Background: The National Board of Medical Examiners (NBME) mandates shelf examinations for all upper-level medical students completing the Internal Medicine (IM) clerkship. Undergraduate medical curricula have adopted many disparate strategies for succinctly delivering “high-yield” topics to students prior to their examinations, such as PowerPoint presentations, mock examinations, and review of challenging questions from question banks (1). There is a paucity of literature in regards to the efficacy of such methods in the IM clerkship (2).
Methods: MedStar Georgetown University Hospital (MGUH) residents conducted a monthly one-hour structured question-and-answer format of common IM topics in a PowerPoint presentation format prior to the IM shelf examination beginning in July 2016 until present. The mean IM shelf examination scores prior to and after the initiation of the resident-led shelf review were compared.
Results: A total of 827 third-year medical students were included in this study. 438 students took the exam during the experimental period, while 389 took the exam during the control period. There was no statistically significant association (p > 0.05) found between the mean NBME scores in the experimental or control groups. There was no significant difference in terms of the mean two lowest scores in each group, the percentage of students scoring 70 or less, or the number of students achieving the maximum score.
Conclusions: Given the negative results of our resident-led shelf review on mean scores of the IM shelf exam, we propose that alternative methods, such as problem-based learning (PBL) or team-based learning (TBL), be further assessed for efficacy. Future research should examine the impact of such interventions in other specialties and at other medical institutions.