Predicting academic performance at a predominantly black medical school

A study was conducted by the authors that examined the validity of the Medical College Admission Test (MCAT), undergraduate grade-point average (GPA), and "competitiveness" of undergraduate college in predicting the performance of students at a predominantly black college of medicine. The performance measures used in the analysis consisted of course grades in all four years of medical school and scores on both Part I and Part II of the National Board of Medical Examiners (NBME) examinations. The predictive validities of the MCAT scores and undergraduate GPAs were found to be similar to those revealed in earlier studies conducted at predominantly white schools. Two exceptions to these similarities were found. First, the MCAT scores at the black school had a somewhat lower validity in predicting NBME examination scores than was the case at the other schools. Second, of the six MCAT subtest scores, Skills Analysis: Reading had the highest correlation with first-year grades, in contrast to results at the other schools. No differences between men and women were found in the validity of MCAT scores and the GPA. The competitiveness of the undergraduate college attended was found to contribute significantly to the prediction of all measures of medical school performance.     

Use of MCAT data in selecting students for admission to medical school

In the spring of 1986, medical school admissions personnel were surveyed on their institutions' admissions practices and the use of Medical College Admission Test (MCAT) data in student selection. The admissions officers listed sources of information considered in processing applications. The variables accorded high importance were: overall and science undergraduate grade-point averages, quality of degree-granting institutions, letters of evaluation, interview ratings, MCAT scores, extracurricular activities, work in areas related to health care, breadth and/or difficulty of course work, and state of legal residence. Variables judged of medium importance were: nonscience grade-point average, graduate study, narratives supplied through the American Medical College Application Service or supplemental narratives, demographic factors, and undergraduate research. The respondents divided the 15-point MCAT scale into exemplary, acceptable, and unacceptable ranges of performance. These responses varied widely among institutions. The mean response for the bottom of the acceptable range was a score of seven, and the mean for the beginning of the exemplary range was 11. In considering individual MCAT subtest scores, 34 percent of the admissions officers regarded the six scores individually and equally, 51 percent weighted the areas in ways related to their curricula, and 43 percent summed or averaged scores with equal weights at some point. Thirty-one percent used MCAT scores to adjust grade-point averages across undergraduate institutions.     

A model for predicting performance on the NBME Part I examination

Multiple regression analyses were employed to determine the relationships between achievement variables as predictors of the performance on Part I of the National Board of Medical Examiners examinations (NBME-I) of 366 medical students. The students' examination score averages in first- and second-year basic science courses were sequentially added to a composite Medical College Admission Test (MCAT) score to investigate the increases in prediction accuracy. Four prediction equations were cross validated on two subsequent medical school classes. While the multiple correlation between the predicted NBME-I score and the actual score significantly increased as first- and second-year course examination scores were added to the equations, the overall accuracy in predicting passing or failing did not substantially increase. The most useful equation employed a combination of the MCAT score and the first semester anatomy course examination score. The NBME-I predictions were given by letter to the 1984 and 1985 students approximately a year before they were to take the NBME-I examination so that students at risk of failure could undertake remedial study.     

Predictors of success in an anesthesiology residency

The selection of residents in medical specialty programs is a difficult task facing all selection committees. The present authors examined factors that contribute to successful residency performance by 26 anesthesiology residents in order to assist the program's selection committee in developing selection criteria. The best predictor of a resident's academic average in the anesthesiology program was the number of years the resident had spent in other specialties. Comparison of the residents' scores on the Anesthesiology In-Training Examination (ITE) and their scores on Part I of the examinations of the National Board of Medical Examiners (NBME) showed a statistically significant negative correlation. The higher that residents scored on the NBME Part I examination, the lower they scored on the ITE. No significant correlations were found between the residents' ITE scores and undergraduate grade-point average or nonacademic variables such as the residents' age or parents' level of education. The residents' composite grade-point average (GPA) for the residency and their interview scores had a strong positive relationship significant at the 0.06 level.     

Use of a medical reasoning aptitude test to help predict performance in medical school

A medical reasoning aptitude test (MRAT) was designed to assess aptitude for clinical problem-solving in medical school applicants. The purpose of the study reported here was to determine whether the information provided by this test, when used in conjunction with college grade-point averages (GPAs) and scores on the Medical College Admission Test (MCAT), would improve the prediction of medical school performance. Specifically, the authors investigated the incremental predictive value of the MRAT relative to students' overall performance in medical school and, more specifically, to their knowledge and clinical reasoning during preclinical years and clinical performance during the clerkship year. Overall, it was found that, with the exception of the first year, the addition of MRAT scores to the GPAs and MCAT scores increased precision in identifying students who performed poorly or exceptionally well in the second year and the clinical clerkship year. This last finding is especially useful, since few other tests have provided that information. On the basis of the preliminary findings, the authors propose further use and validation of the MRAT.     

