Table 1.
Baseline Student Characteristics, Self-rated Proficiency, and Application of Communication and Clinical Reasoning Skills
| AIME Students (n=59)* | Non-AIME Students (n=60)* | |
|---|---|---|
| Baseline characteristics | ||
| Age | 24.4 years | 24.1 years |
| Male gender (%) | 50.8 | 50.0 |
| College major (%) | ||
| Science | 66.1 | 76.7 |
| Nonscience | 11.9 | 13.3 |
| Both | 22.0 | 10.0 |
| Previous interviewing experience (%) | 66.1 | 48.3 |
| Previous health professional training, % | 33.9† | 16.7† |
| Self-rated proficiency of skills, median (IQR) Communication skills ‡ | ||
| Using verbal and nonverbal cues | 4 (3–4) | 4 (3–4) |
| Encouraging questions from patients regarding health/illness | 3 (3–4) | 3 (3–3) |
| Eliciting patients' beliefs about health or illness | 3 (2–3) | 2.5 (2–3) |
| Eliciting patients' expectations for tests or treatment | 2 (2–3) | 2 (2–3) |
| Clinical reasoning skills | ||
| Creating a problem list | 2 (1–3) | 2 (1–3) |
| Using methods to develop a differential diagnosis | 2 (2–3)§ | 2 (1–2)§ |
| Students' observed assessment of a videotaped clinical encounter | ||
| Recognizing physician communication behaviors (% of students) | ||
| Data gathering | ||
| Agenda setting | 27.6 | 35.0 |
| Interrupting the patient | 37.9 | 41.6 |
| Eliciting beliefs about illness | 36.2 | 35.0 |
| Establishing rapport | ||
| Appropriate eye contact | 87.9 | 88.3 |
| Expression of empathy | 72.4 | 76.7 |
| Patient education and counseling | NR | NR |
| Clinical reasoning skills, mean (SD) | ||
| Problem list | ||
| Problems listed | 5.9 (1.2) | 5.8 (1.1) |
| History of present illness items | 2.4 (0.8) | 2.3 (0.8) |
| Differential diagnoses | ||
| Diagnoses listed | 4.4 (1.1) | 4.3 (1.0) |
| Supporting factors for the correct diagnosis | 2.1 (1.7) | 1.8 (0.8) |
| Refuting factors for the correct diagnosis | 0.15 (0.44) | 0.06 (0.24) |
| Diagnostic Thinking Inventory total score | 149.3 (15.5) | 145.3 (14.8) |
| Clinical reasoning skills | ||
| Psychosocial history items listed (% of students) | ||
| No items listed | 2 | 0 |
| ≥1 items listed | 98 | 100 |
*
Data available for 119 of 121 students
†
P=.04 by χ2analysis.
‡
Median and interquartile range (IQR) for ratings of proficiency: 0=no exposure, 1=familiar with concept, 2=can perform skill somewhat, 3=can perform skill well, and 4=can teach to other students.
§
P=.01 by Wilcoxon rank-sum test
AIME, An Integrated Medical Encounter; NR, not rated.