Kumar Kusum, Nguyen Hoa, Indurkhya Alka
Division of Human Pathology, Department of Epidemiology, Michigan State University, MI 48824, USA.
Hum Pathol. 2003 May;34(5):417-22. doi: 10.1016/s0046-8177(03)00082-0.
A collaborative multi-institutional study was conducted to study the relationship between characteristics of pathology instruction and student performance in the United States Medical Licensing Examination (USMLE), Step 1. Detailed descriptions of pathology instruction, such as curriculum format, style of instruction, and design of instruction of various areas of pathology for the 1996-1997 academic year were matched with Step 1 total scores and pathology subscores for 10,159 students from 88 schools who took the June 1997 examination. Hierarchical linear modeling was used for analysis while controlling for students' MCAT-bpv scores (Medical College Admission Test scores, average of biological and physical sciences and verbal reasoning). The Step 1 total scores correlate with Step 1 pathology subscores, and both correlate with students' MCAT-bpv scores. The MCAT-bpv scores account for most of the variation in Step 1 scores. Of all of the curricular variables analyzed, 2 possible factors that significantly influence the impact of MCAT-bpv scores on Step 1 scores are (1) multidisciplinary format of instruction and (2) discipline-based general pathology instruction in year 2. Overall, the multidisciplinary format reduced the impact of MCAT-bpv scores on both the Step 1 total score and the pathology subscore by 1 point per MCAT-bpv. Overall, the general pathology instruction in year-2 increased that impact on Step 1 total score by 1 point per MCAT-bpv. The slope became less steep with multidisciplinary format and more steep with year-2 general pathology instruction. As a result, students with higher MCAT-bpv scores tend to benefit from year-2 general pathology instruction, whereas those with lower MCAT-bpv scores appear to benefit from a multidisciplinary format. These differences become more apparent as the MCAT-bpv scores move away from the mean in either direction, indicating that scores of most students are not affected by curricular variables. Overall, there is no significant difference in the school means of Step 1 total scores and pathology subscores of schools with different curricular approaches. This is most likely due to the finding that the students' MCAT-bpv scores, and not curricular variables, are the major predictors of Step 1 scores, and all schools have a mix of students with various MCAT-bpv scores.
开展了一项多机构合作研究，以探究美国医师执照考试（USMLE）第一步中病理学教学特点与学生成绩之间的关系。1996 - 1997学年病理学教学的详细描述，如课程形式、教学风格以及病理学各领域的教学设计，与1997年6月参加考试的来自88所学校的10159名学生的第一步总成绩和病理学分项成绩进行了匹配。在控制学生的医学院入学考试生物与物理科学及语言推理平均成绩（MCAT - bpv分数）的同时，使用分层线性模型进行分析。第一步总成绩与第一步病理学分项成绩相关，且二者均与学生的MCAT - bpv分数相关。MCAT - bpv分数占第一步成绩中大部分的变异。在所有分析的课程变量中，有两个可能显著影响MCAT - bpv分数对第一步成绩影响的因素：（1）多学科教学形式；（2）二年级基于学科的普通病理学教学。总体而言，多学科教学形式使MCAT - bpv分数对第一步总成绩和病理学分项成绩的影响每MCAT - bpv降低1分。总体而言，二年级的普通病理学教学使对第一步总成绩的影响每MCAT - bpv增加1分。多学科教学形式下斜率变缓，二年级普通病理学教学时斜率变陡。因此，MCAT - bpv分数较高的学生往往受益于二年级的普通病理学教学，而MCAT - bpv分数较低的学生似乎受益于多学科教学形式。随着MCAT - bpv分数向均值两侧偏离，这些差异变得更加明显，这表明大多数学生的成绩不受课程变量影响。总体而言，采用不同课程方法的学校在第一步总成绩和病理学分项成绩的学校均值上没有显著差异。这很可能是因为学生的MCAT - bpv分数而非课程变量是第一步成绩的主要预测因素，且所有学校都有不同MCAT - bpv分数的学生组合。
