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The Effect of a 6-week vs 4-week Clerkship on NBME Shelf Scores in Obstetrics and Gynecology

Purpose: To determine the effect of a 6-week vs 4-week clerkship on NBME shelf scores in Obstetrics and Gynecology

Background: A medical school wide curriculum change took place at Penn State College of Medicine during the 2017-2018 academic year to increase longitudinal and integrated learning.  The OB/GYN clerkship was shortened to 4 weeks and placed into a fifteen-week block with other rotations.  OB/GYN students continued to rotate through three clinical sites.  Shelf exams, previously given at clerkship conclusion, were then administered in the final week of the block.  

Methods: A retrospective review of NBME shelf scores for our Obstetrics and Gynecology clerkship was performed for academic years 2015-2017 and compared to those from academic year 2017-2018.  Student scores were collected and de-identified.  Mean scores were then obtained for each six-week rotation in 2015-2017 as well as the 4-week rotation school year.  

Results: A comparison of 4-week versus 6-week shelf scores at each site showed a significant decrease of 2.16 in the shelf scores at Hershey during the 4-week rotation (P=0.03).  Harrisburg Hospital scores decreased by 0.31 (P=0.83) while York scores increased by 2.23 (P=0.21) during 4-week rotations.  However, a decrease in overall mean shelf score in 4-week scores compared to 6-week scores across all sites by 0.08 was not significant (P=0.93).

Discussions: Analysis of the shelf scores across all of the 4-week rotations following curriculum change revealed no significant difference in mean scores when compared to the 6-week rotations.  However, there was a site-specific significant decrease in mean scores at our main hospital.  

Topics: CREOG & APGO Annual Meeting, 2019, Student, Faculty, Clerkship Director, Clerkship Coordinator, Medical Knowledge, UME, Assessment,