Do coursework summative assessments predict clinical performance? A systematic review.

Area of Science:

• Health Professions Education
• Medical Education Assessment
• Clinical Performance Prediction

Background:

• Summative assessments in health professions education aim to ensure high-stakes decisions and predict future performance.
• This review critically examines the predictive ability of various summative assessment modes for clinical performance.

Purpose of the Study:

• To systematically investigate the predictive validity of different summative assessment methods for health profession students' clinical performance.
• To identify which assessment modes are most effective in predicting future clinical success.

Main Methods:

• A systematic literature search was conducted across PubMed, CINAHL, SPORTDiscus, ERIC, and EMBASE.
• Inclusion/exclusion criteria ensured focus on summative assessment and clinical performance; data extraction and critical appraisal (modified Downs and Black checklist) were performed by two independent reviewers.

Main Results:

• Eighteen studies were included, primarily from medical fields, assessing various assessment types like Objective Structured Clinical Examinations (OSCEs) and written exams.
• OSCE scores explained 1.4-39.7% of variance in performance; written exams (MCQ/EMQ, short answer) explained 3.2-29.2%.
• Most studies were rated 'fair' quality, with high inter-rater agreement (Kappa=0.852).

Conclusions:

• OSCEs and written examinations demonstrate significant relationships with health professional students' clinical performance.
• Caution is advised when using these as predictive measures due to limited evidence and variable predictive strength.
• OSCEs may be the most suitable current tool for identifying at-risk students, but further research is essential to strengthen predictive relationships.