Journal of Educational Evaluation for Health Professions

Research article

Longitudinal relationships between Korean medical students’ academic performance in medical knowledge and clinical performance examinations: a retrospective longitudinal study: Yulim Kang, Hae Won Kim; J Educ Eval Health Prof. 2025;22:18. Published online June 10, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.18

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Abstract PDF Supplementary Material: 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 (β=0.472, P<0.001) and CCSE at T2 predicted PT at T3 (β=0.527, P<0.001). The CPX at T1 predicted the CCSE at T2 (β=0.163, P=0.006), and the CPX at T2 predicted the CCSE at T3 (β=0.154, P=0.006). The PT at T1 predicted the CPX at T2 (β=0.273, P=0.006).
Conclusion
The study identified each examination’s stability and the complexity of the longitudinal relationships between them. These findings may help predict medical students’ performance on subsequent examinations, potentially informing the provision of necessary student support.

Review

Insights into undergraduate medical student selection tools: a systematic review and meta-analysis: Pin-Hsiang Huang, Arash Arianpoor, Silas Taylor, Jenzel Gonzales, Boaz Shulruf; J Educ Eval Health Prof. 2024;21:22. Published online September 12, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.22; Correction in: J Educ Eval Health Prof 2024;21(0):41

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Purpose
Evaluating medical school selection tools is vital for evidence-based student selection. With previous reviews revealing knowledge gaps, this meta-analysis offers insights into the effectiveness of these selection tools.
Methods
A systematic review and meta-analysis were conducted applying the following criteria: peer-reviewed articles available in English, published from 2010 and which include empirical data linking performance in selection tools with assessment and dropout outcomes of undergraduate entry medical programs. Systematic reviews, meta-analyses, general opinion pieces, or commentaries were excluded. Effect sizes (ESs) of the predictability of academic and clinical performance within and by the end of the medicine program were extracted, and the pooled ESs were presented.
Results
Sixty-seven out of 2,212 articles were included, which yielded 236 ESs. Previous academic achievement predicted medical program academic performance (Cohen’s d=0.697 in early program; 0.619 in end of program) and clinical exams (0.545 in end of program). Within aptitude tests, verbal reasoning and quantitative reasoning predicted academic achievement in the early program and in the last years (0.704 & 0.643, respectively). Overall aptitude tests predicted academic achievement in both the early and last years (0.550 & 0.371, respectively). Neither panel interviews, multiple mini-interviews, nor situational judgement tests (SJT) yielded statistically significant pooled ES.
Conclusion
Current evidence suggests that learning outcomes are predicted by previous academic achievement and aptitude tests. The predictive value of SJT and topics such as selection algorithms, features of interview (e.g., content of the questions) and the way the interviewers’ reports are used, warrant further research.

Citations

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Predictive Validity of Pre-Clinical Academic Achievements in Comprehensive Basic Science Examination: A Nationwide Cohort of Iranian Medical Students
Farhang Rashidi, Reza Sattarpour, Alipasha Meysamie
Advances in Medical Education and Practice.2025; Volume 16: 1747. CrossRef
Notice of Retraction and Replacement: Insights into undergraduate medical student selection tools: a systematic review and meta-analysis
Pin-Hsiang Huang, Arash Arianpoor, Silas Taylor, Jenzel Gonzales, Boaz Shulruf
Journal of Educational Evaluation for Health Professions.2024; 21: 41. CrossRef

Research article

Impact of a change from A–F grading to honors/pass/fail grading on academic performance at Yonsei University College of Medicine in Korea: a cross-sectional serial mediation analysis: Min-Kyeong Kim, Hae Won Kim; J Educ Eval Health Prof. 2024;21:20. Published online August 16, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.20; Correction in: J Educ Eval Health Prof 2024;21(0):35

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Abstract PDF Supplementary Material

Purpose
This study aimed to explore how the grading system affected medical students’ academic performance based on their perceptions of the learning environment and intrinsic motivation in the context of changing from norm-referenced A–F grading to criterion-referenced honors/pass/fail grading.
Methods
The study involved 238 second-year medical students from 2014 (n=127, A–F grading) and 2015 (n=111, honors/pass/fail grading) at Yonsei University College of Medicine in Korea. Scores on the Dundee Ready Education Environment Measure, the Academic Motivation Scale, and the Basic Medical Science Examination were used to measure overall learning environment perceptions, intrinsic motivation, and academic performance, respectively. Serial mediation analysis was conducted to examine the pathways between the grading system and academic performance, focusing on the mediating roles of student perceptions and intrinsic motivation.
Results
The honors/pass/fail grading class students reported more positive perceptions of the learning environment, higher intrinsic motivation, and better academic performance than the A–F grading class students. Mediation analysis demonstrated a serial mediation effect between the grading system and academic performance through learning environment perceptions and intrinsic motivation. Student perceptions and intrinsic motivation did not independently mediate the relationship between the grading system and performance.
Conclusion
Reducing the number of grades and eliminating rank-based grading might have created an affirming learning environment that fulfills basic psychological needs and reinforces the intrinsic motivation linked to academic performance. The cumulative effect of these 2 mediators suggests that a comprehensive approach should be used to understand student performance.

