Comparing the performance of graduate-entry and school-leaver medical students

Encouraging Study in Health Sciences: Informing School Students Through Interprofessional Healthcare Simulations

INTRODUCTION

Although commonly considered postgraduate-level study, universities are increasingly providing options for direct undergraduate entry into health professional programs. This presents a need to inform high school students about the wide variety of careers available in the medical and allied health professions.

METHODS

To accomplish this, the developed "Health Simulation Experience" uses a case-based learning approach to introduce high school students to careers in health through the management and care of simulated patients. Participants worked through 3 simulated scenarios during the 1-day event and reported their perceptions on written feedback forms at the conclusion. A qualitative research approach was used to identify whether the simulation-based structure was an appropriate approach to assist with enhancing their understanding of career options within the primary and allied healthcare systems.

RESULTS

Of the 528 student attendees who engaged with the program between 2018-2022, 333 provided ratings of their experience (94% overall satisfaction) and written feedback. From qualitative analysis of written comments, the following 3 key themes emerged: the approach provided insights into health professions careers; they enjoyed the authentic and immersive approach to learning; and the event developed an understanding of commonly performed clinical skills.

CONCLUSIONS

Overall, the use of case-based learning with interprofessional hands-on experiences is an effective approach to introduce students to future study options and career pathways in primary and allied health.

Comparison of Younger and Older medical student performance outcomes: A retrospective analysis in Japan

The present study examined the impact of age on medical student repeat-year experience and performance outcomes on the objective structured clinical examination (OSCE), Clinical Clerkship (CC), and other relevant examinations in the Japanese medical school system. This retrospective analysis examined the number of students with repeat-years and the years required to graduate, stratifying students by the age they entered medical school (Younger: within 4 years of high school graduation; Older: 5 or more years after high school graduation). Scores of the Pre-CC OSCE, Computer-based testing (CBT), CC performance, CC integrative test, and graduation exams were compared among those graduating from our medical school between 2018 and 2020, and examined correlations between student age and performance outcomes. From 2018 to 2020, 328 medical students graduated. Of these, 283 had entered within 4 years of high school graduation (Younger), while 45 did so 5 or more years after high school graduation (Older). The number of repeat-years did not differ significantly between groups. The average number of years required to graduate was slightly higher for the Older group and the Younger group scored significantly higher on the CC integrative test. No significant differences were found for the remaining tests. These results suggest that older medical students in general show no significant inferiority in their performance of most clinical skills and competencies relative to younger students in Japan.

A comparison of the academic performance of graduate entry and undergraduate entry pharmacy students at the course exit level

INTRODUCTION

Graduate entry (GE) pharmacy students are trained in a shorter timeframe than undergraduate entry (UE) students. This study compares the academic performance of GE and UE pharmacy students at the course exit point.

METHODS

A retrospective analysis of final exam grades in written and objective structured clinical examination (OSCE) was performed between GE and UE students from three graduating cohorts. Final written examination contained clinical case study questions, whereas OSCE involved role play with simulated patients or doctors. Statistical analyses were performed by t-test and one-way analysis of variance at .05 significance level and Pearson's correlation coefficient.

RESULTS

No significant difference in academic performance was seen between GE and UE groups at course exit (P > .05). There was a trend for GE students performing marginally better in OSCE than UE students. Females showed better performances in verbal communication than males. GE males showed significantly lower empathy scores than all other groups. No significant difference was seen in problem-solving scores amongst all groups. Both UE and GE groups scored significantly better in written examinations compared with OSCE.

CONCLUSIONS

Graduate entry pharmacy students from accelerated learning pathway and UE students performed similarly at the course exit point, providing empirical support for non-traditional graduate entry pathway as a viable option.

