Student Performance on Course Objectives in a First-Year Medical School Foundational Science Course Correlate with USMLE Step 1 Scores

Figures & data

Table 1 Correlation Between Pre-Matriculation Metrics and Molecular and Cellular Foundations of Medicine Course Objective Performance with Molecular and Cellular Foundations of Medicine Course Grade and USMLE^® Step 1 Score

	Molecular and Cellular Foundations of Medicine Course Grade				USMLE^® Step 1
	Pearson’s (r)	Score Variations (Adjusted r^2)	p	N	Pearson’s (r)	Score Variations (Adjusted r^2)	p	N
Pre-Matriculation Metrics
Science uGPA	0.378	13.9%	<0.001	210	0.316	9.5%	<0.001	196
Total uGPA	0.353	12.1%	<0.001	210	0.276	7.2%	<0.001	196
MCAT	0.476	22.3%	<0.001	210	0.396	15.3%	0.001	196
Molecular and Cellular Foundations of Medicine Course Objectives
1	0.426	17.8%	<0.001	210	0.310	9.2%	<0.001	193
2	0.208	3.8%	0.002	210	0.250	5.7%	<0.001	193
3	0.339	11.1%	<0.001	210	0.307	9.0%	<0.001	193
4	0.350	11.8%	<0.001	210	0.428	17.9%	<0.001	193
5	0.268	6.8%	<0.001	210	0.121	1.0%	<0.001	193
6	0.366	12.9%	<0.001	210	0.314	9.4%	<0.001	193
7	0.369	13.2%	<0.001	210	0.393	15.0%	<0.001	193
8	0.348	11.7%	<0.001	210	0.249	5.7%	0.003	193
9	0.402	15.8%	<0.001	210	0.212	4.0%	<0.001	193
10	0.486	23.2%	<0.001	210	0.276	7.1%	<0.001	193
Molecular and Cellular Foundations of Medicine Course Exam Grade and Final Course Grade
Multiple-Choice Exam Grade	0.998	99.6%	<0.001	210	0.500	24.6%	<0.001	193
Final Course Grade	N/A	N/A	N/A	N/A	0.511	25.7%	<0.001	193

Note: Molecular and Cellular Foundations of Medicine course objectives are presented.

Abbreviations: USMLE^®, United States Medical Licensing Examination^®; p, p-value; N, number of students; uGPA, undergraduate grade point average; MCAT, Medical College Admission Test; N/A, Not applicable.

Figure 1 Student performance on summative assessments in the molecular and cellular foundations of medicine course. Summative course exam and final course grade. Number of students = 211.

Table 2 Molecular and Cellular Foundations of Medicine Course Objectives for Academic Years 2018–2019 and 2019–2020

Molecular and Cellular Foundations of Medicine Course Objective	Number of Multiple-Choice Summative Exam Questions Mapped to Objective*
1. Describe the subcellular elements of a eukaryotic cell; recognize that these structures and their associated biochemical processes underlie the seven characteristic processes of life: homeostasis, metabolism, organization, growth, adaptation response to stimuli and reproduction.	15
2. Describe the characteristics of protein folding into structural components and enzymes in cells and explain how small changes in this amino acid sequence or its local environment can alter protein function, kinetics and dynamics.	15
3. Describe how cells communicate and the major signal transduction pathways by which they can elaborate responses to received messages.	18
4. Evaluate the regulation of both anabolic and catabolic processes; explain their respective regulation and key cofactors (eg, vitamins), and discuss their roles in metabolic homeostasis and development.	55
5. Describe gene structure and the processes of transcription, translation and post-translational modification; list means by which these processes are regulated during growth and development.	14
6. Evaluate pedigrees to identify single gene, chromosomal, multifactorial/complex, epigenetic and mitochondrial modes of inheritance and calculate their probability for recurrence; estimate population gene frequencies and associated phenotypes.	28
7. Describe the regulation of the cell cycle, DNA replication and repair; relate how disruptions in these processes contribute to the basis of disease and development.	15
8. Analyze results of biochemical or molecular testing and evaluate how this information is used in clinical decision making.	31
9. Describe the fundamental principles of pharmacokinetics (relate how drug absorption, distribution, metabolism, and elimination are influenced by parameters including the chemical nature of the drug and its route of administration, pharmacogenomic differences and biometrics) and dynamics (general processes by which cells can become desensitized to hormones and therapeutic agents, and explain the manner by which drug dose-response relationships are mathematically characterized and visualized.	6
10. Recognize that mitigation of disease risk includes adopting lifestyle choices including exercise and a healthy balanced diet providing the micro and macronutrients needed for optimal cellular function.	9

Notes: *One multiple-choice question could be mapped to more than one course objective. Total number of exam items = 109.

Figure 2 Student performance on molecular and cellular foundations of medicine course objectives. (A) Student performance on all questions mapped to molecular and cellular foundations of medicine course objectives. Obj 1: N = 15 (7.28); Obj 2: N = 15 (7.28); Obj 3: N = 18 (8.74); Obj 4: N = 55 (26.70); Obj 5: N = 14 (6.80); Obj 6: N = 28 (13.59); Obj 7: N = 15 (7.28); Obj 8: N = 31 (15.05); Obj 9: N = 6 (2.91); Obj 10: N = 9 (4.37). Obj. = Molecular and cellular foundations of medicine objective. N(%) = number of questions (% of questions) mapped to each molecular and cellular foundations of medicine objective. A question can be mapped to more than one FDNS objective. Number of students = 211. (B) Percent of students scoring ≥69.5% on molecular and cellular foundations of medicine course objectives. Number of students = 211.