Early prediction of the risk of scoring lower than 500 on the COMLEX 1

Abstract

Background The Comprehensive Osteopathic Medical Licensing Examination of the United States Level 1 (COMLEX 1) is important for medical students to be able to graduate. There is a glaring need to identify students who are at a significant risk of performing poorly on COMLEX 1 as early as possible so that extra assistance can be provided to those students. Our goal is to produce a reliable predictive model to identify students who are at risk of scoring lower than 500 on COMLEX 1 at the earliest possible time. Methods Academic data from medical students who matriculated at Rocky Vista University College of Osteopathic Medicine between 2011 and 2017 were obtained. Odds ratios were used to assess the predictors for scoring lower than 500 on COMLEX 1. Correlation with COMLEX 1 scores was assessed with Pearson correlation coefficient. The predictive models were developed by multiple logistic regression, backward logistic regression, and logistic regression with average scores in courses in the first three semesters, and were based on performances on the Medical College Admissions Test (MCAT) before admission, as well as students’ performances in preclinical courses during the first three semesters. The models were generated in about 82% of the student performance data and were then validated in the remaining 18% of the data. Results Odds ratios showed that MCAT scores and final grades in each course in the first three semesters were significant in predicting a score lower than 500 on COMLEX 1. Performances in third-semester courses including Renal System II, Cardiovascular System II, and Respiratory System II were most important in prediction. The three predictive models had sensitivities of 65.8 -71%, and specificities of 83.2 - 88.2% in predicting a score lower than 500 on COMLEX 1. Conclusions Lower MCAT scores and lower grades in the first three semesters of medical school predict scoring lower than 500 on COMLEX 1. Students who are identified at risk by our models will have a 65.8 -71% chance of actually scoring lower than 500 on COMLEX 1. Those students will have enough time to receive assistance before taking COMLEX 1.

Effects of Organ System Courses of the First Two Years of Medical School on the Performance of the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) Level 2-Cognitive Evaluation

“…As described in our previous publication [1], Rocky Vista University College of Osteopathic Medicine (RVUCOM) has a stepwise organ system-based curriculum for the first two preclinical years. Each organ system is covered twice, with the first course in the first year focusing on anatomy and physiology, and the second course in the second year focusing on pathology, pharmacology, and diagnosis and treatment.…”

“…Each organ system is covered twice, with the first course in the first year focusing on anatomy and physiology, and the second course in the second year focusing on pathology, pharmacology, and diagnosis and treatment. Details of the major courses in the first three semesters are listed in our previous study [1].…”

“…Academic data of students who enrolled at RVUCOM between 2011 and 2017 were retrieved. The project entitled "Using Simulation Modeling to Predict Failure on COMLEX 1 and 2 at First Attempt Through a Longitudinal Investigation" was approved by the IRB committee of RVUCOM (IRB number: IRB #2019-0079) [1]. Informed consent was waived because the IRB committee determined that this project was exempt.…”

“…Students in osteopathic medical schools must pass the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) series Level 1 and Level 2-Cognitive Evaluation (CE) to graduate and match to residency programs. These examinations are equivalent to the United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) tests in allopathic medicine, respectively [1]. Students usually take COMLEX Level 2-CE in the third or fourth year of medical school.…”

“…Although some studies have explored the prediction of performance on COMLEX Level 1 [1,5], only a few studies have been focused on the prediction of COMLEX Level 2-CE performance [6][7][8]. Preadmission undergraduate science grade point average (sciGPA) or Medical College Admission Test (MCAT) scores show a small but significant correlation with COMLEX Level 2-CE performance [6][7][8].…”