Comparing Surgical Clerkship Performance of Medical and Physician Assistant Students

Abstract

Third-year medical students (MS-III) and second-year physician assistant students (PA-S) have similar core clinical rotations during their education. Uniquely at our institution, both groups rotate together and are assessed by the same evaluation and grading standards. This study compares the performance of MS-III and PA-S during their combined surgical clerkship rotation. A retrospective analysis on students' final clerkship grades, individual grades for clinical performance evaluation, objective structured clinical examination, faculty tutorials, and National Board of Medical Education (NBME) general surgery examination for academic years 2013 and 2014. Statistical analysis using the Statistical Package for Social Sciences (SPSS) was used. A p < 0.05 was considered statistically significant. The study took place in the Department of Surgery at the University of Oklahoma School of Community Medicine, Tulsa, Oklahoma. All MS-III and PA-S that performed a clinical rotation in the Department of Surgery at the University of Oklahoma School of Community Medicine, Tulsa were included in the study. Fourth-year medical students on elective rotations were excluded. A total of 95 students were included, 51 MS-III and 44 PA-S. The results indicated that MS-III had statistically significant higher clinical performance evaluation (p = 0.005), NBME (p < 0.001), and tutorial scores (p = 0.03) as compared to PA-S. However, there were no statistically significant findings between final grades and objective structured clinical examination scores. In comparing 2013 to 2014 MS-III classes, no statistically significant differences existed, but the 2014 PA-S class had statistically significant higher NBME (p = 0.022) and tutorial scores (p = 0.015) as compared to 2013 PA-S class. MS-III performed better in tests evaluating medical knowledge, possibly a reflection of more in-depth different organ systems physiology and pathophysiology education that MS-III receive. No significant difference in clerkship performance was found. This could be attributed to similar clinical education both receiving as well as PA-S often having a history of prior professional health care experience. Over time of the study, PA-S performance seems to have improved. These observations might help to improve future curricula for MS-III as well as for PA-S.