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Investigation of answer changes on the USMLE® Step 2 Clinical Knowledge examination.

ABSTRACT: BACKGROUND:Examinees often believe that changing answers will lower their scores; however, empirical studies suggest that allowing examinees to change responses may improve their performance in classroom assessments. To date, no studies have been able to examine answer changes during large scale professional credentialing or licensing examinations. METHODS:In this study, we expand the research on answer changes by analyzing responses from 27,830 examinees who completed the Step 2 Clinical Knowledge (CK) examination between August of 2015 and August of 2016. RESULTS:The results showed that although 68% of examinees changed at least one item, the overall average number of changes was small. Among the examinees who changed answers, approximately 45% increased their scores and approximately 28% decreased their scores. On average, examinees spent shortest time on the item changes from wrong to right and they were more likely to change their scores from wrong to right than right to wrong. CONCLUSIONS:Consistent with previous studies, these findings support the beneficial effects of answer changes in high-stakes medical examinations and suggest that examinees who are overly cautious about changing answers may put themselves at a disadvantage.

SUBMITTER: Ouyang W

PROVIDER: S-EPMC6806526 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Investigation of answer changes on the USMLE® Step 2 Clinical Knowledge examination.

Ouyang Wenli W Harik Polina P Clauser Brian E BE Paniagua Miguel A MA

BMC medical education 20191023 1

<h4>Background</h4>Examinees often believe that changing answers will lower their scores; however, empirical studies suggest that allowing examinees to change responses may improve their performance in classroom assessments. To date, no studies have been able to examine answer changes during large scale professional credentialing or licensing examinations.<h4>Methods</h4>In this study, we expand the research on answer changes by analyzing responses from 27,830 examinees who completed the Step 2 ...[more]

PMID: 31647012

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Project description:ObjectiveThe research sought to ascertain medical and dental libraries' collection development policies, evaluation methods, purchase decisions, and issues that relate to print and electronic United States Medical Licensing Examination (USMLE) and National Board Dental Examination (NBDE) preparation materials.MethodsThe investigators surveyed librarians supporting American Association of Medical Colleges (AAMC)-accredited medical schools (n = 58/125) on the USMLE and librarians supporting American Dental Association (ADA)-accredited dental schools (n = 23/56) on the NBDE. The investigators analyzed the data by cross-tabulating and filtering the results using EFM Continuum web survey software. Investigators also surveyed print and electronic USMLE and NBDE preparation materials from 2004-2007 to determine the number of publications and existence of reviews.ResultsA majority of responding AAMC libraries (62%, n = 58) provide at least 1 electronic or online USMLE preparation resource and buy an average of 11.6 print USMLE titles annually. Due to a paucity of NBDE print and electronic resources, ADA libraries bought significantly fewer print resources, and only 1 subscribed to an electronic resource. The most often reported evaluation methods for both populations were feedback from medical or dental students, feedback from medical or dental faculty, and online trials. Some AAMC (10%, n = 58) and ADA libraries (39%, n = 23) libraries reported that no evaluation of these materials occured at their libraries.ConclusionsFrom 2004-2007, publishers produced 45 USMLE preparation resources (total n = 546) to every 1 NBDE preparation resource (total n = 12). Users' needs, institutional missions and goals, financial status, and official collection policies most often underlie decisions to collect or not collect examination preparation materials. Evaluating the quality of examination preparation materials can be problematic due to lack of published reviews, lack of usability testing by libraries, and librarians' and library users' unfamiliarity with the actual content of examinations. Libraries must integrate faculty and students into the purchase process to make sure examination preparation resources of the highest quality are purchased.

Project description:BackgroundNearly all U.S. medical students engage in a 4-8 week period of intense preparation for their first-level licensure exams, termed a "dedicated preparation period" (DPP). It is widely assumed that student well-being is harmed during DPPs, but evidence is limited. This study characterized students' physical, intellectual, emotional, and social well-being during DPPs.MethodsThis was a cross-sectional survey sent electronically to all second-year students at four U.S. medical schools after each school's respective DPP for USMLE Step 1 or COMLEX Level 1 in 2019. Survey items assessed DPP characteristics, cost of resources, and perceived financial strain as predictors for 18 outcomes measured by items with Likert-type response options. Open-ended responses on DPPs' influence underwent thematic analysis.ResultsA total of 314/750 (42%) students completed surveys. DPPs lasted a median of 7 weeks (IQR 6-8 weeks), and students spent 70 h/week (IQR 56-80 h/week) studying. A total of 62 (20%) reported experiencing a significant life event that impacted their ability to study during their DPPs. Most reported 2 outcomes improved: medical knowledge base (95%) and confidence in ability to care for patients (56%). Most reported 9 outcomes worsened, including overall quality of life (72%), feeling burned out (77%), and personal anxiety (81%). A total of 25% reported paying for preparation materials strained their finances. Greater perceived financial strain was associated with worsening 11 outcomes, with reported amount spent associated with worsening 2 outcomes. Themes from student descriptions of how DPPs for first-level exams influenced them included (1) opportunity for synthesis of medical knowledge, (2) exercise of endurance and self-discipline required for professional practice, (3) dissonance among exam preparation resource content, formal curriculum, and professional values, (4) isolation, deprivation, and anguish from competing for the highest possible score, and (5) effects on well-being after DPPs.ConclusionsDPPs are currently experienced by many students as a period of personal and social deprivation, which may be worsened by perceived financial stress more than the amount of money they spend on preparation materials. DPPs should be considered as a target for reform as medical educators attempt to prevent student suffering and enhance their well-being.

Project description:BackgroundUnited States Medical Licensing Examination Step 1 will transition from numeric grading to pass/fail, sometime after January 2022. The aim of this study was to compare how program directors in orthopaedics and internal medicine perceive a pass/fail Step 1 will impact the residency application process.MethodsA 27-item survey was distributed through REDCap to 161 U.S. orthopaedic residency program directors and 548 U.S. internal medicine residency program directors. Program director emails were obtained from the American Medical Association's Fellowship and Residency Electronic Interactive Database.ResultsWe received 58 (36.0%) orthopaedic and 125 (22.8%) internal medicine program director responses. The majority of both groups disagree with the change to pass/fail, and felt that the decision was not transparent. Both groups believe that the Step 2 Clinical Knowledge exam and clerkship grades will take on more importance. Compared to internal medicine PDs, orthopaedic PDs were significantly more likely to emphasize research, letters of recommendation from known faculty, Alpha Omega Alpha membership, leadership/extracurricular activities, audition elective rotations, and personal knowledge of the applicant. Both groups believe that allopathic students from less prestigious medical schools, osteopathic students, and international medical graduates will be disadvantaged. Orthopaedic and internal medicine program directors agree that medical schools should adopt a graded pre-clinical curriculum, and that there should be a cap on the number of residency applications a student can submit.ConclusionOrthopaedic and internal medicine program directors disagree with the change of Step 1 to pass/fail. They also believe that this transition will make the match process more difficult, and disadvantage students from less highly-regarded medical schools. Both groups will rely more heavily on the Step 2 clinical knowledge exam score, but orthopaedics will place more importance on research, letters of recommendation, Alpha Omega Alpha membership, leadership/extracurricular activities, personal knowledge of the applicant, and audition electives.

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Investigation of answer changes on the USMLE® Step 2 Clinical Knowledge examination.

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Investigation of answer changes on the USMLE® Step 2 Clinical Knowledge examination.

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