Academic performance of longitudinal integrated clerkship versus rotation-based clerkship students: a matched-cohort study

Acad Med. 2014 Feb;89(2):292-5. doi: 10.1097/ACM.0000000000000110.


Purpose: Prior studies suggest that students on a longitudinal integrated clerkship (LIC) have comparable academic performance to those on a rotation-based clerkship (RBC); however, most of these studies did not adjust for preclerkship academic performance. The objective of this study was to compare the academic performance of LIC and RBC students matched on prior academic performance over a three-year period.

Method: Each LIC student in the University of Calgary classes of 2009, 2010, and 2011 (n = 34) was matched with four RBC students (n = 136) of similar prior academic performance. Knowledge and clinical skills performance between the streams was compared. Knowledge was evaluated by internal summative examinations and the Medical Council of Canada Part 1 licensing exam. Clinical skills were evaluated via in-training evaluation report (ITERs) and performance on the clerkship objective structured clinical examination (OSCE). Meta-analysis was used to compare knowledge evaluations and clinical performance for all core clerkship disciplines, and pooled effect sizes from the fixed-effect models were reported.

Results: Meta-analyses showed no statistically significant heterogeneity. There were no differences between LIC and RBC students on knowledge evaluations (pooled effect size 0.019; 95% confidence interval [-0.155, 0.152], P = .8), ITERs (pooled effect size -0.015 [-0.157, 0.127], P = .8), or mean OSCE ratings (67.9 [SD = 4.6] versus 68.6 [SD = 5.8], P = .5).

Conclusions: After matching on prior academic performance, LIC and RBC students at one school had comparable performance on summative evaluations of knowledge, clinical performance, and clinical skills over three years.

Publication types

  • Observational Study

MeSH terms

  • Clinical Clerkship / methods
  • Clinical Clerkship / standards*
  • Clinical Competence
  • Cohort Studies
  • Education, Medical, Undergraduate / methods
  • Education, Medical, Undergraduate / standards*
  • Educational Measurement*
  • Humans
  • Longitudinal Studies
  • Prospective Studies
  • Research Design