Impact of Reduced Clinical Time on NBME and OSCE Performance in the Ob/Gyn Clerkship: A Quasi-Experimental Study

Authors

DOI:

https://doi.org/10.5195/ijms.2025.3154

Keywords:

• Education, Medical [I02.358.399], Education, Medical, Undergraduate, Clerkship, Clinical, Curriculum, Competency-Based Education, problem based learning, Obstetrics, Obstetrics and gynecology, medical students, health occupations students, comparative study, evaluation study, multicenter study, clinical competency, educational measurements, academic performances, academic success, learning, self directed learning as a topic, teaching hospital, university hospital, teaching methods, educational models, retrospective study, time management, behaviorism, online learning, pandemics, Corona Virus Disease (COVID)-19, physical distance, Statistics, students, universities, workload, goals, personal satisfaction, fatigue, perception

Abstract

Background: Clinical clerkships are crucial in medical education for developing competent physicians. This study examined reduced clinical time during an Obstetrics and Gynecology (Ob/Gyn) clerkship on performance in the National Board of Medical Examiners (NBME) and Objective Structured Clinical Examination (OSCE). It arose from the need to modify curriculum due to pandemic-related restrictions such as social distancing and lockdowns.

Methods: This retrospective quasi experimental study evaluated four student groups with different clinical exposures. Group 1-7 (n=110) completed standard rotations, while Groups 8-10 had reduced clinical time: Group 8 (n=15) by 50%, Group 9 (n=19) with no clinical time but made up 2 weeks later, and Group 10 (n=14) by 17%. Reductions were supplemented with virtual learning and independent study. NBME and OSCE scores were analyzed to assess the effects of reduced clinical time on performance.

Results: Analysis using the Wilcoxon rank-sum test revealed no significant difference in NBME and OSCE scores. Groups 8 and 10 displayed slight improvements in median NBME performance, while OSCE scores varied minimally. These findings suggest that reduction in clinical experience did not affect the performance on examinations.

Conclusion: The results demonstrated no significant differences in NBME and OSCE scores when comparing the experimental groups to the control group. Confounding variables include the differences in motivation levels, varying workloads, and student’s sense of burnout. Given the small sample size, the study is quite underpowered. To optimize the learning environment, future studies are recommended to collect data from other clerkships at other universities with similar curricula.

Metrics

Metrics Loading ...

Author Biographies

Hyeon Park, MD. Loma Linda University, Loma Linda, USA

Department of Obstetrics & Gynecology, PGY-1

Stephanie Chang, MD. Loma Linda University, Loma Linda, USA

Department of Obstetrics & Gynecology, PGY-4

Stephanie Zebedeus, Fourth-year Medical Student, MMS. Loma Linda University, Loma Linda, USA

Fourth year medical student

Alexandra Maidan, MD. Loma Linda University, Loma Linda, USA

Department of Obstetrics & Gynecology, PGY-1

Juthamas Kositsawat, MD. Assistant Professor, School of Medicine, Loma Linda University, Loma Linda, USA6. MD. Assistant Professor, School of Me6. MD. Assistant Professor, School of Medicine, Loma Linda University, Loma Linda, USAdicine, Loma Linda University, Loma Linda, USA

Department of Obstetrics & Gynecology, Assistant Professor

Elaine Hart, MD. Associate Professor, School of Medicine, Loma Linda University, Loma Linda, USA

Department of Obstetrics & Gynecology, Associate Professor

References

Coronel-Couto GM, Landa-Galindez AM, Armas ML, Bonnin R. Time does matter: reduced internal medicine clerkship clinical experiences due to COVID-19. Cureus. 2022;14(12):e32445.

Monrad SU, Zaidi NLB, Gruppen LD, Gelb DJ, Grum C, Morgan HK, et al. Does reducing clerkship lengths by 25% affect medical student performance and perceptions? Acad Med. 2018;93(12):1833-1840.

Ouyang W, Cuddy MM, Swanson DB. US medical student performance on the NBME subject xxamination in internal medicine: do clerkship sequence and clerkship length matter? J Gen Intern Med. 2015;30(9):1307-1312.

