Journal List > J Korean Med Assoc > v.55(2) > 1042514

J Korean Med Assoc. 2012 Feb;55(2):116-123. Korean.
Published online February 08, 2012.
Copyright © 2012 Korean Medical Association
The impact of introducing the Korean Medical Licensing Examination clinical skills assessment on medical education
Hoon-Ki Park, MD
Department of Medical Education, Hanyang University College of Medicine, Seoul, Korea.

Corresponding author: Hoon-Ki Park, Email:
Received January 06, 2012; Accepted January 20, 2012.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Evaluation systems can produce curricular change. Korean medical schools face a new responsibility to prepare students for the Korean Medical Licensing Examination (KMLE) clinical skills test (CST) that had been administered since 2009. Several innovations in medical education have resulted, including augmentation of hand-on skills training and a standardized patient program during clerkships. This review explored the results of a survey of 41 medical schools on the impact of the CST on medical education in Korea as of 2011. The majority of respondents reported having an independent skills training laboratory and conducting a clinical skills assessment during the third or fourth year of medical school. The preparatory undergraduate courses were perceived as helpful for self-confidence, communication with real patients, basic clinical skills for work, information sharing with patients, and getting the confidence of patients during internship and residency. However, an extreme policy emphasizing maintenance of a high pass rate has warped the curriculum with simple preparatory courses for the CST. The long-term educational outcomes of the CST of the KMLE must be evaluated again a few years later focused on searching for any relationship with a reduction in medical errors or increase in patient satisfaction in real practice.

Keywords: Undergraduate medical education; Objective structured clinical examination; Simulation; Standardized patients


Figure 1
The establishment year of clinical skills training center at 41 medical schools.
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Table 1
The change of educational facilities and curricular contents of medical schools after the introduction of clinical skills test in 2009 at KMLE
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Table 2
The change of opportunity for medical students to practice during clerkship rotations after the introduction of CSA in KMLE
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Table 3
The behavioral change of interns or the first year residents at university hospital rated by professors, nurses, and patients after the introduction of clinical skills assessment of KMLE in 2009
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Table 4
Usefulness of preparatory undergraduate medical education for the CSA of KMLE on the role of interns and residents afterward
Click for larger image


This study was supported by funding from the Research Institute for Healthcare Policy of the Korean Medical Association in 2011.

1. Guskey TR. How classroom assessments improve learning. Educ Leadersh 2003;60:6–11.
2. Carraccio C, Wolfsthal SD, Englander R, Ferentz K, Martin C. Shifting paradigms: from Flexner to competencies. Acad Med 2002;77:361–367.
3. Park JH, Kim UM, Lee WC, Lee YS. A study on the satisfaction of medical licensing examination and the present condition of skill test in medical schools. J Educ Eval Health Prof 2004;1:77–86.
4. Park H. Clinical skills assessment in Korean Medical Licensing Examination. Korean J Med Educ 2008;20:309–312.
5. Papadakis MA. The Step 2 clinical-skills examination. N Engl J Med 2004;350:1703–1705.
6. Kim KS. Introduction and administration of the clinical skill test of the Medical Licensing Examination, Republic of Korea (2009). J Educ Eval Health Prof 2010;7:4.
7. Hauer KE, Teherani A, Kerr KM, O'sullivan PS, Irby DM. Impact of the United States Medical Licensing Examination Step 2 Clinical Skills exam on medical school clinical skills assessment. Acad Med 2006;81 10 Suppl:S13–S16.
8. Wartman SA, Littlefield JH. Changes in the US Medical Licensure Examination and impact on US medical schools. JAMA 2005;293:424–425.
9. Pfeiffer CA, Ardolino AJ, Madray H. The impact of a curriculum renewal project on students' performances on a fourth-year clinical skills assessment. Acad Med 2001;76:173–175.
10. Mehta NP, Kramer DB. A Critique of the USMLE clinical skills examination. MedGenMed 2005;7:76.
11. Petrusa ER. Taking standardized patient-based examinations to the next level. Teach Learn Med 2004;16:98–110.
12. McGaghie WC, Issenberg SB, Petrusa ER. Simulation-Savior or Satan? A rebuttal. Adv Health Sci Educ Theory Pract 2003;8:97–103.
13. Rickles NM, Tieu P, Myers L, Galal S, Chung V. The impact of a standardized patient program on student learning of communication skills. Am J Pharm Educ 2009;73:4.
14. Hauer KE, Hodgson CS, Kerr KM, Teherani A, Irby DM. A national study of medical student clinical skills assessment. Acad Med 2005;80 10 Suppl:S25–S29.
15. Davis MH, Harden RM. Planning and implementing an undergraduate medical curriculum: the lessons learned. Med Teach 2003;25:596–608.
16. Turner JL, Dankoski ME. Objective structured clinical exams: a critical review. Fam Med 2008;40:574–578.
17. Dauphinee WD, Wood-Dauphinee S. The need for evidence in medical education: the development of best evidence medical education as an opportunity to inform, guide, and sustain medical education research. Acad Med 2004;79:925–930.
18. Perez JA Jr, Greer S. Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination performance. Adv Health Sci Educ Theory Pract 2009;14:753–758.