Effects of a Resident-Led Subject Exam Review on Mean Scores of Internal Medicine Subject Exam: a Case-control Study
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SHORT COMMUNICATION
Effects of a Resident-Led Subject Exam Review on Mean Scores of Internal Medicine Subject Exam: a Case-control Study Samuel A. Kareff 1
&
Olivia d’Aliberti 2
&
Nikki Duong 1
Accepted: 5 November 2020 # International Association of Medical Science Educators 2020
Abstract The National Board of Medical Examiners (NBME) offers Subject Examinations (SE) for students completing the Internal Medicine (IM) clerkship. There is a paucity of literature in regard to the efficacy of review methods prior to rendering said examination. Our medical center’s residents conducted a structured review session in preparation for SE administration. The mean SE scores prior to and after the initiation of the resident-led review session were compared. There was no statistically significant association found between the mean NBME scores in the experimental or control groups. We propose that alternative methods be further assessed for efficacy. Keywords Undergraduate medical education . Graduate medical education . Internal Medicine clerkship . Shelf exam . NBME
Background The National Board of Medical Examiners (NBME) offers Subject Examinations (SE, colloquially termed “[the] shelf [exams]”) for all upper-level medical students completing American Association of Medical Colleges–required core clinical rotations, including the Internal Medicine (IM) clerkship. These examinations, typically occurring at the end of a clinical rotation, offer medical colleges the ability to quantify individual and group scores against a national average. As such, medical schools and clerkship directors strive to identify specific predictors as well as interventions that may best increase examination scores. There is substantial controversy in the literature regarding which, if any, individual predictors might lead to higher SE
* Samuel A. Kareff [email protected] Olivia d’Aliberti [email protected] Nikki Duong [email protected] 1
Department of Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Rd, NW, Washington, DC 20007, USA
2
Department of Mathematics and Statistics, Georgetown University, 3700 O St NW, Washington, DC 20007, USA
scores. Early statistical analyses previously posited that female gender and older age were perhaps associated with higher SE scores [1]. Later studies have challenged these associations related to the IM SE specifically [2]. Group-level predictors have also been hypothesized. One study found that increased small-group hours, exposure to community-based preceptors, and number of patients cared for per day were positively associated with NBME scores [3]. Such results challenge traditionally held beliefs in the medical education community that academic variables are the sole consistent clinical predictors of examination performance in medical school [4]. There are studies in the General Surgery and Psychiatry literature that also have examined factors contributing to SE scores. One single-center study found that the strongest predictor of failure was performance on t
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