Development of a Clinical Simulation Video to Evaluate Multiple Domains of Clinical Competence: A Cross-sectional Study (Preprint)

BACKGROUND Medical students in Japan undergo a two-year postgraduate residency program to acquire clinical knowledge and general medical skills. The General Medicine In-Training Examination (GM-ITE) assesses postgraduate residents’ clinical knowledge. OBJECTIVE This study aimed to evaluate the relationship between GM ITE scores and residents’ diagnostic skills by having them watch a clinical simulation video (CSV) of a medical examination and provide a diagnosis. METHODS The participants included 56 postgraduate medical residents who took the GM ITE between 21 January and 28 January 2021, watched the CSV, and then provided a diagnosis. We compared the CSV and GM ITE scores and examined the validity of the simulations using discrimination indices wherein ≥0.20 indicated high discriminatory power and >0.40 indicated a very good measure of the subject’s qualifications. RESULTS A total of six participants (10.7%) provided the correct diagnosis, and all were from the second postgraduate year. All domains indicated high discriminatory power. The (anonymous) follow-up responses indicated that the CSV format was more suitable than the conventional GM ITE for assessing clinical competence. CONCLUSIONS The findings indicated that CSV modules simulating real-world clinical examinations were successful in assessing examinees’ clinical competence across multiple domains. CLINICALTRIAL NA