PMID- 17558538
OWN - NLM
STAT- MEDLINE
DCOM- 20070803
LR  - 20240213
IS  - 1525-1497 (Electronic)
IS  - 0884-8734 (Print)
IS  - 0884-8734 (Linking)
VI  - 22
IP  - 8
DP  - 2007 Aug
TI  - Impact of student ethnicity and primary childhood language on communication skill 
      assessment in a clinical performance examination.
PG  - 1155-60
AB  - BACKGROUND: Clinical performance examinations (CPX) with standardized patients 
      (SPs) have become a preferred method to assess communication skills in US medical 
      schools. Little is known about how trainees' backgrounds impact CPX performance. 
      OBJECTIVE: The objective of this paper is to examine the impact of student 
      ethnicity, primary childhood language, and experience of diversity on the 
      communication scores of a high-stakes CPX using SPs. DESIGN: This research was 
      designed as an observational study. PARTICIPANTS: The participants of this study 
      were third-year medical students at one US medical school. MEASUREMENTS AND MAIN 
      RESULTS: The measurements used in this study were CPX scores from mandatory exam, 
      student demographics and experience with diversity measured by self-report on a 
      survey, and Medical College Admission Test (MCAT) and United States Medical 
      Licensing Examination (USMLE) scores. A total of 135 students participated. Asian 
      and black students scored lower than white students on the communication portion 
      of the CPX by approximately half a standard deviation (Asian, 67.4%; black, 
      64.4%; white, 69.4%, p < .05). There were no differences by ethnicity on 
      history/physical exam scores. Multivariate analysis controlling for MCAT verbal 
      scores reduced ethnic differences in communication scores (Asian-white mean 
      differences = 1.95, p = 0.02), but Asian-white differences were eliminated only 
      after sequential models included primary childhood language (difference = 0.57, p 
      = 0.6). CONCLUSIONS: Even after controlling for English language knowledge as 
      measured in MCAT verbal scores, speaking a primary childhood language other than 
      English is associated with lower CPX communication scores for Asian students. 
      While poorer communication skills cannot be ruled out, SP exams may contain 
      measurement bias associated with differences in childhood language or culture. 
      Caution is indicated when interpreting CPX communication scores among diverse 
      examinees.
FAU - Fernandez, Alicia
AU  - Fernandez A
AD  - UCSF Department of Medicine, School of Medicine, University of California, P.O. 
      Box 1364, San Francisco, CA 94143-1364, USA. afernandez@medsfgh.ucsf.edu
FAU - Wang, Frances
AU  - Wang F
FAU - Braveman, Melissa
AU  - Braveman M
FAU - Finkas, Lindsay K
AU  - Finkas LK
FAU - Hauer, Karen E
AU  - Hauer KE
LA  - eng
GR  - G20 RR018324/RR/NCRR NIH HHS/United States
GR  - K23 RR018324-01/RR/NCRR NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20070609
PL  - United States
TA  - J Gen Intern Med
JT  - Journal of general internal medicine
JID - 8605834
SB  - IM
MH  - Adult
MH  - Clinical Competence
MH  - *Communication
MH  - Education, Medical, Undergraduate
MH  - Educational Measurement
MH  - *Ethnicity
MH  - Female
MH  - Humans
MH  - Language
MH  - Male
MH  - Medical History Taking
MH  - Physical Examination
MH  - *Physician-Patient Relations
MH  - Socioeconomic Factors
MH  - *Students, Medical
PMC - PMC2305733
EDAT- 2007/06/15 09:00
MHDA- 2007/08/04 09:00
PMCR- 2008/08/01
CRDT- 2007/06/15 09:00
PHST- 2007/01/31 00:00 [received]
PHST- 2007/05/15 00:00 [accepted]
PHST- 2007/06/15 09:00 [pubmed]
PHST- 2007/08/04 09:00 [medline]
PHST- 2007/06/15 09:00 [entrez]
PHST- 2008/08/01 00:00 [pmc-release]
AID - 250 [pii]
AID - 10.1007/s11606-007-0250-0 [doi]
PST - ppublish
SO  - J Gen Intern Med. 2007 Aug;22(8):1155-60. doi: 10.1007/s11606-007-0250-0. Epub 
      2007 Jun 9.