Predictive validity of the MCAT for students with two sets of scores

Addressed in the study reported here is the question of which set of scores for those students who retake the Medical College Admission Test (MCAT) yields a better predictive validity. The sample was comprised of 304 students who retook the MCAT prior to entering Jefferson Medical College between 1978 and 1981. Five sets of MCAT scores were considered as predictors in the study: earlier, later, higher, and lower sets of MCAT scores and the average of the earlier and later scores for each MCAT subtest. Twenty-five criteria were used, including grades earned in the freshman and sophomore years and scores on the subtests of Part I and Part II of the examinations of the National Board of Medical Examiners. Correlational techniques, such as bivariate and multiple correlation analyses and canonical correlation followed by redundancy analysis were utilized. The magnitude of redundancy indices indicated that the set of MCAT scores in which the earlier and later scores were averaged was the best predictor, followed by the earlier, lower, higher, and later sets of MCAT scores. The implications of these findings for the admissions process and for validity studies are discussed.     

The effect of commercial coaching courses on performance on the MCAT

Two studies on the relationship between taking a commercial coaching course and performance on the Medical College Admission Test (MCAT) are reported. In both studies, one based on repeating examinees and another based on first-time examinees, differences in scores favoring coached examinees were found on the Science Knowledge and Science Problems subtests. The results on the Skills Analysis: Quantitative subtest were mixed, while neither study found differences between the two groups in scores on the Skills Analysis: Reading subtest. The analyses further revealed that the differences in scores on the Science Knowledge and Science Problems subtests were less pronounced for examinees with low scores on the Skills Analysis: Reading and Skills Analysis: Quantitative subtests, examinees with very low or very high undergraduate grade-point averages, and examinees from very selective undergraduate colleges. The substantive importance of the differences was also explored. The coaching effect was estimated to increase an average student's probability of acceptance by 5 percentage points. The results suggest that coaching for the MCAT has a limited effect that supports rather than undermines the validity of the test.     

Traditional criteria as predictors of minority student success in medical school.

There have been many reports stating that the traditional criteria of the Medical College Admission Test (MCAT) and undergraduate grade-point average (GPA) have little, if any, value in predicting success in the preclinical years of medical school among students from underrepresented (racial and ethnic) minority groups. In contrast to previous articles this report emphasizes that traditional criteria and the quality of the undergraduate college attended are of some statistical value in predicting success in the preclinical years of medical school among accepted students from under represented minority groups. Of these criteria, the one with the greatest predictive value is the selectivity of the undergraduate college attended.     

Program for increasing enrollment of early acceptees in medical school

Early acceptees by medical schools generally have higher Medical College Admission Test (MCAT) scores and grade-point averages than those accepted later. Between 1977 and 1979, the number of these individuals actually enrolling at the University of Medicine and Dentistry of New Jersey Rutgers Medical School (UMDNJ-RMS) declined from 20.4 to 6.5 percent of all incoming medical students. This prompted the development in 1980 of a one-day, preenrollment program informing early acceptees about the UMDNJ-RMS educational program. Subsequently, more than 40 percent of the early acceptees have enrolled at the UMDNJ-RMS, and this noticeable increase appears to be related directly to the program.     

Changes in the qualifications of medical school applicants, 1981 to 1985

The decline in the number of medical school applicants has prompted concerns among medical educators regarding the effects of this decrease on the qualifications of the applicant pool. Changes in the qualifications of medical school applicants were analyzed in terms of age, sex, and ethnicity or racial group using two measures of quality: Medical College Admission Test (MCAT) scores and grade-point averages. The distributions of these measures for 1981 and 1985 applicants were compared. The results showed that there were significant but modest gains over the years in the percentage of men and women applicants who scored from 10 to 15 on the MCAT biology, chemistry, physics, and science problems subtests. There were also significant percentage gains for applicants in all age categories, except applicants over age 32, and for all ethnic or racial groups except blacks. The authors conclude that a variety of sociodemographic, educational, and selection factors may account for these changes.     

多学科综合性考试在医学生考试中的应用分析

目的通过对医学生多学科综合性考试成绩和单学科考试成绩的对比分析,反映出医学生在学科间知识的联系方面还存在不足,说明多学科综合性考试在医学教育中具有非常重要的意义.方法对昆明医学院2005级临床医学专业102名学生的毕业综合考试成绩和内科、外科、妇儿科出科考试成绩进行对比分析.结果毕业综合考试平均分为69.20分,出科考试平均分为83.50分.结论单学科考试成绩明显高于多学科综合性考试成绩,说明学生对单学科知识掌握较好,但在学科间知识的联系方面还存在不足.学校应加强多学科综合性考试,以提高学生灵活运用知识的能力.     

