Poster5 - 02: PREDICTING SUCCESS: A COMPARATIVE ANALYSIS OF STUDENT PERFORMANCE ON THE SURGICAL CLERKSHIP AND THE NBME SURGERY SUBJECT EXAM
Jamil Jaber, BS1, Natasha Keric, MD2, Paul Kang, MS, MPH1, Ara Feinstein, MD2; 1University of Arizona College of Medicine Phoenix, 2Banner University Medical Center Phoenix
Introduction: The third-year surgical clerkship curriculum represents a significant change in the learning environment as compared to the first two years of medical education. During the surgical clerkship, benchmarks, objectives, and evaluations are superimposed on the complexities of clinical care. Subsequently, assessing student knowledge and understanding has proven challenging. The National Board of Medical Examiners (NBME) surgery subject examinations (Shelf) is a well-established objective assessment of student medical knowledge. Because it is administered at the end of the clerkship, the exam fails to identify students who are struggling with assimilating medical Knowledge. This retrospective study was designed to explore the predictive viability of weekly quizzes during a surgical clerkship with specific emphasis on the correlation between quiz performance and shelf exam scores. We hypothesized that weekly quiz scores would correlate with shelf exam performance.
Methods: Data was collected from internal records of 156 third-year students who participated in a 12-week surgical clerkship from 2015-2017, and was analyzed using Kruskal Wallis, Wilcoxon Rank Sum, and linear regression.
Results: NBME performance as a function of quiz scores showed that Trauma/Burns, Esophagus/Anorectal, and Wound/ICU content corresponded with β-coefficients of 1.57(p<0.001), 1.42(p<0.001), 1.38(p<0.001), respectively. The likelihood of scoring <70 points as a function of quiz performance showed that Wound/ICU and Cardio/Vascular content corresponded with an odds ratio of 0.75(p=0.03), and 0.68(p=0.02), respectively. Aggregate quiz scores stratified by academic block were calculated to be 67(IQR 64-69.5), 77(IQR 74.5-80), 76.5(IQR of 67-89.5), 83(IQR of 76-85) corresponding to academic blocks 1,2,3,and 4, respectively (P<0.001).
Discussion: This study demonstrates the viability of modeling surgical shelf exam outcomes as a function of weekly quiz performance during a 12-week surgery clerkship. Quizzes with content corresponding with Wound/ICU, Esophagus/Anorectal, and Trauma/Burns demonstrated a relative increase in surgical shelf exam performance. Wound/ICU and Cardio/Vascular quizzes were predictive of students scoring < 70 points on the surgical shelf exam. Students participating in the clerkship later in the third year have increased performance on weekly quizzes and the surgical shelf exam. These results may help to tailor educational efforts and identify students who may be at risk for poor shelf exam performance.