Hedgepeth Dylan, Wlasowicz Samuel, Lott Ronald, Smith Travis
College of Medicine, Lake Erie College of Osteopathic Medicine, Erie, USA.
Clinical Curriculum Integration and Assessment, Lake Erie College of Osteopathic Medicine - Bradenton, Bradenton, USA.
Cureus. 2023 Mar 14;15(3):e36154. doi: 10.7759/cureus.36154. eCollection 2023 Mar.
The United States Medical Licensing Examination (USMLE) Step 1 recently shifted from a three-digit scoring format to a pass/fail scoring rubric. Lake Erie College of Osteopathic Medicine (LECOM) is among a number of osteopathic medical schools that traditionally included passing Step 1 as a graduation requirement. However, LECOM removed this requirement following the change in scoring format. National Board of Medical Examiners (NBME) subject examinations have a significant impact on the clerkship grades of third-year medical students. Therefore, our pilot study compared NBME subject examination scores among third-year LECOM medical students that did and did not take and pass Step 1. We anticipate that both high pre-clinical grade point average (GPA) and having passed Step 1 will be associated with higher subject exam scores, but passing Step 1 will have a relationship with higher subject exam scores that is independent of pre-clinical GPA.
Using voluntary response sampling, 201 osteopathic medical students from LECOM completed an online survey through Google Forms regarding their pre-clinical GPA, subject exam scores, whether they took and passed USMLE Step 1, and their study resources used throughout clerkships. Results: There was a positive correlation ( < 0.05) found between pre-clinical GPA and exam scores across all subjects among students that took Step 1. There was no relationship between pre-clinical GPA and exam scores across all subjects among students that did not take Step 1 ( > 0.05). Students that took Step 1 had a higher pre-clinical GPA than those that did not. Students that took and passed Step 1 scored higher on subject exams. Fifty-nine percent of respondents indicated they would have studied more for Step 1 if these exams were scored on the three-digit format, while zero respondents indicated they would have studied less.
Although higher pre-clinical GPA and taking Step 1 were associated with higher scores on subject exams, taking Step 1 appears to have an independent influence on subject exams because there was no relationship found between pre-clinical GPA and subject exam scores among students that did not take Step 1. Therefore, there may be features related to preparing for this exam that better equip osteopathic medical students to perform well on subject exams.
美国医师执照考试（USMLE）第一步最近从三位数评分格式改为通过/不通过评分标准。伊利湖骨科医学院（LECOM）是众多传统上把通过第一步考试作为毕业要求的骨科医学院之一。然而，在评分格式改变后，LECOM取消了这一要求。美国国家医学考试委员会（NBME）的科目考试对三年级医学生的临床实习成绩有重大影响。因此，我们的试点研究比较了LECOM三年级医学生中参加并通过第一步考试和未参加第一步考试的学生的NBME科目考试成绩。我们预计临床前平均绩点（GPA）高和通过第一步考试都将与更高的科目考试成绩相关，但通过第一步考试与更高的科目考试成绩之间的关系将独立于临床前GPA。
采用自愿回应抽样，201名来自LECOM的骨科医学生通过谷歌表单完成了一项在线调查，内容涉及他们的临床前GPA、科目考试成绩、是否参加并通过了USMLE第一步考试以及他们在整个临床实习期间使用的学习资源。结果：在参加第一步考试的学生中，临床前GPA与所有科目的考试成绩之间存在正相关（<0.05）。在未参加第一步考试的学生中，临床前GPA与所有科目的考试成绩之间没有关系（>0.05）。参加第一步考试的学生临床前GPA高于未参加的学生。参加并通过第一步考试的学生在科目考试中得分更高。59%的受访者表示，如果这些考试采用三位数评分格式，他们会为第一步考试多学习，而0%的受访者表示会少学习。
虽然较高的临床前GPA和参加第一步考试与科目考试的较高分数相关，但参加第一步考试似乎对科目考试有独立影响，因为在未参加第一步考试的学生中，临床前GPA与科目考试成绩之间没有关系。因此，可能存在与准备该考试相关的因素，能让骨科医学生在科目考试中表现得更好。
