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The Impact of Internal Medicine Clerkship Characteristics and NBME Subject Exams on USMLE Step 2 Clinical Knowledge Exam Performance. Journal Article
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| Authors: | Fitz, M; Adams, W; Heincelman, M; Haist, S; Whelan, K; Cox, L; Cao, UT; 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; Bansal, S; Paauw, D; Lai, CJ; Pincavage, A; Agarwal, G; Burns, C; Holzer, H; Lappé, K; John, V; Barker, B; Mingioni, N; Rao, D; Zakowski, L; Chakraborti, C; Williams, W; Kelly, W |
| Article Title: | 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 ß = 0.45, p .001) and NBME medicine subject exam performance (standardized ß = 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 = -3.17 p .001). Students who had a criterion score for passing the NBME medicine subject exam scored higher on Step 2 CK (M = 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 (ß=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. |
| Journal Title: | Journal of general internal medicine |
| ISSN: | 1525-1497; 0884-8734 |
| Publisher: | Unknown |
| Date Published: | 2022 |
