a David Geffen School of Medicine , University of California , Los Angeles , CA , USA.
Med Teach. 2018 Dec;40(12):1287-1292. doi: 10.1080/0142159X.2018.1430353. Epub 2018 Feb 1.
Multiple undergraduate achievements have been used for graduate admission consideration. Their relative values in the prediction of residency performance are not clear. This study compared the contributions of major undergraduate assessments to the prediction of internship performance.
Internship performance ratings of the graduates of a medical school were collected from 2012 to 2015. Hierarchical multiple regression analyses were used to examine the predictive values of undergraduate measures assessing basic and clinical sciences knowledge and clinical performances, after controlling for differences in the Medical College Admission Test (MCAT).
Four hundred eighty (75%) graduates' archived data were used in the study. Analyses revealed that clinical competencies, assessed by the USMLE Step 2 CK, NBME medicine exam, and an eight-station objective structured clinical examination (OSCE), were strong predictors of internship performance. Neither the USMLE Step 1 nor the inpatient internal medicine clerkship evaluation predicted internship performance. The undergraduate assessments as a whole showed a significant collective relationship with internship performance (ΔR = 0.12, p < 0.001).
The study supports the use of clinical competency assessments, instead of pre-clinical measures, in graduate admission consideration. It also provides validity evidence for OSCE scores in the prediction of workplace performance.
多项本科成绩已被用于研究生入学考虑。它们在预测住院医师表现方面的相对价值尚不清楚。本研究比较了主要本科评估对实习表现预测的贡献。
从 2012 年至 2015 年收集医学院毕业生的实习表现评分。在控制 MCAT（医学院入学考试）差异后，使用层次多重回归分析来检验评估基础和临床科学知识以及临床表现的本科措施的预测值。
本研究使用了 480（75%）名毕业生的存档数据。分析显示，由 USMLE Step 2 CK、NBME 医学考试和八项客观结构化临床考试（OSCE）评估的临床能力是实习表现的有力预测因素。USMLE Step 1 或住院内科实习评估均不能预测实习表现。本科评估总体上与实习表现呈显著的整体关系（ΔR=0.12，p<0.001）。
该研究支持在研究生入学考虑中使用临床能力评估，而不是基础医学措施。它还为 OSCE 分数在预测工作场所表现方面提供了有效性证据。
