• Vicki R LeBlanc, Diana Tabak, Roger Kneebone, Debra Nestel, Helen MacRae, and Carol-Anne Moulton.
• Wilson Centre, Faculty of Medicine, University of Toronto, 200 Elizabeth St., 1ES-565, Toronto, Ontario, M5G 2C4 Canada. vicki.leblanc@utoronto.ca
• Am. J. Surg. 2009 Jan 1;197(1):96-101.

PurposeThe Integrated Procedural Performance Instrument (IPPI) consists of clinical scenarios in which bench-top models are positioned to simulated patients. Trainees are required to perform technical skills while engaging with the patient. The purpose of this study was to determine whether an IPPI format examination could discriminate between different levels of trainees.MethodsSixteen fourth-year medical students and 16 first-year surgery residents participated in 4 IPPI scenarios. Videotaped performances were scored by 2 blinded independent clinician raters on previously validated instruments: checklist of technical skills, Global Rating Scale of technical skills, and communication scale. We conducted separate mixed design analyses of variance (level x cases) on the 3 scales.ResultsResidents performed better than medical students on the checklist (74% vs 60%, P < .05), the Global Rating Scale of technical skills (75% vs 56%, P < .01), and the coherence communication subscale (79% vs 69%, P < .05).ConclusionsAn IPPI examination discriminated between students' and residents' technical skills and coherence in communication skills. It also highlighted a potential gap in the training of residents' communication skills.

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