Relative progress and academic performance of graduate vs undergraduate entrants to an Australian medical school

BACKGROUND

Whether graduate entrants to medical school perform better academically than undergraduate entrants remains controversial. Differences in the discipline backgrounds of graduates may, at least in part, have accounted for differences in the results of comparative studies reported to date. This study aimed to address the dual issues of whether academic performance and progression rates were different between GE and UG students and the extent to which the discipline background of GE students may underpin any differences observed.

METHODS

Relative academic performance as well as indicators of student progression (supplementary examinations, repeat years, leave of absence, withdrawal from the programme) were compared between graduate entrants (GE) (N = 410) and both school leaver entrants (SLE) (N = 865) and non-standard entrants (some prior tertiary education) (NSE) (N = 148) who combined for the final 4 yr. of a 6 yr. MBBS undergraduate programme in 8 consecutive cohorts from 2006 to 2013 in Western Australia.

RESULTS

Examination scores were generally at or very close to a distinction grade or higher across all groups. Higher mean examination scores were seen for GE versus both SLE and NSE in the first 2 years with no significant differences in the final 2 years. GE from biological science / science backgrounds (N = 241) or physical science backgrounds (N = 26) performed the same as SLE and NSE throughout the programme. GE with a health / allied health background (N = 91), however, performed better throughout. They also performed better when compared to their GE counterparts from a humanities (N = 32) or a biological science / science background. GE had increased odds of withdrawing when compared to SLE (OR 2.50, 95% CI 1.30, 4.79, P = 0.006), but not compared to NSE. NSE had increased odds of repeating at least one level when compared to either GE (OR 2.74, 95% CI 1.21, 6.21, P = 0.016) or SLE (OR 4.10, 95% CI 1.93, 8.70, P < 0.001). There were no differences by entry category in the odds of sitting at least one supplementary examination during the programme. There was an increase in the odds of taking at least one leave of absence in both SLE (OR 2.55, 95% CI 1.79, 3.63, P < 0.001) and NSE (OR 2.47, 95% CI 1.50, 4.07, P < 0.001) compared to GE.

CONCLUSIONS

Better academic performance by GE compared to SLE and NSE was predominantly due to higher scores for GE with a health / allied health background. GE were also less likely to have impeded progress during the course.

Impact of accelerated, graduate-entry medicine courses: a comparison of profile, success, and specialty destination between graduate entrants to accelerated or standard medicine courses in UK

BACKGROUND

Little research has compared the profile, success, or specialty destinations of graduates entering UK medical schools via accelerated, 4-yr, standard 5-yr and 6-yr programmes. Four research questions directed this investigation:- What are the success rates for graduates entering graduate-entry vs. undergraduate medicine courses? How does the sociodemographic and educational profile differ between these two groups? Is success - in medical school and foundation training - dependent on prior degree, demographic factors, or aptitude test performance at selection? What specialty do graduate entry medicine students subsequently enter?

METHODS

The data from two cohorts of graduates entering medical school in 2007 and 2008 (n = 2761) in the UKMED (UK Medical Education Database) database were studied: 1445 taking 4-yr and 1150 taking 5-yr medicine courses, with smaller numbers following other programmes.

RESULTS

Completion rates for degree programmes were high at 95%, with no significant difference between programme types. 4-yr entrants were older, less likely to be from Asian communities, had lower HESA (Higher Education Statistics Agency) tariff scores, but higher UKCAT (UK Clinical Aptitude Test) and GAMSAT (Graduate Medical School Admissions Test) scores, than 5-yr entrants. Higher GAMSAT scores, black or minority ethnicity (BME), and younger age were independent predictors of successful completion of medical school. Foundation Programme (FPAS) selection measures (EPM - educational performance measure; SJT - situational judgment test) were positively associated with female sex, but negatively with black or minority ethnicity. Higher aptitude test scores were associated with EPM and SJT, GAMSAT with EPM, UKCAT with SJT. Prior degree subject, class of degree, HESA tariff, and type of medicine programme were not related to success.

