Use of objective examinations in medicine clerkships. Ten-year experience.

Student performance during the internal medicine clerkship at the University of Washington School of Medicine has been evaluated by clinical ratings and a written examination containing multiple-choice questions and patient management problems for the past 10 years. Measures of the correlation among the evaluation methods were determined by analyzing data from 1,544 students. The correlations of clinical ratings with the total examination score (r = 0.27), multiple-choice questions (r = 0.23), and patient management problems (r = 0.19) suggest that clinical ratings alone are not adequate for measuring student progress. The relationships of evaluation methods used in the medicine clerkship to other measures of performance such as selection to Alpha Omega Alpha and National Board examinations were also determined. The ability to predict student performance was enhanced considerably when the results of the clerkship examination were considered in addition to clinical ratings. These data suggest that a comprehensive assessment of student performance in medicine clerkships should include written examinations in addition to clinical ratings.