A drop in pediatric subject examination scores after curriculum changes that emphasize general pediatric topics.
OBJECTIVE
To determine whether emphasizing a limited number of general pediatric objectives and using a test based on them would improve student knowledge of the topic areas.


METHODS
Before-after trial.


METHODS
Community-based medical school.


METHODS
Third-year medical students on a required clerkship in pediatrics.


METHODS
Six core objectives: recognizing the seriously ill child, stabilizing such a child, fluid and electrolyte requirements and therapy, newborn care, well child care, and variability of normal vital signs in children based on their age were defined and a modified essay examination was constructed. The test was given to pediatric students close to the end of their clerkship. In study year 1, no warning was given about the examination and results did not affect student grades. In study year 2, passing all items was a requirement and failure required remedial oral examination of any missed items. All students completed the National Board of Medical Examiners pediatric subject examination.


RESULTS
For 7 of 8 essay items, significant increases in numbers of students passing were seen in study year 2, but students scored 51 points lower on the National Board of Medical Examiners pediatric subject examination (P=.002). The decrease in scores was not seen in any other clerkship or among pediatric students from a different campus of the medical school.


CONCLUSIONS
Emphasis on core objectives and an essay examination significantly improved students' knowledge of the defined topics but decreased the scores on the National Board of Medical Examiners subject examination. This may be attributable to a difference in content between the 2 tests. Faculty proposing new curriculum guidelines need to review student assessment methods to avoid such unexpected changes in scores.
Potts
M J
MJ
Department of Pediatrics, University of Illinois, College of Medicine at Rockford, 61104, USA. michaelp@uic.edu
Phelan
K W
KW
D001291:Attitude of Health Personnel; D002982:Clinical Clerkship / Q000458:organization & administration*; D002983:Clinical Competence / Q000592:standards; D003479:Curriculum; D004521:Educational Measurement; D005180:Faculty, Medical; D006801:Humans; D008007:Licensure, Medical; D009936:Organizational Innovation; D010372:Pediatrics / Q000193:education*; D013337:Students, Medical / Q000523:psychology