Assessment of longitudinal retention of basic sciences in clinical clerkships for continuous quality improvement

Abstract

Abstract Introduction: One of the challenges in medical education is to effectively assess basic science knowledge retention. National Board of Medical Examiners (NBME) clerkship subject exam performance is reflective of the basic science knowledge accrued during preclinical education. The goal of this study was to determine if measurement of retention of basic science knowledge in the clerkship NBME subject exam can guide specific preclinical curricular changes to address the deficiencies identified. Methods: We acquired a customized NBME item analysis report of our institution’s pediatric clerkship subject exams from the academic year 2018-2019 and developed a question-by-content Q-matrix by identifying skills necessary to master content. As a pilot study, students’ content mastery in 14 major basic science content areas using a CDA model called DINA (deterministic input, noisy “and” gate) was analyzed. Results: The results allowed us to identify strong and weak basic science content areas for students in the pediatric clerkship. For example: “Reproductive systems” and “Skin and subcutaneous tissue” showed a student mastery of 83.8±2.2% and 60.7±3.2% respectively.Conclusions: Cumulative data from all the clerkships will make it possible to narrow down consistent areas of strengths and weaknesses in the undergraduate curriculum. This can guide continuous quality improvement in the medical school curriculum.