Socioeconomic factors and test preparation strategies are related to success on the USMLE Step 2 clinical knowledge (CK) exam: a single-institution study
Abstract Background Since the elimination of numerical scoring of the United States Medical Licensing Examination (USMLE) Step 1, the perceived importance of USMLE Step 2 Clinical Knowledge (CK) scores in residency placement has increased. It is known that socioeconomic status (SES) and other demogr...
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BMC
2024-12-01
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| Online Access: | https://doi.org/10.1186/s12909-024-06414-x |
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| author | Hila Ghersin Michelle C. Gulfo Bailey A. Frohlich Scott M. Wilson Ashley A. Berlot Janice S. Zhang Rohan Kankaria Ashley Radparvar Juan Lin Michelle A. Blackmore Amanda C. Raff |
| author_facet | Hila Ghersin Michelle C. Gulfo Bailey A. Frohlich Scott M. Wilson Ashley A. Berlot Janice S. Zhang Rohan Kankaria Ashley Radparvar Juan Lin Michelle A. Blackmore Amanda C. Raff |
| author_sort | Hila Ghersin |
| collection | DOAJ |
| description | Abstract Background Since the elimination of numerical scoring of the United States Medical Licensing Examination (USMLE) Step 1, the perceived importance of USMLE Step 2 Clinical Knowledge (CK) scores in residency placement has increased. It is known that socioeconomic status (SES) and other demographic factors can be barriers to success in standardized assessment, but few recent studies report the relationship between student demographics, including SES, with Step 2 CK scores in the context of exam practice material access and usage. In this study, we investigated predictors of Step 2 CK success across two years at one institution. Methods A survey regarding Step 2 CK exam preparation and demographic factors was administered to two student cohorts at a New York medical school in 2022 and 2023. The cohorts were comprised of all students in a given class year who had taken Step 2 CK. De-identified survey responses were linked to metrics including Step 1, Step 2 CK, shelf exam, and Medical College Admission Test (MCAT) scores. Results The mean Step 2 CK score among the respondents (n = 213) was 254 ± 13. There was a strong positive correlation between Step 2 CK score and composite shelf scores (rho = 0.80, p < 0.01). Almost all participants used the UWorld question-bank to prepare for the exam (98.1%), and completion of more than 2500 unique questions was associated with better exam performance (256 vs. 252, p = 0.04). On bivariate analysis, students had significantly lower mean Step 2 CK scores if they self-identified as socioeconomically disadvantaged (SED) (250 vs. 256, p < 0.01) and self-reported that financial limitations prevented them from purchasing study resources (249 vs. 257, p < 0.01). In adjusted models, there was no longer a relationship between self-identified SED and Step 2 CK score (beta=-3.50, 95% CI (-8.25, 1.26), p = 0.15). Conclusions This study provides insight into the relationship between exam performance, study habits, and demographic factors at a single institution where students, on average, performed above the national mean on Step 2 CK. Results support that Step 2 CK scores are modulated by a high composite shelf score, number of unique UWorld questions completed, dedicated study period length, and socioeconomic inequity. Trial registration Study registered with our institutional IRB (IRB number 20177537). |
| format | Article |
| id | doaj-art-b5e5bc7c5ac54d6d80f3a5dd52c9d4d7 |
| institution | OA Journals |
| issn | 1472-6920 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj-art-b5e5bc7c5ac54d6d80f3a5dd52c9d4d72025-08-20T02:30:59ZengBMCBMC Medical Education1472-69202024-12-012411910.1186/s12909-024-06414-xSocioeconomic factors and test preparation strategies are related to success on the USMLE Step 2 clinical knowledge (CK) exam: a single-institution studyHila Ghersin0Michelle C. Gulfo1Bailey A. Frohlich2Scott M. Wilson3Ashley A. Berlot4Janice S. Zhang5Rohan Kankaria6Ashley Radparvar7Juan Lin8Michelle A. Blackmore9Amanda C. Raff10Albert Einstein College of Medicine BronxAlbert Einstein College of Medicine BronxAlbert Einstein College of Medicine BronxAlbert Einstein College of Medicine BronxAlbert Einstein College of Medicine BronxAlbert Einstein College of Medicine BronxDepartment of Medicine, Johns