Amanda E Pope, M.S., B.S. - Creighton University School of Medicine; John W Schmidt, M.D. - Creighton University School of Medicine
Title: Evaluation of Pediatric Shelf Exam Performance – Do consistent weaknesses exist?
Background: Third year medical students at Creighton University School of Medicine participate in a pediatric clerkship which culminates in the pediatric NBME shelf exam. The exam results provide information indicating the percentage of students that correctly answer each exam question. The results also note which specific NBME content area each question addresses. We sought to utilize the information to evaluate for areas of weakness among each clerkship group and to see if the weaknesses were different between groups.
Methods: We analyzed the shelf exam results for each clerkship group (approximately 20 students per group) over an academic year. Each question was categorized according to USMLE Step 2 content areas. If eighty percent of test-takers from Creighton did not correctly answer the majority of questions from a content area, it was deemed a weak content area. We compared the weak areas between clerkship groups.
Results: We found that areas of weakness were extremely consistent amongst each clerkship group. The four weak content areas were: diseases of the respiratory system; diseases of the nervous system and special senses; renal, urinary, and male reproductive sytems; and nutrition and digestive disorders.
Discussion: Since the weak areas were so consistent among each clerkship group, the findings may point to a primary deficiency in student education during the first two years of medical education or lapses in the pediatric clerkship curriculum. The clerkship curriculum was modified to focus attention on the weak areas. This was achieved by emphasizing common illnesses within each organ system, assigning corresponding CLIPP cases, and incorporating appropriate readings and board-style questions. The clerkship groups utilizing the revised curriculum are currently being evaluated to determine if the students improve their knowledge in the weak content areas.