Establishing the Validity of Test Score Inferences: Performance of 4th-Year U.S. Medical Students on the ECFMG Clinical Skills Assessment

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.