Dataset Information

The Impact of Internal Medicine Clerkship Characteristics and NBME Subject Exams on USMLE Step 2 Clinical Knowledge Exam Performance.

ABSTRACT:

Background

Residency program directors will likely emphasize the United States Medical Licensing Exam (USMLE) Step 2 clinical knowledge (CK) exam more during residency application given the recent USMLE Step 1 transition to pass/fail scoring. We examined how internal medicine clerkship characteristics and NBME subject exam scores affect USMLE Step 2 CK performance.

Design

The authors used univariable and multivariable generalized estimating equations to determine associations between Step 2 CK performance and internal medicine clerkship characteristics and NBME subject exams. The sample had 21,280 examinees' first Step 2 CK scores for analysis.

Results

On multivariable analysis, Step 1 performance (standardized β = 0.45, p < .001) and NBME medicine subject exam performance (standardized β = 0.40, p < .001) accounted for approximately 60% of the variance in Step 2 CK performance. Students who completed the internal medicine clerkship last in the academic year scored lower on Step 2 CK (M_diff = -3.17 p < .001). Students who had a criterion score for passing the NBME medicine subject exam scored higher on Step 2 CK (M_diff = 1.10, p = .03). There was no association between Step 2 CK performance and other internal medicine clerkship characteristics (all p > 0.05) nor with the total NBME subject exams completed (β=0.05, p = .78).

Conclusion

Despite similarities between NBME subject exams and Step 2 CK, the authors did not identify improved Step 2 CK performance for students who had more NBME subject exams. The lack of association of Step 2 CK performance with many internal medicine clerkship characteristics and more NBME subject exams has implications for future clerkship structure and summative assessment. The improved Step 2 CK performance in students that completed their internal medicine clerkship earlier warrants further study given the anticipated increase in emphasis on Step 2 CK.

SUBMITTER: Fitz M

PROVIDER: S-EPMC9296728 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

The Impact of Internal Medicine Clerkship Characteristics and NBME Subject Exams on USMLE Step 2 Clinical Knowledge Exam Performance.

Fitz Matthew M Adams William W Heincelman Marc M Haist Steve S Whelan Karina K Cox LeeAnn L Cao Uyen-Thi UT Hingle Susan S Raff Amanda A Houghton Bruce B Fitzpatrick Janet J Nall Ryan R Foster Jennifer J Appelbaum Jonathan J Grum Cyril C Donovan Anna A Kiken Stuart S Abraham Reeni R Hlafka Marti M Miller Chad C Bansal Saurabh S Paauw Douglas D Lai Cindy J CJ Pincavage Amber A Agarwal Gauri G Burns Cynthia C Holzer Horatio H Lappé Katie K John Viju V Barker Blake B Mingioni Nina N Rao Deepti D Zakowski Laura L Chakraborti Chayan C Williams Winter W Kelly William W

Journal of general internal medicine 20220628 9

<h4>Background</h4>Residency program directors will likely emphasize the United States Medical Licensing Exam (USMLE) Step 2 clinical knowledge (CK) exam more during residency application given the recent USMLE Step 1 transition to pass/fail scoring. We examined how internal medicine clerkship characteristics and NBME subject exam scores affect USMLE Step 2 CK performance.<h4>Design</h4>The authors used univariable and multivariable generalized estimating equations to determine associations betw ...[more]

PMID: 35764759

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Dataset Information

The Impact of Internal Medicine Clerkship Characteristics and NBME Subject Exams on USMLE Step 2 Clinical Knowledge Exam Performance.

Background

Design

Results

Conclusion

Publications

The Impact of Internal Medicine Clerkship Characteristics and NBME Subject Exams on USMLE Step 2 Clinical Knowledge Exam Performance.

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