The Association between External Ear Size and Medical Student Performance: A Purely Hypothetical Study John Star Student, B.S. and Jane Doe Mentor, M.D., Ph.D. The Fictional School of Medicine, Department of Otolaryngology, Anywhere USA Careful listening is thought to be an important component of classroom leaning and medical student performance. However, little is known about what distinguishes careful listeners from those who don’t listen carefully. To test the hypothesis that larger external ear size is associated with greater listening and learning as measured by medical student class performance. Study Design: An observational cohort study. Participants: 1st year medical students enrolled in the Pathology class at the Fictional School of Medicine. Measurements: External ear area (height x width of the helix). Daily Pathology Class attendance from video surveillance Prior knowledge of pathology, based on pre-course exam score of baseline knowledge. Outcome: Medical student performance was assessed as the percentage of correct responses to Pathology exam questions based on information included in class lectures but not in the assigned textbook or syllabus. Analysis: Linear regression was used to assess the correlation between external ear area and medical student performance. FIGURE 1: Scatterplot of ear size versus medical student performance. TABLE 2: Correlations between medical student performance and ear size, with and without adjustment for potential confounding by prior knowledge and class attendance. Larger external ear size was significantly associated with better medical student performance. These findings appear to be explained by differences in class attendance. After taking into account the correlation between class attendance and medical student performance, the association between ear size and medical student performance was no longer statistically significant. These results do not support the hypothesis that external ear size per se is a primary factor in medical student performance. However, because careful listening is only one aspect of medical student performance, these results do not exclude the possibility that external ear size may be related to careful listening. Future studies that include measures more directly associated with listening, such as hearing acuity, should be considered. This research was funded by the Fictional Funding Institute for Medical Student Research. We greatly appreciate the cooperation of the 1st year medical students of Fictional Medical School. We thank Joe Number for teaching J.S.S. the basics of linear regression. CONCLUSIONS BACKGROUND RESULTS PURPOSE SIGNIFICANCE METHODS ACKNOWLEDGEMENTS Independent variables in regression model Partial Regression Coefficient, p value Ear size, mm2 0.89, p <0.001 Ear size, adjusted for prior knowledge 0.87, p <0.001 Ear size, adjusted for class attendance 0.09, p=0.52