Score reporting on NBME examinations

Abstract

Because the National Board of Medical Examiners (NBME) will introduce new comprehensive Part I and Part II examinations in 1991, a review has been made of score reporting methods to be used in the new examinations. The review was conducted also because of concern expressed by some that NBME examination scores are misused in medical schools and in resident selection. In this paper, selected aspects of score reporting are defined, the uses of score reports outlined, and the potential for misuse described. It should be noted that the NBME is obliged to make available numerical scores to state medical boards and to examinees. Individual scores are reported to others only with the permission of the examinee. The results of an opinion poll conducted by the NBME of medical educators and medical students are presented. The range of opinion is broad but favors numerical score reporting and a designated pass/fail score.

Numerical Versus Pass/Fail Scoring on the USMLE: What Do Medical Students and Residents Want and Why?

“…Numerical scores have been reported on all NBME examinations since 1916, 8 and prior to the CEUP, the NBME upheld this practice following reviews of its scorereporting policy in 1989 9 and 1997. 8 Reporting of numerical scores has prompted an ongoing debate because Emergency medicine 25 (3) Internal medicine/pediatrics…”

“…1,5,8 Medical student preference for pass/fail scoring has varied over time. In the review conducted by the NBME in 1989, 9 fewer than half of all respondents favored pass/fail scoring for either Step 1 or 2. In its more recent review conducted in 1997, 8 61% were in favor of pass/fail scoring, and although the CEUP did not provide specific figures, it reported that surveys of medical student leaders revealed a strong preference for pass/fail scoring.…”

“…Substantial literature exists on this topic, and most studies have demonstrated that USMLE scores correlate with performance during residency and future certifying examinations. 6,8,9,17,[20][21][22][23] The degree of correlation varies depending on which USMLE Step/Part is evaluated and the outcomes of interest, with the highest correlation generally between performance on the USMLE and future examinations, either during or at conclusion of training. Still, even when evaluating which measures best predict resident ratings by faculty or performance in practice, USMLE scores have consistently been the most significant and accurate variable.…”

“…6 The NBME acknowledges these concerns, and in response has performed regular reviews of its score reporting policy. 8,9 This survey-based study was undertaken to evaluate medical students' and residents' opinions regarding the implications of a potential shift to pass/fail scoring of the USMLE Steps 1 and 2 Clinical Knowledge (CK). Survey questions focused on USMLE scoring as it relates to medical knowledge assessment and applications for residency training.…”

Orthopaedic In-Training Examination Scores: A Correlation with USMLE Results

“…As noted previously, the USMLE is a licensing examination and is not designed to predict future performance on other examinations nor is it designed to predict resident performance or, ultimately, the quality of the practice of medicine. Test results can be biased by medical school characteristics and curricula that are patterned on a USMLE format, resulting in substantial advantages to those students taking the examination 28,29 . Fine and Hayward 30 reported that the performance of internal medicine residents, as measured by faculty evaluations, was most strongly correlated with honors during the medical school internal medicine clerkship, as opposed to NBME scores.…”