Surgical clerkship or medical clerkship first: Does it make a difference?

The Impact of Shortened Clinical Clerkships on Medical Student Performance and Clerkship Assessment

INTRO

Medical schools sometimes need to adjust the length of third-year clinical clerkships. The literature surrounding the effects of shortened clerkships on student experience and performance is mixed.

METHODS

Our medical school shortened the third year by an average of 20% per clerkship to accommodate a curricular re-design in 2018-2019. We examined test scores and measures of clinical performance as well as student experience in order to understand the impact of this change.

RESULTS

Two hundred and eight students were included in the analysis, 104 in each cohort. No statistically significant differences were noted between cohorts on NBME subject examination results. There were no significant differences on Step 2 CK scores between the traditional curriculum cohort (M = 249.4, SD = 13.7) and shortened curriculum cohort (M = 248.7, SD = 15.8). Student performance on OSCE cases was similar. Similar percentages of students rated each clerkship either "good" or "excellent" in the traditional (77%) and shortened (78%) curriculum.

CONCLUSION

There was no significant impact on student test scores after shortening the curriculum. Measures of student satisfaction and experience also remained stable, likely related to emphasis on retaining patient care experiences and streamlining of didactics. Curricular shortening during the third year of medical school was feasible and safe from the student perspective in our experience.

Artificial intelligence-tutoring problem-based learning in ophthalmology clerkship

Background

Artificial intelligence (AI) is an increasingly popular tool in medical investigations. However, AI’s potential of aiding medical teaching has not been explored. This study aimed to evaluate the effectiveness of AI-tutoring problem-based-learning (PBL) in ophthalmology clerkship and to assess the student evaluations of this module.

Methods

Thirty-eight Grade-two students in ophthalmology clerkship at Sun Yat-Sen University were randomly assigned to two groups. In Group A, students learned congenital cataracts through an AI-tutoring PBL module by exploring and operating an AI diagnosis platform. In Group B, students learned congenital cataracts through traditional lecture given with the same faculty. The improvement in student performance was evaluated by comparing the pre- and post-lecture scores of a specific designed test using paired-T tests. Student evaluations of AI-tutoring PBL were measured by a 17-item questionnaire.

Results

The post-lecture scores were significantly higher than the pre-lecture scores in both groups (Group A: P<0.0001, Group B: P<0.0001). The improvement of group A in the part of sign and diagnosis test (Part I) was more significant than that of group B (P=0.016). However, there was no difference in the improvement in the part of treatment plan test (Part II) between two groups (P=0.556). Overall, all respondents were satisfied and agreed that AI-tutoring PBL was helpful, effective, motive and beneficial to help develop critical and creative thinking.

Conclusions

The application of AI-tutoring PBL into ophthalmology clerkship improved students’ performance and satisfaction. AI-tutoring PBL teaching showed advantage in promoting students’ understanding of signs of diseases. The instructors play an indispensable role in AI-tutoring PBL curriculum.

Best Study Strategy for the NBME Clinical Science Surgery Exam

INTRODUCTION

Providing medical students with effective study strategies is paramount in fostering their success on the NBME Clinical Science Surgery exam. As of yet, there has not been a comprehensive inquiry into a study strategy for this exam. We aim to identify if the following are associated with higher NBME raw exam scores: (1) the use of popular study materials, (2) the number of study materials used, and (3) the amount of time spent studying throughout the clerkship.

METHODS

Over the period of 1 academic year, third-year medical students at our institution were administered a survey during their surgical clerkship inquiring about study materials used and hours spent studying per week. The data were then matched to students' raw NBME scores and then depersonalized. A total of 82 of 193 (42%) students responded with an overall average raw score of 76.74 on the NBME Clinical Science Surgery exam. By comparing our data to the NBME national average of 70 with a standard deviation of 8, a z test was used to compare the population mean to our sample means.

RESULTS

When investigating resources used, the combination of using an online question bank and a high yield review book yielded a high z score (6.23) and using 4 resources yielded the highest z score (6.28). Regarding study hours, the highest z scores were seen when students studied for 6 to 10 hours per week during the first half of the clerkship, and 11 to 15 hours per week during the second half of the clerkship (5.76 and 6.02, respectively).

CONCLUSIONS

In conclusion, higher NBME Clinical Science Surgery exam scores were correlated with the use of multiple and varied types of resources and increasing study time closer to the exam date. The resources and methods utilized by students achieving the highest exam scores can be recommended by surgical educators and employed by other medical students to foster academic success.