Comparison of medical student performance in summative undergraduate paediatric examinations and a clinician-designed minimum accepted competency (MAC) assessment

Abstract Background

It is recognised that newly qualified doctors feel unprepared in many areas of their daily practice and that there is a gap between what students learn during medical school and their clinical responsibilities early in their postgraduate career. This study aimed to assess if undergraduate students and junior paediatric doctors met a Minimum Accepted Competency (MAC) of knowledge.
Methods

The knowledge of undergraduates and junior paediatric doctors was quantitatively assessed by their performance on a 30-item examination (the MAC examination). The items within this examination were designed by non-academic consultants to test ‘must-know’ knowledge for starting work in paediatrics. The performance of the students was compared with their official university examination results and with the performance of the junior doctors.
Results

For the undergraduate student cohort ( n = 366) the mean examination score achieved was 45.9%. For the junior doctor cohort ( n = 58) the mean examination score achieved was significantly higher, 64.2% ( p < 0.01). 68% of undergraduate students attained the pass mark for the MAC examination whilst a significantly higher proportion, 97%, passed their official university examination ( p < 0.01). A Spearman’s rank co-efficient showed a moderate but statistically significant positive correlation between students results in their official university examinations and their score in the MAC examination.
Conclusion

This work demonstrates a disparity between both student and junior doctor levels of knowledge with consultant expectations from an examination based on what front-line paediatricians determined as “must-know” standards. This study demonstrates the importance of involvement of end-users and future supervisors in undergraduate teaching.