Hopkins HospitalDepartment of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine BronxDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine BronxOffice of Academic Support and Counseling, Albert Einstein College of Medicine BronxDepartment of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine BronxAbstract Background Since the elimination of numerical scoring of the United States Medical Licensing Examination (USMLE) Step 1, the perceived importance of USMLE Step 2 Clinical Knowledge (CK) scores in residency placement has increased. It is known that socioeconomic status (SES) and other demographic factors can be barriers to success in standardized assessment, but few recent studies report the relationship between student demographics, including SES, with Step 2 CK scores in the context of exam practice material access and usage. In this study, we investigated predictors of Step 2 CK success across two years at one institution. Methods A survey regarding Step 2 CK exam preparation and demographic factors was administered to two student cohorts at a New York medical school in 2022 and 2023. The cohorts were comprised of all students in a given class year who had taken Step 2 CK. De-identified survey responses were linked to metrics including Step 1, Step 2 CK, shelf exam, and Medical College Admission Test (MCAT) scores. Results The mean Step 2 CK score among the respondents (n = 213) was 254 ± 13. There was a strong positive correlation between Step 2 CK score and composite shelf scores (rho = 0.80, p < 0.01). Almost all participants used the UWorld question-bank to prepare for the exam (98.1%), and completion of more than 2500 unique questions was associated with better exam performance (256 vs. 252, p = 0.04). On bivariate analysis, students had significantly lower mean Step 2 CK scores if they self-identified as socioeconomically disadvantaged (SED) (250 vs. 256, p < 0.01) and self-reported that financial limitations prevented them from purchasing study resources (249 vs. 257, p < 0.01). In adjusted models, there was no longer a relationship between self-identified SED and Step 2 CK score (beta=-3.50, 95% CI (-8.25, 1.26), p = 0.15). Conclusions This study provides insight into the relationship between exam performance, study habits, and demographic factors at a single institution where students, on average, performed above the national mean on Step 2 CK. Results support that Step 2 CK scores are modulated by a high composite shelf score, number of unique UWorld questions completed, dedicated study period length, and socioeconomic inequity. Trial registration Study registered with our institutional IRB (IRB number 20177537).https://doi.org/10.1186/s12909-024-06414-xUSMLEStep 2 CKPerformanceNBMEStudy habitsSocioeconomic status |
| spellingShingle | Hila Ghersin Michelle C. Gulfo Bailey A. Frohlich Scott M. Wilson Ashley A. Berlot Janice S. Zhang Rohan Kankaria Ashley Radparvar Juan Lin Michelle A. Blackmore Amanda C. Raff Socioeconomic factors and test preparation strategies are related to success on the USMLE Step 2 clinical knowledge (CK) exam: a single-institution study BMC Medical Education USMLE Step 2 CK Performance NBME Study habits Socioeconomic status |
| title | Socioeconomic factors and test preparation strategies are related to success on the USMLE Step 2 clinical knowledge (CK) exam: a single-institution study |
| title_full | Socioeconomic factors and test preparation strategies are related to success on the USMLE Step 2 clinical knowledge (CK) exam: a single-institution study |
| title_fullStr | Socioeconomic factors and test preparation strategies are related to success on the USMLE Step 2 clinical knowledge (CK) exam: a single-institution study |
| title_full_unstemmed | Socioeconomic factors and test preparation strategies are related to success on the USMLE Step 2 clinical knowledge (CK) exam: a single-institution study |
| title_short | Socioeconomic factors and test preparation strategies are related to success on the USMLE Step 2 clinical knowledge (CK) exam: a single-institution study |
| title_sort | socioeconomic factors and test preparation strategies are related to success on the usmle step 2 clinical knowledge ck exam a single institution study |
| topic | USMLE Step 2 CK Performance NBME Study habits Socioeconomic status |
| url | https://doi.org/10.1186/s12909-024-06414-x |
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