Citations

Citations to this article as recorded by

Alternative grading approaches in health professions education: a scoping review protocol
Elena Wong Espiritu, Aine O’Connor, Sara Blass, Kathryn L. Dambrino, Angela Shelton Clauson
JBI Evidence Synthesis.2025; 23(11): 2301. CrossRef
Erratum: Impact of a change from A–F grading to honors/pass/fail grading on academic performance at Yonsei University College of Medicine in Korea: a cross-sectional serial mediation analysis

Journal of Educational Evaluation for Health Professions.2024; 21: 35. CrossRef

Review

The relationship of non-cognitive factors to academic and clinical performance in graduate rehabilitation science students in the United States: a systematic review: Kelly Reynolds, Caroline Bazemore, Cannon Hanebuth, Steph Hendren, Maggie Horn; J Educ Eval Health Prof. 2021;18:31. Published online November 23, 2021; DOI: https://doi.org/10.3352/jeehp.2021.18.31

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Abstract PDF Supplementary Material

Purpose
Rehabilitation science programs utilize cognitive and non-cognitive factors to select students who can complete the didactic and clinical portions of the program and pass the licensure exam. Cognitive factors such a prior grade point average and standardized test scores are known to be predictive of academic performance, but the relationship of non-cognitive factors and performance is less clear. The purpose of this systematic review was to explore the relationship of non-cognitive factors to academic and clinical performance in rehabilitation science programs.
Methods
A search of 7 databases was conducted using the following eligibility criteria: graduate programs in physical therapy (PT), occupational therapy, speech-language pathology, United States-based programs, measurement of at least 1 non-cognitive factor, measurement of academic and/or clinical performance, and quantitative reporting of results. Articles were screened by title, abstract, and full text, and data were extracted.
Results
After the comprehensive screening, 21 articles were included in the review. Seventy-six percent of studies occurred in PT students. Grit, self-efficacy, emotional intelligence, and stress were the most commonly studied factors. Only self-efficacy, emotional intelligence, and personality traits were examined in clinical and academic contexts. The results were mixed for all non-cognitive factors. Higher grit and self-efficacy tended to be associated with better performance, while stress was generally associated with worse outcomes.
Conclusion
No single non-cognitive factor was consistently related to clinical or academic performance in rehabilitation science students. There is insufficient evidence currently to recommend the evaluation of a specific non-cognitive factor for admissions decisions.

Citations

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Research articles

Changes in academic performance in the online, integrated system-based curriculum implemented due to the COVID-19 pandemic in a medical school in Korea: Do-Hwan Kim, Hyo Jeong Lee, Yanyan Lin, Ye Ji Kang; J Educ Eval Health Prof. 2021;18:24. Published online September 23, 2021; DOI: https://doi.org/10.3352/jeehp.2021.18.24

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Abstract PDF Supplementary Material

Purpose
This study examined how students’ academic performance changed after undergoing a transition to online learning during the coronavirus disease 2019 (COVID-19) pandemic, based on the test results of 16 integrated courses conducted in 3 semesters at Hanyang University College of Medicine in Korea.
Methods
For the 16 required courses that formed an integrated system-based curriculum running for 3 semesters, the major examinations’ raw scores were collected for each student. Percent-correct scores were used in the subsequent analysis. We used the t-test to compare grades between 2019 and 2020, and the Cohen D was calculated as a measure of effect size. The correlation of scores between courses was calculated using Pearson correlation coefficients.
Results
There was a significant decrease in scores in 2020 for 10 courses (62.5%). While most of the integrated system-based curriculum test scores showed strong correlations, with coefficients of 0.6 or higher in both 2019 and 2020, the correlation coefficients were generally higher in 2020. When students were divided into low, middle, and high achievement groups, low-achieving students consistently showed declining test scores in all 3 semesters.
Conclusion
Our findings suggest that the transition to online classes due to COVID-19 has led to an overall decline in academic performance. This overall decline, which may occur when the curriculum is centered on recorded lectures, needs to be addressed. Further, medical schools need to consider establishing a support system for the academic development of low-achieving students.

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Anatomy learning profiles in relation to student motivation and academic success: A multi‐center cross‐sectional study
Birte Barbian, Thomas Shiozawa, Morris Gellisch, Irene Brunk, Katharina Langer‐Fischer, Nicole Wagner, Sina Benker, Michelle Bellstedt, Nils Otto, Dogus Darici
Anatomical Sciences Education.2025; 18(10): 1057. CrossRef
Study delay during emergency remote teaching among students at Dutch universities: the role of students’ education satisfaction and academic wellbeing
Manja Vollmann, Renée A. Scheepers, Femke Hilverda
European Journal of Psychology of Education.2024; 39(3): 2849. CrossRef
Impact of the Covid-19 pandemic and ensuing online teaching on pre-clinical medical education
Houman Goudarzi, Masahiro Onozawa, Makoto Takahashi
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Correlation between physician assistant students’ performance score of history taking and physical exam documentation and scores of Graduate Record Examination, clinical year grade point average, and score of Physician Assistant National Certifying Exam in the United States: Sara Lolar, Jamie McQueen, Sara Maher; J Educ Eval Health Prof. 2020;17:16. Published online May 27, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.16

