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An Effective Evidence-Based Student Run Near-Peer Support Group for the USMLE Step 1 Exam

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Abstract

Background

Despite the existence of data describing student factors and test-taking habits associated with success, preclinical medical students preparing for the USMLE Step 1 exam face the challenges of creating a study plan and selecting between study-aid resources while preparing for this high-stakes test. This is often an expensive and anxiety-provoking experience.

Methods

A near-peer support group for second year medical students studying for the USMLE Step 1 exam at the Albert Einstein College of Medicine (Einstein) provided evidence-based recommendations with goals of facilitating study planning and raising scores. An annual survey evaluating study habits and group perception was collected to identify study habits associated with higher Step 1 scores, evaluate group effectiveness, and refine the evidence-based recommendations for optimal exam preparation.

Results

Over a 3-year period, 302 students responded to the survey. After simultaneous adjustment for factors associated with Step 1 performance in bivariate analyses, preclinical medical school performance (P < 0.01), initiation of study 6 months prior to the test date (P < 0.01), and completion of >4000 practice questions (P = 0.05) remained independently associated with Step 1 scores. There was a significant increase in the average Step 1 score from 226.8 to 230.5 (P = 0.002) after the group began providing evidence-based advice to students. Over 90 % of respondents were aware of the group and 64 % followed the group’s advice. Sixty-seven percent would recommend the group to subsequent students and 79 % found the near-peer format useful.

Conclusions

A student run near-peer support group was a popular and effective mechanism to assist students preparing for the USMLE Step 1 exam by accumulating and disseminating evidence-based study habit recommendations. Certain habits including a start date approximately 6 months in advance and completion of >4000 test-like practice questions may be beneficial in preparing for the Step 1 exam. The increase in average Step 1 score at Einstein may be in part due to this intervention or may represent part of a national trend.

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References

  1. National Resident Matching Program, Data Release and Research Committee: results of the 2012 NRMP Program Director Survey. Accessed online on March 17, 2014 at http://www.nrmp.org/data/programresultsbyspecialty2012.pdf

  2. Thadani RA, Swanson DB, Galbraith RM. A preliminary analysis of different approaches to preparing for the USMLE step 1. Acad Med. 2000;75(10 suppl):S40–S2.

    Article  Google Scholar 

  3. Kasuya RT, Naguwa GS, Guerrero APS, Hishinuma ES, Lindberg MA, Judd NK. USMLE performances in a predominantly Asian and Pacific islander population of medical students in a problem-based learning curriculum. Acad Med. 2003;78(5):483–90.

    Article  Google Scholar 

  4. Cuddy MM, Swanson DB, Clauser BE. A multilevel analysis of examinee gender and USMLE step 1 performance. Acad Med. 2008;83:S58–62.

    Article  Google Scholar 

  5. Paolo AM, Bonaminio GA, Durham D, Stites SW. Comparison and cross-validation of simple and multiple logistic regression models to predict USMLE step 1 performance. Teach Learn Med. 2004;16:69–73.

    Article  Google Scholar 

  6. Donnon T, Paolucci EO, Violato C. The predictive validity of the MCAT for medical school performance and medical board licensing examinations: a meta-analysis of the published research. Acad Med. 2007;82(1):100–6.

    Article  Google Scholar 

  7. Zhang C, Rauchwarger A, Toth C, O’Connell M. Student USMLE step 1 preparation and performance. Adv Health Sci Educ Theory Pract. 2004;9(4):291–7.

    Article  Google Scholar 

  8. Hu Y, Martindale JR, LeGallo RD, White CB, McGahren ED, Schroen AT Relationships between preclinical course grades and standardized exam performance. Adv Health Sci Educ Theory Pract. 2015. ePub September 2015.

  9. West C, Kurz T, Smith S, Graham L. Are study strategies related to medical licensing exam performance? Int J Med Educ. 2014;5:199–204.

