Comparison of medical student performance in summative undergraduate paediatric examinations and a clinician-designed minimum accepted competency (MAC) assessment

Patrick Mccrossan,Dara O’Donoghue,Alf Nicholson,Naomi Mccallion

doi:10.1186/s12909-021-02642-7

Patrick Mccrossan, Dara O’Donoghue + Show 2 more

Open Access

https://doi.org/10.1186/s12909-021-02642-7

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Abstract

BackgroundIt is recognised that newly qualified doctors feel unprepared in many areas of their daily practice and that there is a gap between what students learn during medical school and their clinical responsibilities early in their postgraduate career. This study aimed to assess if undergraduate students and junior paediatric doctors met a Minimum Accepted Competency (MAC) of knowledge.MethodsThe knowledge of undergraduates and junior paediatric doctors was quantitatively assessed by their performance on a 30-item examination (the MAC examination). The items within this examination were designed by non-academic consultants to test ‘must-know’ knowledge for starting work in paediatrics. The performance of the students was compared with their official university examination results and with the performance of the junior doctors.ResultsFor the undergraduate student cohort (n = 366) the mean examination score achieved was 45.9%. For the junior doctor cohort (n = 58) the mean examination score achieved was significantly higher, 64.2% (p < 0.01). 68% of undergraduate students attained the pass mark for the MAC examination whilst a significantly higher proportion, 97%, passed their official university examination (p < 0.01). A Spearman’s rank co-efficient showed a moderate but statistically significant positive correlation between students results in their official university examinations and their score in the MAC examination.ConclusionThis work demonstrates a disparity between both student and junior doctor levels of knowledge with consultant expectations from an examination based on what front-line paediatricians determined as “must-know” standards. This study demonstrates the importance of involvement of end-users and future supervisors in undergraduate teaching.

Highlights

It is recognised that newly qualified doctors feel unprepared in many areas of their daily practice and that there is a gap between what students learn during medical school and their clinical responsibilities early in their postgraduate career
A General Medical Council (GMC) report exploring the extent to which United Kingdom (UK) medical graduates are prepared for practice’ recognised that newly qualified doctors feel unprepared in many areas of their daily practice and recommended transition interventions, such as assistantships or work-shadowing, to address this [4]
This study aims to evaluate how undergraduate students perform in a knowledge-based examination set by non-faculty clinicians at a level that they deemed was “must -know”, i.e. the basic level of knowledge they would expect from a junior doctor (Senior House Officer (SHO)) starting in paediatrics

Summary

Introduction

It is recognised that newly qualified doctors feel unprepared in many areas of their daily practice and that there is a gap between what students learn during medical school and their clinical responsibilities early in their postgraduate career. Undergraduate curricula are generally designed to provide a broad base of paediatric knowledge for doctors in all fields, but there are potential difficulties [5]. A year’s experience working in general clinical practice may consolidate clinical skills, but it appears that undergraduate specialty knowledge is often poorly retained This could have implications for both undergraduate content and methods of learning and for postgraduate training programs and induction

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