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 insufficient knowledge and whether counseling affects final examination pass rates. METHOD: The authors reviewed students\u27 mean scores from two internal medicine clerkship tests at the Wright State University School of Medicine from February 1993 to July 1996. To determine the sensitivity and specificity of the tests for identifying students with insufficient knowledge, they compared 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 Examiners\u27 (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 examination. Of those, 17 had low mean clerkship test scores (sensitivity of 68%). The specificity of a low mean clerkship test score was 81%. Counseling did not improve final examination pass rates. CONCLUSION: In-clerkship tests can identify students who are at risk of failing an end-of-clerkship examination. Because counseling may be insufficient to raise final examination pass rates, further study into the appropriate clerkship intervention for low-achievement students is needed