Medical Student Performance on the National Board of Medical Examiners Emergency Medicine Advanced Clinical Examination and the National Emergency Medicine M4 Exams

Abstract

IntroductionIn April 2013, the National Board of Medical Examiners (NBME) released an Advanced Clinical Examination (ACE) in emergency medicine (EM). In addition to this new resource, CDEM (Clerkship Directors in EM) provides two online, high-quality, internally validated examinations. National usage statistics are available for all three examinations, however, it is currently unknown how students entering an EM residency perform as compared to the entire national cohort. This information may help educators interpret examination scores of both EM-bound and non-EM-bound students.ObjectivesThe objective of this study was to compare EM clerkship examination performance between students who matched into an EM residency in 2014 to students who did not. We made comparisons were made using the EM-ACE and both versions of the National fourth year medical student (M4) EM examinations.MethodIn this retrospective multi-institutional cohort study, the EM-ACE and either Version 1 (V1) or 2 (V2) of the National EM M4 examination was given to students taking a fourth-year EM rotation at five institutions between April 2013 to February 2014. We collected examination performance, including the scaled EM-ACE score, and percent correct on the EM M4 exams, and 2014 NRMP Match status. Student t-tests were performed on the examination averages of students who matched in EM as compared with those who did not.ResultsA total of 606 students from five different institutions took both the EM-ACE and one of the EM M4 exams; 94 (15.5%) students matched in EM in the 2014 Match. The mean score for EM-bound students on the EM-ACE, V1 and V2 of the EM M4 exams were 70.9 (n=47, SD=9.0), 84.4 (n=36, SD=5.2), and 83.3 (n=11, SD=6.9), respectively. Mean scores for non-EM-bound students were 68.0 (n=256, SD=9.7), 82.9 (n=243, SD=6.5), and 74.5 (n=13, SD=5.9). There was a significant difference in mean scores in EM-bound and non-EM-bound student for the EM-ACE (p=0.05) and V2 (p<0.01) but not V1 (p=0.18) of the National EM M4 examination.ConclusionStudents who successfully matched in EM performed better on all three exams at the end of their EM clerkship.

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.…”

“…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).…”

“…Studies that are conducted at multiple institutions are important since they demonstrate that the intervention is effective in a variety of settings and may be more generalizable to others who wish to implement a similar program. This year, 10 (16%) studies were conducted at more than two sites . Researchers in EM can be more confident in the value of their interventions if they produce excellent results when applied to many different types of learners and taught by a variety of instructors.…”