La culture de l’annulation : exploration des conséquences involontaires du retrait de l’examen clinique pour l’octroi de la licence au Canada
DOI :
https://doi.org/10.36834/cmej.73889Résumé
L’évaluation est le moteur de l’apprentissage. Cependant, lorsqu’il s’agit d’examens à enjeux élevés (par exemple, pour l’obtention du titre de licencié ou la certification), ces évaluations de l’apprentissage peuvent être perçues comme inutiles par certains. L’évaluation des compétences cliniques pour l’obtention du titre de licencié, en particulier, a été critiquée au fil des ans. Récemment, des évaluations comme l’examen d’aptitude du Conseil médical du Canada, partie II, un examen clinique objectif structuré permettant d’évaluer les compétences cliniques, ont été définitivement retirées. Les auteurs explorent les conséquences potentielles de l’annulation de ces évaluations incluant celles non intentionnelles et indésirables, ainsi que des perspectives sur l’évaluation des habiletés cliniques.
Statistiques
Références
Schuwirth L, van der Vleuten C. Merging views on assessment. Med Educ. 2004;38(12):1208-1210. https://doi.org/10.1111/j.1365-2929.2004.02055.x
Wood T. Assessment not only drives learning, it may also help learning. Med Educ. 2009;43(1):5-6. https://doi.org/10.1111/j.1365-2923.2008.03237
Wormald BW, Schoeman S, Somasunderam A, Penn M. Assessment drives learning: an unavoidable truth? Anat Sci Educ. 2009;2(5):199-204. https://doi.org/10.1002/ase.102
Scott IM. Beyond ‘driving’: The relationship between assessment, performance and learning. Med Educ. 2020;54(1):54-59. https://doi.org/10.1111/medu.13935
Pugh D, Regehr G. Taking the sting out of assessment: is there a role for progress testing? Med Educ. 2016;50(7):721-729. https://doi.org/10.1111/medu.12985
Lougheed T. Is it time to rethink the MCCQE Part II? Can Med Educ J. 2016;7(1):e87-e88
Jayakumar KL. The limited value of USMLE Step 2CS (letter to the editor). Acad Med. 2018;93(3):345
Lehman EP, Guercio JR. The Step 2 clinical skills exam – a poor value proposition. NEJM. 2013;368(10):889-891. https://doi.org/10.1056/NEJMp1213760
Tsichlis JT, Del Re AM, Carmody JB. The past, present, and future of the United States medical licensing examination step 2 clinical skills examination. Cureus 2021;13(8):e17157. https://doi.org/10.7759/cureus.17157
Larsen DP, Butler AC, Roediger HL III. Test-enhanced learning in medical education. Med Educ. 2008;42(10):959–66. https://doi.org/10.1111/j.1365-2923.2008.03124.x
Ecker DJ, Milan FB, Cassese T, et al. Step up – Not on – the Step 2 Clinical Skills exam: Directorsof clinical skills courses (DOCS) oppose ending Step 2CS. Acad Med. 2018;93(5):693-698. https://doi.org/10.1097/ACM.0000000000001874
Vodden C. Licentiate to heal: a history of the Medical Council of Canada. Medical Council of Canada. 2008 pp.66-69
Touchie C, Streefkerk C. for the Blueprint Project Team. Blueprint and content specifications. Ottawa, Ontario. September 2014. Available at https://mcc.ca/media/Blueprint-Report-1.pdf
Holmboe ES. Faculty and the observation of trainees’ clinical skills: problems and opportunities. Acad Med. 2004;79(1):16-22. https://doi.org/10.1097/00001888-200401000-00006
Tamblyn R, Abrahamowicz M, Dauphinee D, et al. Physician scores on a national clinical skills examination as predictors of complaints to medical regulatory authorities. JAMA. 2007;288(23):993-1001. https://doi.org/10.1001/jama.288.23.3019
Cadieux G, Abrahamowicz M, Dauphinee D, Tamblyn R. Are physicians with better clinical skills on licensing examinations less likely to prescribe antibiotics for viral respiratory infections in amburlatory care settings? Med Care 2011;49(2):156-165. https://doi.org/10.1097/MLR.0b013e3182028c1a
Meguerditchian AN, Dauphinee D, Girard N, Eguale T, Riedel K et al. Do physician communication skills influence screening mammography utilization? BMC Health Serv Res. 2012;12:219-226. https://doi.org/10.1186/1472-6963-12-219
De Champlain A, Ashworth N, Kain N, Qin S, Wiebe D, Tian F. Does pass/fail on medical licensing exams predict future physician performance in practice? A longitudinal cohort study of Albertan physicians. J Med Reg. 2020;106(4):17-26
Holmboe ES, Sherbino J, Englander R, Snell L, Frank JR. A call to action: The controversy of and rationale for competency-based medical education. Med Teach. 2017;39(6):574-581. https://doi.org/10.11080/0142159X.2017.13115067
Mak-van der Vossen M. ‘Failure to fail’: the teacher’s dilemma revisited. Med Educ. 2019;53(1):106-114. https://doi.org/10.1111/medu.13772
Yepes-Rios M, Dudek N, Duboyce R, Curtis, J, Allard RJ, Varpio L. The failure to fail underperforming trainees in health professions education: A BEME systematic review: BEME Guide No. 42. Med Teach. 2016;38(11):1092-1099. https://doi.org/10.1080/0142159X.2016.1215414
Pugh D, Desjardins I, Eva K. How do formative objective structured clinical examinations drive learning? Analysis of residents’ perceptions. Med Teach. 2018;40(1):45-52. https://doi.org/10.1080/0142159X.2017.1388502
National Academies of Sciences, Engineering, and Medicine. Crossing the quality chasm: A new health system for the 21st century. 2001. Washington, DC: The National Academies Press.
