fmCASES National Examination as a Pretest in a Family Medicine Clerkship

Abstract

Background and Objectives: Pretests have been shown to contribute to improved performance on standardized tests by serving to facilitate development of individualized study plans. fmCASES is an existing validated examination used widely in family medicine clerkships throughout the country. Our study aimed to determine if implementation of the fmCASES National Examination as a pretest decreased overall failure rates on the end-of-clerkship National Board of Medical Examiners (NBME) subject examination, and to assess if fmCASES pretest scores correlate with student NBME scores. Methods: One hundred seventy-one and 160 clerkship medical students in different class years at a single institution served as the control and intervention groups, respectively. The intervention group took the fmCASES National Examination as a pretest at the beginning of the clerkship and received educational prescriptions based on the results. Chi-square analysis, Pearson correlation, and receiver operating curve analysis were used to evaluate the effectiveness and correlations for the intervention. Results: Students completing an fmCASES National Examination as a pretest failed the end-of-clerkship NBME exam at significantly lower rates than those students not taking the pretest. The overall failure rate for the intervention group was 8.1% compared to 17.5% for the control group (P=0.01). Higher pretest scores correlated with higher NBME examination scores (r=0.55, P<0.001). Conclusions: fmCASES National Examination is helpful as a formative assessment tool for students beginning their family medicine clerkship. This tool introduces students to course learning objectives, assists them in identifying content areas most in need of study, and can be used to help students design individualized study plans.

Enhancing Examination Success: the Cumulative Benefits of Self-Assessment Questions and Virtual Patient Cases

“…Additionally, we can explore approaches for integrating VPCs and SAQs in an active learning environment. Recent studies have begun to examine the use of validated examinations as pretests for NBME subject examinations [ 24 ]. This exploration could contribute to developing additional SAQs with the necessary psychometric properties to support students’ desire for study aids that will positively affect examination performance.…”

“…Moroz et al [ 23 ] showed that increases in scores on the self-assessment examinations in physical medicine and rehabilitation were significantly related to improvements in board scores. Nguyen et al [ 24 ] report that students who took a comprehensive family medicine exam at the beginning of the clerkship and received educational support based on the exam results significantly reduced their NBME subject exam failure rate.…”

“…Published studies using VPCs found self-assessment resulted in higher examination scores [ 34 ] and decreased failure rates on the NBME examination [ 24 ]. Still, there has been little work demonstrating the effectiveness of the feedback-rich formative assessment environment of VPC on subsequent performance on summative assessments in the form of final exams.…”

Impact of the Introduction of the Clinical Science Mastery Series on Family Medicine NBME Subject Examination Performance

“…6 fmCASES National Examination is a helpful formative assessment tool for students beginning their family medicine clerkship. 7 However, use of MedU (now Aquifer) virtual cases did not impact NBME scores. 8 Performance on CSMS self-assessments and clinical science subject examinations was related.…”