CONCLUSIONS

The type of medicine programme has little effect on graduate entrant completion, or EPM or SJT scores, despite differences in student profile. Aptitude test score has some predictive validity, as do sex, age and BME, but not prior degree subject or class. Further research is needed to disentangle the influences of BME.

Predictors of academic performance in the discipline specific bioscience paper: A retrospective quantitative study [corrected]

INTRODUCTION

The cohort of students enrolled in the discipline-specific bioscience paper reflects a structural diversity in that it includes students of multiple ethnicities, varied age groups, differing scholastic and life experiences. These divergent identities of students are known to influence academic performance. The purpose of this retrospective quantitative study was to determine the ability of a set of variables such as age, gender, ethnicity, level of prior education, the place from which prior education was obtained, work experience and prior academic achievement to predict academic performance in the discipline-specific bioscience paper.

METHOD

The sample for this study was a purposive sample of all oral health students who had enrolled in the paper at the Auckland University of Technology from 2011 to 2014. The desensitised empirical data of 116 students from the University's database were subject to multivariable regression analysis. Pearson's correlation coefficients were calculated.

RESULTS

Prior academic achievement was a statistically significant predictor variable (P < 0.001) for the academic performance in the discipline-specific bioscience paper and was also positively correlated (r = 0.641, P < 0.001) to the grades in the discipline-specific bioscience paper.

CONCLUSION

Prior academic achievement was the only variable that was demonstrated to be correlated to and predictive of the academic performance in the discipline-specific bioscience paper.

Comparison of graduate-entry and direct school leaver student performance on an applied dental knowledge test

AIMS

To compare the academic performance of graduate-entry and direct school leavers in an undergraduate dental programme.

METHODS

This study examined the results of students in applied dental knowledge (ADK) progress tests conducted during two academic years. A mixed model analysis of variance (ANOVA) was conducted to compare the performance of graduate-entry and direct school leavers. ADK was treated as a repeated measures variable, and the outcome variable of interest was percentage score on the ADK.

RESULTS

The results show statistically significant main effects for ADK [F (1,113) = 61.58, P < 0.001, η²_p = 0.35], Cohort [F (1,113) = 88.57, P < 0.001, η²_p = 0.44] and Entry [F (1,113) = 11.31, P = 0.001, η²_p = 0.09]. That is, students do better on each subsequent test (main effect of ADK), students in later years of the programme perform better than those in earlier years (main effect of cohort), and graduate-entry students outperform direct school leavers.

CONCLUSIONS

This is the first study to explore the differences in the academic performance of graduate-entry and direct school leavers in an undergraduate dental programme. The results show that the academic performance of graduate students was better than the direct school leavers in years 2 and 3. Further research is required to compare the performance of students longitudinally across the entire duration of undergraduate dental programmes and evaluate whether this difference persists throughout.

Disadvantaged? Dual level learning in pre-registration graduate entry nursing and midwifery education: An evaluation

Preparation for health or social work professional registration is offered at undergraduate and postgraduate level and the requirement to co-teach is often resource and logistically mediated. This learning context creates opportunity to explore student perceptions of learning in dual level cohorts. Evaluative research of dual level learning is limited but suggests that the quality of learning experiences is influenced by factors such as establishing a cohort identity, managing individual perceptions of ability and the value of individual contributions to the cohort experience. Completing health care students from one HEI who were part of a co-taught cohort were asked to evaluate their learning experiences, using an anonymous questionnaire. A total of 81 undergraduate and 18 postgraduate students participated. All responses submitted were from Nursing and Midwifery programmes. Responses suggested lack of consistency in student expectations. Whilst the majority of undergraduates were satisfied with their experience, post graduate students were less so. Good practice in facilitation of learning was identified but was inconsistent and some undergraduates felt overawed by their post graduate peers. The findings of this small study suggest it is possible to achieve positive learning experiences for co taught cohorts but this requires careful and consistent planning and management.

High school versus graduate entry in a Saudi medical school - is there any difference in academic performance and professionalism lapses?

