Adapting the Key Features Examination for a clinical clerkship

PURPOSE: A written test of clinical decision-making, the Key Features Examination, was developed for use in clerkship. METHODS: Following the guidelines provided by the Medical Council of Canada, a Key Features Examination was developed and implemented in an internal medicine clinical clerkship, during the 1998/99 clerkship year. The reliability and concurrent validity of the exam were assessed. RESULTS: A 2 hour examination, containing 15 key feature problems, was administered to 101 students during 6 consecutive internal medicine clerkship rotations. The reliability of the exam, calculated from Cronbach's alpha, was 0.49. The exam had modest correlation with other measures of knowledge and clinical performance. CONCLUSION: The Key Feature Examination is a feasible and reliable evaluation tool that may be implemented as a component of student assessment during a clinical clerkship.