National Academies of Sciences, Engineering, and Medicine. Improving diagnosis in health care. 2015. Washington, DC: The National Academies Press.
Levinson W, Lesser CS, Epstein RM. Developing physician communication skills for patient-centered care. Health Affairs. 2019;29(7):1310-1318. https://doi.org/10.1377/hlthaff.2009.0450
Yudkowsky R, Szauter K. Farewell to the Step 2 Clinical Skills exam: New opportunities, obligations and next steps. Acad Med. 2021;96(9):1250-1253. https://doi.org/10.1097/ACM.0000000000004209
Association of the Faculties of Medicine. Entrustable professional activities for the transition from medical schools to residency. 2016 (updated in 2019). Available at https://www.afmc.ca/sites/default/files/pdf/AFMC_Entrustable%20Professional%20Activities_EN_Final.pdf
Soukoulis V, Martindale J, Bray MJ, Bradley E, Gusi ME. The use of EPA assessments in decision-making: do supervision ratings correlate with other measures of clinical performance? Med Teach. 2021;July 9:1-7 (Online ahead of print). https://doi.org/10.1080/0142159X.2021.1947480
Thoma B, Monteiro S, Pardhan A, Waters H, Chan T. Replacing high-stakes summative examinations with graduated medical licensure in Canada. CMAJ 2022;194:E169-170. https://doi:10.1503/cmaj.211816
Association of the Faculties of Medicine. Joint commitment to action on Indigenous Health. May 2019. Available at http://www.afmc.ca/sites/default/files/pdf/AFMC_Position_Paper_JCAIH_EN.pdf
Canadian Medical Association, College of Family Physicians of Canada and Royal College of Physicians and Surgeons of Canada. Virtual Care – Recommendations for scaling up virtual medical services. Report of the virtual care task force. February 2020. Available at https://policybase.cma.ca/documents/PolicyPDF/PD20-07.pdf
Canadian Interprofessional Health Collaborative. A national interprofessional competency framework. February 2010. Available at https://drive.google.com/file/d/1Des_mznc7Rr8stsEhHxl8XMjgiYWzRIn/view
Eva KW, Bordage G, Campbell C, Galbraith R, Ginsburg S et al. Towards a program of assessment for health professionals: from training into practice. Adv in Health Sci Educ Theory Pract. 2016;21(4):897-913. https://doi.org/10.1007/s10459-015-9653-6
Burdick WP, Boulet JR, LeBlanc KE. Can we increase the value and decrease the cost of clinical skills assessment? Acad Med. 2018;93(5):690-692. https://doi.org/10.1097/ACM.0000000000001867
Nevins AB, Boscardin C, Kahn D, May W, Murdock-Vlautin T et al. A call to action from the California consortium for the assessment of clinical competence: Making the case for regional collaboration. Acad Med 2022 (on-line ahead of print). https://doi.org/10.1097/ACM.0000000000004663
Thomas John J, Gowda D, Schlair S, Hojsak J, Milan F, Auerbach L. After the discontinuation of Step 2 CS: A collaborative statement from the directors of clinical skills education (DOCS). Teach Learn Med 2022 (on-line ahead of print). https://doi.org/10.1080/10401334.2022.2039154
Téléchargements
Publié-e
Comment citer
Numéro
Rubrique
Licence
(c) Tous droits réservés Claire Touchie, Debra Pugh 2022
Cette œuvre est sous licence Creative Commons Attribution - Pas d'Utilisation Commerciale - Pas de Modification 4.0 International.
La soumission d’un manuscrit original à la revue constitue une indication qu’il s’agit d’un travail original, qu’il n’a jamais été publié et qu’il n’est pas envisagé pour publication dans une autre revue. S’il est accepté, il sera publié en ligne et ne pourra l’être ailleurs sous la même forme, à des fins commerciales, dans quelque langue que ce soit, sans l’accord de l’éditeur.
La publication d’une recherche scientifique a pour but la diffusion de connaissances et, sous un régime sans but lucratif, ne profite financièrement ni à l’éditeur ni à l’auteur.
Les auteurs qui publient dans la Revue canadienne d’éducation médicale acceptent de publier leurs articles sous la licence Creative Commons Paternité - Pas d’utilisation commerciale, Pas de modification 4.0 Canada. Cette licence permet à quiconque de télécharger et de partager l’article à des fins non commerciales, à condition d’en attribuer le crédit aux auteurs. Pour plus de détails sur les droits que les auteurs accordent aux utilisateurs de leur travail, veuillez consulter le résumé de la licence et la licence complète.
