Evaluating the Impact of Participating in KNIGHTS (Keeping Neighbors In Good Health Through Service) Clinic on Clinical Performance and Skills Development.

Introduction Student-run free clinics provide early clinical exposure for preclinical medical students and are associated with improved self-reported confidence and preparedness. However, there is limited objective evidence evaluating whether these experiences translate into measurable differences in standardized assessments of clinical competence. Objective Structured Clinical Examinations (OSCEs) are commonly used to assess clinical skills, though their ability to capture competencies developed in real-world clinical settings remains uncertain. This study examined the association between participation in the University of Central Florida's KNIGHTS (Keeping Neighbors In Good Health Through Service) free clinic and OSCE performance. Methods Deidentified OSCE scores (0-100) were obtained for second-year medical students (MS2s) and third-year medical students (MS3s) from 2020 to 2024 and stratified by KNIGHTS volunteer status and by patient-facing roles as advanced student providers (ASP). Independent t-tests and repeated measures ANOVA were used (p < 0.05). Analyses were conducted using SPSS Statistics v. 31 (IBM Corporation, Armonk, NY, US). Results A total of 354 students were included in the analysis. No statistically significant differences in OSCE performance were observed between KNIGHTS volunteers (n = 113) and non-volunteers (n = 241) at either time point (MS2: 83.6 ± 10.1 vs. 83.2 ± 10.9, p = 0.75; MS3: 77.8 ± 3.8 vs. 77.3 ± 3.9, p = 0.27). Similarly, no significant differences were found between ASP (n = 40) and non-ASP (n = 73) volunteers (all p > 0.05). Conclusion Participation in the KNIGHTS student-run free clinic was not associated with higher MS2 or MS3 OSCE scores in this cohort. These findings should be interpreted as associations rather than causal effects. One possible explanation is that some competencies developed through real-world patient care are not fully represented in standardized OSCE outcomes. However, such competencies were not independently measured in this study.