How well does the academic performance of Ethiopian anaesthetists predict their National Licensing Examination scores: a cross-sectional study

OBJECTIVES: This study assessed the relationship between academic performance and National Licensing Examination (NLE) scores of Ethiopian anaesthetists and proposed academic performance thresholds that predict failing the NLE. DESIGN: A retrospective cross-sectional study. SETTING: Academic performance measures were collected from eight universities and matched to total and subdomain NLE scores for anaesthetists. Four universities were first generation (oldest), three were second generation and one was third generation (newest). PARTICIPANTS: 524 anaesthetists. MEASURES: Selected course grades, yearly (Y1-Y4) and cumulative grade point averages (GPAs) and in-school exit exam status were correlated with NLE scores. Linear regression was used to identify predictors of NLE score. Receiver operating characteristic curves were plotted to estimate GPA thresholds that predict failing the NLE. RESULTS: Total and general surgery anaesthesia subdomain NLE scores showed moderate to strong linear relationships with most academic performance indicators. However, correlations between the rest of the subdomain NLE scores and composite course scores were either small or negligible (r<0.5). For every 1-point increase in a 4-point cumulative GPA and composite senior year practicum course score, the first-attempt NLE score increased by 12.61 (95% CI 10.03 to 15.19; p<0.0001) and 3.98 (95% CI 1.77 to 6.19; p=0.001) percentage points, respectively. Those entering university directly from high school and those attending a third-generation university would, on average, score 2.79 (95% CI 0.23 to 5.35; p=0.033) and 4.34 (95% CI 1.42 to 7.26; p=0.004) higher NLE scores compared with nurse entrants and first-generation university graduates, respectively. On a 4-point grading system, the thresholds for failing the NLE were below 2.68 for year-1 GPA, 2.62 for year-2 GPA, 2.72 for year-3 GPA, 3.04 for year-4 GPA and 2.87 for cumulative GPA. CONCLUSIONS: The Ethiopian anaesthetist's NLE score modestly correlated with most academic performance indicators. Based on pass/fail thresholds, the NLE could assist training programmes in improving NLE pass rates.