Abstract Details

Title Assessing the Clinical Skill of Neurological Localization Using Extended-Matching Questions

Topic Neurologic ��ɫ��

Presentation(s) S27 - (-)

Poster/Presentation
Number 001

Objective

Background Neurological localization (NL) is important for physicians managing patients with neurological disorders, as it is the first step to making an accurate diagnosis. NL is recognized as a core topic by the ��ɫ��, yet there are few data about assessment of NL in trainees. Extended-Matching Questions (EMQ), a type of multiple-choice question (MCQ) with varying numbers of answer options, have been shown to adequately assess processes of clinical reasoning. EMQ also allow greater discrimination compared to standard MCQ as responses are more widely distributed.

Design/Methods We initially designed a 59-question EMQ assessment tool testing NL in various clinical scenarios; 25 answer choices were provided. After a pilot study, 4 questions were removed, leaving 55 questions. We then conducted the 55-question EMQ in medical undergraduates and postgraduate trainees; this closed-book pen-and-paper test took 1 hour to complete. Test scores were expressed as a percentage of the maximum score. Differences between undergraduates and postgraduates were tested with the unpaired t-test.

Results We recruited 106 participants, including 4th year medical undergraduates (n=56) and postgraduate trainees (internal medicine residents and neurology registrars, n=50). Mean scores for undergraduates and postgraduate trainees were 76.7±1.7 and 83.0±1.6 respectively (all values expressed as mean±standard error of mean, p=0.009). The higher scores with increased clinical experience supported the validity of the EMQ. The EMQ showed good reliability (Cronbach's alpha 0.85) and generalizability (G-coefficient 0.85).

Conclusions Our results show that the 55-question EMQ can be validly and reliably used to assess NL, a vital skill in neurology, in undergraduate and postgraduate learners. It is a feasible, practical and cost-effective tool to aid in the teaching and assessment of clinical neurology.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Kevin Tan, MD, FAAN (National Neuroscience Institute)	Dr. Tan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Tan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Tan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck.
Suleiman Kojan, MD, FAAN (Flint Neurological Center)	No disclosure on file
Erle C. Lim, MBBS (Singapore General Hospital)	No disclosure on file
	No disclosure on file
Nigel C. Tan, MBBS (National Neuroscience Institute)	No disclosure on file

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