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USMLE listens: students and residents offer feedback

Posted: March 27, 2019

To deepen its awareness of student and resident perspectives, United States Medical Licensing Examination® (USMLE) program staff hosted the Medical Student and Resident Advisory Panel in February 2019. The panel, which meets twice a year, is designed to:

  • Test assumptions about the USMLE with an examinee audience
  • Collect feedback from medical students and residents on issues and topics specific to USMLE
  • Gain insight into the perspective of examinees on USMLE policy issues

Prior to their visit, panelists provided input about topics they wanted to discuss during the meeting.

Panelists shared their medical school journey
  • Panelists shared their personal journey in medical education and training, as well as insights into how the current USMLE program impacts their journey. They then explored the impact of USMLE scores and test preparation from the perspectives of different stakeholders, including examinees, medical schools, and residency programs. USMLE staff noted that the journeys were quite different, due to differences in school size, name recognition, grading policy, and many other factors. 
  • Staff asked the panelists what the leaders of the USMLE program should be mindful of as they consider USMLE score reporting within the continuum of medical education. Several themes emerged: the desire for medical students and residents to feel a sense of control over their individual journeys; the need to acknowledge the strong emotions arising from the current discussion of Step score reporting; the need to mitigate unintended consequences arising from any change(s) to USMLE.

Feedback about Step 2 CS score reports
In prior meetings, the panelists provided feedback on the Step 1, 2 Clinical Knowledge (CK), and Step 3 score report redesign prototypes. At this meeting, the panel reviewed a prototype design for the new Step 2 Clinical Skills (CS) examinee score reports, and offered feedback. The guiding principles for all the redesigns have been:

  • Improve transparency regarding what will be on the exam and the score report 
  • Increase guidance for failing examinees 
  • Create more consistency in category labels 
  • Maximize granularity (while minimizing unintended use) 
  • Create reports that are interactive

USMLE videos coming soon
At previous meetings, the panel weighed in concerning the types of information medical students and residents need to hear from USMLE. The panel indicated that providing information about the USMLE journey and highlighting that it is a licensing examination would be beneficial to new or first-time examinees.

The panel also suggested that information about who works on USMLE (e.g., who writes the actual test items) would also be of interest and help to “humanize” the program with examinees. At this meeting, the panel previewed two videos produced to address their recommendations and indicated that the video format and quality of information shared in each was useful and would help to fill gaps they had experienced in their journey as USMLE examinees. Look for the videos to be available on USMLE.org in coming weeks.

USMLE research; proposed checklists
Students and residents were also briefed about recent USMLE research, as well as proposed checklists for examinees to use to feel ready on exam day or to ensure they’ve completed all the steps for registration.

USMLE staff are grateful for actionable input from the panel. The date for the next in-person meeting of the panel has not yet been set, though it is likely to reconvene by conference call in late spring or early summer.


USMLE Step 1 and Step 2 CK content changes scheduled for mid-2020

Posted: November 05, 2019

Beginning in mid-2020, the Step 1 and Step 2 Clinical Knowledge (CK) examinations will include an increased number of questions assessing communication skills, system-based practice and patient safety, and legal/ethical skills and professionalism. The length of the testing days for Step 1 and Step 2 CK will not change.

Decisions about the balance of content on USMLE examinations are the responsibility of two groups: the USMLE Composite Committee and USMLE Management Committee. Both are composed of educators, practicing physicians, members with experience on state medical licensure boards, and public members. These committees approved the increase in the number of test items assessing the important competencies listed above. 

Timetable:

  • Beginning in May 2020, Step 1 will include additional questions assessing communication skills.
  • Beginning in June/July 2020, Step 2 Clinical Knowledge will include additional questions on systems-based practice, patient safety, legal/ethical issues, and professionalism.
  • No changes to the Step 3 examination are planned during this timeframe. 

Sample test items illustrating assessment of communications skills, systems-based practice and patient safety, and legal/ethical skills and professionalism are provided in the Step 1 Content Description and General Information booklet (pp. 7-11) and in the Step 2 Clinical Knowledge Content Description and General Information booklet (pp. 8-11).

The practice materials available on USMLE.org will be updated in early 2020 to reflect these changes in the distribution of exam content across content categories on Step 1 and Step 2 CK.


Possible changes to USMLE scores – continuing the discussion

Posted: October 08, 2019

A podcast featuring two members of the Invitational Conference on USMLE Scoring (InCUS) planning committee, Dr. Michael Barone, Vice President of Licensure Programs for NBME, and Dave Johnson, Senior Vice President, Assessment Services for the Federation of State Medical Boards, is now available. They discuss themes from the public comments, upcoming improvements to USMLE, and insight into the vision for the program.

You can listen to the podcast here.


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