Assessing the effectiveness of combining evaluation methods for the early identification of students with inadequate knowledge during a clerkship - PubMed
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. 2001 Oct;23(6):580-584.
doi: 10.1080/014215901200901023.
Assessing the effectiveness of combining evaluation methods for the early identification of students with inadequate knowledge during a clerkship
Paul A. Hemmer 
1
, Thomas Grau, Louis N. Pangaro
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1 Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine, Bethesda, MD, USA.
PMID:
12098479
DOI:
10.1080/014215901200901023
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Assessing the effectiveness of combining evaluation methods for the early identification of students with inadequate knowledge during a clerkship
Paul A. Hemmer et al.
Med Teach.
2001 Oct.
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. 2001 Oct;23(6):580-584.
doi: 10.1080/014215901200901023.
Authors
Paul A. Hemmer 
1
, Thomas Grau, Louis N. Pangaro
Affiliation
1 Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine, Bethesda, MD, USA.
PMID:
12098479
DOI:
10.1080/014215901200901023
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This study examined the predictive validity of in-clerkship evaluation methods to identify medical students who have insufficient knowledge. Study subjects were 124 third-year medical students at the Uniformed Services University. Insufficient knowledge was defined by: (1) a clerkship 'pre-test' score one standard deviation below the mean or lower; or (2) any teacher verbally rating a student's general knowledge as 'marginal' or less; or (3) a student did not pass Step One of the United States Medical Licensing Examination (USMLE). We determined sensitivity and specificity using a standard score of </= 300 on the end of clerkship National Board of Medical Examiners (NBME) subject examination in medicine as the outcome variable. Sixteen students scored </= 300 on the NBME examination. The sensitivity of the 'pre-test' or verbal comments alone was 44% (seven of 16 students). By combining methods, 11 students were identified, for a sensitivity of 69%. The specificity of all methods was > 90%. Using USMLE Step One pass-fail performance did not improve sensitivity. Combining a 'pre-test' and instructors' formal evaluation session comments improves the early identification of students with insufficient knowledge, allowing for formative feedback and remediation during the clerkship.
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