Correlates of clinical performance during medical school.

Many efforts have been made to define the complex factors related to successful clinical performance and to determine relationships among them. This study was an attempt to increase the understanding of cognitive and noncognitive attributes of clinical performance. Intercorrelations among overall clinical performance ratings, quarterly comprehensive examination scores, total scores on the Part II examination of the National Board of Medical Examiners, and overall grade-point average were computed for a graduating class of medical students. Aspects of clinical performance pertaining to information, concepts, skills, ingenuity, and conscientiousness were found to correlate with academic achievement as measured by grades and cognitive tests; however, such a correlation was not found for other aspects pertaining to attitude, peer relations, maturity, patient rapport, and integrity.     

Student evaluation of accelerated program at the University of Miami

The University of Miami School of Medicine has an accelerated, six-year B.S.-M.D. program called the Honors Program in Medicine (HPM). In 1985 the HPM and traditional program students were surveyed at the end of their first year in medical school regarding their opinions about accelerated medical education. Eighty-seven percent of the traditional students felt that HPM students had ability equal to that of the average medical student (that is, neither more nor less ability), but 41 percent felt that the HPM students were less mature than the average class member. The traditional students felt the HPM students were required to follow a rigid collegiate curriculum (76 percent) and had an inadequate nonscience background (68 percent) and that the HPM would negatively affect both the future professional competence of HPM participants (59 percent) and the medical profession (34 percent). A larger percentage of the HPM than the traditional students (63 versus 48 percent) reported earning more than a minor in nonscience subjects, and fewer HPM than traditional students (9 versus 36 percent) felt that pressure to maintain a high grade-point average limited their selection of college courses. The HPM students felt that they were well prepared for medical school academically (82 percent) and emotionally (91 percent). The HPM students excelled academically in college and in the preclinical curriculum.     

History of not completing courses as predictor of academic difficulty among first-year students

The study reported here was undertaken to determine whether the prediction of academic difficulty in the first year of medical school is enhanced by a consideration of the number of courses withdrawn from, repeated courses, and incomplete courses on a student's undergraduate academic record. All students enrolled from 1981 through 1985 at Southern Illinois University School of Medicine who experienced academic difficulty in the first year were selected for the study. Successful students were matched with these students in terms of minority or majority status and served as a control group. Discriminant and classification analyses were performed in a hierarchical stepwise manner to predict success or difficulty in the first year. The variables that were significant in discriminating between minority students who had academic difficulty and those who did not were the science grade-point average (grades in biology, chemistry, physics, and mathematics), the score on the reading subtest of the Medical College Admission Test (MCAT), and the number of withdrawals from courses. For majority students, the significant discriminating variables were the score on the MCAT biology subtest and the number of incompletes taken for courses. The results of this study have implications for medical school admissions committees, premedical advisers, and premedical students.     

Using ratings of resident competence to evaluate NBME examination passing standards

The passing standards of the National Board of Medical Examiners (NBME) examinations were empirically evaluated by analyzing the distributions of examination scores received by 1,994 graduates of one medical school in relation to the clinical competence ratings given to the graduates by their first-year residency directors. A significant association was found between the NBME examination scores and ratings in the cognitive areas of clinical competence. The graduates who scored 420 or less on the NBME Part I or the Part II examination received significantly lower medical knowledge ratings than did the total group of graduates. A similar analysis of NBME Part III examination scores was less clear-cut but also suggested that a score of 420 or less could identify those graduates at significant risk of receiving low knowledge ratings. When low ratings were used as an outcome measure, analysis showed that the NBME Part II examination was not sensitive in detecting such graduates. Based on these data, the authors do not propose changes in the passing standards for the NBME examinations but recommend that these standards continue to be reassessed and further measures be taken to strengthen the internal evaluation methods in medical schools.     

Effect of two preclinical curricula on NBME Part I examination performance

The Michigan State University College of Human Medicine conducts two preclinical medical education programs. In Track I (lecture-based), students attend classes 24 hours per week, and lecture time totals 908 hours over a 50-week period. In Track II (problem-based), students attend classes only 12 hours per week, and lecture time totals 112 hours over the same 50-week period. Institution of the Part I examination of the National Board of Medical Examiners (NBME) as a graduation requirement provided an opportunity to compare the performances of students in both tracks. When students from each track with similar Science Problems subtest scores on the Medical College Admission Test were compared, no significant differences were observed in the students' total scores or pass rate on the NBME examination. However, there were significant differences in scores on the microbiology subtest of the NBME examination, with the Track I students achieving higher scores. The 1984 report of the Project Panel on the General Professional Education of the Physician and College Preparation for Medicine of the Association of American Medical Colleges stressed the need to examine critically and consider reducing the scheduled instructional and lecture hours in preclinical medical education programs. In the study reported here, the authors demonstrated that reduction of scheduled instructional time, when replaced by a guided problem-solving program, is not detrimental to students' performance on the NBME Part I examination.     

