Our originally-developed clinical training system, specialty-based physical examination (SBPE), was introduced for 4th-year medical students to improve their clinical skills through instruction by specialists in each body region. We previously reported that SBPE has a beneficial effect on results of performance tests. This time, therefore, we studied the effects of SBPE on written tests by comparing test results before and after the introduction of SBPE. We found that SBPE did not have any beneficial effect on results of a written test, despite having improved results of a performance test. These results were confirmed by analyses of students' questionnaires and a correlation between the two. Thus, our results suggest that written tests and performance tests evaluate different things: written tests evaluate acquisition of diagnostic knowledge, and performance tests evaluate mastery of clinical skills, which seem not to affect each other at the initial stage of clinical education.
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