Are medical student results affected by allocation to different sites in a dispersed rural medical school?
Prof Tarun Sen Gupta, James Cook University, Australia
Prof Richard Hays, Bond University Australia*
Ms Gill Kelly, James Cook University, Australia
Dr Petra Buttner, James Cook University, Australia
Background: Many new rural medical schools are placing students in more dispersed clinical environments than is seen in urban medical schools. These dispersed clinical environments may have smaller populations, different health care needs, different teaching arrangements and even different health care systems, and yet students are generally assessed against endpoint learning objectives through centrally driven practices. This paper presents an analysis of the assessment results of students allocated to different clinical environments in one new medical school to explore the effect or dispersal on learning outcomes.
Methods: Summative assessment results of the second to fifth graduating cohorts were analysed through analysis of variance to determine if there were differences between sites and the Kruskal-Wallis test on median scores to explore any effects on the rank order of student test performances following dispersal. The dispersal also marked a change from predominantly campus-based to predominantly workplace-based assessment. Ethics approval was granted by the James Cook University Ethics Committee.
Results: There were no significant differences in the mean scores of students studying at each site (p values = 0.15 – 0.63). There were also no significant differences overall between median rankings across years as students dispersed to the different clinical sites (p values = 0.09 – 0.78). There were some small changes in rank order of students within sites, but with no effect on pass decisions.
Conclusion: The choice of clinical school site for the final two years of an undergraduate rural medical school course had no effect on mean assessment scores and only a minor effect on a rank order of student scores. While workplace immersed placements may suit some students better than others, at this school they may provide a valuable transition experience between undergraduate and post graduate learning.
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