The relationship between medical students’ learning approaches and performance on a summative high-stakes clinical performance examination

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Table

Practice points

Deep approach to learning showed significant positive correlation with total CPX performance, primarily the patient–physician interaction and overall patient satisfaction CPX categories. Surface approach to learning showed significant negative correlation with total CPX performance and all CPX categories. Female students performed significantly better on the CPX than males and were more likely than males to use a strategic approach, but there were no significant gender differences in the use of the deep and surface approaches.

Table 1  Differences in ASSIST scale scores by quartile of CPX scores

	Quartile of CPX score				Unit: mean ± SD
Approaches to learning	I (Bottom)	II	III	IV (Top)	p-value* Tukey post hoc test
Deep approach	57.40 ± 6.68	60.85 ± 8.29	62.23 ± 7.81	62.70 ± 6.17	0.006 I < (III, IV)
Strategic approach	69.75 ± 8.79	71.65 ± 11.30	71.28 ± 11.93	75.80 ± 8.70	0.059
Surface approach	48.53 ± 10.90	43.10 ± 8.62	41.00 ± 8.65	37.88 ± 8.62	0.000 I > (II, III, IV)

Note: *Indicates significance at p < 0.017 level (0.05/3 = 0.017).

Table 2  Differences in ASSIST scale scores by gender

	Gender			Unit: mean ± SD
Approaches to learning	Male	Female	t	p-value*
Deep approach	61.01 ± 8.06	60.51 ± 6.76	0.419	0.676
Strategic approach	70.37 ± 10.66	74.42 ± 9.72	−2.470	0.015
Surface approach	42.77 ± 10.00	42.43 ± 9.97	0.210	0.834

Note: *Indicates significance at p < 0.017 level (0.05/3 = 0.017).

Table 3  Correlations between scores on ASSIST scales and CPX category scores

	CPX categories
Approaches to learning	History taking	Physical examination	Information sharing	Patient—physician interaction	Overall patient satisfaction
Deep approach	0.048	0.007	0.154	0.316*	0.254*
Strategic approach	0.126	0.120	0.061	0.059	0.192*
Surface approach	−0.261*	−0.177	−0.190*	−0.217*	−0.255*

Note: *Indicates significance at p < 0.017 level (0.05/3 = 0.017).