Does Self-Regulated Test-Prep Work To Improve USMLE Step 1 Scores?   

USMLE: Probably, and it is likely most helpful for the students with lower-than-median MCAT scores, according to this non-randomized intervention for pre-clinical medical students.  All students in one class were provided free access to a commercial NBME-style question bank and their access to questions was tracked.  Higher utilization of test questions was associated with higher objective achievement including USMLE 1 scores for all students, but the gain was much higher in those students with lower-than-average MCAT scores.  For example, in going from 0 to nearly 1,500 questions accessed (the range seen in this group), students with the median MCAT score of 30 were projected to raise their USMLE 1 score by about 20 points.  Students in the lowest MCAT group were projected to have a rise of about 40 points, while those in the highest group experienced a minimal rise. The authors suggest that this access may “benefit all students while conferring relatively greater benefit to students who may enter medical school with greater academic risk or less well-developed standardized test-taking skills.”  Obvious confounders are student persistence and work ethic.  It would be useful to find out exactly how the students are using these questions – e.g. mostly to “cram” for exams, or for paced re-exposure to previously-learned material. — Laura Willett, MD

Baños JH, Pepin ME, Van Wagoner N. Class-Wide Access to a Commercial Step 1 Question Bank During Preclinical Organ-Based Modules: A Pilot Project. Acad Med. 2017 Aug 16.

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