Comparing clerkship sites in a community-based medical school by evaluating studentsʼ undergraduate and postgraduate performances

Markert, Ronald J.; Barnes, H. Verdain; Dunn, Marvin; Goldenberg, Kim; Hennessey, James V.

doi:10.1097/00001888-199304000-00018

Cited by 5 publications

(12 citation statements)

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“…Appendix S2 (online) summarises the demographic characteristics of the study samples, the selection strategies and outcomes assessed, and the overall risk for bias of the studies included. The 80 studies encompassed 17 selection strategies and 17 outcome measures and involved a total of 41 704 participants. Selection strategies evaluated were: age; consensus committee rank (CCR); deans’ letters; extracurricular activities (Ex Curr); interview (Int); medical school reputation (MS Rep); Alpha‐Omega‐Alpha Honor Medical Society status (AOA); medical school marks in clerkship (MSM clrk); overall medical school grade point average (MSM GPA); medical school marks pre‐clerkship (MSM pre‐clrk); reference letters (Ref Ltr); research publications (Rsch Pubs); Medical College Admission Test (MCAT) score; National Board of Medical Examiners (NBME) Parts I and II scores, and USMLE Step 1 and 2 scores.…”

Section: Resultsmentioning

confidence: 99%

Associations between residency selection strategies and doctor performance: a meta-analysis

2013

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OBJECTIVES The purpose of this study was to use meta-analysis to establish which of the information available to the resident selection committee is associated with resident or doctor performance.METHODS Multiple electronic databases were searched to 4 September 2012. Two reviewers independently selected studies that met the present inclusion criteria and extracted data in duplicate; disagreement was resolved by consensus. Risk for bias was assessed using a customised bias assessment tool. Measures of association were converted to a common effect size (Hedges' g). Meta-analysis was performed using the random-effects model for each selection strategy and all outcomes without pooling. Sensitivity analysis for each selection strategy-outcome pair was performed with pooling of effect size.RESULTS Eighty studies involving a total of 41 704 participants were included in the metaanalysis. Seventeen different selection strategies and 17 outcomes were assessed across these studies. The strongest positive associations referred to examination-based selection strategies, such as the US Medical Licensing Examination (USMLE) Step 1, and examination-based outcomes, such as scores on intraining examinations. Moderate positive associations were present for medical school marks and both examination-based and subjective outcomes. Minimal or no associations were seen for the selection tools represented by interviews, reference letters and deans' letters.CONCLUSIONS Standardised examination performance and medical school grades show the strongest associations with current measures of doctor performance. Deans' letters, reference letters and interviews all show a lower than expected strength of association given the relative value often assigned to them during resident doctor selection. Objective selection strategies are potentially the most useful to residency selection committees based on current evaluative methods. However, reports in the literature of validated long-term doctor performance outcomes are scant.

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Section: Resultsmentioning

confidence: 99%

Associations between residency selection strategies and doctor performance: a meta-analysis

2013

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“…Markert and colleagues offered evidence for a similar method of comparing the quality of clinical site instruction by contrasting student NBME scores and clerkship grades, along with other postgraduate measures. 15 …”

Section: Discussionmentioning

confidence: 99%

Script Concordance Tests for Formative Clinical Reasoning and Problem-Solving Assessment in General Pediatrics

et al. 2022

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Introduction Script Concordance Tests (SCTs) are short clinical vignettes with proposed diagnoses, diagnostic studies, treatments, and management options for patient care scenarios. The SCTs included in this resource were incorporated into a required pediatric clerkship to facilitate formative student feedback and additional opportunities for precepting faculty to provide midclerkship feedback. Pediatric cases were specifically selected due to the scarcity of medical student experience with common pediatric clinical presentations. Methods We developed eight themed SCTs comprising 72 individual test items focused on common topics in general pediatrics. Items were administered to a convenience sample of third-year medical students during their required pediatric clerkship between fall 2016 and spring 2020. To evaluate the SCTs, we conducted item analyses, as well as comparing student performance to summative assessments. Results The mean aggregate percentage score across all SCTs was .84 ( SD = .08). Student SCT performance was related to USMLE Step 2 Clinical Knowledge scores, clerkship grades, and NBME Pediatrics Shelf Exam scores. Discussion These SCTs facilitated feedback to medical students in the clinical learning environment. Their current form provides a means of exploring student clinical reasoning and problem-solving and can be used at a single point or to measure longitudinally. When paired with structured subject- and competency-specific midclerkship student evaluation, SCTs helped facilitate timely feedback to students via immediate explanations of each question. SCTs can assist students in recognizing and reflecting on potential knowledge gaps.

