The Correlation between CPX and Written Examination Scores in Medical Students / 한국의학교육

PURPOSE: The purpose of this study is to analyse the gap between what medical students learn in theory and their clinical performance in reality. The hypothesis is that students with high written examination scores will also perform better in the Clinical Performance Examination (CPX). METHODS: 128 Catholic University medical students in year four took the CPX on 24th, September 2005. 40 standardized patients (SPs) were involved as assessors. Each student performed five CPX cases. The students' written examination scores of year three, SPs' assessment scores were used as instruments. Students were divided into two groups (A and B) and each group consisted of 64 students. Correlation between the written examination scores and the CPX scores, CPX case scores and related written examination scores were analysed. RESULTS: Overall, there was no significant correlation between the CPX score and the written examination scores in total, but significant correlations were shown in family medicine CPX scores of both groups A and B (pearson=.308, p=.199; pearson=.258, p=.051). From the analysis of the CPX cases and related written examination scores, group A showed significant correlation in three out of the five cases. No significant correlation seen in group B. CONCLUSION: It can be concluded that large gaps still exist between theory and practice. Some suggestions are given to minimize these gap.

The Appropriateness of using Standardized Patients' (SPs) Assessment Scores in Clinical Performance Examination (CPX) / 한국의학교육

PURPOSE: The purpose of the study is to analyse the appropriateness of using standardized patients' (SPs) assessment scores of medical students in clinical performance examination (CPX). METHODS: 110 fourth year medical students in year four were divided into two large groups (group A and group B). Each group of students performed four different cases and overall, eight cases were tested. The examination were done by professors and the SPs using the same examination paper. Test scores were analysed per station and per each test domain. The differences between the two examiners were studied using paired t-test. RESULTS: There were significant differences in the scores given out by the professors' and the SP' s in four out of the eight stations. According to the examination results of each domain, four cases showed significant differences in the history taking category, three cases in the physical examination, one case in the information sharing, four cases in clinical courtesy, and two cases in physician-patient relationship category. Cronbach' s alpha scores of all stations were over 0.6, reflecting that the test items were appropriate for the examination. CONCLUSION: From the result of this study and according to many preceding studies, using SPs' evaluation scores in CPX is appropriate. Some limitation of this study and ideas for improvement in using SPs in CPX are suggested.

Changes of Antioxidant Capacity in Colorectal Cancer Patients

PURPOSE: Free radicals are defined as any species capable of independent existence that contains one or more unpaired electrons and they have the effects on carcinogenesis and tumor progression by causing mutations on genetic structure or suppressing repair of mutated DNA. This study was aimed to identify changes of antioxidant capacity in carcinogenesis and tumor progression of colorectal cancer (CRC). METHODS: We studied the level of serum antioxidant capacity using ABTS technique for 34 CRC patients who were operated between July 1997 and January 1998 at department of surgery, Taegu Catholic Medical Center and compared with 38 persons who had normal value of liver function during the same period. RESULTS: CRC patients showed decreased serum antioxidant capacity level compared to that of control group (CRC male 1.23 0.15 mmol/L, CRC female 1.11 0.13 mmol/L, control male 1.40 0.15, control female 1.35 0.11 mmol/L). Changes of antioxidant capacity levels were not correlated with stages, even though the marginal difference between T-stages (T1/2 1.23 0.10 mmol/L, T3/4 1.16 0.15 mmol/L). CONCLUSIONS: Free radicals may be the causative agent of colorectal carcinogenesis and can be associated with early phase of carcinogenesis rather than tumor progression.