Journal article
The Impact of Internal Medicine Clerkship Characteristics and NBME Subject Exams on USMLE Step 2 Clinical Knowledge Exam Performance
Journal of general internal medicine : JGIM, v 37(9), pp 2208-2216
2022
Featured in Collection : UN Sustainable Development Goals @ Drexel
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.
Metrics
Details
- Title
- The Impact of Internal Medicine Clerkship Characteristics and NBME Subject Exams on USMLE Step 2 Clinical Knowledge Exam Performance
- Creators
- Matthew Fitz - Loyola University ChicagoWilliam Adams - Loyola University ChicagoMarc Heincelman - Medical University of South CarolinaSteve Haist - Northern Kentucky UniversityKarina Whelan - University of North Carolina at Chapel HillLeeAnn Cox - Indiana UniversityUyen-Thi Cao - Texas A&M Health Science CenterSusan Hingle - Southern Illinois University School of MedicineAmanda Raff - Albert Einstein College of MedicineBruce Houghton - Creighton UniversityJanet Fitzpatrick - Drexel UniversityRyan Nall - Florida CollegeJennifer Foster - Florida Atlantic UniversityJonathan Appelbaum - Florida State UniversityCyril Grum - University of Michigan–Ann ArborAnna Donovan - University of PittsburghStuart Kiken - Rosalind Franklin University of Medicine and ScienceReeni Abraham - The University of Texas Southwestern Medical CenterMarti Hlafka - Southern Illinois University School of MedicineChad Miller - Tulane UniversitySaurabh Bansal - Illinois CollegeDouglas Paauw - University of WashingtonCindy J Lai - University of California, San FranciscoAmber Pincavage - University of ChicagoGauri Agarwal - University of MiamiCynthia Burns - Wake Forest UniversityHoratio Holzer - Icahn School of Medicine at Mount SinaiKatie Lappé - University of UtahViju John - Rush Medical CollegeBlake Barker - The University of Texas Southwestern Medical CenterNina Mingioni - Thomas Jefferson UniversityDeepti Rao - University of New MexicoLaura Zakowski - University of Wisconsin–MadisonChayan Chakraborti - Tulane UniversityWinter Williams - UAB Heersink School of Medicine, Birmingham, AL, USA.William Kelly - Uniformed Services University of the Health Sciences
- Publication Details
- Journal of general internal medicine : JGIM, v 37(9), pp 2208-2216
- Publisher
- Springer International Publishing
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- MD (Doctor of Medicine) Program
- Web of Science ID
- WOS:000817849900002
- Scopus ID
- 2-s2.0-85130304250
- Other Identifier
- 991019169517704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Health Care Sciences & Services