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.