BACKGROUND

King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) was the first university in the Kingdom of Saudi Arabia offering both high school entry and graduate entry (GE) students into medical school. We compared the academic performance and professionalism lapses of high school entry and GE students who undertook the same curriculum and examinations in the College of Medicine, Riyadh, KSAU-HS.

METHODS

Examination scores of 196 high school graduates and 54 GE students over a 4-year period (2010-2014) were used as a measure of academic achievement. For assessment of professionalism lapses, we compared the number of warning letters in both streams of students.

RESULTS

In some pre-clinical courses, high school entry students performed significantly better than GE students. There was no significant difference in academic performance of high school entry and GE students in clinical rotations. GE students had a significantly greater number of warning letters per student as compared to high school entry students.

DISCUSSION

This is the first Saudi study to compare the performance of high school entry and GE students in a medical school. Overall, both streams of students performed equally well with high school entry students performing better than GE students in a few pre-clinical courses. We compared professionalism lapses and found an increase in number of warning letters for GE students. More studies are needed to evaluate if there are differences in other assessments of professionalism between these two streams of students.

Association between learning style preferences and anatomy assessment outcomes in graduate-entry and undergraduate medical students

An improved understanding of the relationship between anatomy learning performance and approaches to learning can lead to the development of a more tailored approach to delivering anatomy teaching to medical students. This study investigated the relationship between learning style preferences, as measured by Visual, Aural, Read/write, and Kinesthetic (VARK) inventory style questionnaire and Honey and Mumford's learning style questionnaire (LSQ), and anatomy and clinical skills assessment performance at an Irish medical school. Additionally, mode of entry to medical school [undergraduate/direct-entry (DEM) vs. graduate-entry (GEM)], was examined in relation to individual learning style, and assessment results. The VARK and LSQ were distributed to first and second year DEM, and first year GEM students. DEM students achieved higher clinical skills marks than GEM students, but anatomy marks did not differ between each group. Several LSQ style preferences were shown to be weakly correlated with anatomy assessment performance in a program- and year-specific manner. Specifically, the "Activist" style was negatively correlated with anatomy scores in DEM Year 2 students (rs = -0.45, P = 0.002). The "Theorist" style demonstrated a weak correlation with anatomy performance in DEM Year 2 (rs = 0.18, P = 0.003). Regression analysis revealed that, among the LSQ styles, the "Activist" was associated with poorer anatomy assessment performance (P < 0.05), while improved scores were associated with students who scored highly on the VARK "Aural" modality (P < 0.05). These data support the contention that individual student learning styles contribute little to variation in academic performance in medical students. Anat Sci Educ 9: 391-399. © 2016 American Association of Anatomists.

How Does Student Educational Background Affect Transition into the First Year of Veterinary School? Academic Performance and Support Needs in University Education

The first year of university is critical in shaping persistence decisions (whether students continue with and complete their degrees) and plays a formative role in influencing student attitudes and approaches to learning. Previous educational experiences, especially previous university education, shape the students' ability to adapt to the university environment and the study approaches they require to perform well in highly demanding professional programs such as medicine and veterinary medicine. The aim of this research was to explore the support mechanisms, academic achievements, and perception of students with different educational backgrounds in their first year of veterinary school. Using questionnaire data and examination grades, the effects upon perceptions, needs, and educational attainment in first-year students with and without prior university experience were analyzed to enable an in-depth understanding of their needs. Our findings show that school leavers (successfully completed secondary education, but no prior university experience) were outperformed in early exams by those who had previously graduated from university (even from unrelated degrees). Large variations in student perceptions and support needs were discovered between the two groups: graduate students perceived the difficulty and workload as less challenging and valued financial and IT support. Each student is an individual, but ensuring that universities understand their students and provide both academic and non-academic support is essential. This research explores the needs of veterinary students and offers insights into continued provision of support and improvements that can be made to help students achieve their potential and allow informed "Best Practice."

