Innovative OB/GYN Clerkship Assessment: Students’ Perceptions And Results of An Oral Examination

INTRODUCTION: In 2023, an oral examination was added to the John A. Burns School of Medicine (JABSOM) OB/GYN Clerkship as an alternative assessment method to evaluate medical students’ oral presentation and clinical reasoning skills. However, few studies have examined students’ perceptions of oral examinations in the OB/GYN clerkship (1). Previous studies have showed mixed results on the correlation between oral examination scores and National Board of Medical Examiners (NBME) shelf examination scores (2,3).

OBJECTIVES: This study aims to 1) understand third-year medical students’ attitudes regarding the effectiveness of an oral examination in evaluating knowledge and clinical skills and 2) evaluate the relationship between oral examination scores and NBME OB/GYN subject exam scores.

METHODS: During the 2023-2024 academic year, third year JABSOM medical students that completed the inpatient OB/GYN clerkship took a non-standardized oral examination conducted by trained faculty and answered unlinked, pre- and post-clerkship surveys. Students responded to statements about their perceptions using a 5-point Likert scale. Statistical significance of the surveys was analyzed with Chi-square and correlation between the medical student’s NBME shelf exam scores and oral exam scores was analyzed by Kendall’s rank test.

RESULTS: Of the 75 students, pre-examination, the majority of students (65%) felt very nervous or nervous about the oral examination. The results of the oral examination were 49% honors, 27% high pass and 24% pass or low pass. Post-examination, the majority of students agreed or strongly agreed that the oral examination effectively evaluated their oral presentation skills (71%) and knowledge and clinical reasoning (76%). However, there was an increase in the percentage of students (pre- 12% vs. post-39%; p-value less than 0.001) who strongly disagreed or disagreed that all clerkships should include an oral examination. There was a statistically significant correlation between the students’ oral examination scores and NBME subject examination scores, however the tau value indicates a weak positive correlation (R = 0.019, p = 0.025).

DISCUSSION: Although most medical students were nervous about the oral examination, they performed well and opined it was an effective method of evaluating their clinical skills. Medical student performance on the oral examination correlated with their performance on the NBME subject exam. Further research is needed to understand the discrepancy between the students’ positive attitudes towards the oral examination and their disagreement of its inclusion in all clinical clerkships and compare the effectiveness of competency-based oral examinations with multiple choice examinations.

References
1. Tolsma R, Shebrain S, Berry SD, Miller L. Medical student perceptions of assessments of clinical reasoning in a general surgery clerkship. BMC Medical Education 24:211 (2024).
2. Awad SS, Liscum KR, Aoki N, Awad SH, Berger DH. Does the Subjective Evaluation of Medical Student Surgical Knowledge Correlate with Written and Oral Exam Performance? Journal of Surgical Research 104; 36-39 (2002).
3. Saab SS, Pollack S, Lerner V, Banks E, Salva, CR, Colbert-Getz J. Validity Study of an End-of-Clerkship Oral Examination in Obstetrics and Gynecology. Journal of Surgical Education. 80 (2); 294-301 (2023).