Glaser K, Sackett D, Pazdernik VK. Success Predictors For Third-Year Osteopathic Medical Students on National Standardized Examinations: A Family Medicine Clerkship Course Study. J Am Osteopath Assoc 2020;120(4):253–262. doi: https://doi.org/10.7556/jaoa.2020.042.
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Medical education institutions often use community-based sites and preceptors during students' third and fourth years for clinical training. However, differences in the sites, preceptors, assessment methods, and students may result in variations in clinical training, potentially affecting educational outcomes. During clerkships at A.T. Still University School of Osteopathic Medicine in Arizona, all students are evaluated by several methods for each required clerkship course. Required assessments include the clinical preceptor's evaluation, online coursework specific to each clerkship, patient log documentation, and the Comprehensive Osteopathic Medical Achievement Test (COMAT) relevant to that clerkship.
To evaluate which methods of student assessment in a family medicine clerkship course were most predictive of the future success of students on national standardized examinations.
Third-year osteopathic medical students from a single class who had completed the Comprehensive Osteopathic Medical Licensing Examination (COMLEX)-USA Level 2-Cognitive Evaluation (CE) and 2-Performance Evaluation (PE) and the COMAT were included in the study. Scores on the examinations were used as success benchmarks. Analysis of 4 categories of predictor variables—clerkship site, previous student performance, preceptor evaluation, and clerkship coursework assessment (ie, assignment scores and log numbers)—was used to predict success on the national standardized examinations.
Ninety-nine of 105 students were eligible for inclusion. No associations were found between examination scores and clerkship site or log numbers (all P≥.10). Correlations were found for previous student performance (ie, grade point average for first-year and second-year coursework) and all examinations except COMLEX-USA Level 2-PE (r=0.56-0.74, all P<.001), and between total score in family medicine clerkship coursework and COMLEX-USA Level 2-CE and COMAT scores (r=0.28-0.39, all P≤.006). Correlations were also found between preceptor evaluation (total score and subscore on medical knowledge) and all assessed national standardized examinations (r=0.20-0.34, all P<.049).
Our results suggest that analysis of predictor variables in clerkship courses can reasonably predict success on national standardized examinations and may be useful for early identification of struggling students who may need additional support to perform well on the examinations.
a A negative proportion indicates a negative relationship. Proportion of variance explained was reported as R2 from analysis of variance and linear regressions, McFadden R2 from logistic regressions, and uncertainty coefficient from Fisher exact test.
b Mean across all required clerkships (family medicine, internal medicine, pediatrics, obstetrics and gynecology, psychiatry, general surgery).
c Two incomplete quizzes (score of 0) were included in the analysis.
d Two incomplete quizzes were excluded from the analysis.
Abbreviations: CE, cognitive evaluation; CHC, community health center; COMAT, Comprehensive Osteopathic Medical Achievement Test; COMLEX-USA, Comprehensive Osteopathic Medical Licensing Examination; CRE, clinical rotation evaluation; FM, family medicine; GPA, grade point average; LO, learning objective; PE, performance evaluation; NA, not applicable; SOAP, subjective, objective, assessment, and plan.
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