An observational study of an approach to accommodate a fourth-year to third-year neurology clerkship curricular transition

Figures & data

Table 1. OHSU medical student characteristics and course material access behaviors according to whether they took the neurology required clerkship or chose to opt-out

Assessment Variables	Neurology Clerkship Students (n = 57)	Option B Test Out Students (n = 76)	p value	Test Statistic (df~)
Medical Student Characteristics
Age	Mean (SD††) 30.3 (5.2)	Mean (SD) 30.1 (3.3)	0.89*	t = 0.137 (df = 131)
Gender Male Female	n (%) 27 (47.4%) 30 (52.6%)	n (%) 45 (59.2%) 31 (40.8%)	0.18†	Chi-Square = 1.840 (df = 1)
USMLE Step 1 Raw Score	Mean (SD) 222.9 (18.6)	Mean (SD) 231.1 (18.2)	0.01*	t = −2.618 (df = 120)
USMLE Step 1 Pass/Fail Pass Fail	n (%) 54 (94.7%) 3 (5.3%)	n (%) 74 (97.4%) 2 (2.6%)	0.43†	Chi-Square = 0.623 (df = 1)
NBME IM Subject Exam Score	Mean (SD) 74.1 (8.4)	Mean (SD) 74.2 (9.4)	0.93*	t = −0.089 (df = 131)
Course Materials Accessed
# Times Main Course Materials Accessed None Mean #, if not 0 Range, not including 0	n (%) 38 (66.7%) Mean (SD) 10.8 (28.3) Range 2-185	n (%) 67 (88.2%) Mean (SD) <1 (2.1) Range 1-14	0.04† 0.008*	Chi-Square = 9.051 (df = 1) t = 3.162 (df = 131)
# Times OHSU Lecture Resources Accessed None Mean #, if not 0 Range, not including 0	n (%) 26 (45.6%) Mean (SD) 2.5 (3.5) Range 1-15	n (%) 57 (75%) Mean (SD) <1 (2.0) Range 1-11	0.01† 0.002*	Chi-Square = 11.989 (df = 1) t = 3.435 (df = 131)
# Times Online AAN Neurology Resources Accessed None Mean # (SD†), if any Range, not including 0	n (%) 19 (33.3%) 2.9 (4.4) Range 1-27	n (%) 37 (48.7%) 1.9 (2.7) Range 1-10	0.45† 0.11*	Chi-Square = 3.149 (df = 1) t = 1.607 (df = 131)

*Independent samples t-test

†Chi Square

~ df-degrees of freedom

Table 2. OHSU medical student performance outcomes according to whether they took the neurology required clerkship or chose to opt-out

Medical Student Outcomes	Neurology Clerkship Students (n = 57)	Option B Test Out Students (n = 76)	p value	Test Statistic (df~)
US-NBME Neurology Subject Exam Score Raw Score Percentile	Mean (SD) 77.6 (8.7) 49.6 (32.4)	Mean (SD) 76.9 (7.0) 45.3 (26.3)	0.61* 0.41*	Raw t = 0.43 (df = 131) % t = 0.745 (df = 131)
Student Grades Honors (%) Near Honors (%) Satisfactory (%) Marginal (%) Failure (%)	n (%) 16 (28.1%) 12 (21.1%) 28 (49.1%) 1 (1.8%) 0	n (%) 11 (14.3%) 22 (28.6%) 38 (49.4%) 5 (6.5%) 1 (1.3%)	0.19†	Chi-Square = 5.582 (df = 4)
Residency Training Disciplines	n (%)	n (%)	0.042†	Chi-Square = 25.612 (df = 15)
Anesthesia	2 (3.6%)	5 (6.8%)
Emergency Medicine	5 (8.9%)	11 (14.9%)
Family Medicine	9 (16.1%)	8 (10.8%)
General Surgery	0	8 (10.8%)
Internal Medicine	10 (32.1%)	11 (14.9%)
Medicine Preliminary	5 (8.9%)	6 (8.1%)
OB/GYN	2 (3.6%)	5 (6.8%)
Orthopedic Surgery	0	4 (5.4%)
Otolaryngology	0	2 (2.7%)
Pediatrics	4 (7.1%)	2 (2.7%)
Psychiatry	6 (10.7%)	2 (2.7%)
Neurology	1 (1.8%)	0
Surgery Preliminary	2 (3.6%)	5 (6.8%)
Transitional	1 (1.8%)	3 (4.1%)
Pathology	1 (1.8%)	1 (1.4%)

*Independent samples t-test

†Chi Square

~ df-degrees of freedom

Table A1. Author contributions

Name	Location	Role	Contribution
Jeff Kraakevik, MD	Oregon Health & Science University, Portland, OR	Author	Study concept and design, acquisition of data, analysis and interpretation of data, drafting of initial manuscript, and approval of final version
Meredith Frederick, MD	North Colorado Medical Center, Banner Health, Greeley, CO	Author	Study concept and design, acquisition of data, critical revision of manuscript for intellectual content, and approval of final version
Nicole Ryan, BS	Oregon Health & Science University, Portland, OR	Author	Acquisition of data and critical revision of manuscript for intellectual content, and approval of final version
Leslie Haedinger, MS	Oregon Health & Science University, Portland, OR	Author	Acquisition of data and critical revision of manuscript for intellectual content, and approval of final version
Patricia Carney, PhD, MS	Oregon Health & Science University, Portland, OR	Author	Study concept and design, analysis and interpretation of data, drafting of initial manuscript, and approval of final version