Stepping Back: How Should Pass/Fail Scoring Influence Step 1 Timing?

Although most students complete Step 1 before clerkships, some institutions delay the exam until after clerkships. The change to pass/fail grading adds additional complexity that should be considered when deciding about exam timing. Both early and late administration may affect learning outcomes, learner behavior, student well-being, and residency match success.

Many Paths to the Summit: Survey of Step 1 Study Methods with Pass/Fail Scoring.

Introduction: After the United States Medical Licensing Examination (USMLE) shifted the Step 1 licensure exam to pass/fail, there have been limited studies to analyze changes in student study strategies.

Material And Methods: Surveys were distributed to third- and fourth-year medical students at the University of Michigan Medical School (UMMS). The response rate was 66%.

Using Natural Language Processing to Evaluate the Quality of Supervisor Narrative Comments in Competency-Based Medical Education.

Purpose: Learner development and promotion rely heavily on narrative assessment comments, but narrative assessment quality is rarely evaluated in medical education. Educators have developed tools such as the Quality of Assessment for Learning (QuAL) tool to evaluate the quality of narrative assessment comments; however, scoring the comments generated in medical education assessment programs is time intensive. The authors developed a natural language processing (NLP) model for applying the QuAL score to narrative supervisor comments.

Can Incoming Interns Be Entrusted to Recognize Medical Emergencies? Implementation of a Vignette-Based Cross-Cover Assessment.

Background: Interns must recognize urgent clinical situations and know when to seek assistance. However, assessing this skill is challenging.

Objective: We explored whether graduating medical students could determine urgency of medical cross-cover scenarios and what factors were associated with this ability.

The critical role of infrastructure and organizational culture in implementing competency-based education and individualized pathways in undergraduate medical education.

In 2010, several key works in medical education predicted the changes necessary to train modern physicians to meet current and future challenges in health care, including the standardization of learning outcomes paired with individualized learning processes. The reframing of a medical expert as a flexible, adaptive team member and change agent, effective within a larger system and responsive to the community's needs, requires a new approach to education: competency-based medical education (CBME). CBME is an outcomes-based developmental approach to ensuring each trainee's readiness to advance through stages of training and continue to grow in unsupervised practice.

What faculty write versus what students see? Perspectives on multiple-choice questions using Bloom's taxonomy.

Background: Using revised Bloom's taxonomy, some medical educators assume they can write multiple choice questions (MCQs) that specifically assess higher (analyze, apply) versus lower-order (recall) learning. The purpose of this study was to determine whether three key stakeholder groups (students, faculty, and education assessment experts) assign MCQs the same higher- or lower-order level.

Methods: In Phase 1, stakeholders' groups assigned 90 MCQs to Bloom's levels.

What is the association between student well-being and high-stakes examination scores?

Introduction: As educators seek to improve medical student well-being, it is essential to understand the interplay between distress and important outcomes. Performance on Step 1 of the United States Medical Licensing Examination has played a significant role in selection for postgraduate residency positions in the United States and consequently has been a source of great stress for medical students. The purpose of this study was to examine whether student well-being correlates with performance on a high stakes licensing examination.

Managing expansions in medical students' clinical placements caused by curricular transformation: perspectives from four medical schools.

Many challenges could occur that result in the need to handle an increase in the number of medical student clinical placements, such as curricular transformations or viral pandemics, such as COVID 19. Here, we describe four different institutions' approaches to addressing the impact of curricular transformation on clerkships using an implementation science lens. Specifically, we explore four different approaches to managing the 'bulge' as classes overlap in clerkships Curriculum leaders at four medical schools report on managing the bulge of core clinical placements resulting from reducing the duration of the foundational sciences curriculum and calendar shifts for the respective clerkship curriculum.

Medical Student Attitudes toward USMLE Step 1 and Health Systems Science - A Multi-Institutional Survey.

Because of its importance in residency selection, the United States Medical Licensing Examination Step 1 occupies a critical position in medical education, stimulating national debate about appropriate score use, equitable selection criteria, and the goals of undergraduate medical education. Yet, student perspectives on these issues and their implications for engagement with health systems science-related curricular content are relatively underexplored. We conducted an online survey of medical students at 19 American allopathic medical schools from March-July, 2019.

2015 American College of Rheumatology Workforce Study and Demand Projections of Pediatric Rheumatology Workforce, 2015-2030.

Objective: To describe the character and composition of the 2015 pediatric rheumatology workforce in the US, evaluate current workforce trends, and project future supply and demand of the pediatric rheumatology workforce through 2030.

Methods: The American College of Rheumatology created the workforce study group to study the rheumatology workforce. The workforce study group used primary and secondary data to create a representative workforce model.

