Health Sciences Education Symposium
Presentation Format
Poster
Type of Activity
Innovation
Original Presentation Date
2023
Date of Submission
March 2023
Abstract/Short Description
Background: Medical education changed due to the COVID-19 pandemic. Educational sessions were offered virtually. There are published education innovations for pre-clinical curricula (1). However, providing virtual education during the clinical clerkship was a daunting challenge. In addition to the delay in patient care exposure, students’ performance in the NBME Subject Matter (Shelf) Exam scores have declined during the pandemic (2). VCU School of Medicine also needed to provide continued instructions to students whose clinical clerkships were delayed.
Description of the Innovation: Due to the COVID-19 pandemic, the clinical start for the class of 2022 was delayed by 3 months. During the 3-month time, various non-clinical (virtual) educational curricula were offered. For the Pediatrics clerkship, we designed and implemented a two-week, virtual “bootcamp” for students to prepare for the NBME Subject Matter (Shelf) Exam. We offered didactic sessions (two 1-hour sessions per day), M4 Teaching Assistant (TA) study sessions (1-hour session per day), virtual office hours for students to connect with the M4 TAs and the clerkship director to ask questions, and self-study time. At the end of the two-week curriculum, students were given the option to take the exam at the end of the two weeks or take the exam at the end of the clinical clerkship.
Results: We examined the Shelf Exam performance for the Class of 2021 (pre-COVID), Class of 2022 and 2023 (COVID affected) who were offered the two-week virtual, non-clinical bootcamp, and the class of 2024 (post-COVID). For the classes of 2021 and 2024, students had weekly didactic sessions (one half-day per week) and self-study time. All students were required to take the Shelf exam at the end of the clinical block. We specifically looked at the total number and percentage of students achieving an exemplary mark (indicated by Shelf exam score ≥ 80%). For the classes of 2022 and 2023 (COVID affected), we looked at the number of students achieving the exemplary mark who took the exam at the end of the two-week curriculum. Our hypothesis was that COVID-affected students would perform less well than their pre-COVID or post-COVID counterparts due to the fact that these students were preparing for the exam without the benefit of clinical education. For the class of 2024, the Shelf exam grades for the first 5 blocks (out of 7) are available for analysis. The percentage of students who achieved an exemplary designation was similar in all 4 years (class of 2021=56%, class of 2022=56%, class of 2023=64%, and class of 2024=46%). The mean Shelf exam scores from exemplary designations were also not statistically significant (class of 2021=84.57, class of 2022=85.11, p=0.324, class of 2023=85.23, p=0.224, and class of 2024=84.81, p=0.654).
Conclusion: We were able to successfully develop and implement a two-week, virtual, non-clinical curriculum that prepared the students for the NBME Subject Matter Exam. When compared to the pre-COVID student cohort, there was no difference in the percentage of students who achieved an exemplary mark as well as the mean exam score. In fact, we were able to demonstrate this from two class cohorts (classes of 2022 and 2023). From our experience, we can surmise that the Shelf exam performance does not depend on clinical experience. Students who took the Shelf exam prior to starting the clinical clerkship were less stressed about studying for an exam and concentrated more on patient care. This approach to clinical education may be worth duplicating in other clerkships and in future years.
References
1. Bird EC, Pettepher CC, Ball MAZ et al. Zooming into the COVID Era Together. Med Sci Educ. 2022. 15;32(5):1183-1188. doi: 10.1007/s40670-022- 01611-z
2.Hanson AE, P’Pool A, Starr MC, Byrne BJ. Decline in Pediatric Shelf Examination Performance During COVID-19. Cureus. 2021. 13(10):e18453. doi: 10.7759/cureus.18453
3.Tracy BM, Hazen BJ, Ward CR et al. Sustained Clinical Performance During Surgical Rotations Predicts NBME Shelf Exam Outcomes. J Surg Educ. 2020. 77(6):e116-e120. doi: 10.1016/j.jsurg.2020.06.033
4.Fitz MM, Adams W, Haist SA, Hauer, KE et al. Which Internal Medicine Clerkship Characteristics are Associated with Students’ Performance on the NBME Medicine Subject Exam? A Multi-institutional Analysis. Acad Med. 2020. 95(9):1404-1410. doi: 10.1097/ACM.0000000000003322
5.Prigoff J, Hunter M, Nowygrod R. Medical Student Assessment in the Time of COVID-19. J Surg Educ. 2021. 78(2):370-374. doi: 10.1016/j.jsurg.2020.07.040
Rights
© The Author(s)
Is Part Of
VCU Medical Education Symposium
First Author Information
Clifton Lee, MD, FAAP, SFHM, Director, Pediatric Clerkship, Virginia Commonwealth University School of Medicine