Medical student satisfaction, coping and burnout in direct-entry versus graduate-entry programmes

CONTEXT

There is ongoing debate regarding the optimal length of medical training, with concern about the cost of prolonged training. Two simultaneous tracks currently exist in Australia: direct entry from high school and graduate entry for students with a bachelor degree. Medical schools are switching to graduate entry based on maturity, academic preparedness and career-choice surety. We tested the assumption that graduate entry is better by exploring student preferences, coping, burnout, empathy and alcohol use.

METHODS

From a potential pool of 2188 participants, enrolled at five Australian medical schools, a convenience sample of 688 (31%) first and second year students completed a survey in the middle of the academic year. Participants answered questions about demographics, satisfaction and coping and completed three validated instruments.

RESULTS

Over 90% of students preferred their own entry-type, though more graduate-entry students were satisfied with their programme (82.4% versus 65.3%, p < 0.001). There was no difference between graduate-entry and direct-entry students in self-reported coping or in the proportion of students meeting criteria for burnout (50.7% versus 51.2%). Direct-entry students rated significantly higher for empathy (concern, p = 0.022; personal distress, p = 0.031). Graduate-entry students reported significantly more alcohol use and hazardous drinking (30.0% versus 22.8%; p = 0.017).

CONCLUSIONS

Our multi-institution data confirm that students are generally satisfied with their choice of entry pathway and do not confirm significant psychosocial benefits of graduate entry. Overall, our data suggest that direct-entry students cope with the workload and psychosocial challenges of medical school, in the first 2 years, as well as graduate-entry students. Burnout and alcohol use should be addressed in both pathways. Despite studies showing similar academic outcomes, and higher total costs, more programmes in Australia are becoming graduate entry. Further research on non-cognitive issues and outcomes is needed so that universities, government funders and the medical profession can decide whether graduate entry, direct entry, or a mix, is ideal.

The influence of academic discourses on medical students' identification with the discipline of family medicine

PURPOSE

To understand the influence of academic discourses about family medicine on medical students' professional identity construction during undergraduate training.

METHOD

The authors used a multiple case study research design involving international medical schools, one each from Canada, France, Spain, and the United Kingdom (UK). The authors completed the fieldwork between 2007 and 2009 by conducting 18 focus groups (with 132 students) and 67 semistructured interviews with educators and by gathering pertinent institutional documents. They carried out discursive thematic analyses of the verbatim transcripts and then performed within- and cross-case analyses.

RESULTS

The most striking finding was the diverging responses between those at the UK school and those at the other schools. In the UK case, family medicine was recognized as a prestigious academic discipline; students and faculty praised the knowledge and skills of family physicians, and students more often indicated their intent to pursue family medicine. In the other cases, family medicine was not well regarded by students or faculty. This was expressed overtly or through a paradoxical academic discourse that stressed the importance of family medicine to the health care system while decrying its lack of innovative technology and the large workload-to-income ratio. Students at these schools were less likely to consider family medicine.

CONCLUSIONS

These results stress the influence of academic discourses on medical students' ability to identify with the practice of family medicine. Educators must consider processes of professional identity formation during undergraduate medical training as they develop and reform medical education.

Exam Success at Undergraduate and Graduate-Entry Medical Schools: Is Learning Style or Learning Approach More Important? A Critical Review Exploring Links Between Academic Success, Learning Styles, and Learning Approaches Among School-Leaver Entry ("Traditional") and Graduate-Entry ("Nontraditional") Medical Students

PHENOMENON: The literature on learning styles over many years has been replete with debate and disagreement. Researchers have yet to elucidate exactly which underlying constructs are measured by the many learning styles questionnaires available. Some academics question whether learning styles exist at all. When it comes to establishing the value of learning styles for medical students, a further issue emerges. The demographics of medical students in the United Kingdom have changed in recent years, so past studies may not be applicable to students today. We wanted to answer a very simple, practical question: what can the literature on learning styles tell us that we can use to help today's medical students succeed academically at medical school?

