Aquifer is excited to share the publication of an important validation study of our own Key Features Exam (KFE) for Internal Medicine in Academic Medicine: Journal of the Association of American Medical Colleges. The article, Validity Evidence for a Brief Online Key Features Examination in the Internal Medicine Clerkship, presents a range of evidence supporting the use of the Key Features Exam as a complementary assessment during the third-year internal medicine clerkship, specifically to test clinical decision-making skills. This publication is the result of a multi-institutional validation study led by Valerie Lang, MD, MHPE, Aquifer Academic Director for Assessment, and a team that included Aquifer Educators Consortium members Dr. Kirk Bronander and Dr. Heather Harrell.

The study results show strong evidence for response-process and relationship-to-other-variables validity for using a Key Features Exam to complement other assessments in U.S. internal medicine clerkships. Results also revealed moderate internal structure validity. The study concludes that Aquifer’s nationally developed KFE is well suited as a standardized complement to other assessments in this context.

Although Key Features Exams are widely used internationally, Aquifer’s KFE is the first designed for use in U.S. medical schools. The key features approach focuses on the critical or challenging decisions in the diagnosis and management of a clinical problem to better target critical decision points. Key features exam structure includes a case vignette, followed by several questions specifically targeting the key clinical decisions.The Aquifer Key Features Exam aligns directly with CDIM’s national curriculum as well as the Aquifer Internal Medicine course, and it is specifically designed to test clinical decision-making skills at the end of the internal medicine clerkship. The exam launched in October 2017 and is currently offered to Aquifer Internal Medicine subscribers free of charge for the 2018-19 subscription year. To learn more about the Aquifer Key Features Exam and the key features approach, please visit our Exams and Assessment page.