Establishing the validity of test score inferences: performance of 4th-year U.S. medical students on the ECFMG Clinical Skills Assessment

Teach Learn Med. 2001 Fall;13(4):214-20. doi: 10.1207/S15328015TLM1304_01.


Background: Although the relations among prematriculation, matriculation, and residency assessments have been studied, measures pertaining to clinical skills have rarely been incorporated in any analyses.

Purpose: The purpose of this article was to investigate the relations between scores obtained on the Educational Commission for Foreign Medical Graduates Clinical Skills Assessment (CSA) prototype and aptitude-ability measures designed to select medical students, to assess medical students while in medical school, and to evaluate physicians in postgraduate training programs. The sample included 122 4th-year medical students.

Methods: Relations among scores were summarized with correlation coefficients. Analysis of variance was used to compare CSA scores by departmental grades.

Results: Significant correlations (p < .01) were found between scores from assessments commonly used in medical school (i.e., United States Medical Licensing Exam [USMLE] Steps 1 and 2) and CSA component scores. There were weak associations between CSA measures and both Medical College Admissions Test scores and residency program evaluations.

Conclusions: The relations between CSA scores and various other medically oriented ability measures provide additional evidence that inferences based on CSA scores are appropriate and valid.

MeSH terms

  • Adult
  • Analysis of Variance
  • Aptitude Tests
  • Clinical Competence*
  • Female
  • Humans
  • Male
  • Students, Medical*