Correlation of the National Emergency Medicine M4 Clerkship Examination with USMLE Examination Performance

Abstract

IntroductionAssessment of medical students’ knowledge in clinical settings is complex yet essential to the learning process. Clinical clerkships use various types of written examinations to objectively test medical knowledge within a given discipline. Within emergency medicine (EM), a new national standardized exam was developed to test medical knowledge in this specialty. Evaluation of the psychometric properties of a new examination is an important issue to address during test development and use. Studies have shown that student performance on selected standardized exams will reveal students’ strengths and/or weaknesses, so that effective remedial efforts can be implemented. Our study sought to address these issues by examining the association of scores on the new EM national exam with other standardized exam scores.MethodsFrom August 2011 to April 2013, average National EM M4 examination scores of fourth-year medical students taken at the end of a required EM clerkship were compiled. We examined the correlation of the National EM M4 examination with the scores of initial attempts of the United States Medical Licensing Exam (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) examinations. Correlation coefficients and 95% confidence intervals of correlation coefficients are reported. We also examined the association between the national EM M4 examination score, final grades for the EM rotation, and USMLE Step 1 and Step 2 CK scores.Results133 students were included in the study and achieved a mean score of 79.5 SD 8.0 on the National EM M4 exam compared to a national mean of 79.7 SD 3.89. The mean USMLE Step 1 score was 226.8 SD 19.3. The mean USMLE Step 2 CK score was 238.5 SD 18.9. National EM M4 examination scores showed moderate correlation with both USMLE Step 1 (mean score=226.8; correlation coefficient=0.50; 95% CI [0.28–0.67]) and USMLE Step 2 CK (mean score=238.5; correlation coefficient=0.47; 95% CI [0.25–0.65]). Students scoring below the median on the national EM M4 exam also scored well below their colleagues on USMLE exams.ConclusionThe moderate correlation of the national EM M4 examination and USMLE Step 1 and Step 2 CK scores provides support for the utilization of the CDEM National EM M4 examination as an effective means of assessing medical knowledge for fourth-year medical students. Identification of students scoring lower on standardized exams allows for effective remedial efforts to be undertaken throughout the medical education process.

Critical Appraisal of Emergency Medicine Educational Research: The Best Publications of 2015

“…A total of 434 papers and abstracts satisfied the search criteria, and 61 papers met the inclusion criteria . The authors scored these 61 manuscripts, and the 10 highest scoring quantitative and two qualitative articles are reviewed below, in alphabetical order by first author's last name.…”

“…demonstrated that studies that were funded tended to be of higher quality when assessed on a validated tool. In 2015, 12 studies (20%) were funded, one received federal funding, two received foundational funding, and eight received support from an institution or unspecified organization . Four of the 12 highlighted articles (33%) this year were funded research …”

“…There were 10 papers (16%) that employed survey methodology but none met the criteria for a highlighted article . The remaining 36 papers (59%) were observational studies and accounted for 50% of the highlighted articles . It is interesting to note that each study design had representation in meeting the validated criteria to be a highlighted article, with the exception, this year, of survey methodology.…”

“…The study populations included medical students (36%), residents (54%), and a variety of others (attending physicians, nurses, interprofessional teams, fellows, midlevel providers, paramedics, validity evidence, and department flow).…”

Taking More Society for Academic Emergency Medicine Practice Tests Does Not Lead to Improved National EM-M4 Exam Scores

“…Previous studies on the SAEM final tests found they are moderately correlated with the US Medical Licensing Examination (USMLE) Step 1, and USMLE Step 2 Clinical Knowledge (CK). 6 The unselected questions from the original question bank has been preserved and promoted as a study tool at www.saemtests.org . We provided students access to this question bank during the EM AI.…”