Welch Thomas R, Olson Brad G, Nelsen Elizabeth, Beck Dallaghan Gary L, Kennedy Gloria A, Botash Ann
Department of Pediatrics, State University of New York Upstate Medical University, Syracuse, NY.
Department of Pediatrics, State University of New York Upstate Medical University, Syracuse, NY.
J Pediatr. 2017 Sep;188:270-274.e3. doi: 10.1016/j.jpeds.2017.05.057. Epub 2017 Jun 16.
To determine whether training site or prior examinee performance on the US Medical Licensing Examination (USMLE) step 1 and step 2 might predict pass rates on the American Board of Pediatrics (ABP) certifying examination.
Data from graduates of pediatric residency programs completing the ABP certifying examination between 2009 and 2013 were obtained. For each, results of the initial ABP certifying examination were obtained, as well as results on National Board of Medical Examiners (NBME) step 1 and step 2 examinations. Hierarchical linear modeling was used to nest first-time ABP results within training programs to isolate program contribution to ABP results while controlling for USMLE step 1 and step 2 scores. Stepwise linear regression was then used to determine which of these examinations was a better predictor of ABP results.
A total of 1110 graduates of 15 programs had complete testing results and were subject to analysis. Mean ABP scores for these programs ranged from 186.13 to 214.32. The hierarchical linear model suggested that the interaction of step 1 and 2 scores predicted ABP performance (F[1,1007.70] = 6.44, P = .011). By conducting a multilevel model by training program, both USMLE step examinations predicted first-time ABP results (b = .002, t = 2.54, P = .011). Linear regression analyses indicated that step 2 results were a better predictor of ABP performance than step 1 or a combination of the two USMLE scores.
Performance on the USMLE examinations, especially step 2, predicts performance on the ABP certifying examination. The contribution of training site to ABP performance was statistically significant, though contributed modestly to the effect compared with prior USMLE scores.
确定培训地点或考生先前在美国医师执照考试(USMLE)第一步和第二步中的表现是否可以预测美国儿科学会(ABP)认证考试的通过率。
获取了2009年至2013年间完成ABP认证考试的儿科住院医师培训项目毕业生的数据。对于每一位毕业生,获取了ABP初始认证考试的结果以及美国国家医学考试委员会(NBME)第一步和第二步考试的结果。采用分层线性模型将首次ABP考试结果嵌套在培训项目中,以在控制USMLE第一步和第二步分数的同时,分离出项目对ABP考试结果的影响。然后使用逐步线性回归来确定这些考试中哪一项是ABP考试结果的更好预测指标。
15个项目的1110名毕业生有完整的考试结果并接受了分析。这些项目的ABP平均分数在186.13至214.32之间。分层线性模型表明,第一步和第二步分数的交互作用可预测ABP考试表现(F[1,1007.70] = 6.44,P = 0.011)。通过按培训项目进行多层次模型分析,两项USMLE考试均能预测首次ABP考试结果(b = 0.002,t = 2.54,P = 0.011)。线性回归分析表明,第二步考试结果比第一步考试结果或两项USMLE分数的组合更能预测ABP考试表现。
USMLE考试的表现,尤其是第二步考试的表现,可预测ABP认证考试的表现。培训地点对ABP考试表现的影响具有统计学意义,不过与先前的USMLE分数相比,其对结果的影响较小。