Disparities Impacts Psychiatry Competency Assessments among Students in a Nigerian Medical School

Abstract

Background: Assessments in medical education must reliably evaluate competencies while addressing potential gender disparities. This study examines the reliability of psychiatry competency assessments among final-year medical students at the University of Ilorin, Nigeria, and explores gender differences in performance. The aim was to evaluate the internal consistency of formative (progressive assessment) and summative (final MBBS) examinations, analyse correlations between assessment components, and compare gender-based performance. Methodology: A retrospective analysis of all 137 (77 male, 60 female) final year medical students’ psychiatry competence assessments was conducted. Reliability was measured using Cronbach’s alpha, correlations between exam components were assessed via Pearson’s correlation, and gender differences were analysed using t-tests and Cohen’s d. Results: The combined assessments showed high reliability (α = 0.857), though lower for females (α = 0.553 vs. males: α = 0.618). Progressive assessment correlated moderately with theory components (Multiple Choice Questions: r = 0.507) but weakly with clinical tools (picture test: r = 0.158). Females outperformed males in both theory (mean difference: +1.71, p = 0.001) and clinical exams (mean difference: +1.08, p = 0.019), with moderate effect sizes (Cohen’s d = 0.63 and 0.42, respectively). Conclusion: While the assessment system demonstrates strong overall reliability, gendered disparities suggest a need for more equitable evaluation methods. Females consistently outperformed males, but lower reliability in their combined scores calls for refined formative tools. Integrating more multimodal assessments may enhance fairness and validity.