The Impact of Internal Medicine Clerkship Characteristics and NBME Subject Exams on USMLE Step 2 Clinical Knowledge Exam Performance.
Publication/Presentation Date
7-1-2022
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
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.
Volume
37
Issue
9
First Page
2208
Last Page
2216
ISSN
1525-1497
Published In/Presented At
Fitz, M., Adams, W., Heincelman, M., Haist, S., Whelan, K., Cox, L., Cao, U. T., Hingle, S., Raff, A., Houghton, B., Fitzpatrick, J., Nall, R., Foster, J., Appelbaum, J., Grum, C., Donovan, A., Kiken, S., Abraham, R., Hlafka, M., Miller, C., … Kelly, W. (2022). The Impact of Internal Medicine Clerkship Characteristics and NBME Subject Exams on USMLE Step 2 Clinical Knowledge Exam Performance. Journal of general internal medicine, 37(9), 2208–2216. https://doi.org/10.1007/s11606-022-07520-6
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
35764759
Department(s)
Administration and Leadership
Document Type
Article