The results are coherent with the studies that show that performance based examination using SPs can be used without introducing biases into students score.
Previous projects (Combell I & II) to assess clinical skills were conducted in medical schools in Catalonia, in order to introduce a model of such an assessment using standardized patients (SP). The aim of this study (Combell III) was to measure selected characteristics of our model. Seventy-three medical students in the final year at the Bellvitge teaching unit of the University of Barcelona participated in a clinical skills assessment (CSA) project that used 10 SP cases. The mean group scores for the four components of clinical skills for each day of testing were studied, and ratings for each student in the 10 sequential encounters were checked. The study also compared the clinical skills scores with their academic grades. The total case mean score (mean score of history-taking, physical examination and patient notes scores) was 51.9%, and the mean score for communication skills was 63.6%. The clinical skills scores over the 8 testing days showed no day-to-day differences. The study did not find differences among the sequential encounters for each student (training effect). There was a lack of correlation between clinical skills scores and academic grades. The project demonstrated the feasibility of the method for assessing clinical skills, confirmed its reliability, and showed that there is no correlation between scores with this method and academic examinations that mainly reflect knowledge.
The purpose of the present study was to estimate the cost-effectiveness of three alternative community programs to prevent dental caries among Catalonia's schoolchildren. The programs were: fluoridation of the public water supply, fort-nightly 0.2% NaF mouthrinses administered in schools, and supervised toothbrushing with a fluoride toothpaste in schools. Caries prevalence data for Catalan children are given and the methodology for the study is described. The estimated cost of saving 1 DMFS with each program was: 53.40 Pts (US$ 0.39) with fluoridation of the water supply; 305.20 Pts (US$ 2.26) with fluoride mouthrinses; and 1498 Pts (US$ 11.09) with supervised toothbrushing. The feasibility of the programs in Catalonia and their educational values for the target population are considered.
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