USMLE PRACTICE TEST 138 PROFESSIONAL

Our medical school recently underwent a major curriculum reform to its clerkship year, which included elimination of NBME subject tests from core clerkship performance evaluation.

USMLE PRACTICE TEST 138 PROFESSIONAL

Illuminating clerkship students’ self-regulated preparation for periodic high-stakes exams also could promote understanding of how residents and independently practicing physicians navigate certification requirements among the demands of everyday work and continuing professional development, an important and relatively unexplored question. This evidence may inform efforts to adopt programmatic assessment of clerkship performance by revealing the potential unintended consequences of building an evaluation strategy on low-stakes assessments. Nevertheless, for educators seeking to address the potential negative impact on immersive clinical learning of grading based on high-stakes written exams, understanding students’ Step 2 CK preparation in their absence is important it replaces assumptions about what might happen with actual evidence. Knowledge testing is so prevalent in clerkship performance evaluation that it may be difficult to imagine valid assessment approaches that exclude it. Given that so few medical schools exclude NBME subject tests from clerkship performance evaluation, however, it is unknown what students do to prepare for Step 2 CK without them and what impact this may have on scores.

Moreover, removing this scaffold may widen disparities in test performance arising from disadvantageous learning strategies, which curriculum structure could potentially alleviate. Left to their own devices, students may resort to ‘cramming,’ (i.e., intense, last-minute preparation) which could negatively affect their scores. Removing subject tests or other high-stakes knowledge exams from clerkship grading may promote the clinical immersion envisioned by the apprenticeship model of clinical training.Ī consequence of removing NBME subject tests from clerkship performance evaluation is that the pacing of Step 2 CK exam preparation would no longer be structured by the curriculum, requiring students to self-regulate their study. Moreover, carrying the weight of exams while adapting to workplace learning may further stress students already burdened by heavy workload and navigating the transition from classroom to clinic. Clerkship training comprises medical students’ primary exposure to the clinical workplace, and the professional development that uniquely occurs in this setting may be degraded or delayed if students are elsewhere, studying for written tests. Ī potential disadvantage of using NBME subject tests for clerkship grading is that students may prioritize exam preparation over clinical learning. Using subject tests for clerkship knowledge assessment may provide a structured approach to distributing Step 2 CK preparation over time, which could improve study quality and long-term outcomes. When used in multiple clerkship rotations, subject tests also represent a form of cumulative assessment that is preparatory for the United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge (CK) test, which contains similar questions and commonly is taken after completion of clerkship training.

Subject tests are advantageous for knowledge assessment because they are relatively efficient to administer, and validity evidence warranting their use for this purpose is well-documented. Subject tests’ content is specific to core clerkship specialty, making these exams useful for assessing the knowledge outcomes of block rotations. In the USA, the National Board of Medical Examiners (NBME) subject tests are routinely used for clerkship performance evaluation, sometimes as a key factor in determining grades and honors.

Usmle practice test 138