摘要：Purpose:This school-level longitudinal study examined 7 years of clinical performance data to determine differences (effects) in students and annual changes within a school and between schools;examine how much their predictors (characteristics) influenced the variation in student performance;and calculate estimates of the schools’ initial status and growth. Methods:A school-level longitudinal model was tested:level 1 (between students),level 2 (annual change within a school),and level 3 (between schools). The study sample comprised students who belonged to the CPX Consortium (n=5,283 for 2005~2008 and n=4,337 for 2009~2011). Results:Despite a difference between evaluation domains,the performance outcomes were related to individual large-effect differences and small-effect school-level differences. Physical examination,clinical courtesy,and patient education were strongly influenced by the school effect,whereas patient-physician interaction was not affected much. Conclusion:Student scores are influenced by the school effect (differences),and the predictors explain the variation in differences, depending on the evaluation domain.
关键词：Longitudinal studies;Multilevel analysis;Clinical performance examination;School effect;Quasi-longitudinal data
