Philosophical musings on tests in medical school and beyond

Yesterday I read the latest “On Being A Doctor” in the Annals of Internal Medicine.  The story – Murky Water – tells the story of a classmate who committed suicide after failing step 1 by 1 question.  Over the last 12 hours I have pondered this story as well as an article in the same issue titled The MCAT’s Restrictive Effect on the Minority Physician Pipeline: A Legal Perspective. What do standardized tests tell us?  In college, as a psychology major I took a course in Psychometrics.  I understand the principles behind designing tests that produce bell shaped curves. Test scores measure retention of information and the ability to use that information to understand and answer questions.  We all know colleagues who are particularly good at taking such tests (even when they do not know the material that well) and other colleagues who consistently underperform on those tests. Clinician educators see students who do very well during the first two years of medical school and on step 1, but who struggle during clinical rotations.  We also see “bottom quartile” students who blossom during their clinical years. As I have pondered the value of these tests.  What are the dimensions of master physicians?  The Closler initiative (moving us closer to Osler) lists 4 large dimensions: Connecting with patients Clinical reasoning Passion in the medical profession Lifelong learning in clinical excellence Of all these perhaps #4 could be test...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs