Longitudinal relationships between Korean medical students' academic performance in medical knowledge and clinical performance examinations: a retrospective longitudinal study

Abstract

Purpose: This study investigated the longitudinal relationships between performance on 3 examinations assessing medical knowledge and clinical skills among Korean medical students in the clinical phase. This study addressed the stability of each examination score and the interrelationships among examinations over time. Methods: A retrospective longitudinal study was conducted at Yonsei University College of Medicine in Korea with a cohort of 112 medical students over 2 years. The students were in their third year in 2022 and progressed to the fourth year in 2023. We obtained comprehensive clinical science examination (CCSE) and progress test (PT) scores 3 times (T1-T3), and clinical performance examination (CPX) scores twice (T1 and T2). Autoregressive cross-lagged models were fitted to analyze their relationships. Results: For each of the 3 examinations, the score at 1 time point predicted the subsequent score. Regarding cross-lagged effects, the CCSE at T1 predicted PT at T2 (beta=0.472, P<0.001) and CCSE at T2 predicted PT at T3 (beta=0.527, P<0.001). The CPX at T1 predicted the CCSE at T2 (beta=0.163, P=0.006), and the CPX at T2 predicted the CCSE at T3 (beta=0.154, P=0.006). The PT at T1 predicted the CPX at T2 (beta=0.273, P=0.006). Conclusion: The study identified each examination&apos;s stability and the complexity of the longitudinal relationships between them. These findings may help predict medical students&apos; performance on subsequent examinations, potentially informing the provision of necessary student support.