Comparison of academic performance of medical students previously and non-previously graduated from other college courses in a PBL hybrid curriculum.

backgroundThe admission of graduate students (GS) into medical courses is seen as a mechanism that allows students to have better academic performance during the medical course and to become more competent professionals. For these reasons, specific programs for this purpose agree that GS may have better academic performance in medical courses than nongraduate students (NGS). This study aimed to assess whether graduate-entry students (GS) outperformed admission test (AT) and transfer (Tr) students in both the pre-clinical and clinical phases of an undergraduate medical program that adopts a hybrid Problem-Based Learning (PBL) methodology.

methodsA retrospective longitudinal cohort study was carried out, collecting and analysing non-academic data upon entry into the course, as well as academic and non-academic data during the course, from medical students enrolled at the time of the study (2016-2023). We analysed the data relating to the students who, at the beginning of the course, were previously graduates (GS) or nongraduates (NGS), which were composed of students submitted to the admission test (AT) and transferred (Tr). Continuous variables were presented as the median, the interquartile ranges (IR) was used to calculate the measure of dispersion of the data and Cohen's d was used to estimate effect size. Differences were evaluated using the Kruskal‒Wallis test and post hoc multiple comparisons were carried out with Dunn's test. The Bonferroni correction was used to control for Type I error across the three pairwise comparisons, in most of the data presented, setting a revised significance threshold of α = 0.0167 for each test (0.05 / 3). Thus, only p-values below 0.0167 were deemed statistically significant.

resultsGS students performed better than AT and Tr students in terms of overall grades, in the Tutorial sessions, in special in attitudinal performance, and on areas of Clinical skills, Primary care and Clerkship, better than Tr. In Clinical skills and Clerkship, AT performed better than Tr. In the progress test (PT), GS performed better than all the other groups and AT performed better than Tr also in the OSCE. In the GS group, male and female students performed similarly, and both groups performed better than male and female students in all the other groups (except for the both gender of the GS group that performed similarly to both gender of the AT group). GS students had a greater median age than did all the other students. On the other hand, Tr students presented the lowest scores for all analysed parameters and presented, except for the AT in the Primary care and Attitudinal, for GS in the OSCE. Tr presented a greater median age than did the AT group.

conclusionThis study suggests that there are advantages of adapting programs to integrate GS students into medical courses that adopt the hybrid PBL model before the clerkship.