title: Relationship between the Clinical Performance Examination and Associated Variables.
abstract: OBJECTIVE
  The purpose of this study was to identify the causal relationship between the following variables: basic science score, written examination score (Internal medicine and Pediatrics), clinical clerkship score (Internal medicine and Pediatrics), and affective factors (self-efficacy, anxiety, and perception of preparedness).
  
  
  METHODS
  Forty-two medical students took the clinical performance examination (CPX) at the end of the first semester. One day before the CPX, the students completed a brief survey, which included 11 items that sampled their self-efficacy, preparedness and anxiety with regard to the CPX. The responses from the 38 identifiable surveys (90%), out of 42, were analyzed for this study. Structural equation modeling techniques were used to test the relationships between the variables. The students' basic science scores, clinical clerkship scores, and written examination scores were considered for this study.
  
  
  RESULTS
  We found that self-efficacy influenced students' CPX scores indirectly through their preparedness and anxiety. Preparedness influenced students' CPX scores indirectly through their anxiety. Anxiety was predicated on self-efficacy directly or indirectly and it predicted CPX scores. The clinical clerkship scores affected the students' CPX scores indirectly. The written examination scores and basic science scores, however, did not impact the students' CPX scores directly or indirectly. The basic science scores, clinical clerkship scores, and written examination scores were not associated with self-efficacy.
  
  
  CONCLUSIONS
  Our findings highlight the importance of clinical clerkship education and reasonable medical teaching methods in improving the student self-efficacy for the CPX.
authors: Department of Medical Education, School of Medicine, Gachon University of Medicine and Science, Incheon, Korea.
authors: Kwi Hwa
authors: KH
authors: Park
authors: Department of Medical Education, School of Medicine, Gachon University of Medicine and Science, Incheon, Korea.
authors: Wook Jin
authors: WJ
authors: Chung
authors: Department of Medical Education, School of Medicine, Gachon University of Medicine and Science, Incheon, Korea.
authors: Duho
authors: D
authors: Hong
authors: Department of General Surgery, School of Medicine, Gachon University of Medicine and Science, Incheon, Korea.
authors: Woon Kee
authors: WK
authors: Lee
authors: Department of Internal Medicine, School of Medicine, Gachon University of Medicine and Science, Incheon, Korea.
authors: Eak Kyun
authors: EK
authors: Shin
keywords: Anxiety; Clinical clerkship; Clinical competence; Self efficacy