A Review from Medical Science Educator from Dr. Dani McBeth

Each month the IAMSE Publications Committee reviews published articles from Medical Science Educator. This month’s review, written by Dr. Dani McBeth, is taken from the article titled Factors Predictive of Performance on USMLE Step 1: Do Commercial Study Aids Improve Scores? (doi:10.1007/s40670-019-00722-4) published in Medical Science Educator, Volume 29, (pages 667–672), 2019 by Parry, S., Pachunka, J. & Beck Dallaghan, G.L.

I read with great interest an article in Medical Science Educator, Factors Predictive of Performance on USMLE Step 1: Do Commercial Study Aids Improve Scores?, Parry et al. The Step 1 exam has obtained such outsize importance, that it drives the way our students approach their studies. While this may be abhorrent to many of us, it is reality. Therefore, I found this article and the associated references to be of great interest. In my school, I plan to use the article in our Step 1 coaching program.

The study sought to correlate the results of Step 1 performance in 2 cohorts of students from a single medical school with academic performance in the curriculum and the use of commercially available study aids. While some of the results may not be too surprising, there were others that may be helpful in advising students about their approach to the exam. Not surprisingly, the strongest correlation to Step 1 scores was academic performance in the curriculum. The consistent use of the UWorld Qbank and the numbers of questions completed in the Qbank were also strongly correlated with Step 1 scores. Those students completing the entire Qbank twice had the highest Step 1 performance. There was no correlation between Step 1 scores and the numbers of practice exams completed, either the UWorld provided exams or the NBME CBSSA’s. This result does not negate the importance of self-assessment during the dedicated study process but may offer some advice as to the numbers of such self-assessment exams that are useful. It is my experience that too frequent self-assessment in many students may serve to increase anxiety levels. Perhaps surprisingly given the numbers of students who religiously rely on it, the extent to which First Aid was read and re-read did not correlate with increased Step 1 performance. Finally, there was a negative correlation to increased preparation time. In our school, we have seen an increasing number of students delaying their exams with the certitude that this will result in their desired score. Anecdotally, I have heard that this is an increasing issue at other schools as well.  The authors correctly point out the limitations of their study; a single medical school over only a to year period. Despite that, the article is useful in provoking thought about approaching how to help students think about their exam preparation. Similar studies with a larger sample of schools and expanding to include other commercially available resources including full prep courses would be of interest to many.

Respectfully submitted by
Dani L McBeth, PhD
Publications Committee member