    Article  Google Scholar 

  10. Kumar AD, Shah MK, Maley JH, Evron J, Gyftopoulos A, Miller C. Preparing to take the USMLE step 1: a survey on medical students’ self-reported study habits. Postgrad Med J. 2015;91:257–61.

    Article  Google Scholar 

  11. Werner LS, Bull BS. The effect of three commercial coaching courses on step one USMLE performance. Med Educ. 2003;37:527–31.

    Article  Google Scholar 

  12. McGaghie WC, Downing SM, Kubilius R. What is the impact of commercial test preparation courses on medical examination performance? Teach Learn Med. 2004;16:202–11.

    Article  Google Scholar 

  13. Tompkins J. Money for nothing? The problem of the board-exam coaching industry. N Engl J Med. 2011;365(2):104–5.

    Article  Google Scholar 

  14. Cate OT, Durning S. Peer teaching in medical education: twelve reasons to move from theory to practice. Med Teach. 2007;29:591–9.

    Article  Google Scholar 

  15. Cate OT, Durning S. Dimensions and psychology of peer teaching in medical education. Med Teach. 2007;29:546–52.

    Article  Google Scholar 

  16. Bulte C, Betts A, Garner K, Durning S. Student teaching: views of student near-peer teachers and learners. Med Teach. 2007;29:583–90.

    Article  Google Scholar 

  17. Jackson TA, Evans DJR. Can medical students teach? A near-peer-led teaching program for year 1 students. Adv Physiol Educ. 2012;36:192–6.

    Article  Google Scholar 

  18. Heckmann JG, Dütsch M, Rauch C, Lang C, Weih M, Schwab S. Effects of peer-assisted training during the neurology clerkship: a randomized controlled study. Eur J Neurol. 2008;15(12):1365–70.

    Article  Google Scholar 

  19. Secomb J. A systematic review of peer teaching and learning in clinical education. J Clin Nurs. 2008;17:703–16.

    Article  Google Scholar 

  20. Field M, Burke JM, McAllister D, Lloyd DM. Peer-assisted learning: a novel approach to clinical skills learning for medical students. Med Educ. 2007;41:411–8.

    Article  Google Scholar 

  21. Weyrich P, Celebi N, Schrauth M, Möltner A, Lammerding-Köppel M, Nikendei C. Peer-assisted versus faculty staff-led skills laboratory training: a randomised controlled trial. Med Educ. 2009;43:113–20.

    Article  Google Scholar 

  22. Blank W, Blankenfeld H, Vogelmann R, Linde K, Schneider A. Can near-peer medical students effectively teach a new curriculum in physical examination? BMC Med Educ. 2013;13:165.

    Article  Google Scholar 

  23. Meller SM, Chen M, Chen R, Haeseler FD. Near-peer teaching in a required third-year clerkship. Yale J Biol Med. 2013;86:583–9.

    Google Scholar 

  24. Yu TC, Wilson NC, Singh PP, Lemanu DP, Hawken SJ, Ag H. Medical students-as-teachers: a systematic review of peer-assisted teaching in medical school. Adv Med Educ Pract. 2011;2:157–72.

    Google Scholar 

  25. Wong JG, Waldrep TD, Smith TG. Formal peer teaching in medical school improves academic performance: the MUSC supplemental instructor program. Teach Learn Med. 2007;19:216–20.

    Article  Google Scholar 

  26. Lockspeiser TM, O’Sullivan P, Teherani A, Muller J. Understanding the experience of being taught by peers: the value of social and cognitive congruence. Adv Health Sci Educ. 2008;13:361–72.

    Article  Google Scholar 

  27. Johnson JH, Jordan EJ, Silbinger S. Process and experience of creating a student-run step 1 guidance program. Einstein J Biol Med. 2013;29:52–3.

    Google Scholar 

  28. Alcamo AM, Davids AR, Way DP, Lynn DJ, Vandre DD. The impact of a peer-designed and -led USMLE step 1 review course: improvement in preparation and scores. Acad Med. 2010;85(10 suppl):S45–8.

