Are Clerks Proficient in the Basic Sciences? Assessment of Third‐Year Medical Students’ Basic Science Knowledge Retention and Reinforcement

Abstract

IntroductionBasic sciences (anatomy, biochemistry, microbiology, pathology, pharmacology, physiology) are a cornerstone of undergraduate medical education (UME), as they provide a foundation for the development of clinical science knowledge and clinical reasoning skills. However, studies demonstrate that medical students’ basic science knowledge is not well retained. This lack of knowledge retention may also be contributing to the lack of proficiency of current trainees reported by clinical facilitators. Based on this evidence, there is a need for an educational model that ensures students are retaining fundamental basic science concepts prior to entering clerkship. Thus, the purpose of this study was to establish third‐year (clerks) medical students’ basic science knowledge retention and reinforcement during clerkship year.MethodsA basic science assessment was created for each clerkship rotation (family medicine, psychiatry, paediatrics, obstetrics and gynaecology (OB/GYN), surgery, internal medicine). Assessments were distributed as a pre‐ and post‐test for each rotation to assess clerks’ knowledge retention and reinforcement of basic science concepts. i) Clerkship groups’ pre‐test scores were analyzed using an Analysis of Variance (ANOVA) to determine if rotation order had an effect on clerks’ performance, and ii) post‐test scores were compared (ANOVA) to establish if there were any differences between clerkship groups. iii) Pre‐test data was organized into quartiles, following which post‐test scores were analyzed (ANOVA, paired t‐test) to determine if the improvement of post‐test scores was influenced by pre‐test performance.Resultsi) There were no significant differences between group’s pre‐test scores regardless of rotation order ii) Data revealed no differences between clerkship groups’ pre‐test scores or post‐test scores (p>0.05). iii) Only the students falling in the lower quartiles on the pre‐test, demonstrated a significant improvement on the post‐test in all six clerkship rotations (p≤0.05).ConclusionsResults indicate that rotation order had no effect on clerks’ pre‐test performance, suggesting that clerks’ basic science knowledge retention was not influenced by their prior clerkship experience. Our data also revealed that there were no differences between clerkship groups’ pre‐ and post‐test scores suggesting that all groups are comparable. Finally, we revealed that low performing students (pre‐test) demonstrated the greatest knowledge gain on the post‐test following each rotation, indicating that the clinical experience of clerkship reinforced fundamental basic science concepts. Overall, the findings of our research indicate that earlier clinical exposure may enhance low performing students’ basic science knowledge. Thus, future research should explore the influence of early integration between the basic sciences and clinical experiences on medical students’ clerkship performance.Support or Funding InformationOntario Graduate Scholarship, American Association for Anatomy Education Research Scholarship