Comprehensive undergraduate medical assessments improve prediction of clinical performance.

OBJECTIVES

This study aimed to compare an essay-style undergraduate medical assessment with modified essay, multiple-choice question (MCQ) and objective structured clinical examination (OSCE) undergraduate medical assessments in predicting students' clinical performance (predictive validity), and to determine the relative contributions of the written (modified essay and MCQ) assessment and OSCE to predictive validity.

DESIGN

Before and after cohort study.

SETTING

One medical school running a 6-year undergraduate course.

PARTICIPANTS

Study participants included 137 Year 5 medical students followed into their trainee intern year.

MAIN OUTCOME MEASURES

Aggregated global ratings by senior doctors, junior doctors and nurses as well as comprehensive structured assessments of performance in the trainee intern year.

RESULTS

Students' scores in the new examinations predicted performance significantly better than scores in the old examinations, with correlation coefficients increasing from 0.05-0.44 to 0.41-0.81. The OSCE was a stronger predictor of subsequent performance than the written assessments but combining assessments had the strongest predictive validity.

CONCLUSION

Using more comprehensive, more reliable and more authentic undergraduate assessment methods substantially increases predictive validity.