Durning Steven J, Dong Ting, Hemmer Paul A, Gilliland William R, Cruess David F, Boulet John R, Pangaro Louis N
Department of Medicine, Uniformed Services University of the Health Sciences,4301 Jones Bridge Road, Bethesda, MD 20814.
F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
Mil Med. 2015 Apr;180(4 Suppl):18-23. doi: 10.7205/MILMED-D-14-00569.
To determine if there is an association between several commonly obtained premedical school and medical school measures and board certification performance. We specifically included measures from our institution for which we have predictive validity evidence into the internship year. We hypothesized that board certification would be most likely to be associated with clinical measures of performance during medical school, and with scores on standardized tests, whether before or during medical school.
Achieving board certification in an American Board of Medical Specialties specialty was used as our outcome measure for a 7-year cohort of graduates (1995-2002). Age at matriculation, Medical College Admissions Test (MCAT) score, undergraduate college grade point average (GPA), undergraduate college science GPA, Uniformed Services University (USU) cumulative GPA, USU preclerkship GPA, USU clerkship year GPA, departmental competency committee evaluation, Internal Medicine (IM) clerkship clinical performance rating (points), IM total clerkship points, history of Student Promotion Committee review, and United States Medical Licensing Examination (USMLE) Step 1 score and USMLE Step 2 clinical knowledge score were associated with this outcome.
Ninety-three of 1,155 graduates were not certified, resulting in an average rate of board certification of 91.9% for the study cohort. Significant small correlations were found between board certification and IM clerkship points (r = 0.117), IM clerkship grade (r = 0.108), clerkship year GPA (r = 0.078), undergraduate college science GPA (r = 0.072), preclerkship GPA and medical school GPA (r = 0.068 for both), USMLE Step 1 (r = 0.066), undergraduate college total GPA (r = 0.062), and age at matriculation (r = -0.061). In comparing the two groups (board certified and not board certified cohorts), significant differences were seen for all included variables with the exception of MCAT and USMLE Step 2 clinical knowledge scores. All the variables put together could explain 4.1% of the variance of board certification by logistic regression.
This investigation provides some additional validity evidence that measures collected for purposes of student evaluation before and during medical school are warranted.
确定医学院预科阶段和医学院阶段获取的多项常见指标与委员会认证表现之间是否存在关联。我们特别纳入了本校在实习年具有预测效度证据的指标。我们假设委员会认证最有可能与医学院阶段的临床表现指标以及标准化考试成绩相关,无论这些考试是在医学院预科阶段还是医学院阶段进行。
以美国医学专业委员会某专业的委员会认证作为1995年至2002年这7年毕业人群的结局指标。入学年龄、医学院入学考试(MCAT)成绩、本科院校平均绩点(GPA)、本科院校理科GPA、军医大学(USU)累积GPA、USU临床前GPA、USU临床实习年GPA、科室能力委员会评估、内科(IM)临床实习临床表现评分(分数)、IM临床实习总分、学生晋升委员会审查记录,以及美国医师执照考试(USMLE)第一步成绩和USMLE第二步临床知识成绩均与该结局相关。
1155名毕业生中有93人未获得认证,研究队列的委员会认证平均率为91.9%。委员会认证与IM临床实习分数(r = 0.117)、IM临床实习成绩(r = 0.108)、临床实习年GPA(r = 0.078)、本科院校理科GPA(r = 0.072)、临床前GPA和医学院GPA(两者均为r = 0.068)、USMLE第一步(r = 0.066)、本科院校总GPA(r = 0.062)以及入学年龄(r = -0.061)之间存在显著的小相关性。在比较两组(获得委员会认证和未获得委员会认证的队列)时,除了MCAT和USMLE第二步临床知识成绩外,所有纳入变量均存在显著差异。通过逻辑回归分析,所有变量综合起来可解释委员会认证方差的4.1%。
本调查提供了一些额外的效度证据,表明为医学院预科阶段和医学院阶段学生评估目的而收集的指标是有必要的。