APPROACH

We conducted a literature review to synthesise the available evidence on how two different aspects of learning-the way in which students like to receive information in a learning environment (termed learning "styles") and the motivations that drive their learning (termed learning "approaches")-can impact on medical students' academic achievement.

FINDINGS

Our review confirms that although learning "styles" do not correlate with exam performance, learning "approaches" do: those with "strategic" and "deep" approaches to learning (i.e., motivated to do well and motivated to learn deeply respectively) perform consistently better in medical school examinations. Changes in medical school entrant demographics in the past decade have not altered these correlations. Optimistically, our review reveals that students' learning approaches can change and more adaptive approaches may be learned. Insights: For educators wishing to help medical students succeed academically, current evidence demonstrates that helping students develop their own positive learning approach using "growth mind-set" is a more effective (and more feasible) than attempting to alter students' learning styles. This conclusion holds true for both "traditional" and graduate-entry medical students.

Comparison of performance in a four year graduate entry medical programme and a traditional five/six year programme

BACKGROUND

In 2006 the Royal College of Surgeons in Ireland, (RCSI), introduced the first four year Graduate Entry Programme (GEP) in medicine in Ireland in line with national policy to broaden access to medical education. One concern considered at the time, was whether the GEP students could be trained to the same standard as their undergraduate Direct Entry Programme (DEP, five/six year duration) counterparts in the shorter time frame. Since students from both cohorts undertake the same examinations in the final two years, it is possible to directly compare GEP vs DEP outcomes. The primary aim of the current study was to analyse the comparative performance of GEP and DEP students undergoing these examinations between 2008 and 2013.

METHODS

Scores from five assessments performed during the final two years were transformed to z scores for each student and 4 scores for the penultimate year were summed to create a unit weighted composite score. The resultant scores for each of the two years were used to assess the comparative performance of GEP vs DEP cohorts and to perform sub-cohort analyses of GEP outcomes.

RESULTS

In all cohorts/years examined, evidence demonstrated significantly better assessment outcomes for the GEP group for the final two years' examinations as compared with the DEP group. In all but one cohort examined, this advantage was retained when nationality factors were excluded. Further analyses showed no difference in outcomes between GEP students having science vs. non-science backgrounds and/or between those from EU vs non-EU backgrounds. Finally, data suggested weak correlations between total composite scores and entry scores in American (r = 0.15) and Australian (r = 0.08) medical school admissions tests.

CONCLUSIONS

We have shown for the first time in Ireland, that graduate-entry students perform at least as well, or even better, than a corresponding undergraduate-entry group. Moreover, having a scientific background on entry to the GEP confers no advantage in final assessments. These data provide evidence of the viability of the graduate entry route into medical education in Ireland.

Studying medicine - a cross-sectional questionnaire-based analysis of the motivational factors which influence graduate and undergraduate entrants in Ireland

Objectives

The number of places available in Ireland for graduate entry to medical school has steadily increased since 2006. Few studies have, however, characterized the motivational factors underlying decision to study medicine via this route. We compared the factors motivating graduate entrants versus undergraduate entry (UGE) students to choose medicine as a course of study.

Design

The present study was a quantitative cross-sectional questionnaire-based investigation.

Setting

The study was conducted in University College Cork and University of Limerick, Ireland.

Participants

It involved 185 graduate entry (GE) and 120 UGE students.

Outcome measures

Questionnaires were distributed to students addressing the following areas: demographic/academic characteristics; factors influencing the selection of academic institution and motivation to study medicine; and the role of career guidance in choice of study.

Results

When asked to list reasons for selecting medicine, both groups listed a wish to help and work with people, and a desire to prevent and cure disease. UGE students were significantly more motivated by intellectual satisfaction, encouragement by family/friends, financial reasons, and professional independence. Approximately half of GE students selected their first degree with a view to potentially studying medicine in the future. GE and UGE students differed significantly with respect to sources consulted for career guidance and source of study information.

