Patel Maitray D, Tomblinson Courtney M, Benefield Thad, Ali Kamran, DeBenedectis Carolynn M, England Eric, Gaviola Glenn C, Ho Christopher P, Jay Ann K, Milburn James M, Ong Seng, Robbins Jessica B, Sarkany David S, Heitkamp Darel E, Jordan Sheryl G
Executive Board, Society of Radiologists in Ultrasound, Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona.
Associate Program Director Diagnostic Radiology Residency; Associate Director, Women in Radiology, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
J Am Coll Radiol. 2020 Aug;17(8):1037-1045. doi: 10.1016/j.jacr.2020.02.017. Epub 2020 Mar 24.
We analyzed multi-institutional data to understand the relationship of US Medical Licensing Examination (USMLE) Step scores to ABR Core examination performance to identify Step score tiers that stratify radiology residents into different Core performance groups.
We collected USMLE Step scores and ABR Core examination outcomes and scores for anonymized residents from 13 different diagnostic radiology residency programs taking the ABR Core examination between 2013 and 2019. USMLE scores were grouped into noniles using z scores and then aggregated into three tiers based on similar Core examination pass-or-fail outcomes. Core performance was grouped using standard deviation from the mean and then measured by the percent of residents with scores below the mean. Differences between Step tiers for Core outcome and Core performance were statistically evaluated (P < .05 considered significant).
Differences in Step 1 terciles Core failure rates (45.9%, 11.9%, and 3.0%, from lowest to highest Step tiers; n = 416) and below-mean Core performance (83.8%, 54.1%, and 21.1%, respectively; n = 402) were significant. Differences in Step 2 groups Core failure rates (30.0%, 10.6%, and 2.0%, from lowest to highest Step tiers; n = 387) and below-mean Core performance (80.0%, 43.7%, and 14.0%, respectively; n = 380) were significant. Step 2 results modified Core outcome and performance predictions for residents in Step 1 terciles of varying statistical significance.
Tiered scoring of USMLE Step results has value in predicting radiology resident performance on the ABR Core examination; effective stratification of radiology resident applicants can be done without reporting numerical Step scores.
我们分析了多机构数据，以了解美国医师执照考试（USMLE）各阶段分数与美国放射学会（ABR）核心考试成绩之间的关系，从而确定能将放射科住院医师分为不同核心考试表现组的分数层级。
我们收集了2013年至2019年间参加ABR核心考试的13个不同诊断放射科住院医师培训项目中匿名住院医师的USMLE各阶段分数以及ABR核心考试结果和分数。利用z分数将USMLE分数分为九分位数，然后根据相似的核心考试通过或未通过结果汇总为三个层级。核心考试表现根据与均值的标准差进行分组，然后通过分数低于均值的住院医师百分比来衡量。对核心考试结果和核心考试表现的各阶段分数层级之间的差异进行统计学评估（P <.05为显著）。
第一阶段分数三分位数的核心考试不及格率存在显著差异（从最低到最高阶段分数层级分别为45.9%、11.9%和3.0%；n = 416），以及低于均值的核心考试表现也存在显著差异（分别为83.8%、54.1%和21.1%；n = 402）。第二阶段分数组的核心考试不及格率存在显著差异（从最低到最高阶段分数层级分别为30.0%、10.6%和2.0%；n = 387），以及低于均值的核心考试表现也存在显著差异（分别为80.0%、43.7%和14.0%；n = 380）。第二阶段的结果对处于不同统计学显著性的第一阶段分数三分位数中的住院医师的核心考试结果和表现预测进行了修正。
USMLE各阶段结果的分层评分在预测放射科住院医师在ABR核心考试中的表现方面具有价值；无需报告具体的阶段分数即可对放射科住院医师申请人进行有效分层。
