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espanolObjetivo El objetivo de este estudio fue validar la version en espanol del Communication Assessment Tool (CAT), para ser utilizada por pacientes estandarizados en un examen clinico objetivo estructurado (OSCE), con el fin de evaluar habilidades de comunicacion centrada en el paciente de manera estandarizada. Metodos Pacientes estandarizados evaluaron a 125 medicos recien graduados durante un OSCE de 12 estaciones. Un total de 1.500 resultados de CAT fueron analizados. Se llevo a cabo analisis factorial exploratorio y confirmatorio, asi como analisis de confiabilidad. Resultados Encontramos un solo factor en la version en espanol del CAT, similar a lo descrito por el autor original. El alfa de Cronbach fue de 0,93 a 0,97. El promedio de «excelentes» fue del 38,07%. Conclusiones La version en espanol del CAT puede ser utilizada en OSCE por pacientes estandarizados para evaluar habilidades de comunicacion de una manera estandarizada. EnglishObjective The aim of this study was to validate the Spanish version of the Communication Assessment Tool (CAT) to be used in an Objective Structured Clinical Evaluation (OSCE) to assess communication skills. Methods Data were collected from standardized patients evaluating 125 recent medical school graduates during a 12-station OSCE. A total of 1,500 completed CAT instruments were analyzed. Exploratory and confirmatory factorial analysis were performed and tested the internal consistency of the tool. Results We found a single factor solution in the Spanish version of the instrument, similar to that described by the original author. Cronbach's alpha was high, ranging from 0.93 to 0.97. The overall mean percentage of ‘excellent’ ratings for the recent graduates was 38.07%. Conclusions The Spanish version of CAT is a feasible tool to be used in OSCE by standardized patients to assess communication skills in a standardized manner.

Background: Outcomes-based education is a trend in medical education and its assessment is one of the main challenges. The Objective Structured Clinical Examination (OSCE) is one of the tools used to assess clinical competencies. Although Chilean medical schools have used OSCEs for 18 years, there is a vast variability in the way these examinations are administered. Aim: To design and implement an integrated OSCE to assess clinical competencies at the end of the medical program in Chilean medical schools, aiming to reduce variability between these schools. Material and Methods: Seven medical schools, supported by experts from the National Board of Medical Examiners, designed a 12 station OSCE to measure clinical outcomes at the end of the seventh year of medical training. Unlike traditional OSCEs, this new examination incorporated the assessment of clinical reasoning and communication skills, evaluated from patients’ perspective. Results: One hundred twenty-five volunteers took the same exam at five different venues. The internal consistency was 0.62. Following a compensatory approach, 85% of students passed the exam. Communication assessment showed poorer results than those reported in the literature. Conclusions: Among Chilean medical students, the assessment of clinical outcomes in a collaborative way, through a valid and reliable exam, is feasible. A consensus on how to teach and assess clinical reasoning across the medical curriculum is required. The assessment of students’ communication skills requires further development.

Introduction: Ward round skills are essential for doctors in hospital settings. Literature shows medical students deficiencies in these skills. Simulation has been used to train these skills. However, exposing learners to simulation at an early stage may be associated with a high cognitive load and limited learning. This study aims to determine how students experience this load and its interplay with performance and which factors promote and impair learning.Method: Fifty-six final year medical students participated in a simulated ward round training exercise. Both students’ performance and cognitive load were measured to determine if there was any correlation and interviews were carried out to understand which factors support and impair learning.Results: Performance scores revealed deficiencies in ward round skills. Students experienced a cognitive load that weakly correlated with performance. Qualitative findings provided important insights into simulated ward-based learning. It is clear that well-designed clinical scenarios, prioritization tasks, teamwork and feedback support students’ learning process whereas distractions impair learning.Conclusion: WRS proved to be a good teaching method to improve clinical skills at this stage as the cognitive load is not too high to impair learning. Hence, including tasks in the simulation design can enhance the learning process.