Conclusions

This study is the first systematic examination of study and career motivation in GE medical students since the programme was offered by Irish universities and provides insight into the reasons why graduate entrants in Ireland choose to study medicine via this route.

Comparing the cognitive, personality and moral characteristics of high school and graduate medical entrants to the Tehran University of Medical Sciences in Iran

BACKGROUND

Tehran University of Medical Sciences has two streams of medical student admission: an established high school entry (HSE) route and an experimental graduate entry (GE) route.

AIM

To compare the cognitive skills, personality traits and moral characteristics of HSE and GE students admitted to this university.

METHODS

The personal qualities assessment tool (PQA; www.pqa.net.au ) was translated from English to Persian and then back-translated. Afterwards 35 individuals from the GE and 109 individuals from the 2007 to 2008 HSE completed the test. The results were compared by t-test and Chi-square.

RESULTS

The HSE students showed significantly higher ability in the cognitive skills tests (p < 0.001). They were also more libertarian (p = 0.022), but had lower ability to confront stress and unpleasant events (p < 0.001), and had lower self-awareness and self-control (p < 0.001).

CONCLUSION

On the basis of their personal qualities, the GE students had more self-control and strength when coping with stress than the HSE students, but the latter had superior cognitive abilities. Hence it may be useful to include cognitive tests in GE students' entry exam and include tests of personal qualities to exclude those with unsuitable characteristics.

Profiling strugglers in a graduate-entry medicine course at Nottingham: a retrospective case study

BACKGROUND

10-15% of students struggle at some point in their medicine course. Risk factors include weaker academic qualifications, male gender, mental illness, UK ethnic minority status, and poor study skills. Recent research on an undergraduate medicine course provided a toolkit to aid early identification of students likely to struggle, who can be targeted by established support and study interventions. The present study sought to extend this work by investigating the number and characteristics of strugglers on a graduate-entry medicine (GEM) programme.

METHODS

A retrospective study of four GEM entry cohorts (2003-6) was carried out. All students who had demonstrated unsatisfactory progress or left prematurely were included. Any information about academic, administrative, personal, or social difficulties, were extracted from their course progress files into a customised database and examined.

RESULTS

362 students were admitted to the course, and 53 (14.6%) were identified for the study, of whom 15 (4.1%) did not complete the course. Students in the study group differed from the others in having a higher proportion of 2ii first degrees, and scoring less well on GAMSAT, an aptitude test used for admission. Within the study group, it proved possible to categorise students into the same groups previously reported (struggler throughout, pre-clinical struggler, clinical struggler, health-related struggler, borderline struggler) and to identify the majority using a number of flags for early difficulties. These flags included: missed attendance, unsatisfactory attitude or behaviour, health problems, social/family problems, failure to complete immunity status checks, and attendance at academic progress committee.

CONCLUSIONS

Problems encountered in a graduate-entry medicine course were comparable to those reported in a corresponding undergraduate programme. A toolkit of academic and non-academic flags of difficulty can be used for early identification of many who will struggle, and could be used to target appropriate support and interventions.

Selection of student-selected component [SSCs] modules across the medical undergraduate curriculum: relationship with motivational factors

Student-selected components (SSCs) encourage the following within the undergraduate medical curriculum: greater exploration of core curriculum topics; exploration of non-core subjects/experiences; research and self-directed learning; and personal and professional development opportunities. This study examined the motivational factors which influence SSC choice to assess (a) SSC selection patterns across each year of the curriculum (direct and graduate entry) and (b) motivation underlying SSC selection across the curriculum. During SSC registration at University College Cork, all medical undergraduates (years 1-3, graduate-entry medicine) were required to select an SSC and provide a written justification for their selection. Five primary motivational factors were identified: correction of perceived deficits; genuine interest in subject and wish to study in more depth; career strategy; exam strategy; and taking a chance. A complex pattern of relationships emerged in relation to matching of motivational factors with SSC categories, e.g. selection of research skills SSCs was strongly associated with the 'career strategy' motivation. Significant differences were observed across curriculum years, as well as between direct-entry versus graduate-entry undergraduates, with respect to SSC selections and underlying motivation. This study provides insight into changing patterns of SSC selection in medicine, as well as accompanying motivational factors, across the undergraduate years.