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“…6,9,14,18,21,23,24,[28][29][30] In articles that did not specifically refer to accreditation, authors offered concerns about educational quality in decentralized training locations, about whether the heterogeneity of clinical experiences and practitioners from community hospitals can maintain the same teaching standards as expected in academic teaching hospitals, and ultimately, whether differences in learning experiences may impact learning outcomes. 15,16,20,26,27,31,33…”

Section: Rationale For Educational Comparabilitymentioning

confidence: 99%

“…For example, many articles discussed the importance of adopting effective governance systems to enable centralized decision-making on key learning objectives and assessment approaches with full and mandatory participation from faculty leaders across all teaching campuses. 6,9,15,23 One such governance model is the Balanced Matrix Organization framework, which originated from the business field. This framework "promotes diverse input from across the organization, stimulates efficiency by combining resources, and encourages shared leadership towards common goals."…”

Section: Inputsmentioning

confidence: 99%

“…These activities were typical strategies for faculty and staff to discuss matters related to curriculum delivery, administration policies, scheduling student placements, enabling assessment activities, and reviewing student performances. 9,15,33 Such cooperative approaches were reported as allowing for consideration of different health priorities and resource availability across teaching sites in regional, rural, and community-based practice environments rather than using the central site as the gold standard against which other sites are measured. 37 We found little that spoke directly to educational activities being delivered to ensure comparability other than lectures that are synchronously delivered in classroom-based learning.…”

Section: Inputsmentioning

confidence: 99%

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Conceptualizing Educational Comparability in Distributed Health Professions Education: A Scoping Review

Hsu,

Martin,

Teunissen

et al. 2024

Acad Med

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Purpose This study aimed to create greater clarity about the current understanding and formulate a model of how educational comparability has been used in the literature to inform practice. Method The authors conducted a literature search of 9 online databases, seeking articles published on comparability in distributed settings in health professions education before August 2021, with an updated search conducted in May 2023. Using a structured scoping review approach, 2 reviewers independently screened articles for eligibility with inclusion criteria and extracted key data. All authors participated in the descriptive analysis of the extracted data. Results Twenty-four articles published between 1987 and 2021 met the inclusion criteria. Most articles were focused on medical education programs (n = 21) and located in North America (n = 18). The main rationale for discussing comparability was accreditation. These articles did not offer definitions or discussions about what comparability means. The program logic model was used as an organizing framework to synthesize the literature on practices that schools undertake to facilitate and demonstrate comparability in the design (inputs), implementation (activities), and evaluation (outcomes) of distributed education. Inputs include common learning objectives, identical assessment tools and policies, governance models that enable clear communication, and reporting structure that is supported by technological infrastructure. Activities include faculty planning meetings and faculty development training. Outcomes include student experiences and academic performances. Conclusions This study demonstrated that a more complex understanding of the dynamics of educational processes and practices is required to better guide the practice of educational comparability within distributed education programs. In addition to highlighting the need to develop an accepted definition of educational comparability, further elucidation of the underlying dynamics among input, activities, and outcomes would help to better determine what drivers should be prioritized when considering educational change with attention to context within distributed education.

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Comparing clerkship sites in a community-based medical school by evaluating studentsʼ undergraduate and postgraduate performances

Abstract: Virtually no differences in the students' performances on the undergraduate and postgraduate measures were found among sites for the two clerkships.

Cited by 5 publications

References 0 publications

Associations between residency selection strategies and doctor performance: a meta-analysis

Associations between residency selection strategies and doctor performance: a meta-analysis

Script Concordance Tests for Formative Clinical Reasoning and Problem-Solving Assessment in General Pediatrics

Conceptualizing Educational Comparability in Distributed Health Professions Education: A Scoping Review

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