Exploring the Relationships Between USMLE Performance and Disciplinary Action in Practice: A Validity Study of Score Inferences From a Licensure Examination.

Purpose: Physicians must pass the United States Medical Licensing Examination (USMLE) to obtain an unrestricted license to practice allopathic medicine in the United States. Little is known, however, about how well USMLE performance relates to physician behavior in practice, particularly conduct inconsistent with safe, effective patient care. The authors examined the extent to which USMLE scores relate to the odds of receiving a disciplinary action from a U.

International variation in performance by clinical discipline and task on the United States medical licensing examination step 2 clinical knowledge component.

Purpose: To investigate country-to-country variation in performance across clinical science disciplines and tasks for examinees taking the Step 2 Clinical Knowledge (CK) component of the United States Medical Licensing Examination.

Method: In 2012 the authors analyzed demographic characteristics, total scores, and percent-correct clinical science discipline and task scores for more than 88,500 examinees taking Step 2 CK for the first time during the 2008-2010 academic years. For each examinee and score, differences between the score and the mean performance of examinees at U.

The relationship between the american board of anesthesiology part 1 certification examination and the United States medical licensing examination.

Background: The graduate medical education community uses results from the United States Medical Licensing Examination (USMLE) to inform decisions about individuals' readiness for postgraduate training.

Objective: We sought to determine the relationship between performance on the USMLE and the American Board of Anesthesiology (ABA) Part 1 Certification Examination using a national sample of examinees, and we considered the relationship in the context of undergraduate medical education location and examination content.

Methods: Approximately 7800 individuals met inclusion criteria.

The impact of postgraduate training on USMLE® step 3® and its computer-based case simulation component.

Background: The United States Medical Licensing Examination® (USMLE®) Step 3® examination is a computer-based examination composed of multiple choice questions (MCQ) and computer-based case simulations (CCS). The CCS portion of Step 3 is unique in that examinees are exposed to interactive patient-care simulations.

Objective: The purpose of the following study is to investigate whether the type and length of examinees' postgraduate training impacts performance on the CCS component of Step 3, consistent with previous research on overall Step 3 performance.

Relationship between performance on the NBME Comprehensive Basic Sciences Self-Assessment and USMLE Step 1 for U.S. and Canadian medical school students.

Background: This study examined the relationship between performance on the National Board of Medical Examiners Comprehensive Basic Science Self-Assessment (CBSSA) and performance on United States Medical Licensing Examination Step 1.

Method: The study included 12,224 U.S.

Validity evidence for USMLE examination cut scores: results of a large-scale survey.

Purpose: This research examined the credibility of the cut scores used to make pass/fail decisions on United States Medical Licensing Examination (USMLE) Step 1, Step 2 Clinical Knowledge, and Step 3.

Method: Approximately 15,000 members of nine constituency groups were asked their opinions about (1) current initial and ultimate fail rates and (2) the highest acceptable, lowest acceptable, and optimal initial and ultimate fail rates.

Results: Initial fail rates were generally viewed as appropriate; more variability was associated with ultimate fail rates.

The use of standardized patient assessments for certification and licensure decisions.

Although standardized patients have been employed for formative assessment for over 40 years, their use in high-stakes medical licensure examinations has been a relatively recent phenomenon. As part of the medical licensure process in the United States and Canada, the clinical skills of medical students, medical school graduates, and residents are evaluated in a simulated clinical environment. All of the evaluations attempt to provide the public with some assurance that the person who achieves a passing score has the knowledge and/or requisite skills to provide safe and effective medical services.

Computer-delivered patient simulations in the United States Medical Licensing Examination (USMLE).

To obtain a full and unrestricted license to practice medicine in the United States, students and graduates of the MD-granting US medical schools and of medical schools located outside of the United States must take and pass the United States Medical Licensing Examination. United States Medical Licensing Examination began as a series of paper-and-pencil examinations in the early 1990s and converted to computer-delivery in 1999. With this change to the computerized format came the opportunity to introduce computer-simulated patients, which had been under development at the National Board of Medical Examiners for a number of years.

The relationship between performance on a medical school's clinical skills assessment and USMLE Step 2 CS.

Background: Little is known about the relationship between performance on clinical assessments during medical school and performance on similar licensing tests.