Harris BS, Harris HM, Baldwin MA, Dotters-Katz SK. Medical student duty hours, and shelf performance: Is there a correlation? Am J Perinatol. 2024;41(S 01):e2135-e2137. Epub 2023 May 25.

Myers JA, Vigneswaran Y, Gabryszak B, Fogg LF, Francescatti AB, Golner C, et al. NBME subject examination in surgery scores correlate with surgeryclerkship clinical experience. J Surg Educ. 2014;71(2):205-210. Epub 2013 Sept 21.

Barnum TJ, Halverson AL, Helenowski L, Odell DD. All work and no play: addressing medical students’ concerns about duty hours on the surgical clerkship. Am J Surg. 2018;218(2):419-423. Epub 2018 Dec 11.

Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World health organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020;76:71-76. Erratum in: Int J Surg. 2020;77:217. Epub 2020 Feb 26.

Association of American Medical Colleges. Important guidance for medical students on clinical rotations during the coronavirus (COVID-19) outbreak [press release]. Available from: https://www.aamc.org/news/press-releases/important-guidance-medical-students-clinical-rotations-during-coronavirus-covid-19-outbreak. Last updated March 17, 2020; cited May 20, 2022.

Krasowski MD, Blau JL, Chen SJ, Jones KA, Schmidt TJ, Bruch LA. Teaching pathology in an integrated preclinical medical school curriculum and adaptations to COVID-19 restrictions. Acad Pathol. 2021;8:23742895211015337.

Watson A, McKinnon T, Prior SD, Richards L, Green CA. COVID-19: time for a bold new strategy for medical education. Med Educ Online. 2020;25(1):1764741.

Bongomin F, Olum R, Nakiyingi L, Lalitha R, Ssinabulya I, Sekaggya-Wiltshire C, et al. Internal medicine clerkship amidst COVID-19 pandemic: a cross-sectional study of the clinical learning experience of undergraduate medical students at makerere university, Uganda. Adv Med Educ Pract. 2021;12:253-262.

Tzeng TY, Hsu CA, Yang YY, Yuan EJ, Chang YT, Li TH, et al. The impact of COVID-19 pandemic on the learning outcomes of medical students in Taiwan: a two-year prospective cohort study of OSCE performance. Int J Environ Res Public Health. 2021;19(1):208.

Noel ER, Mizuo B, Yamamoto LG, Ishikawa KM, Chen JJ, Len KA. Effect of the COVID-19 pandemic on medical student performance and evaluation scores. SVOA Med Res. 2024; 2(1):10-18. Epub 2024 Jun 24.

This image outlines a six-step learning process: (1) Pre-class preparation, (2) Individual Readiness Assurance Test (IRAT), (3) Team Readiness Assurance Test (TRAT), (4) Immediate feedback and clarification, (5) Clinical problem-solving activities, and (6) Close..

Downloads

Published

2025-08-13 — Updated on 2025-09-22

How to Cite

Joshua Salguero, Park, H., Chang, S., Zebedeus, S., Maidan, A., Kositsawat, J., & Hart, E. (2025). Impact of Reduced Clinical Time on NBME and OSCE Performance in the Ob/Gyn Clerkship: A Quasi-Experimental Study. International Journal of Medical Students, 13(3), 276–284. https://doi.org/10.5195/ijms.2025.3154

Issue

Vol. 13 No. 3 (2025)

Section

Original Article

Categories

License

Copyright (c) 2025 Joshua Salguero, Stella Park, Stephanie Chang, Stephanie Zebedeus, Alexandra Maidan, Juthamas Kositsawat, Elaine Hart

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

  1. The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
  2. Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
  3. The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
    1. Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
    2. The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
    3. Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
    4. Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
    5. The Author represents and warrants that:
      1. the Work is the Author’s original work;
      2. the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
      3. the Work is not pending review or under consideration by another publisher;
      4. the Work has not previously been published;
      5. the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
      6. the Work contains no libel, invasion of privacy, or other unlawful matter.
    6. The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.

Enforcement of copyright

The IJMS takes the protection of copyright very seriously.

If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.

If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to contact@ijms.org

 

Infringing material

If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to contact@ijms.org