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Thursday, December 10 • 3:00pm - 3:50pm
Direct Observation Tools for Clerks - A Literature Review (Poster)

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Direct observation tools (DOTs) are used to help preceptors assess students’ clinical competence by systematically observing them engage in a clinical encounter. Miller’s Pyramid of Assessment (separating knowledge from competence from performance from action) provides the theoretical basis for this evaluation method. These tools allow for evaluation in natural settings, assess soft skills, minimize recall bias and improve accuracy of judgement. This literature review appraises the psychometric properties, strengths and weaknesses of DOTs to make recommendations for use in ambulatory clinical training settings.

Clinical encounter cards (CECs) are pocket-sized cards that involve 1) assessment of different competencies pertinent to a clinical encounter and 2) a single global rating on all domains assessed. Encounter cards have good validity properties and reach high reliability after only a few encounters. They have garnered support from learners and teachers due to their exceptional ability to promote formative feedback. The Mini-Clinical Evaluation Exercise is a frequently-used tool that requires ratings on six domains of clinical competence along with open ended feedback. It has consistently strong construct validity and reliability but is only moderately able to predict performance on other measures of competence.

Clinical encounter cards are the most reliable, valid and successful in providing formative feedback; this prompted McMaster University to create an evidence-based CEC for use in a family medicine clinical rotation. Intuitively, the CEC may be generalized for use in personal interaction training for other professionals (e.g. psychologists, social workers, project managers). Future research in these settings is necessary to corroborate this theory.


Judy Baird

McMaster University
avatar for Romesa Khalid

Romesa Khalid

McMaster University

Thursday December 10, 2015 3:00pm - 3:50pm EST
McMaster Innovation Park Atrium