Training Medical Students to Create and Collaboratively Review Multiple-Choice Questions: A Comprehensive Workshop.

Introduction: Multiple-choice question (MCQ) creation is an infrequently used active-learning strategy. Previous studies demonstrated that medical students find value in the process, but have minimal training, which may limit potential learning benefits. We therefore developed a process for question-creation that required students to complete in-depth training, in addition to collaborative question-writing and editing.

Creating assessments as an active learning strategy: what are students' perceptions? A mixed methods study.

: Teaching students how to create assessments, such as those involving multiple-choice questions (MCQs), has the potential to be a useful active learning strategy. In order to optimize students' learning, it is essential to understand how they engage with such activities. : To explore medical students' perceptions of how completing rigorous MCQ training and subsequently writing MCQs affects their learning.

Competency Committees in Undergraduate Medical Education: Approaching Tensions Using a Polarity Management Framework.

Implementing competency-based medical education in undergraduate medical education (UME) poses similar and unique challenges to doing so in graduate medical education (GME). To ensure that all medical students achieve competency, educators must make certain that the structures and processes to assess that competency are systematic and rigorous. In GME, one such key structure is the clinical competency committee.

Workforce Trends in Rheumatology.

The United States is facing a rheumatology provider shortage over the next decade, which will negatively affect care for patients with rheumatic disease across the nation if this deficit is not thoughtfully addressed. The increasing numbers of retiring rheumatology specialists, women entering the workforce, and rheumatology graduates seeking part-time employment were identified as the most significant factors driving the projected decline in supply of providers. The major factors driving the projected increase in demand include an aging and growing population and improved treatment options, both of which increase disease prevalence and the challenge of managing chronic rheumatologic diseases.

Employing a Root Cause Analysis Process to Improve Examination Quality.

Problem: Multiple-choice question (MCQ) examinations represent a primary mode of assessment used by medical schools. It can be challenging for faculty to produce content-aligned, comprehensive, and psychometrically sound MCQs. Despite best efforts, sometimes there are unexpected issues with examinations.

Does Reducing Clerkship Lengths by 25% Affect Medical Student Performance and Perceptions?

Purpose: Transforming a medical school curriculum wherein students enter clerkships earlier could result in two cohorts in clerkships simultaneously during the transition. To avoid overlapping cohorts at the University of Michigan Medical School, the length of all required clerkships was decreased by 25% during the 2016-2017 academic year, without instituting other systematic structural changes. The authors hypothe sized that the reduction in clerkship duration would result in decreases in student perfor mance and changes in student perceptions.

Early Diagnosis and Treatment of Rheumatoid Arthritis.

Rheumatoid arthritis is the most common inflammatory arthritis, and a significant cause of morbidity and mortality. Primary care providers should be able to distinguish the clinical presentation of rheumatoid arthritis from osteoarthritis, because the treatment and outcomes differ greatly between these 2 common forms of arthritis. This article provides a current overview of our understanding of rheumatoid arthritis, with an emphasis on early diagnosis and approaches to treatment.

2015 American College of Rheumatology Workforce Study: Supply and Demand Projections of Adult Rheumatology Workforce, 2015-2030.

Objective: To describe the character and composition of the 2015 US adult rheumatology workforce, evaluate workforce trends, and project supply and demand for clinical rheumatology care for 2015-2030.

Methods: The 2015 Workforce Study of Rheumatology Specialists in the US used primary and secondary data sources to estimate the baseline adult rheumatology workforce and determine demographic and geographic factors relevant to workforce modeling. Supply and demand was projected through 2030, utilizing data-driven estimations regarding the proportion and clinical full-time equivalent (FTE) of academic versus nonacademic practitioners.

2015 American College of Rheumatology Workforce Study: The Role of Graduate Medical Education in Adult Rheumatology.

Objective: Graduate medical education (GME), through fellowship training, plays a critical role in preparing new rheumatologists for our workforce and is an essential component when addressing the gap of excess demand for adult rheumatology care. This study was undertaken to assess the demographic characteristics and employment trends of new entrants entering the rheumatology workforce and the impact this will have on the supply of rheumatologits over the next 15 years.

Methods: Primary and secondary data sources were used to develop an integrated workforce model.

Antinuclear antibody prevalence in a general pediatric cohort from Mexico City: discordance between immunofluorescence and multiplex assays.

Objective: To characterize antinuclear antibody (ANA) prevalence according to distinct assay methodologies in a pediatric cohort from Mexico City, and to further examine associations with age and sex.

Methods: Serum ANA were measured by indirect immunofluorescence assay (IFA) and multiplex immunoassay in 114 children aged 9-17 years. IFA was considered positive at a cutoff titer of ≥1:80.