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      Early identification of struggling learners: using prematriculation and early academic performance data

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          Abstract

          Introduction

          A perennial difficultly for remediation programmes in medical school is early identification of struggling learners so that resources and assistance can be applied as quickly as is practical. Our study investigated if early academic performance has predictive validity above and beyond pre-matriculation variables.

          Methods

          Using three cohorts of medical students, we used logistic regression modelling and negative binomial regression modelling to assess the strength of the relationships between measures of early academic performance and outcomes—later referral to the academic review and performance committee and total module score.

          Results

          We found performance on National Board of Medical Examiners (NBME) exams at approximately 5 months into the pre-clerkship curriculum was predictive of any referral as well as the total number of referrals to an academic review and performance committee during medical school (MS)1, MS2, MS3 and/or MS4 years.

          Discussion

          NBME exams early in the curriculum may be an additional tool for early identification of struggling learners.

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          Most cited references 13

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          Factors associated with success in medical school: systematic review of the literature.

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            Burnout and serious thoughts of dropping out of medical school: a multi-institutional study.

            Little is known about students who seriously consider dropping out of medical school. The authors assessed the severity of thoughts of dropping out and explored the relationship of such thoughts with burnout and other indicators of distress. The authors surveyed medical students attending five medical schools in 2006 and 2007 (prospective cohort) and included two additional medical schools in 2007 (cross-sectional cohort). The survey included questions about thoughts of dropping out, life events in the previous 12 months, and validated instruments evaluating burnout, depression symptoms, and quality of life (QOL). Data were provided by 858 (65%) students in the prospective cohort and 2,248 (52%) in the cross-sectional cohort. Of 2,222 respondents, 243 (11%) indicated having serious thoughts of dropping out within the last year. Burnout (P < .0001), QOL (P < .003 each domain), and depressive symptoms (P < .0001) at baseline predicted serious thoughts of dropping out during the following year. Each one-point increase in emotional exhaustion and depersonalization score and one-point decrease in personal accomplishment score at baseline was associated with a 7% increase in the odds of serious thoughts of dropping out during the following year. On subsequent confirmatory multivariable analysis, low scores for personal accomplishment, lower mental and physical QOL, and having children were independent predictors of students having serious thoughts of dropping out during the following year. Approximately 11% of students have serious thoughts of dropping out of medical school each year. Burnout seems to be associated with increased likelihood of serious thoughts of dropping out.
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              The predictive validity of the MCAT for medical school performance and medical board licensing examinations: a meta-analysis of the published research.

              To conduct a meta-analysis of published studies to determine the predictive validity of the MCAT on medical school performance and medical board licensing examinations. The authors included all peer-reviewed published studies reporting empirical data on the relationship between MCAT scores and medical school performance or medical board licensing exam measures. Moderator variables, participant characteristics, and medical school performance/medical board licensing exam measures were extracted and reviewed separately by three reviewers using a standardized protocol. Medical school performance measures from 11 studies and medical board licensing examinations from 18 studies, for a total of 23 studies, were selected. A random-effects model meta-analysis of weighted effects sizes (r) resulted in (1) a predictive validity coefficient for the MCAT in the preclinical years of r = 0.39 (95% confidence interval [CI], 0.21-0.54) and on the USMLE Step 1 of r = 0.60 (95% CI, 0.50-0.67); and (2) the biological sciences subtest as the best predictor of medical school performance in the preclinical years (r = 0.32 95% CI, 0.21-0.42) and on the USMLE Step 1 (r = 0.48 95% CI, 0.41-0.54). The predictive validity of the MCAT ranges from small to medium for both medical school performance and medical board licensing exam measures. The medical profession is challenged to develop screening and selection criteria with improved validity that can supplement the MCAT as an important criterion for admission to medical schools.
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                Author and article information

                Contributors
                layne.bennion@usuhs.edu
                Journal
                Perspect Med Educ
                Perspect Med Educ
                Perspectives on Medical Education
                Bohn Stafleu van Loghum (Houten )
                2212-2761
                2212-277X
                27 September 2019
                27 September 2019
                October 2019
                : 8
                : 5
                : 298-304
                Affiliations
                [1 ]GRID grid.265436.0, ISNI 0000 0001 0421 5525, Uniformed Services University of Health Sciences, ; 20814 Bethesda, MD USA
                [2 ]GRID grid.430503.1, ISNI 0000 0001 0703 675X, School of Medicine, , University of Colorado, ; Aurora, CO USA
                Article
                539
                10.1007/s40037-019-00539-2
                6820636
                31562635
                © The Author(s) 2019

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                Categories
                Original Article
                Custom metadata
                © The Author(s) 2019

                Education

                identification of struggling learners, remediation, medical education

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