ASSESSING STUDENT PERFORMANCE ON A PEDIATRIC CLERKSHIP

Objective: To determine whether any of 4 parameters used as evaluation methods in the pediatric clerkship at Children's National Medical Cen ter, Washington, DC, could predict a student's performance, as measure d by the final grade. Design: A retrospective study in which the follo wing data were collected: (1) a record of the diagnoses and total numb er of patients seen during the rotation, (2) clinical performance grad e, (3) the National Board of Medical Examiners (NBME) pediatric shelf test score, (4) case presentation grade, and (5) the final clerkship g rade for overall performance. Setting: Third-year pediatric clerkship in the 1987-1988 academic year at Children's National Medical Center, the George Washington University School of Medicine. Results: A total of 128 students had complete data. Correlations among the clinical par ameters, ie, number of patients seen, clinical grade, case grade, and the NBME shelf test score were all statistically nonsignificant. In ad dition, multiple regression modeling of NBME test scores, using measur es such as clinical grade, average case grade, and number of patients seen, was unsuccessful, with only clinical performance entering the re gression model. In contrast, modeling of the final clerkship grade res ulted in explaining almost 80% of the variation on a student's final g rade (R(2)=0.79). Variables submitted to the model were number of pati ents seen, clinical grade, average case presentation grade, and ordere d examination score. Last, a highly significant relationship (chi(2)=1 5.98, P<.001) was noted between students receiving a final grade of ho nors and an ''A'' on their case grade. Conclusions: Results confirmed that there is no single best predictor of performance on a pediatric c lerkship. While there was only a weak correlation between each single measure and the final grade, together these accounted for 80% of the v ariation in students' scores. Based on the study data, the use of vari ed evaluative methods to determine a student's final grade is recommen ded.