Varied clinical rotations and the shelf exam
Subspecialty exposure in a psychiatry clerkship does not improve student performance in the subject examination. Retamero C et al. Academic Psychiatry 2013; 37(3):179-181.
Reviewed by Gary Beck
What was the study question?
Does subspecialty psychiatry exposure improve NBME Psychiatry Subject Examination performance?
How was the study done?
The authors compared the NBME subject examination scores and individual examinee performance profile (EPP) data of 3rd-year medical students completing the psychiatry clerkship at two medical schools (Temple and Drexel Universities in Philadelphia) where students completed the rotations either entirely on an adult psychiatry unit, or divided between an adult and child unit, or divided between an adult unit and the emergency room. The authors categorized EPP data as 1=low, 2=average, and 3=high to obtain an average score for child, adult, and emergency topics from the subject examination. Comparisons were made between groups of students based on their clerkship rotations (adult only vs child/adult, etc.). The analysis was done by school and in aggregate.
What were the results?
When analyzing university-specific results or the combined data, no statistically significant findings were identified for any of the comparisons (Adult vs Child/Adult; Adult vs Adult/ER).
What are the implications of these findings?
As the authors note, results on a knowledge-based exam were independent of clinical experiences; therefore, fragmenting clerkship experiences may not be merited. This study reinforces the importance of providing clinical experiences that are supported by the course objectives.
Editor's note: Once again, it has been demonstrated that there is little correlation between clinical experiences on a core clerkship and performance on an end of the clerkship NBME subject examination (RR).