Chang Chi, Laird-Fick Heather S, Mitchell John D, Parker Carol, Solomon David
Office of Medical Education Research and Development, and Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
Ann Med. 2025 Dec;57(1):2443812. doi: 10.1080/07853890.2024.2443812. Epub 2024 Dec 28.
This study quantified the impact of clinical clerkships on medical students' disciplinary knowledge using the Comprehensive Clinical Science Examination (CCSE) as a formative assessment tool.
This study involved 155 third-year medical students in the College of Human Medicine at Michigan State University who matriculated in 2016. Disciplinary scores on their individual Comprehensive Clinical Science Examination reports were extracted by digitizing the bar charts using image processing techniques. Segmented regression analysis was used to quantify the differences in disciplinary knowledge before, during, and after clerkships in five disciplines: surgery, internal medicine, psychiatry, pediatrics, and obstetrics and gynecology (ob/gyn).
A comparison of the regression intercepts before and during their clerkships revealed that, on average, the participants improved the most in ob/gyn (11.193, .0001), followed by psychiatry (10.005, .001), pediatrics (6.238, .0001), internal medicine (1.638, .30), and improved the least in surgery (-2.332, .10). The regression intercepts of knowledge during their clerkships and after them, on the other hand, suggested that students' average scores improved the most in psychiatry (7.649, .008), followed by ob/gyn (4.175, .06), surgery (4.106, .007), and pediatrics (1.732, .32).
These findings highlight how clerkships influence the acquisition of disciplinary knowledge, offering valuable insights for curriculum design and assessment. This approach can be adapted to evaluate the effectiveness of other curricular activities, such as tutoring or intersessions. The results have significant implications for educators revising clerkship content and for students preparing for the United States Medical Licensing Examination Step 2.
本研究使用综合临床科学考试（CCSE）作为一种形成性评估工具，量化临床实习对医学生学科知识的影响。
本研究纳入了2016年入学的密歇根州立大学人类医学院的155名三年级医学生。通过使用图像处理技术将柱状图数字化，提取他们个人综合临床科学考试报告中的学科分数。采用分段回归分析来量化在外科、内科、精神病学、儿科学以及妇产科这五个学科的实习前、实习期间和实习后的学科知识差异。
对实习前和实习期间的回归截距进行比较发现，平均而言，参与者在妇产科（11.193，.0001）的进步最大，其次是精神病学（10.005，.001）、儿科学（6.238，.0001）、内科（1.638，.30），在外科的进步最小（-2.332，.10）。另一方面，实习期间和实习后的知识回归截距表明，学生的平均分数在精神病学（7.649，.008）中提高最多，其次是妇产科（4.175，.06）、外科（4.106，.007）和儿科学（1.732，.32）。
这些发现突出了临床实习如何影响学科知识的获取，为课程设计和评估提供了有价值的见解。这种方法可用于评估其他课程活动（如辅导或学期中间课程）的有效性。这些结果对修订临床实习内容的教育工作者以及为美国医师执照考试第二步做准备的学生具有重要意义。
