Validation of Checklists and Evaluation of Clinical Skills in Cases of Abdominal Pain With Simulation in Formative, Objective, Structured Clinical Examination With Audiovisual Content in Third-Year Medical Students' Surgical Clerkship

Abstract

OBJECTIVES: The objective of this study was to develop and validate 6 checklists for evaluating abdominal pain in clinical simulation scenarios; to assess student competencies in managing 6 clinical cases using OSCE, based on faculty evaluations; and to analyze discrepancies between faculty and student evaluations. DESIGN: A practical workshop was designed to address 6 clinical scenarios of abdominal surgical conditions. Four scenarios employed medium fidelity simulators, while 2 scenarios employed standardized patient methodology. Prior to the workshop, students received theoretical audiovisual material. At the conclusion of the workshop, students were evaluated using checklists that assessed communication, privacy, anamnesis, and technical skills. Ten workshops were conducted over 3 years, using the OSCE (Objective Structured Clinical Examination) format for evaluation. SETTING: In the statistical analysis, t-Student tests or ANOVA were employed to ascertain whether there were any significant differences between the groups. In the process of validating checklists for clinical scenarios, 6 experts were asked to evaluate each item on a scale of 1 to 9. To assess the degree of agreement among experts, the intraclass correlation coefficient (ICC) was employed. PARTICIPANTS: The study involved a total of 670 third-year medical students from the University of Murcia (UMU), Spain, who participated in the subject "Medical-Surgical Skills." RESULTS: High levels of appropriateness were observed for the checklist items, with mean scores above 7.5 points, as well as high levels of inter-expert agreement. Students obtained a mean score of 8 points in the evaluation of each clinical scenario. No significant differences were found between faculty and student scores (p < 0.05). CONCLUSIONS: The learning method focused on clinical scenarios of abdominal surgical diseases effectively enhanced the clinical skills of third-year medical students. It used pre-existing audiovisual materials, hands-on workshops with medium-fidelity simulators, and standardized patients. Consistent evaluations from students and faculty confirmed the efficacy of these strategies.