C4 - 12: ORAL EXAMS IN SURGICAL CLERKSHIP: HIGH LEARNER SATISFACTION DESPITE LOW PERFORMANCE- WHAT ARE THE STUDENTS SAYING?
Valerie Bauer, MD, Clerkship Director, C Neal Ellis, MD, Chairman Program Director; Texas Tech University Health Sciences School of Medicine- Permian Basin
Background: Medical students who perform well on the NBME exam have limited assessment on ability to integrate medical knowledge to applied decision making. Oral examination can be used in to evaluate these skills through level appropriate assessment. Utility of the oral exam and the perceived value to the student is unknown.
Objectives: To determine correlation between shelf exam performance and oral final exam at the end surgical clerkship. To determine performance on the oral exam and perceived value to students. To identify the utility of the oral exam to students not entering surgery.
Methods: Prospective data were collected from 29 third year medical students from 2016-2017. Students took two oral examinations: a midterm and final exam. Questions remained the same. The final was administrated by one board certified surgeon and examiner for the ABS. Performance was graded pass or fail and correlated with the shelf exam. Students completed a learner satisfaction survey on a 5 point, Likert-type scale.
Results: Shelf exam scores averaged 48.5 (SD + 24.7). Overall, 93% passed the shelf exam and 48% passed the oral exam. A weak correlation was found between performance on the shelf exam and oral final exam (Spearman rho=0.12, p=0.542). There was no association between likelihood of passing the NBME and passing the oral exam [chi 2(1)=0.002, p=0.960]. Although half of students failed the oral exam, they reported high satisfaction scores with the oral exam as being important part of the educational experience despite performance outcome [chi2(3)=3.67, p=0.287]. Choice of specialty in surgery had no difference in perceived importance of exam [chi2(3)=3.94, p=0.268]. Nearly two-thirds of all students reported strong disagreement for discontinuing this exam in surgical clerkship (mean average, x=1.96;SD+ 1.1).
Conclusion: Shelf exam performance is not associated with oral exam performance at the clerkship level. Students reported high perceived learner value in taking the oral examination despite poor performance, indicating that the exam experience was important. Learners going into non-surgical fields found the test valuable, indicating this is a skill learners want to be taught, independent of surgical interest. Learners felt they could have performed better and were against discontinuing the exam in clerkship.