Novotny Kaitlyn, Levine Daniel, Netski Dale, Simanton Edward
Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA.
J Med Educ Curric Dev. 2025 Jan 23;12:23821205241296455. doi: 10.1177/23821205241296455. eCollection 2025 Jan-Dec.
The transition of the United States Medical Licensing Examination Step 1 to a pass/fail scoring system is reshaping its role in medical students' residency placements. This compels institutions to rethink Step 2 preparation strategies, raising concerns about a clerkship's impact on various student groups. Traditionally, medical schools followed the traditional block rotation model for clerkships, which limits longitudinal learning, and many schools are switching to longitudinal integrated clerkships and longitudinal interleaved clerkships (LInCs). The growth in longitudinal popularity sparks concern for the success of diverse medical student groups as there is minimal research regarding LInC students' USMLE performance. Our study aims to identify which student groups at Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (KSOM) saw the greatest improvement in their USMLE Step scores after completing the LInC clerkship model.
Utilizing institutional data from KSOM, 145 students from 3 KSOM cohorts' Step 1 and Step 2 3-digit scores and their self-identified demographic information prior to the change in Step 1 grading were categorized by admissions and initial performance factors. Binary groups were created for each variable. Descriptive statistics and t-tests (including Levene's test) gauged score change significance ( < .05) within these groups. Changes were assessed by subtracting Step 1 from Step 2 scores, identifying groups showing significant score improvements after completing the LInC clerkship.
Analysis revealed significant score improvements between Step 1 and Step 2 for the following groups: females, students with low socioeconomic status, and students who originally received lower Step 1 scores.
This study underscores the significance of gender, socioeconomic status, and prior exam performance in clerkship model development given the changes to Step 1 scoring. Further research should discern whether the observed score changes are attributed to the LInC model or its associated testing model.
美国医师执照考试第一步（USMLE Step 1）转变为通过/未通过评分系统，正在重塑其在医学生住院医师匹配中的作用。这迫使各机构重新思考第二步的备考策略，引发了对临床实习对不同学生群体影响的担忧。传统上，医学院采用传统的临床实习分组轮转模式，这种模式限制了纵向学习，许多学校正在转向纵向整合临床实习和纵向交错临床实习（LInC）。纵向模式的日益普及引发了对不同医学生群体成功率的担忧，因为关于LInC学生的USMLE成绩的研究极少。我们的研究旨在确定内华达大学拉斯维加斯分校柯克·科尔科里安医学院（KSOM）的哪些学生群体在完成LInC临床实习模式后，其USMLE成绩有最大幅度的提高。
利用KSOM的机构数据，将来自KSOM三个队列的145名学生在第一步评分改变之前的第一步和第二步三位数成绩以及他们自我认定的人口统计学信息，按照录取和初始成绩因素进行分类。为每个变量创建二元组。描述性统计和t检验（包括Levene检验）衡量这些组内成绩变化的显著性（<0.05）。通过用第二步成绩减去第一步成绩来评估变化，确定在完成LInC临床实习后成绩有显著提高的组。
分析显示，以下群体在第一步和第二步之间成绩有显著提高：女性、社会经济地位低的学生以及最初第一步成绩较低的学生。
鉴于第一步评分的变化，本研究强调了性别、社会经济地位和之前考试成绩在临床实习模式发展中的重要性。进一步的研究应确定观察到的成绩变化是归因于LInC模式还是其相关的考试模式。
