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Transition from Tiered to Competency-Based Grading in the Obstetrics and Gynecology Clerkship
Objective: To assess Obstetrics
and Gynecology core clerkship grades and National Board of Medical Examiners
(NBME) Shelf Exam scores after transitioning from tiered to competency-based
grading.
Methods: Between July 2021 and July 2022, the Icahn School of Medicine at Mount
Sinai (ISMMS) adhered to tiered grading; 60 percent received Honors, 30% High
Pass, 10% Pass. In July 2022, ISMMS transitioned to competency-based grading.
Criteria delineating a score of “Pass” versus “Honors” for each competency were
created. Students needed to meet criteria for Honors for four out of six to
receive Honors for the clerkship. NBME scores and grade distribution between the
first three quarters of academic year (AY) 2021-22 and the first three of AY
2022-2023 were compared.
Results: Number of students studied in AY 2021-2022 and AY 2022-2023 were 55
and 52, respectively. A significantly higher percentage of students received
Honors in AY 2022-2023 than in AY 2021-2022 (96% versus 60%, p < 0.01). Mean
NBME scores were significantly higher for those receiving Honors in AY
2021-2022 than in AY 2022-2023 (p < 0.05); scores for AY 2021-2022 and AY
2022-2023 were 78.9, 95% CI 76.3, 80.9 and 75.1, 95% CI 73.3, 76.9,
respectively. Mean NBME scores for all students were not significantly
different between the two academic cohorts (77.0 versus 74.9, p = 0.11).
Conclusion: These findings support a paradigm that compares learner performance
to predefined measures as opposed to peer performance. Data collection is
ongoing. Future directions include assessing student satisfaction ratings for
the two schemes.
Topics:
ASL, 2023,