    Article  Google Scholar 

  29. Strowd RE, Beard HR, Gorney B, Russell GB, Lambros A. The impact of process-oriented preparation on high-stakes testing in medical school. Med Sci Educ. 2013;23(4):588–94.

    Article  Google Scholar 

  30. Peterson CA, Tucker RP. Medical gross anatomy as a predictor of performance on the USMLE step 1. Anat Rec, Part B, New Anatomist. 2005;283(1):5–8.

    Article  Google Scholar 

  31. Vora A, Maltezos N, Alfonzo L, Hernandez N, Calix E, Fernandez MI. Predictors of scoring at least 600 on COMLEX-USA level 1: successful preparation strategies. J Am Osteopath Assoc. 2013;113(2):164–73.

    Article  Google Scholar 

  32. Pohl CA, Robeson MR, Hojat M, Veloski JJ. Sooner or later? USMLE step 1 performance and test administration date at the end of the second year. Acad Med. 2002;77(10 suppl):S17–9.

    Article  Google Scholar 

  33. Wayne SJ, Fortner SA, Kitzes JA, Timm C, Kalishman S. Cause or effect? The relationship between student perception of the medical school learning environment and academic performance on USMLE step 1. Med Teach. 2013;35:376–80.

    Article  Google Scholar 

  34. Mathis BR, Warm EJ, Schauer DP, Holmboe E, Rouan GW. A multiple choice testing program coupled with a year-long elective experience is associated with improved performance on the internal medicine in-training examination. J Gen Intern Med. 2011;26(11):1253–7.

    Article  Google Scholar 

  35. Chang D, Kenel-Pierre S, Basa J, et al. Study habits centered on completing review questions result in quantitatively higher American Board of Surgery In-Training Exam scores. J Surg Educ. 2014;71(6):e127–31.

    Article  Google Scholar 

  36. USMLE Announcements, Change in minimum passing requirements for Step 1. Available at: http://www.usmle.org/announcements/?ContentId=127. Accessed May 1st 2014.

  37. AAMC Applicants and Matriculants Data. Available at: https://www.aamc.org/download/321494/data/factstable17.pdf. Accessed January 30th, 2015.

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Acknowledgments

Dedicated to the memory of beloved educator and mentor Dr. Sharon Silbiger.

Author’s Contributions

Eric Tanenbaum, Jacob Johnson, Eric Jordan, Jennifer Cottral, Christopher Tenore, Sharon Silbiger, and Amanda Raff contributed to the design and execution of the study. William Burton helped with survey design and dissemination, and Aileen McGinn performed the statistical analysis.

Author information

Authors and Affiliations

  1. University of Washington Medical Center, Seattle, WA, USA

    Eric J Tanenbaum

  2. Massachusetts General Hospital, Boston, MA, USA

    Jacob H Johnson & Jennifer Cottral

  3. UCSF Medical Center, San Francisco, CA, USA

    Eric Jordan

  4. Yale University Hospital, New Haven, CT, USA

    Christopher Tenore

  5. Albert Einstein College of Medicine, Bronx, NY, 10461, USA

    William B Burton & Aileen P McGinn

  6. Montefiore Medical Center, Associate Professor of Medicine, Bronx, NY, 10467, USA

    Amanda C Raff

Authors
  1. Eric J Tanenbaum
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Corresponding author

Correspondence to Eric J Tanenbaum.

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Ethical Approval

The study was reviewed and deemed exempt by the Montefiore Medical Center institutional review board.

Funding/Support

Monetary support for survey gift card incentives was provided through Associate Chair of Medicine for Undergraduate Medical Education funds.

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Tanenbaum, E.J., Johnson, J.H., Jordan, E. et al. An Effective Evidence-Based Student Run Near-Peer Support Group for the USMLE Step 1 Exam. Med.Sci.Educ. 26, 691–699 (2016). https://doi.org/10.1007/s40670-016-0334-8

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  • DOI: https://doi.org/10.1007/s40670-016-0334-8

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