Abstract
In the United States (US), successful passage of United States Medical Licensing Examination (USMLE) Step 2 Clinical Skills (Step 2 CS) is required to enter into residency training. In 2017, the USMLE announced an increase in performance standards for Step 2 CS. As a consequence, it is anticipated that the passage rate for the examination will decrease significantly for both US and international students. While many US institutions offer a cumulative clinical skills examination, their effect on Step 2 CS passage rates has not been studied. The authors developed a six-case, standardized patient (SP)-based examination to mirror Step 2 CS and measured impact on subsequent Step 2 CS passage rates. Students were provided structured quantitative and qualitative feedback and were given a final designation of “pass” or “fail” for the practice examination. A total of 173 out of 184 (94.5%) students participated in the examination. Twenty SPs and $26,000 in direct costs were required. The local failure rate for Step 2 CS declined from 4.5% in the year proceeding the intervention to 2.1% following the intervention. In the same timeframe, the US failure rate for Step 2 CS increased from 3.8 to 5.1%, though the difference between local and national groups was not significantly different (P = .07). Based on the initial success of the intervention, educational leaders may consider developing a similar innovation to optimize passage rates at their institutions.
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Acknowledgments
The authors would like to thank the clerkship directors and simulation center staff at VCU who assisted in the construction of cases, administration of the simulation, and grading of encounter notes described in this manuscript.
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This study was deemed exempt by the Virginia Commonwealth University IRB. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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This work was presented as an oral abstract at the 2018 Association of American Medical Colleges Learn Serve Lead meeting.
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Ryan, M.S., Bradner, M., Rigby, F. et al. Improving Passage Rate on USMLE Step 2 Clinical Skills: Results from a Pilot Program. Med.Sci.Educ. 29, 709–714 (2019). https://doi.org/10.1007/s40670-019-00768-4
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DOI: https://doi.org/10.1007/s40670-019-00768-4