Correlation of the NBME advanced clinical examination in EM and the national EM M4 exams

Critical Appraisal of Emergency Medicine Educational Research: The Best Publications of 2015

OBJECTIVE

The objectives were to critically appraise the medical education research literature of 2015 and review the highest-quality quantitative and qualitative examples.

METHODS

A total of 434 emergency medicine (EM)-related articles were discovered upon a search of ERIC, PsychINFO, PubMED, and SCOPUS. These were both quantitative and qualitative in nature. All were screened by two of the authors using previously published exclusion criteria, and the remaining were appraised by all authors using a previously published scoring system. The highest scoring articles were then reviewed.

RESULTS

Sixty-one manuscripts were scored, and 10 quantitative and two qualitative papers were the highest scoring and are reviewed and summarized in this article.

CONCLUSIONS

This installment in this critical appraisal series reviews 12 of the highest-quality EM-related medical education research manuscripts published in 2015.

Critical Appraisal of Emergency Medicine Educational Research: The Best Publications of 2015

OBJECTIVE

The objectives were to critically appraise the medical education research literature of 2015 and review the highest-quality quantitative and qualitative examples.

METHODS

A total of 434 emergency medicine (EM)-related articles were discovered upon a search of ERIC, PsychINFO, PubMED, and SCOPUS. These were both quantitative and qualitative in nature. All were screened by two of the authors using previously published exclusion criteria, and the remaining were appraised by all authors using a previously published scoring system. The highest scoring articles were then reviewed.

RESULTS

Sixty-one manuscripts were scored, and 10 quantitative and two qualitative papers were the highest scoring and are reviewed and summarized in this article.

CONCLUSIONS

This installment in this critical appraisal series reviews 12 of the highest-quality EM-related medical education research manuscripts published in 2015.

Faculty Evaluations Correlate Poorly with Medical Student Examination Performance in a Fourth-Year Emergency Medicine Clerkship

BACKGROUND

Clerkship directors routinely evaluate medical students using multiple modalities, including faculty assessment of clinical performance and written examinations. Both forms of evaluation often play a prominent role in final clerkship grade. The degree to which these modalities correlate in an emergency medicine (EM) clerkship is unclear.

OBJECTIVE

We sought to correlate faculty clinical evaluations with medical student performance on a written, standardized EM examination of medical knowledge.

METHODS

This is a retrospective study of fourth-year medical students in a 4-week EM elective at one academic medical center. EM faculty performed end of shift evaluations of students via a blinded online system using a 5-point Likert scale for 8 domains: data acquisition, data interpretation, medical knowledge base, professionalism, patient care and communication, initiative/reliability/dependability, procedural skills, and overall evaluation. All students completed the National EM M4 Examination in EM. Means, medians, and standard deviations for end of shift evaluation scores were calculated, and correlations with examination scores were assessed using a Spearman's rank correlation coefficient.

RESULTS

Thirty-nine medical students with 224 discrete faculty evaluations were included. The median number of evaluations completed per student was 6. The mean score (±SD) on the examination was 78.6% ± 6.1%. The examination score correlated poorly with faculty evaluations across all 8 domains (ρ 0.074-0.316).

CONCLUSION

Faculty evaluations of medical students across multiple domains of competency correlate poorly with written examination performance during an EM clerkship. Educators need to consider the limitations of examination score in assessing students' ability to provide quality patient clinical care.

Medical Student Performance on the National Board of Medical Examiners Emergency Medicine Advanced Clinical Examination and the National Emergency Medicine M4 Exams

INTRODUCTION

In April 2013, the National Board of Medical Examiners (NBME) released an Advanced Clinical Examination (ACE) in emergency medicine (EM). In addition to this new resource, CDEM (Clerkship Directors in EM) provides two online, high-quality, internally validated examinations. National usage statistics are available for all three examinations, however, it is currently unknown how students entering an EM residency perform as compared to the entire national cohort. This information may help educators interpret examination scores of both EM-bound and non-EM-bound students.

OBJECTIVES

The objective of this study was to compare EM clerkship examination performance between students who matched into an EM residency in 2014 to students who did not. We made comparisons were made using the EM-ACE and both versions of the National fourth year medical student (M4) EM examinations.

METHOD

In this retrospective multi-institutional cohort study, the EM-ACE and either Version 1 (V1) or 2 (V2) of the National EM M4 examination was given to students taking a fourth-year EM rotation at five institutions between April 2013 to February 2014. We collected examination performance, including the scaled EM-ACE score, and percent correct on the EM M4 exams, and 2014 NRMP Match status. Student t-tests were performed on the examination averages of students who matched in EM as compared with those who did not.

RESULTS

A total of 606 students from five different institutions took both the EM-ACE and one of the EM M4 exams; 94 (15.5%) students matched in EM in the 2014 Match. The mean score for EM-bound students on the EM-ACE, V1 and V2 of the EM M4 exams were 70.9 (n=47, SD=9.0), 84.4 (n=36, SD=5.2), and 83.3 (n=11, SD=6.9), respectively. Mean scores for non-EM-bound students were 68.0 (n=256, SD=9.7), 82.9 (n=243, SD=6.5), and 74.5 (n=13, SD=5.9). There was a significant difference in mean scores in EM-bound and non-EM-bound student for the EM-ACE (p=0.05) and V2 (p<0.01) but not V1 (p=0.18) of the National EM M4 examination.

CONCLUSION

Students who successfully matched in EM performed better on all three exams at the end of their EM clerkship.