Neurology Clerkship: Predictors of Objective Structured Clinical Examination and Shelf Performance

Abstract

Background: We sought to determine whether the following factors are associated with stronger performance on the medical school neurology clerkship: (1) structure of the outpatient rotation (working with a single general neurologist or multiple subspecialists), (2) dedicated shelf exam preparation, and (3) clerkships completed prior to neurology rotation. Methods: A total of 439 Feinberg medical students between 2014 and 2016 were analyzed based on the 3 variables of interest listed above. Student performance was evaluated using the National Board of Medical Examiner shelf exam and Objective Structured Clinical Examination/standardized evaluation scores. Univariate and multivariate analyses were conducted. Results: The format of the 2-week outpatient rotation did not significantly affect shelf examination ( P = .59), or standardized evaluation ( P = .34) scores. Taking a shelf pre-test correlated with overall higher standardized evaluation scores ( P < .01), and higher shelf examination scores ( P < .01). No individual clerkship correlated with better performance; however, the total number of core clerkships was associated with higher shelf examination scores ( P = .007). Each additional core clerkship taken prior to neurology was associated with 0.72 points greater shelf examination score. Conclusions: Greater attending continuity did not appear to be associated with stronger performance perhaps due to a difference in types of cases observed. Students who took a practice shelf exam did better on both their shelf exam and standardized evaluation, suggesting that acquisition of knowledge translates to a better clinical performance. No individual clerkship offers an advantage, but rather it is the total number of clerkships that is correlated with stronger performance.