Concordance of surgical clerkship performance and National Board of Medical Examiners Part II subtest scores. A validation model.

This study compares the National Board of Medical Examiners Part II (NBME II) subtest scores of medical students attaining honors in a clinical clerkship to those of students receiving a passing score to determine if the NBME II examinations could be considered independently as valid indicators of clinical achievement. Significant differences were found in five of the eight clinical clerkships; four of the six NBME II subtests were involved. A validation model was derived, and error estimates were obtained by using the NBME II surgery subtest scores and surgery clerkship performance as the criteria. Although the mean scores of students receiving honors in surgery were significantly higher than those not receiving honors (P less than 0.001), there was a considerable false negative error rate of 61%. These data suggest that on an individual basis, a good correlation does not exist between clinical performance in surgery and objective assessment of knowledge as determined by NBME scores.