Examining the Relationship Between Pediatric Clerkship Timing and Performance: COVID-19 Pandemic and Beyond

Introduction: Medical education experienced significant changes over the past 5 years, with the COVID-19 pandemic having a considerable impact on students’ clinical rotations. The Uniformed Services University (USU) pediatric clerkship, which sends medical students to 11 geographically diverse clerkships sites, was no exception. This study sought to determine if there is a relationship between the COVID-19 pandemic and medical students’ performance outcomes in their pediatric clerkship. Sub-analyses sought to determine if these relationships vary by the clerkship site or timing within the academic year. Methods: Data included mean National Board of Medical Examiners® (NBME) scores from pre-clerkship, and NBME Pediatrics Subject Examination and History and Physical Exam (H&P) scores from the USU medical students who completed the pediatric clerkship during 2018–2023 (N = 978). Statistical analyses examined the relationship between students’ performance and timing, as well as performance across clerkship sites. Results: Students’ NBME scores were significantly lower in 2020 compared to 2018 (p < 0.001), 2019 (p < 0.001), and 2023 (p < 0.05). H&P scores differed significantly by year, but increased rather than decreased during 2020. There was a positive linear relationship between timing during the academic year and performance outcomes, which was more significant in and consistent across sites for NBME scores. Conclusion: Changes made to the clerkship during the COVID-19 pandemic (2020) may have impacted students’ performance on the NBME, but did not appear to impact their H&P scores. Sub-analyses suggest the experiences students have throughout the clerkship year may improve their overall performance.