Abstract
Background
Oral examinations are not consistently included in third-year medical student clerkships.
When included, they are often unstructured, leaving room for variations in difficulty
or scoring. Previous research has demonstrated differences in clinical grade achievement,
with underrepresented in medicine students receiving significantly lower grades than
White students.
Methods
We designed a structured oral examination for third-year medical students on the surgery
clerkship. Students completed 2 oral examination scenarios and were evaluated on their
ability to complete a history and diagnostic workup, interpret laboratory and imaging
results, and devise a treatment plan. Scores from our examination were compared to
previous, unstructured oral examination scores and to student demographics. Students
and faculty were surveyed regarding their experience.
Results
Third-year medical students demonstrated strong knowledge of multiple surgical diseases.
The greatest number of errors occurred in treatment planning (P < .001). Third-year medical students receiving honors clerkship grades achieved higher
percentages of correct items on their oral examination. (94.8% vs 90.4%) (P = .02). Evaluation of prior unstructured oral examinations found underrepresented
in medicine students received lower scores than White students (P = .04). After implementation of our structured examination, no difference was seen
between the scores of underrepresented in medicine and White students (P = .99).
Conclusion
We implemented a standardized oral examination for third-year medical students on
the surgery clerkship with student and faculty satisfaction and demonstrated the ability
to determine domains of knowledge weakness. The application of our structured oral
examination helped to address nonspecific grading practices and eliminate oral examination
grade differences between underrepresented in medicine and White students.
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Article info
Publication history
Published online: December 08, 2021
Accepted:
November 5,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