Clinical assessment performance of graduate- and undergraduate-entry medical students

BACKGROUND

Recent evidence suggests that graduate-entry medical students may have a marginal academic performance advantage over undergraduate entrants in a pre-clinical curriculum in both bioscience knowledge and clinical skills assessments. It is unclear whether this advantage is maintained in the clinical phase of medical training.

AIM

The study aimed to compare graduate and undergraduate entrants undertaking an identical clinical curriculum on assessments undertaken during clinical training in the medical course.

METHODS

Clinical assessment results for four cohorts of medical students (n = 713) were compared at the beginning and at the end of clinical training for graduate and undergraduate entrants.

RESULTS

Results showed that graduate- and undergraduate-entry medical students performed similarly on clinical assessments. Female students performed consistently better than male students.

CONCLUSION

The findings of this study suggest that any academic performance advantage held by graduate-entry medical students is limited to the early years of the medical course, and is not evident during clinical training in the later years of the course.

Predicting success in graduate entry medical students undertaking a graduate entry medical program

BACKGROUND

Success in undergraduate medical courses in the UK can be predicted by school exit examination (A level) grades. There are no documented predictors of success in UK graduate entry medicine (GEM) courses. This study looks at the examination performance of GEM students to identify factors which may predict success; of particular interest was A level score.

METHODS

Data was collected for students graduating in 2004, 2005 and 2006, including demographic details (age and gender), details of previous academic achievement (A level total score and prior degree) and examination results at several points during the degree course.

RESULTS

Study group comprised 285 students. Statistical analyses identified no significant variables when looking at clinical examinations. Analysis of pass/fail data for written examinations showed no relationship with A level score. However, both percentage data for the final written examination and the analysis of the award of honours showed A level scores of AAB or higher were associated with better performance (p<0.001).

DISCUSSION

A prime objective of introducing GEM programs was to diversify admissions to medical school. In trying to achieve this, medical schools have changed selection criteria. The findings in this study justify this by proving that A level score was not associated with success in either clinical examinations or passing written examinations. Despite this, very high achievements at A level do predict high achievement during medical school.

CONCLUSIONS

This study shows that selecting graduate medical students with the basic requirement of an upper-second class honours degree is justifiable and does not disadvantage students who may not have achieved high scores in school leaver examinations.

Learning opportunities in the clinical setting (LOCS) for medical students: A novel approach

INTRODUCTION

Graduate-entry medical programmes (GEP) have been introduced into many UK universities. Their shortened 4-year programme may restrict exposure to the clinical environment. The GEP at Swansea University has introduced Learning Opportunities in the Clinical Setting (LOCS), a novel approach, allowing students to choose half day sessions from a list which aimed at bringing experiential clinical learning to first and second year students on the course.

METHODS

During the academic years 2007-2008 and 2008-2009, student feedback was collected anonymously online with the options 'very useful', 'useful' or 'not useful' followed by a free text box space to feedback their experience. The text was assessed using qualitative analysis methodology.

RESULTS

A total of 730 LOCS feedback comments were analysed, 422 were recorded as 'very useful' (58%), 276 were 'useful' (38%) and 32 'not useful' (4%). Students' feedback were divided into positive (1330) and negative (152) comments. Positive themes were broadly divided into four categories: Positive Teacher experience, Positive Clinical experience, Relevance to the course and significant Personal Development.

CONCLUSION

The LOCS system provides an efficient method of providing students with a choice of additional learning opportunities which has proved popular and, in the opinion of students, educationally effective.