Using in-clerkship tests to identify students with insufficient knowledge and assessing the effect of counseling on final examination performance

Purpose. To determine whether in-clerkship tests identify students with ins ufficient knowledge and whether counseling affects final examination pass r ates. Method. The authors reviewed students' mean scores from two internal medici ne clerkship tests at the Wright State University School of Medicine from F ebruary 1993 to July 1996, To determine the sensitivity and specificity of the tests for identifying students with insufficient knowledge, they compar ed students in the lowest quartile of clerkship test results with those who scored 290 or less on the end-of-clerkship National Board of Medical Exami ners' (NBME) subject examination in medicine, The authors also compared the final examination pass rates of counseled and non-counseled students. Results. Twenty-five students scored 290 or less on the NBME subject examin ation. Of those, 17 had low mean clerkship test scores (sensitivity of 68%) . The specificity of a low mean clerkship test score was 81%, Counseling di d not improve final examination pass rates. Conclusion. In-clerkship tests can identify students who are at risk of fai ling an end-of-clerkship examination, Because counseling may be insufficien t to raise final examination pass rates, further study into the appropriate clerkship intervention for low-achievement students is needed.