Abstract
Introduction: The National Board of Medical Examiners (NBME) subject examinations are used as a standardized metric for performance in required clerkships for third-year medical students. While several medical schools have implemented a review session to help consolidate knowledge acquired during the clerkship, the effects of such an intervention are not yet well-established. An improvement in NBME psychiatry examination scores has previously been reported with a single end-of-clerkship review session, but this was limited by a small sample size and the fact that attendance at the review session was optional, leading to likely selection bias. Methods: A 1.5-hour structured review session was conducted for medical students in the last week of each 4-week psychiatry clerkship between September 2014 and July 2015. Students were required to attend unless excused due to scheduling conflicts. Scores on the NBME psychiatry subject exam were compared with those of students taking the examination in the corresponding time period in each of the previous two academic years. Results: 83 students took the exam during the experimental period, while 176 took the exam during the control period. Statistically significant improvements were found in mean score (p=0.03), mean for the two lowest scores in each group (p<0.0007), and percentage of students scoring 70 or less (p=0.03).Percentage of students achieving the maximum possible score (99) was higher in the experimental group, but did not reach significance (p=0.06). Conclusions: An end-of-clerkship review session led to increased mean scores on the NBME psychiatry subject examination, particularly for students at the lower end of the score range. Future research should investigate the impact of such an intervention in other specialties and other institutions.
Highlights
The National Board of Medical Examiners (NBME) subject examinations are used as a standardized metric for performance in required clerkships for third-year medical students
An end-of-clerkship review session led to increased mean scores on the NBME psychiatry subject examination, for students at the lower end of the score range
The National Board of Medical Examiners (NBME) subject examinations are widely used in North America as a means of assessing overall performance and potential need for remediation in required third-year medical student clerkships; their utility is rooted in the fact that they provide a standardized and objective measure of knowledge acquired during the clerkship[1]
Summary
The National Board of Medical Examiners (NBME) subject examinations are used as a standardized metric for performance in required clerkships for third-year medical students. While the utility of NBME examinations for internal evaluation of students has been questioned[2], this notion is challenged by the findings that performance on these examinations is correlated with other measures of a medical student’s knowledge base[3,4], suggesting that higher scores are associated with improved overall educational outcomes. A single end-of-clerkship review session for the subject examination has demonstrated an increase in scores, but this study was limited by a relatively small sample size, which limited the range of outcomes that could be effectively measured, and by potential selection bias, since attendance at the session was not mandatory[11]. We investigated the impact of a single review session with a larger sample size and with mandatory attendance
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