS program. Students were asked to complete at least one DOCS exercise focused on interviewing, physical examination, or oral case presentation. Results: Of the 79 students who rotated on the Medicine Clerkship during the pilot period, 79% (n=62) participated in DOCS, and 163 forms were submitted for evaluation. Seventy-seven percent (77%) of the clinical observations occurred while on-call or during daily rounds. Seventy-three (73%) of observations were completed in 30 minutes or less. In 89% of encounters students received at least 5 minutes of verbal feedback. Satisfaction ratings from both students and observers were ''moderately satisfied'' or better. Global ratings from DOCS physical exam and case presentation sections were strongly correlated with both faculty ratings of clinical performance and final clerkship grade. DOCS measures were not statistically related to clerkship written examination scores. Conclusions: These data support the feasibility of the DOCS session for formative assessment of student interviewing, physical examination, and oral case presentation skills during a medicine clerkship. Observer ratings from DOCS physical examination and case presentation sections were found to be predictors of final clerkship grade. [ABSTRACT FROM AUTHOR]

Standard ED-2 of the Liaison Committee on Medical Education (LCME) requires medical schools to specify the types of patients that students should encounter, the student's level of responsibility, and the appropriate setting for the encounter. The authors describe the process at Joan and Sanford I. Weill Medical College of Cornell University in New York City for meeting this standard through the development of a Web-based case log. The log permits the medical college to specify expectations for patient encounters and allows the students to record their encounters in an efficient, brief, and user-friendly manner. By downloading the student's reports directly into a database, the medical college can track successes and deficiencies in the student's clinical experiences. However, in response to a questionnaire administered in 2005, students generally expressed dissatisfaction with the case logs, which they described as intrusive busywork.