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Keywords

Constructed response questions, Medical education, Primary care, Clinical competence, Thailand

Abstract

Introduction: The Primary Medical Care course is a core subject for sixth-year Thammasat medical students. Knowledge assessment is conducted using 10 Constructed Response Questions (CRQ), mapped to the standards of the Medical Council of Thailand.

Objectives: To evaluate the performance of sixth-year Thammasat medical students in the Primary Medical Care course through CRQ examinations across multiple affiliated clinical training centers during the academic year 2024 and identify specific diseases or topics requiring improvement at each location.

Methods: Study was conducted using CRQ examination results from all 166 sixth-year medical students at five clinical training centers. Questions and corresponding rubric-scored answers were initially developed by the assigned medical instructor. A panel of five medical instructors convened to review each CRQ and refine the questions and their associated scoring rubrics. The medical instructor responsible for developing each CRQ evaluated the students based on the final rubric scores. Topics falling below the 50% threshold were prioritized for future improvement.

Results: Across six examination rotations, overall mean percentage ranged from 20.46% to 87.27%. Across all centers, mean scores fell below 50% within their respective rotations for the following topics: impetigo (14-34.73%), herpes zoster (24.80-44.80%), irritable bowel syndrome (29.60-41.60%), childhood lymphadenitis (37.83-48%), palliative last hours (23.60-46.36%), and premature ventricular contractions (12-26.91%).

Conclusions: The following topics yielded mean scores below 50%: impetigo, herpes zoster, irritable bowel syndrome, childhood lymphadenitis, palliative last hours, and premature ventricular contractions. Clinical learning models at each center require strategic adjustments, particularly regarding domains where assessment scores remained below a 50% threshold.

References

1. Medical Council of Thailand. Competency standards of the Medical Council of Thailand (2024), Part 2B: professional knowledge and clinical skills. Published 2024. Accessed May 28, 2025. https://www.cotmes.net/documents_category/document-from-us/.
2. Ausayapao P, Vijugprasert P, Sirisopitkul T, Satetarak S, Tanormsing P. Pediatrics constructed response question examination of sixth year medical students of Faculty of Medicine, Ramathibodi hospital and Collaborative Project to Increase Production of Rural Doctor, Mahidol University-Maharat Nakhon Ratchasima Hospital in Aca. MNRHJ. 2024;32:47–52.
3. Yi Y, Chongsuvivatwong V, Sriplung H, Rueanarong C. CPIRD: A successful Thai programme to produce clinically competent medical graduates. F1000Res. 2015;4:158–164.
4. Suvarnabhumi K, Sowanna N, Jiraniramai S, et al. Situational analysis of palliative care education in Thai medical schools. Palliat Care. 2013;7:25–29.
5. Reungkaew J, Thongyoo R, Pattanaprichakul P, et al. Dermatologic clinical exposure in sixth-year Siriraj medical students based on Thai medical competency assessment criteria for national license. Siriraj Med Bull. 2021;14:8–12.

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