title: A formative midterm test increases accuracy of identifying students at risk of failing a third year surgery clerkship.
abstract: BACKGROUND
  Providing midclerkship feedback to identify students at risk for failing is a Liaison Committee on Medical Education standard. Objective criteria for that feedback are critical. The investigators studied the value of a formative midterm (MT) test in identifying students at risk for failing a surgery clerkship.
  
  
  METHODS
  A written midclerkship test, which did not contribute to the final grade, was administered (n = 155). The Bayesian specificity, sensitivity, and predictive values for clerkship failure of low MT score, low global clinical performance rating GCPR, and the combination of low MT and low GCPR were computed.
  
  
  RESULTS
  Low MT as a predictor of clerkship failure was sensitive (1.0) but not specific (.35). Likewise, low GCPR was sensitive (1.0) but not specific (.31). The combination of low MT and GCPR, however, was both specific (1.0) and sensitive (.87).
  
  
  CONCLUSIONS
  The addition of an MT test to clinical performance ratings can stratify students' risk for clerkship failure.
authors.affiliation: Department of Surgery, Feinberg School of Medicine, Northwestern University, 251 E Huron Avenue, Galter 3-150, Chicago, IL 60611, USA. Electronic address: jcorcoran@luriechildrens.org.
authors.forename: Julia
authors.initials: J
authors.lastname: Corcoran
authors.affiliation: Department of Surgery, Feinberg School of Medicine, Northwestern University, 251 E Huron Avenue, Galter 3-150, Chicago, IL 60611, USA.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Halverson
authors.affiliation: Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Schindler
mesh_terms: D002982:Clinical Clerkship / Q000379:methods*; D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education / Q000379:methods*; D004501:Education, Medical / Q000379:methods*; D004521:Educational Measurement; D005180:Faculty, Medical; D013502:General Surgery / Q000193:education*; D006801:Humans; D015203:Reproducibility of Results; D012655:Self-Evaluation Programs / Q000379:methods*; D013337:Students, Medical / Q000523:psychology*
keywords: Composite score; ED-31; Identification struggling student; Midclerkship feedback; Midterm examination; Validity