Predictors of medical school clerkship performance: a multispecialty longitudinal analysis of standardized examination scores and clinical assessments

Abstract

BackgroundEvidence suggests that poor performance on standardized tests before and early in medical school is associated with poor performance on standardized tests later in medical school and beyond. This study aimed to explore relationships between standardized examination scores (before and during medical school) with test and clinical performance across all core clinical clerkships.MethodsWe evaluated characteristics of 435 students at Mayo Medical School (MMS) who matriculated 2000–2009 and for whom undergraduate grade point average, medical college aptitude test (MCAT), medical school standardized tests (United States Medical Licensing Examination [USMLE] 1 and 2; National Board of Medical Examiners [NBME] subject examination), and faculty assessments were available. We assessed the correlation between scores and assessments and determined USMLE 1 cutoffs predictive of poor performance (≤10th percentile) on the NBME examinations. We also compared the mean faculty assessment scores of MMS students vs visiting students, and for the NBME, we determined the percentage of MMS students who scored at or below the tenth percentile of first-time national examinees.ResultsMCAT scores correlated robustly with USMLE 1 and 2, and USMLE 1 and 2 independently predicted NBME scores in all clerkships. USMLE 1 cutoffs corresponding to poor NBME performance ranged from 220 to 223. USMLE 1 scores were similar among MMS and visiting students. For most academic years and clerkships, NBME scores were similar for MMS students vs all first-time examinees.ConclusionsMCAT, USMLE 1 and 2, and subsequent clinical performance parameters were correlated with NBME scores across all core clerkships. Even more interestingly, faculty assessments correlated with NBME scores, affirming patient care as examination preparation. USMLE 1 scores identified students at risk of poor performance on NBME subject examinations, facilitating and supporting implementation of remediation before the clinical years. MMS students were representative of medical students across the nation.

Identifying and Supporting Students at Risk of Failing the National Medical Licensure Examination in Japan Using a Predictive Pass Rate

“…Step 1 score as one of the predictors of performance after Step 1. [8][9][10][11][22][23][24][25][26] The latter may be correlated to our result for CBT. Most studies including the study by Koenig et al 22 have indicated that a high score in…”

“…Step 1 is a predictor of success in many elds in the medical profession (i.e., internal medicine, dermatology, ophthalmology, orthopedic surgery, gynecology, and family medicine), [8][9][10][11][23][24][25] with some opposite results 27,28 . Casey et al 26 noted that the medical college aptitude test (MCAT), Step 1 and Step 2, and subsequent clinical performance parameters correlated with NBME scores across all core clinical clerkships. They also emphasized that Step 1 scores identi ed students at risk of poor performance in NBME subject examinations, facilitating and supporting implementation of remediation before clinical years.…”

Mediators of Racial/Ethnic Disparities in Mentored K Award Receipt Among U.S. Medical School Graduates

“…25 Step l and Step 2 CK scores, which are only two of numerous measures of medical school academic performance, are not themselves part of the K award review process; however, these standardized test scores correlate with other pre-clinical and clinical medical school academic-performance measures. 26–28 Although Step scores have been noted to have limited ability to predict success in clinical medicine or biomedical research, 29 these scores (particularly Step l) are extensively used in the GME resident selection process. 29–31 Of 33 factors used by program directors to select applicants to interview for their programs, Step l score was the most frequently used factor, cited by 94% of 1,793 Program Director Survey respondent.…”

Predicting United States Medical Licensure Examination Step 2 clinical knowledge scores from previous academic indicators

“…This was our rationale for not dichotomizing students into “in danger” or “not in danger.” A recent study by Casey et al used cutoff scores for USMLE Step 1 to predict NBME subject exam scores below the 10th percentile based on sensitivity and specificity. This is a model that we may decide to use in the future as we accumulate additional student data 17. Finally, the projected student scores and the actual student scores should be continuously compared over time to determine the reliability of these models.…”