Standardized patient outcomes trial (SPOT) in neurology

Figures & data

Table 1. Calculation of NPE score

Checklist item on OSCE		Points
		Yes	No
Q1	Washed hands or used sterilizer before and after the exam	1	0
Q2	Examined me from my right	1	0
Q3	Maintained my sense of modesty and comfort throughout the exam	1	0
Q4	Listened to the pulses in my neck on both sides	1	0
Q5	Checked my vision by asking me to read an eye chart (II)	1	0
Q6	Checked my pupils by shining a light in my eyes (II, III)	1	0
Q7	Checked my eye movements (III, IV, VI)	1	0
Q8	Checked my hearing (VIII)	1	0
Q9	Asked me to clench my teeth (V motor)	1	0
Q10	Asked if I can feel a cotton swab on my forehead/cheeks/jaws while my eyes were closed (V sensation)	1	0
Q11	Asked me to raise my eyebrows/close my eyes tightly/smile showing all of my teeth (VII)	1	0
Q12	Asked me to shrug my shoulders while pressing down on them or asked me to turn my head to each side against his/her hand (XII)	1	0
Q13	Asked me to say ‘ahh’ (IX, X)	1	0
Q14	Asked me to stick out my tongue and move it from side to side (XII)	1	0
Q15	Checked the muscle strength in my arms/hands and legs/feet on both sides (Motor function)	1	0
Q16	When my eyes are closed, asked if I could feel them touching my arms/hands and legs/feet on both sides (Sensation)	1	0
Q17	Checked my reflexes in my arms and legs on both sides (Reflexes)	1	0
Q18	Checked my response to having the bottom of my foot stroked (Babinski)	1	0
Q19	Asked me to touch one of their fingers and then my nose on both sides, or asked me to move each of my heels down the opposite shin, or asked me to touch my thigh (or other hand) alternately with my palm and the back of my hand (Coordination)	1	0
Q20	Asked me to walk across the room (Gait)	1	0
Q# (1, 2, 3…) = points received for checklist item
Cranial Nerve Score (CNS) = (Q5 + Q6 + Q7 + Q8 + Q9 + Q10 + Q11 + Q12 + Q13 + Q14)/10
Motor Strength Score (MFS) = Q15
Sensation Score (SS) = Q16
Reflex Score (RS) = (Q17 + Q18)/2
Coordination Score (CS) = Q19
Gait Score (GS) = Q20
Neurologic Physical Exam (NPE) Score = CNS + MFS + SS +RS + CS + GS

Fig. 1.  Histogram of NPE scores for the control and intervention groups.

Table 2. Mean NPE scores in each group and comparisons via a two-tailed unpaired t-test

Data set	N	Mean	Standard deviation
Intervention	58	3.5	1.1
Control	129	2.2	1.1
OSCE control	23	2.7	1.2
Comparison	p-value
Intervention vs. control	<0.0001
Intervention vs. OSCE control	0.004
Control vs. OSCE control	0.03

Fig. 2.  Histogram of NPE scores for the control and OSCE control groups.

Table 3. Mean NPE scores stratified by clerkship timing

	N	Mean	Standard deviation
OSCE before clerkship
Intervention	37	3.4	1.0
Control	74	1.9	1.0
OSCE after clerkship
Intervention	21	3.8	1.1
Control	55	2.5	1.2
	p-value
Intervention vs. control
OSCE before clerkship	<0.0001
OSCE after clerkship	<0.0001
OSCE before clerkship vs. OSCE after clerkship
Intervention	0.1
Control	0.004