Method: Correlation coefficients were computed and corrected for measurement error using data for 217 students who completed a school's clinical assessment and took the Step 2 Clinical Skills (CS) examination.

Results: Observed (and corrected) correlations between the two tests were 0.

Changes in clinical skills education resulting from the introduction of the USMLE step 2 clinical skills (CS) examination.

Background: Step 2 Clinical Skills (CS) was recently introduced into the United States Medical Licensing Examination (USMLE) to ensure that successful candidates for licensure possess the clinical skills to provide safe and effective patient care.

Aims: To explore if medical schools had changed the objectives, content, or emphasis in their pre-clinical curriculum in response to its implementation.

Methods: In April 2005, the Clerkship Directors in Internal Medicine (CDIM) sent an electronic survey to a single member from each medical school with a CDIM member.

Sequence effects in the United States Medical Licensing Examination (USMLE) step 2 clinical skills (cs) examination.

Background: Systematic trends in examinee performance across the testing day (sequence effects) could indicate that artifacts of the testing situation have an impact on scores. This research investigated the presence of sequence effects for United States Medical Licensing Exam (USMLE) Step 2 clinical skills (CS) examination components.

Method: Data from Step 2 CS examinees were analyzed using analysis of covariance and hierarchical linear modeling procedures.

Relationships among subcomponents of the USMLE Step 2 Clinical Skills Examination, the Step 1, and the Step 2 Clinical Knowledge Examinations.

Background: This research examined relationships between and among scores from the United States Medical Licensing Examination (USMLE) Step 1, Step 2 Clinical Knowledge (CK), and subcomponents of the Step 2 Clinical Skills (CS) examination.

Method: Correlations and failure rates were produced for first-time takers who tested during the first year of Step 2 CS Examination administration (June 2004 to July 2005).

Results: True-score correlations were high between patient note (PN) and data gathering (DG), moderate between communication and interpersonal skills and DG, and low between the remaining score pairs.

Modeling longitudinal performances on the United States Medical Licensing Examination and the impact of sociodemographic covariates: an application of survival data analysis.

Background: This study models time to passing United States Medical Licensing Examination (USMLE) for the computer-based testing (CBT) start-up cohort using the Cox Proportional Hazards Model.

Method: The number of days it took to pass Step 3 was treated as the dependent variable in the model. Covariates were: (1) gender; (2) native language (English or other); (3) medical school location (United States or other); and (4) citizenship (United States or other).

A multilevel analysis of the relationships between selected examinee characteristics and United States Medical Licensing Examination Step 2 Clinical Knowledge performance: revisiting old findings and asking new questions.

Background: This study examines: (1) the relationships between examinee characteristics and United States Medical Licensing Examination Step 2 Clinical Knowledge (CK) performance; (2) the effect of gender and examination timing (time per item) on the relationship between Steps 1 and 2 CK; and (3) the effect of school characteristics on the relationships between examinee characteristics and Step 2 CK performance.

Method: A series of hierarchical linear models (examinees-nested-in-schools) predicting Step 2 CK scores was fit to the data set. The sample included 54,487 examinees from 114 U.

The impact of timing changes on examinee pacing on the USMLE Step 2 exam.

Purpose: To examine the impact of a timing change on pacing behavior and perceptions in a high-stakes multiple-choice examination.

Method: Two samples of standard-time examinees were analyzed: (1) 29,796 examinees that completed the examination prior to the timing change, and (2) 28,373 examinees that completed the examination after the change. Subgroups of examinees were identified and compared within and across samples with respect to perceptions, accuracy, and pacing.

Assessing the validity of the USMLE step 2 clinical knowledge examination through an evaluation of its clinical relevance.

Purpose: To assess the validity of the USMLE Step 2 Clinical Knowledge (CK) examination by addressing the degree to which experts view item content as clinically relevant and appropriate for Step 2 CK.

Method: Twenty-seven experts were asked to complete three survey questions related to the clinical relevance and appropriateness of 150 Step 2 CK multiple-choice questions. Percentages, reliability estimates, and correlation coefficients were calculated and ordinary least squares regression was used.

The impact of postgraduate training and timing on USMLE Step 3 performance.

Purpose: This study examined the extent to which differences in clinical experience, gained in postgraduate training programs, affect performance on Step 3 of the United States Medical Licensing Examination (USMLE).

Method: Subjects in the study were 36,805 U.S.