Premedical and medical school performance in predicting first-year residency performance

In the study reported here the authors examined the relationships among 40 measures of undergraduate college and medical school performance and competence in 18 medical care tasks during the first year of residency. A rating form was developed for the study to assess residents' competency in the medical care tasks and was sent to the directors of the residency programs entered by the graduates of a medical school. Stepwise multiple regression procedures were used to analyze the relationship between these ratings of residency performance and the residents' premedical and medical school performance and to identify the best predictors of residency performance for the 1982 and 1984 classes. A Rasch model analysis of the residency performance ratings indicated the ease or difficulty of each of the 18 tasks. The results provide information that would allow medical educators to use premedical and medical school performance to predict residents' competencies. The task of "clinically evaluates research and clinical data" was the most difficult for the graduates; that is, they were rated lower on it than on any other task. Two groups of measures of undergraduate and medical school performance were significantly related to performance in the residency: the Part II examination of the National Board of Medical Examiners (particularly the scores on the obstetrics-gynecology, medicine, surgery, and pediatrics subtests and the overall score) and the clerkships (particularly the third-year medicine clerkship, the fourth-year medicine clerkship, and the surgery clerkship).     

Correlations between SAT scores and MCAT scores of black students in a summer program

The purpose of the study reported here was to determine the relationship between Scholastic Aptitude Test (SAT) scores and Medical College Admission Test (MCAT) scores of black students who had participated in a summer program for minority students interested in health careers held at the Medical College of Georgia. A significant correlation was established between these students' SAT and MCAT scores. These findings suggest that students who are likely to perform well in medical school can be selected for medical school while they are still underclassmen, accepted conditionally, and admitted after completing a prescribed curriculum. Early selection has implications for increasing the number of minority students in medicine and for permitting more liberal arts in the premedical education than the present selection process.     

医学院校大学生生活质量调查

[目的]调查医学院校大学生生活质量状况.[方法]分析延边大学医学部不同民族及不同性别间大学生生活质量的差异及影响因素.[结果]不同民族大学生生活质量总评分及社会关系领域的差异间比较具有统计学意义;家庭环境对大学生生活质量的多个领域产生影响;独生子女在生理健康、心理状态及社会关系领域等方面与非独生子女相比较具有显著性差异,不同性别间差异亦具有统计学意义.[结论]医学院校大学生生活质量受多种因素影响,应针对性地进行干预.     

Undergraduate medical education

The number of applicants to US medical schools, which declined steadily between 1985 and 1988, increased slightly for the class entering in 1989. The profile of entering students showed a small decline from last year in the percentage of students with grade point averages categorized as "A" (3.5 or above on a 4-point scale) and slight declines in four of the six MCAT subtest scores. The percentage of both women and minority students in the entering class increased from the previous year. An interesting observation is the large percentage increase this year in students transferring to LCME medical schools from graduate and professional degree programs and from osteopathic medical schools. While the number of full-time faculty members in medical schools continues to increase, significant vacancy rates exist in some departments. More than 5% of full-time faculty positions are vacant in genetics, pathology, dermatology, family medicine, neurology, obstetrics-gynecology, orthopedics, otolaryngology, pediatrics, and surgery departments. Along with faculty vacancies, there has been a considerable turnover of medical school deans. The curriculum in most medical schools includes some innovative instructional formats, such as problem-based learning and computer-assisted instruction. However, current data do not allow a generalization about the extent to which these are being utilized. It seems that, at least in some institutions, multiple methods are being used to assess the clinical competence of medical students (observation by faculty members and residents, written and oral examinations, and multiple station examinations), including the use of standardized patients. About half of the medical schools require students to pass the NBME Part I examination and about one third require passage of Part II. The subject examinations provided by the NBME seem to be used widely, at least in the clinical disciplines. Within the past year, about 14% of medical schools have reported the presence of students or residents who have been diagnosed with human immunodeficiency virus infection, and 12% have had students or residents diagnosed with hepatitis B virus infection. It is critical that medical schools teach students how to prevent occupational exposure to these infections, as well as ensuring that adequate health insurance coverage be provided for these conditions.