Establishing the validity of test score inferences: Performance of 4th-year US 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.