Comprehensive undergraduate medical assessments improve prediction of clinical performance.
OBJECTIVE
This study aimed to compare an essay-style undergraduate medical assessment with modified essay, multiple-choice question (MCQ) and objective structured clinical examination (OSCE) undergraduate medical assessments in predicting students' clinical performance (predictive validity), and to determine the relative contributions of the written (modified essay and MCQ) assessment and OSCE to predictive validity.


METHODS
Before and after cohort study.


METHODS
One medical school running a 6-year undergraduate course.


METHODS
Study participants included 137 Year 5 medical students followed into their trainee intern year.


METHODS
Aggregated global ratings by senior doctors, junior doctors and nurses as well as comprehensive structured assessments of performance in the trainee intern year.


RESULTS
Students' scores in the new examinations predicted performance significantly better than scores in the old examinations, with correlation coefficients increasing from 0.05-0.44 to 0.41-0.81. The OSCE was a stronger predictor of subsequent performance than the written assessments but combining assessments had the strongest predictive validity.


CONCLUSIONS
Using more comprehensive, more reliable and more authentic undergraduate assessment methods substantially increases predictive validity.
Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand. tim.wilkinson@chmeds.ac.nz
Tim J
TJ
Wilkinson
Christopher M
CM
Frampton
D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods / Q000592:standards*; D004521:Educational Measurement / Q000592:standards*; D006801:Humans; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013337:Students, Medical