Using a Model Board Examination and a Case Study Assessing Clinical Reasoning to Evaluate Curricular Change

Background: This study compared student ability to integrate basic science and clinical information before and after implementing a
curriculum revision that introduced a problem‑oriented case approach as required coursework. Materials and Methods: Student knowledge
and competence were assessed just before entry into clinical training by completion of 100 multiple‑choice questions mirroring the breadth
and type of questions on the national licensing examination (Part I) and by completion of 10 cases to discern clinical decision‑making (Part II).
Scores from students from the classes of 2015 and 2016 (previous curriculum) were compared to those from students from the classes of
2017 and 2018 (current curriculum). Results: Part I scores were not significantly different between any classes in the previous and current
curriculum. Part II scores for 3rd‑year students in the current curriculum were higher than those for comparable students in the past 2 years of
the previous curriculum. Mean scores for the class of 2016, the last year of the previous curriculum, were significantly lower than all other
classes. Conclusion: Students benefit from measured and repetitive practice in clinical reasoning