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Abstract PDF Supplementary Material

Purpose
Learning to perform and document patient history taking and physical exam (H&P) entails a major component of the first year academic education of physician assistant (PA) students at Wayne State University, USA. The H&P is summative of multiple aspects of PA education, and students must master communication with patients and other health care providers. The objectives of this study were first, to determine if there was a correlation between scores on the Graduate Record Examination (GRE) component testing and scores on graded H&Ps. The second objective was to identify a correlation between proficiency with H&P documentation and academic and clinical year grade point average (GPA) and Physician Assistant National Certifying Exam (PANCE) score.
Methods
Subjects included 147 PA students from Wayne State University from 2014–2016. PA students visited local hospitals or outpatient clinics during the academic year to perform and document patient H&Ps. Correlation between the H&P mean scores and GRE component scores, GPAs, and PANCE scores were analyzed.
Results
The subjects were 26.5 years-old (+6.5) and 111 females (75.5%). There was no correlation between the GRE component score and the H&P mean score. The H&P score was positively correlated with GPA 1 (r=0.512, P<0.001), with GPA 2 (r=0.425, P<0.001) and with PANCE score (r=0.448, P<0.001).
Conclusion
PA student skill with H&P documentation was positively related to academic performance score during PA school and achievement score on the PANCE at Wayne State University, USA.

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Case report

Distribution and academic significance of learning approaches among pre-clinical medical students at Trinity School of Medicine, St Vincent and the Grenadines: Keshab Raj Paudel, Hari Prasad Nepal, Binu Shrestha, Raju Panta, Stephen Toth; J Educ Eval Health Prof. 2018;15:9. Published online April 6, 2018; DOI: https://doi.org/10.3352/jeehp.2018.15.9

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Abstract PDF Supplementary Material

Purpose
Different students may adopt different learning approaches: namely, deep and surface. This study aimed to characterize the learning strategies of medical students at Trinity School of Medicine and to explore potential correlations between deep learning approach and the students’ academic scores.
Methods
The study was a questionnaire-based, cross-sectional, observational study. A total of 169 medical students in the basic science years of training were included in the study after giving informed consent. The Biggs’s Revised Two-Factor Study Process Questionnaire in paper form was distributed to subjects from January to November 2017. For statistical analyses, the Student t-test, 1-way analysis of variance followed by the post-hoc t-test, and the Pearson correlation test were used. The Cronbach alpha was used to test the internal consistency of the questionnaire.
Results
Of the 169 subjects, 132 (response rate, 78.1%) completely filled out the questionnaires. The Cronbach alpha value for the items on the questionnaire was 0.8. The score for the deep learning approach was 29.4± 4.6, whereas the score for the surface approach was 24.3± 4.2, which was a significant difference (P< 0.05). A positive correlation was found between the deep learning approach and students’ academic performance (r= 0.197, P< 0.05, df= 130).
Conclusion
Medical students in the basic science years at Trinity School of Medicine adopted the deep learning approach more than the surface approach. Likewise, students who were more inclined towards the deep learning approach scored significantly higher on academic tests.

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Marlen A. Roehe, Carmen Trost, Julia S. Grundnig, Anahit Anvari-Pirsch, Anita Holzinger
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Research article

Does learning style preferences influence academic performance among dental students in Isfahan, Iran?: Najmeh Akhlaghi, Hosein Mirkazemi, Mehdi Jafarzade, Narjes Akhlaghi; J Educ Eval Health Prof. 2018;15:8. Published online March 24, 2018; DOI: https://doi.org/10.3352/jeehp.2018.15.8

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Abstract PDF Supplementary Material

Purpose
The present study aimed to identify the learning preferences of dental students and to characterize their relationship with academic performance at a dental school in Isfahan, Iran.
Methods
This cross-sectional descriptive study included 200 undergraduate dental students from October to November 2016. Data were collected using a 2-part questionnaire. The first part included demographic data, and the second part was a Persian-language version of the visual, aural, read/write, and kinesthetic questionnaire. Data analysis was conducted with the chi-square test, 1-way analysis of variance, and multiple linear regression.
Results
The response rate was 86.6%. Approximately half of the students (51.5%) had multimodal learning preferences. Among the unimodal group (48.5%), the most common mode was aural (24.0%), followed by kinesthetic (15.5%), reading-writing (8.0%), and visual (1.0%). There was a significant association between academic performance and the reading/writing learning style preference (P< 0.01).
Conclusion
Multimodal learning styles were the most preferred. Among single-mode learning styles, the aural style was most common, followed by the kinesthetic style. Students with a reading/writing preference had better academic performance. The results of this study provide useful information for preparing a more problem-based curriculum with active learning strategies.

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