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These authors measured the competency of new interns in the evaluation and management of acute altered mental status (AMS). A cohort of 61 graduates from 39 medical schools who were entering internships at a single military teaching hospital in 2006 completed an Objective Structured Clinical Examination (OSCE). The OSCE consisted of a 12-minute simulated encounter with a nurse actor and a programmed mannequin meant to represent a hospitalized patient with acute AMS. A single neurologist used faculty-determined standards to grade each intern’s competency in obtaining a history, performing a neurologic examination, generating a differential diagnosis, and ordering diagnostic studies.
Hypoglycemia was identified as a potential cause of AMS by 7…