Pre-matriculation clinical experience positively correlates with Step 1 and Step 2 scores

Abstract

Background

This study investigates whether students with pre-matriculation, formalized, clinical experience performed better in Step 1 and Step 2 of the United States Medical Licensing Exams (USMLE) compared to students without formal pre-matriculation clinical experience.

Methods

This research investigation was a retrospective cohort study conducted at the University of Arizona College of Medicine in Tucson, Arizona, USA, and analyzed students in the Class of 2017 and Class of 2018. Formal clinical experience was defined as registered nurses, physician assistants, nurse practitioners, paramedics, emergency medical technicians, or licensed practical nurses for any amount of time prior to matriculation, as well as scribing for at least 6 months prior to matriculation. Students with any amount of shadowing experience were not considered to have clinical experience. The authors performed multiple regression analyses to investigate the effects of formal clinical experience on USMLE exam performance. Statistical significance was defined as P<0.05. All statistical analyses were performed using SAS 9.4.

Results

Our study had a total of 227 students from the two classes, with 40 (17.6%) having formal pre-matriculation clinical experience, as already defined. Nine (3.96%) students were not assessed in USMLE Step 1 calculations, and 61 (26.9%) students were not assessed in USMLE Step 2 calculations due to an absence of recorded USMLE scores. Formal pre-matriculation clinical experience was a statistically significant positive predictor of USMLE Step 1 score (P=0.03) and USMLE Step 2 score (P<0.010).

Conclusion

Formal pre-matriculation clinical experience, as defined previously, positively correlates with an increase in USMLE Step 1 and Step 2 scores.

Keywords:

• medical education
• medical school admissions
• clinical experience
• USMLE Step 1 and Step 2

Acknowledgments

The authors would like to thank the UACOM admissions office for their generosity and time in acquiring the data for this study.

Author contributions

RS made substantial contributions to the study conception and design, data acquisition, and the first and final draft of the article.

CJ was responsible for data analysis and interpretation and contributed to the first and final draft of the article.

DR made substantial contributions to study conception and design as well as the first and final draft of the article.

LAB made substantial contributions to data interpretation and to the first and final draft of the article.

WA-R was the senior author of this project and made substantial contributions to the study conception and design, data interpretation, and the first and final draft of the article.

All authors contributed toward data analysis, drafting and critically revising the paper and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.