Decline in Pediatric Shelf Examination Performance During COVID-19

Area of Science:

• Medical Education
• Pediatrics
• Public Health

Background:

• The COVID-19 pandemic disrupted medical student education, particularly clinical training in pediatrics.
• Limited research exists on the pandemic's impact on pediatric clerkship training and National Board of Medical Examiners (NBME) Pediatrics Shelf Exam performance.
• This study addresses the gap by evaluating NBME Pediatrics Shelf Exam scores before and during the COVID-19 pandemic.

Purpose of the Study:

• To analyze the impact of the COVID-19 pandemic on third-year medical students' NBME Clinical Science Pediatrics Shelf Exam scores.
• To compare pediatric clerkship exam performance between pre-pandemic (in-person) and pandemic (virtual) learning environments.
• To determine if the pandemic increased NBME Pediatrics Shelf Exam failure rates.

Main Methods:

• Retrospective review of 991 medical students' NBME Pediatrics Shelf Exam scores from June 2017 to December 2020 at a single institution.
• Scores were adjusted for block timing and standardized against national norms.
• Comparison of exam outcomes between students completing clerkships before (n=772) and during (n=219) the COVID-19 pandemic using chi-square and ANOVA tests.

Main Results:

• The failure rate on the NBME Pediatrics Shelf Exam increased from 2.5% pre-pandemic to 8.7% during the pandemic (p < 0.001).
• Students completing their pediatric clerkship during COVID-19 were 3.77 times more likely to fail the exam (p < 0.001).
• The shift to predominantly virtual learning during the pandemic correlated with significantly higher failure rates.

Conclusions:

• Predominantly virtual pediatric clerkship learning during the COVID-19 pandemic led to significantly higher NBME Pediatrics Shelf Exam failure rates.
• Increased failure rates suggest potential deficits in pediatric medical knowledge acquisition and retention due to virtual learning.
• Further research is needed to understand the long-term effects of virtual learning platforms on foundational medical knowledge in pediatrics.