Assessing Competences in Medical Students with a Newly Designed 360- Degree Examination of a Simulated First Day of Residency: A Feasibility Study

Abstract Background: Many medical schools worldwide are in the process of curricular change towards competencebased undergraduate medical education to ease the transition to residency. Aspects of patient management, interprofessional interaction and the concept of entrustable professional activities are in the focus of medical educators. Such curricular changes require an assessment with valid and reliable measurements of competences feasible for large numbers of medical students. Methods: Seventy medical students from three German medical schools (Hamburg, Oldenburg, and Munich) participated in our newly designed 360-degree examination based on selected competences relevant for first year residents. A consulting hour with five simulated patients is followed by a patient management phase of 2.5 hours with interprofessional disturbances, followed by a 30-minutes handover of the patients to a resident. Different competences are assessed by the supervisors, simulated patients, nurses, residents, and by the participants themselves. All participants and research assistants evaluated the assessment regarding aspects of organization and content. Results: All participants, assessors, and research assistants were satisfied with the process, technical equipment, and organization of the assessment. All assessors and research assistants stated that their respective training prepared them well for their role in the assessment. The participating students felt satisfied with the content of the assessment. They considered the patient cases to be very realistic. While there was no difference between students in their final year and students below semester 11 with respect to feeling confident during history taking and handover, final year students felt significantly more confident (p=0.02) during the patient management phase. Conclusion: It is feasible to implement a competence-based 360-degree assessment for a large group of students. Further analysis of the data will provide evidence whether students from medical schools with different undergraduate curricula perform differently with respect to competences relevant for first year residents.