The effect of a grading incentive and a problem-specific mobile electronic clinical evaluation tool (eCEX) in the direct observation of medical student’s clinical competencies: A pilot study

Background: Direct observation of medical studentsclinical skills by faculty is uncommon. However, such observation enhances the validity of medical studentsclinical performance evaluation. Objectives: We developed and tested a the effect of a grading incentive along with a mobile, competency-specific assessment tool (eCEX) involving eleven faculty members and twelve students during their internal medicine clerkship. Methods: Six students were required to use the eCEX to for ten discrete clinical observations (e.g. performing an abdominal exam in a patient with abdominal pain) while the other six did not use the eCEX and were had a requirement for a single observed comprehensive history and physical examination. Results: The average number of direct observations per student, per 8 week clerkship, increased from 14.7 + 27 to 26.2 + 16 (p = 0.032). Observing a focused physical examination accounted for the majority of the directly-observed encounters. Students and the faculty both agreed that the CEX helped them understand which problem-specific competencies were targeted for the assessment. Both faculty and students rated the program as easy to use. Faculty generally agreed that eCEX improved their ability to provide feedback to the students.Conclusions: The eCEX holds promise of facilitating direct observation and evaluation of medical studentsclinical skills