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Prediction of clinical performance of medical students in the clerkship phase was made possible in the earliest phase of medical education by a comprehensive and integrative evaluation instrument entitled "Integrative Examination" (INTEX). A proportional sample of the content learned throughout the year is integrated for measuring knowledge, attitudes and skills on various cognitive levels within the clinical context of patient problems. INTEX was found to be a reliable instrument. Also its scores highly correlate with all the constituents of later clinical assessment, creating a valid multitrait-multimethod matrix. The educational implication of an integrative approach to evaluation is discussed. (Author)