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Comparison between Medical Students' Experience, Confidence and Competence
Pamela J. Morgan, M.D.; Doreen Cleave-Hogg, Ph.D.
Anesthesia, Sunnybrook & Women's College Health Sciences Centre, Toronto, Ontario, Canada
Introduction: This study was undertaken to determine whether or not breadth of clinical experience and students' level of confidence were indicators of competency on standardized simulator performance-based evaluations.

Methods: After institutional ethics board approval, all students (n=144) attending an educational session were asked to complete a 25-point questionnaire regarding specific clinical experiences and level of confidence in their ability to manage patient problems. For enumeration of clinical experiences, students were asked to estimate the number of times a situation had been encountered or a skill had been performed. For level of confidence, each response was based on a 5-point Likert scale with 1=novice and 5=expert. Students then participated in one of three standardized performance tests using a high fidelity full patient simulator. Each test presented the student with one patient problem that required recognition and management. The content was based on the curriculum objectives of the undergraduate anesthesia course and pertained to one of the items on the questionnaire. Standardized check lists were used to score the performances. Median and range were calculated and data analyzed using Spearman rank correlation, with a p value <0.05 considered significant. Level of confidence data were compared to performance in the clinical rotation and to marks in the anesthesia final examination.

Results: One hundred and forty-four students participated. There were wide ranges of experience (median 1-10) and confidence (median 1-5) in the 25 listed items. Analysis of data showed high correlation between clinical experience and level of confidence. There was no correlation between clinical experience, level of confidence and performance in a standardized simulation test. (Table) Neither was there any correlation between level of confidence and clinical grades or written examination marks (level of confidence; clinical grade, r=0.078, p=0.37, level of confidence: written examination, r=0.013, p=0.88).

Discussion: This study indicates that students have wide ranges of clinical experience and that these experiences highly correlate with confidence in the performance and management of clinical problems. However, it was found that clinical experience and level of confidence have no predictive value in performance evaluations when using standardized anesthesia simulation tests.

Anesthesiology 2001; 95:A1144
Correlation Correlation
Experiencep valueLevel of Confidencep value
Simulation Test 1r=0.090.57r=0.670.66
Simulation Test 2r=0.200.21r=0.190.19
Simulation Test 3r=-0.090.57r=-0.090.95