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Evaluation & the Health Professions
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Dimensions of Clinical Competence as Conceptualized by Medical School Faculty

David J. Solomon

Alice J. Speer

Michael R. Callaway

Michael A. Ainsworth

The University of Texas Medical Branch

This study identified dimensions of clinical competence underlying faculty ratings of fourth-year student performance in a standardizedpatient examination and assessed the impact of these dimensions onfaculty pass/fail decisions. Content review coupled with exploratoryfactor analysis was used to group 17 of 25 specific behavioral rating categories intofourhomogeneous clusters. Confirmatory factor analysis refined the clusters into four unidimensional scales that included 14 of the original ratings. The dimensions reflected relating to the patient, problem-solving skills, medical history skills, and physical examination skills. The factor structure was crossvalidated in a separate data set. Logistic regression indicated problem solving was the only independent predictor of a student passing the exercise.

Evaluation & the Health Professions, Vol. 19, No. 1, 68-80 (1996)
DOI: 10.1177/016327879601900105
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