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It’s not just a game!
Twenty Questions game performance on medical school entrance predicts clinical performance.
RG Williams et al. Medical Education 2015;49:920-927

Reviewed by Srividya Naganathan

What was the study question?
Does performance on Twenty Questions (TQ) game at medical school entrance predict performance on clinical competence exam near graduation?

How was the study done?
This was a prospective longitudinal, observational cohort study performed at Southern Illinois University School of medicine. A total of 67 students out of a class of 72 participated in a single game of a non- medical topic TQ during the first week of medical school. All students were required to complete and pass the senior clinical competence exam (SCCX) prior to graduation (during the fourth year) which consisted of 14 cases based on common chief complaints and diagnosis. Students were also required to complete a diagnosis justification (DJ) exercise for 8 of the cases. Performance on TQ task was compared to performance on SCCX with special emphasis on DJ.

What were the results?

  1. There was no difference in the SCCX performance among students who identified the correct answer on the TQ task compared to those who did not.
  2. Most students who used a logical approach to the TQ task scored in the top half of the class on SCCX, had higher DJ case score and 100% passed the exam.
  3. Students who did not identify the correct answer on TQ but persevered and asked all the 20 questions passed more SCCX cases than those who did not complete the task.
  4. Approach to task was a better predictor of DJ performance than the MCAT score.

What are the implications of these findings?
Students’ approach to TQ task may be predictor of how they process, organize and use knowledge acquired during medical school training. TQ task process can be incorporated into the mini medical interviews during the admission process.

Editor’s note: That perseverance and a logical approach to a childhood game was predictive of performance on the clinical exam is fascinating. I’ve recommended to the UofC admissions committee that they consider this as an MMI station (SLB).

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