Table 3.

Paired t-tests of pre- to post-course changes in self-ratings of confidence and competence in clinical skills domains tested on the USMLE step 2 CS exam (N=64)^a)

Survey item	N	Pre-course	Post-course	P-value
Taking a focused history
Confidence	64	2.08 ± 0.72	2.72 ± 0.60	< 0.001
Competence	59	2.12 ± 0.70	2.63 ± 0.61	< 0.001
Opening the interview
Confidence	64	2.45 ± 0.91	3.33 ± 0.59	< 0.001
Competence	59	2.49 ± 0.84	3.27 ± 0.61	< 0.001
Gathering patient data
Confidence	64	2.33 ± 0.71	2.83 ± 0.55	< 0.001
Competence	58	2.29 ± 0.70	2.86 ± 0.58	< 0.001
Building the relationship
Confidence	63	2.62 ± 0.73	3.21 ± 0.54	< 0.001
Competence	59	2.53 ± 0.77	3.19 ± 0.57	< 0.001
Sharing information with the patient
Confidence	64	2.09 ± 0.89	2.84 ± 0.62	< 0.001
Competence	58	2.07 ± 0.79	2.88 ± 0.65	< 0.001
Reaching agreement on problems and plans
Confidence	64	2.08 ± 0.84	2.94 ± 0.59	< 0.001
Competence	59	2.05 ± 0.80	2.90 ± 0.61	< 0.001
Providing closure to the interview
Confidence	64	2.00 ± 0.89	2.80 ± 0.72	< 0.001
Competence	58	1.93 ± 0.90	2.79 ± 0.72	< 0.001
Performing a focused physical examination
Confidence	64	1.80 ± 0.69	2.11 ± 0.78	0.009
Competence	59	1.80 ± 0.66	2.12 ± 0.67	0.002
Completing a patient note
Confidence	64	1.19 ± 0.83	2.08 ± 0.84	< 0.001
Competence	59	1.31 ± 0.86	2.02 ± 0.90	< 0.001
Mean score across all items
Confidence	64	2.07 ± 0.54	2.76 ± 0.42	< 0.001
Competence	59	2.07 ± 0.54	2.79 ± 0.42	< 0.001

Values are presented as mean±standard deviation. Items were rated using a 5-point Likert scale (0, poor; 1, below average; 2, average; 3, above average; 4, outstanding).

USMLE, United States Medical Licensing Exam; CS, clinical skills.

^a)Minimal missing responses for competence ratings.