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Gender difference in performance and perception about assessment tools in fifth year …
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Araştırma / Original article
Gender difference in performance and perception about assessment tools in fifth year psychiatry attachment Mostafa AMR1 _________________________________________________________________________________________________________
ABSTRACT Objective and methods: This study examined the influence of gender on undergraduate performance and attitude towards various aspects of the undergraduate final examination in psychiatry that include Objective Structured Clinical Examination (OSCE), Traditional Oral Clinical Examinations (TOCE), portfolio and multiple choice questions (MCQ) written exam among fifth year medical students at the King Faisal University, Al-Ahsa, Saudi Arabia. Results on all sections of the final examination were analyzed in the case of 110 students from the same year. Also, a self administered student survey included eight items questionnaire assessing different aspects of the psychiatry assessment methods was also used. Results: The male students score higher on MCQ but there is no significant difference on the overall mark in both genders. Satisfaction score ranged between 11 and 24 among the studied students with a mean of 18.5±3.3. Females showed higher mean satisfaction score than males but the observed difference was not statistically significant. Conclusion: Female medical students appear to perform as well as their male counterparts in the undergraduate psychiatry clinical attachment but males outperform in MCQ examination. Although we would not recommend specific changes in undergraduate training, course organizers and supervising faculty staff need to identify which aspects of the psychiatry cause difficulty to the female students. This information would usefully inform future developments in undergraduate training. (Anatolian Journal of Psychiatry 2012; 13:174-178) Key words: gender, undergraduate medical students, assessment methods
Beşinci sınıf psikiyatri stajında değerlendirme araçlarıyla ilgili performans ve algıda cinsiyet farklılığı ÖZET Amaç ve yöntem: Bu çalışmada, Suudi Arabistan’da Al Ahsa’daki Kral Faysal Üniversitesi’ndeki beşinci sınıf tıp fakültesi öğrencilerinin Nesnel Yapılandırılmış Klinik Sınav, Geleneksel Sözlü Klinik Sınav, portfolyo ve Çoktan Seçme-li Yazılı Sınavı (ÇSYS) kapsayan psikiyatri stajı final sınavının çeşitli yönlerine karşı performans ve tutumda cinsiyetin etkisi değerlendirildi. Aynı öğretim yılındaki 110 öğrencinin final sınavının tüm bölümlerinin sonuçları analiz edildi. Araştırmada psikiyatri değerlendirme yöntemlerinin farfklı yönlerini değerlendiren sekiz soruluk bir anket de kullanıldı. Sonuçlar: ÇSYS’de erkek öğrencilerin puanı daha yüksekti, fakat iki cinsiyet arasındaki fark anlamlı değildi. Öğren-cilerin memnuniyet puanı 11-24 arasında, ortalama puan 18.5±3.3’tü. Kızların ortalama memnuniyet puanı erkekler-den daha yüksekti, fakat aradaki fark istatistiksel olarak anlamlı değildi. Tartışma: Kız öğrenciler klinik stajında erkek öğrenciler kadar iyi performans gösterdiler, fakat erkekler ÇSYS’de daha iyi performans gösterdi. Tıp eğitiminde özgül değişiklikler önermemekle birlikte, kurs düzenleyen ve denetleyen fakülte personelinin psikiyatrinin hangi yönlerinin kız öğrenciler için güçlük yarattığını belirlemesi gereklidir. Bu bilgi, tıp eğitiminde gelecekteki gelişmeler için yararlı bilgi sağlayacaktır. (Anadolu Psikiyatri Derg 2012; 13:174-178) Anahtar sözcükler: Cinsiyet, mezuniyet öncesi tıp öğrencileri, değerlendirme yöntemleri _________________________________________________________________________________________________________
INTRODUCTION Several studies have found that female undergraduate students outperform male students in overall scores in basic and clinical subjects.1,2 A 10year review of final year medical students 'performance at King Saud University, Riyadh found
that male students performed better at preclinical subjects whereas women had better results at clinical subjects.3 In the specialty of psychiatry, some studies have found gender-based difference to be most marked in clinical assessment.4,5 In
_________________________________________________________________________________________________________ Assist.Prof., Department of Psychiatry, College of Medicine, Mansoura University, Mansoura/Egypt, Address for correspondence / Yazışma adresi: Assit.Prof.Dr. Mostafa AMR, Department of Psychiatry, College of Medicine, Mansoura University, Mansoura/Egypt, E-mail:
[email protected] Geliş tarihi: 25.10.2011, Kabul tarihi: 19.01.2012
Anatolian Journal of Psychiatry 2012; 13:174-178
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contrast, other studies have also found differences in performance in undergraduate psychiatry between males and females but the differences were not significant.6-8 The repertoire of assessment methods in use in medical education has expanded considerably in recent years. New modes of assessment have enriched the ‘conventional’ evaluation setting, formerly characterized by the multiple-choice examination and the evaluation by essay in addition to the traditional oral clinical examination.9 More recently, Objective Structured Clinical or Practical Examinations (OSCE, OSPE) were introduced in medical education context. When students' perceptions and expectations about the different methods used in the assessment of undergraduates and the effect of gender difference. Students prefer the multiple-choice format to the essay type of examination is Zeidner’s10 conclusion for almost all dimensions of his inventory (i.e., perceived difficulty, anxiety, complexity, success expectancy, feeling at ease), both for boys and girls. In a traditional oral (viva) examination, two examiners assess the student’s factual knowledge and problem solving abilities for about 20 minutes in a face to face discussion. Many students find the stress of confrontation distracting and distressing and carries a high possibility of subjectivity and bias.11 The number of questions (subject sample) is usually small and does not cover the spectrum of the subject.12 The questions are usually different for each student to avoid between-student communication. All these factors make it luck dependent.13 Moreover, the questions are usually not structured and the marking system is difficult to standardize. All these disadvantages may be obviated by employing the objective structured clinical examination (OSCE) instead of the traditional oral exam. Our subjective impressions suggested that women performed better than males in King Faisal University. We would hypothesize that the females perform and perceive assessment methods in psychiatry better than males. METHODS We conducted this study at College of Medicine, University of King Faisal which was established in 2003. Here, the students are admitted to five years course in undergraduate medical program; the course of psychiatry is composed of clinical rotation of six-week duration based on a dedicated psychiatric hospital during which they are assigned to a multidisciplinary team headed by a psychiatry attending. Students work most closely with a psychiatry resident in the inpatient section
and are exposed to the broad range of treatment modalities including individual and group psychotherapy and psychopharmacology. Teaching is mediated by lectures, small-group tutorials and group discussion. The male and female medical students were taught by common faculty separately both during lectures and clinical attachment and they take common examination for each course. The methods of assessment include Objective Structured Clinical Examination (OSCE), Traditional Oral Clinical Examinations (TOCE), portfolio and multiple choice questions (MCQ) written exam. Multiple Choice Questions (MCQ): The MCQ paper consisted of 50 A-type MCQs and the time allowed was 2 minutes per MCQ. The examinees answered on OMR (Optical Mark Reader) answer sheets by blackening the bubble with a pencil. Test items were developed following standard, well-described MCQ writing procedures, and were designed to cover the following the six content areas: mood disorders, anxiety disorders, child psychiatry, psychosis, personality disorders and substance abuse. Reliability (Cronbach's alpha) and concurrent validity (Pearson’s r) coefficients (was obtained by correlating the scores of MCQ papers with the overall outcome of the examination) and they were in the ranges of 0.83-0.91 and 0.80-0.93 (p
