Insights into student assessment outcomes in rural clinical campuses

Background: There is an ongoing debate about the impact of studying medicine in rural vs. metropolitan campuses on student assessment outcomes. The UNSW Medicine Rural Clinical School has five main campuses; Albury-Wodonga, Coffs Harbour, Griffith, Port Macquarie and Wagga Wagga. Historical data of student assessment outcomes at these campuses raised concerns regarding potential biases in assessment undertaken, as well as the availability and quality of learning resources. The current study aims to identify the extent to which the location of examination (rural versus metropolitan) has an impact on student marks in OSCEs. Methods: Assessment data was employed for this study from 275 medical students who sat their final examinations in Years 3 and 6 of the undergraduate Medicine program at UNSW in 2018. The data consists of matched student assessment results from the Year 3 (Y3) MCQ examination and OSCE, and from the Year 6 (Y6) MCQ, OSCE and management viva examinations. The analysis used Univariate Analysis of Variance and linear regression models to identify the impact of site of learning and site of examination on assessment outcomes. Results: The results demonstrate that neither site of learning nor site of examination had any significant impact on OSCE or Management Viva assessment outcomes while potential confounders are controlled. Conclusion: It is suggested that some of the supposed disadvantages inherent at rural campuses are effectively mitigated by perceived advantages; more intensive interaction with patients, the general and medical communities at those sites, as well as effective e-learning resources and moderation of assessment grades.