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

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.