CRU Updates - December 2011

Posted December 23rd, 2011

End of Year Update: USMLE Research; Potential Structural Changes


The USMLE continues to evolve in the manner described previously.  Step 2 CS changes anticipated for 2012 have been described.  Additionally, new literature interpretation items have already been incorporated in Step 2 and will soon appear in Step 3.  There are also other activities anticipated to occur in 2012 that will continue in future years and that have the potential to affect USMLE in significant and exciting ways.

Ongoing Research

Staff is actively involved in exploring potential additions to the types of items used to assess examinees in order to extend the power and scope of assessments beyond what is possible with multiple choice questions and the other items presently used in USMLE.  One area of focus is development of new items that effectively assess an examinee's ability to search and appropriately employ information resources to solve clinical problems.  The literature interpretation items described above begin that process and over the next several years we hope to enhance the USMLE's assessment of an examinee's ability to formulate a research question from a clinical dilemma, develop and execute a search of information resources, weigh the results of that search, and use the results to solve a clinical problem.

Staff is also working to develop novel computer-based items that simulate patient care tasks, to extend the breadth and depth of competency assessment in USMLE.  These items might simulate patient admission to the hospital, simple or sophisticated communication with either patients or other health professionals, medication adjustment, and thus measure the knowledge and skills necessary for medical licensure.  This research into new item formats is complemented by content enhancements within existing formats.  In addition to increases in biostatistics and epidemiology items already present in the USMLE Step exams, committee members and staff will be enhancing the quality and quantity of content related to patient safety, helping to fulfill the primary purpose of the USMLE program.

Changes to the Exam Structure

The cumulative changes to the USMLE described previously in conjunction with changes anticipated in the near future suggest that there may be a time within the next several years when changes to fundamental elements of Step examinations (length, item types, domains assessed, etc.) will be needed.  USMLE governance is presently reviewing options that could change USMLE Step examination structure and an announcement related to such changes will likely be made in early 2012.