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Standardized oral examinations allow for assessment of medical student clinical knowledge and decrease racial grading
Katharine E Caldwell1, Jorge G Zarate Rodriguez1, Annie Hess1
1Department of General Surgery, Washington University in St. Louis, MO.
Surgery
|December 13, 2021
Summary
A structured oral examination in medical school surgery clerkships improved assessment consistency. This standardized approach eliminated grade disparities between White students and underrepresented in medicine students.
Area of Science:
- Medical Education
- Surgical Training
- Health Equity
Background:
- Oral examinations are inconsistently used in third-year medical clerkships.
- Current oral exams are often unstructured, leading to variability in difficulty and scoring.
- Prior studies show disparities in clinical grades, with underrepresented in medicine students receiving lower scores than White students.
Purpose of the Study:
- To design and implement a structured oral examination for third-year medical students in the surgery clerkship.
- To compare the outcomes of the structured oral examination with previous unstructured assessments.
- To evaluate the impact of the structured examination on grade equity for diverse student populations.
Main Methods:
- Developed a structured oral examination with two scenarios assessing history taking, diagnostic workup, result interpretation, and treatment planning.
- Compared scores from the structured examination to historical unstructured examination scores and student demographics.
- Surveyed students and faculty on their experience with the new examination format.
Main Results:
- Third-year medical students showed strong knowledge but made the most errors in treatment planning (P < .001).
- Students with honors clerkship grades scored higher on the oral examination (94.8% vs 90.4%, P = .02).
- The structured examination eliminated the previously observed score difference between underrepresented in medicine and White students (P = .99 vs P = .04).
Conclusions:
- A standardized oral examination for surgery clerkships enhances student and faculty satisfaction.
- The structured format effectively identifies areas of knowledge weakness.
- This approach addresses inconsistent grading and eliminates grade disparities among different student groups.
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