How COVID-19 Curricula Changes Impacted Medical Student Exam Performance: A Multi-Institutional Study

Abstract

Abstract Background The COVID-19 pandemic caused medical schools to convert to an online format, and it became imperative to swiftly change medical education delivery. New teaching methods were adapted, with some schools having greater success than others. Kirk Kerkorian School of Medicine's (KSOM) small-group interactive learning style had clear signs of struggle with a significant decrease in exam performance. Rocky Vista University College of Osteopathic Medicine’s (RVUCOM) large-group didactic lecture style had greater success with its curriculum adaptation leading to minimal effect on their exam performance. We aim to define what aspects of medical school curricula are most resilient for online learning by comparing exam scores from KSOM and RVUCOM. Methods KSOM and RVUCOM students were grouped into “above expectations” and “below expectations” categories based on each institution’s standardized exam performance metrics. Independently sampled t-tests were performed to compare groups. KSOM was classified as a small-group interactive curriculum through its heavy reliance on student-led Problem Based Learning (PBL), whereas RVUCOM was classified as a large-group didactic curriculum through its extensive proctor-led slideshow lectures. Results KSOM’s online PBL transition led to fewer students scoring above the national average compared to previous cohorts on NBME exams (55% vs. 77%, respectively, N = 47 & 78, (p < 0.01)). RVUCOM’s transition to online large-group lectures yielded no significant differences between students who performed “above expectations” and students who performed “below expectations” between their cohorts (63% vs. 65%, respectively, N = 305 & 300, (p > 0.05)). Conclusion KSOM’s COVID cohort performed significantly worse than RVUCOM’s COVID cohort during their medical school organ-system exams. We believe that the small-group learning at KSOM is less resilient for online curricula compared to the large-group didactics seen at RVUCOM. Understanding which didactic methods can transition to online learning more effectively than others is vital in guiding effective curriculum adjustments as online delivery becomes more prominent.