Council on Medical Student Education in Pediatrics


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COMSEP Meeting in Ottawa, ON

Poster Presentation:

Does experiencing inpatient pediatrics first during Pediatric Clerkship impact student performance on the National Board of Medical Examiners Subject Exam?

Donnita K. Pelser,University of Kansas School of Medicine-Wichita,Wichita,KS,Judy A. Blair,University of Kansas School of Medicine-Wichita,Wichita,KS,Mark Harrison,University of Kansas School of Medicine-Wichita,Wichita,KS,Geri McFall,University of Kansas School of Medicine-Wichita,Wichita,KS,Matt Engel,,,


Third year medical students are given a summative exam to meet the standard requirements of the Liaison Committee on Medical Education (LCME). Students rotating through our Pediatrics Clerkship are required to take the NBME Pediatric Subject Exam with a minimum passing score of the fifth percentile. Pediatric Clerkship students are divided into two groups. One group begins inpatient, the second group begins outpatient. Groups switch at the end of three weeks. Students on inpatient, have longer days and three on-call shifts. Participants in the outpatient setting experience shorter work days, and weekends off.  

Many pediatric clerkships in the United States and Canada divide their clerkships into inpatient and outpatient portions. Additionally, student class sizes have risen in most medical schools. Given the increased class sizes and disparate features of the inpatient and outpatient components, the two groups of students may perform differently on end of clerkship standardized testing due to the order of the inpatient and outpatient rotations.  


Students beginning their pediatric clerkship with an inpatient rotation score higher than students beginning with the outpatient rotation,

Method and Results:

ANOVAS were used to compare NBME test scores across year and clerkship group for the past 5 years (2010-14). T-tests were used to compare NBME test scores between gender and whether student began on the inpatient or outpatient clerkship first.  Scores for students who started on the inpatient rotation (mean=76.4, SD=8.2) were not significantly different than scores for students who started on an outpatient rotation (mean=75.1, SD = 7.6) (p=0.167) Scores did not appear to differ by year (p=0.109) or by gender (p=0.990). Scores did differ significantly based on clerkship group. Specifically, it appears there was a difference between the first 4 groups and the last 4 groups, (p=0.004) with the last 4 groups scoring higher.


No significant differences were noted on how students are scheduled on the clerkship.  The only difference noted was that the last 4 groups of each academic year scored higher.