Prater Christine M, Tenner Thomas E, Blanton Michael P, Trotter David
Department of Medical Education, Texas Tech University Health Sciences Center, Lubbock, TX 79430 USA.
Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430 USA.
Med Sci Educ. 2024 Jan 15;34(2):357-361. doi: 10.1007/s40670-023-01972-z. eCollection 2024 Apr.
A challenge for medical educators is choosing a method that best evaluates preclinical students' performance in preparation for Step 1. In previous years, block directors (BDs) of the 2nd year (MS2) neuroscience course at Texas Tech University Health Sciences Center School of Medicine issued faculty-written (FW) examinations during the course. In 2022, BDs replaced FW examinations with National Board of Medical Examiners (NBME) custom examinations. The rationale being that the customized NBME exams would better reflect the national neuroscience curriculum and enhance student preparedness for taking standardized exams.
FW examinations (2021) were created by the faculty in the neuroscience course and reviewed by BDs. In contrast, questions that best aligned with the material covered for the 2022 course were selected by BDs using MyNBME Services Portal. The custom questions selected are assigned a "difficulty" score by NBME, generating a predicted national average score. At the end of the course, undergraduate medical students in the School of Medicine at Texas Tech University Health Sciences Center completed an online Qualtrics questionnaire to compare the transition of assessment type.
Participants reported greater satisfaction in their neuroscience education and block organization with NBME examinations. For example, there was a nearly twofold (1.83) increase in the number of students that strongly agreed with the statement "Overall, I am satisfied with the quality of my neuroscience education in this block." They were also less likely to report the workload as being "much too heavy." Overall, students expressed a preference for the customized NBME exams as opposed to faculty generated exams (88.1%).
From the student perspective, building customized assessments through MyNBME Services Portal was found to be useful and preferable for evaluating student performance. From block directors' perspective, it is noted that time is saved assisting faculty in writing valid questions, time defending/justifying FW questions, and time expended generating exams. The only perceived negative regarding the NBME exams is the cost.
医学教育工作者面临的一项挑战是选择一种能最佳评估临床前学生为美国医师执照考试第一步（Step 1）做准备的表现的方法。在过去几年里，德克萨斯理工大学健康科学中心医学院二年级（医学硕士第二年，MS2）神经科学课程的模块负责人（BDs）在课程期间进行教师编写（FW）的考试。2022年，模块负责人用美国国家医学考试委员会（NBME）定制考试取代了教师编写的考试。理由是定制的NBME考试能更好地反映全国神经科学课程，并提高学生参加标准化考试的准备程度。
2021年的教师编写考试由神经科学课程的教师创建并由模块负责人审核。相比之下，模块负责人使用MyNBME服务门户选择与2022年课程涵盖材料最匹配的问题。所选的定制问题由NBME分配一个“难度”分数，得出预测的全国平均分。在课程结束时，德克萨斯理工大学健康科学中心医学院的本科医学生完成了一份在线Qualtrics问卷，以比较评估类型的转变。
参与者表示对NBME考试的神经科学教育和模块组织更满意。例如，强烈同意“总体而言，我对本模块神经科学教育的质量感到满意”这一说法的学生人数增加了近两倍（1.83倍）。他们也不太可能报告工作量“太重”。总体而言，学生表示更喜欢定制的NBME考试，而不是教师出题的考试（88.1%）。
从学生的角度来看，通过MyNBME服务门户构建定制评估被认为对评估学生表现是有用且更可取的。从模块负责人的角度来看，注意到节省了协助教师编写有效问题的时间、为教师编写的问题辩护/说明理由的时间以及生成考试的时间。关于NBME考试唯一察觉到的负面因素是成本。
