Clinical experiences of medical students in a pediatric clerkship and performance on the NBME subject test: are they related?

Abstract

The objective of this study was to determine whether medical students' clinical experiences in pediatrics impact on their performance on the National Board of Medical Examiners (NBME) pediatric subject test. The subjects were 118 George Washington University School of Medicine third-year medical students on their pediatric clerkship in the 1987-88 academic year. Students were instructed that they were expected to record prospectively major patient diagnoses based on their clinical experiences during the academic year. From these logs, the authors determined the four most common patient diagnoses the students recorded:(1) well baby/child;(2) neonates;(3) infectious diseases; and (4) trauma/poisoning. The authors examined the NBME pediatric subject test in 1987-88 and selected questions that reflected each of the four categories. We then sought statistical correlations of student examination performance and the clinical experiences they recorded. There were no statistically significant correlations between number of patients seen in a designated category and the NBME scores which assessed three of the four categories, the exception being the neonate.There were no statistical correlations between overall number of patients seen and the NBME subject test score. This study confirmed the authors' hypothesis that medical students'clinical experiences do not appear to have an impact on their performance on the NBME pediatric subject test. Using an objective, nationally standardized test such as the subject test as an end-of-clerkship evaluative tool measures some of the objectives of the clerkship, but it should not be used as the sole way to measure student performance.