![]() ![]() The local Institutional Review Board approved this project as an exempt protocol.Īs part of a clerkship curriculum change in January 2015, we implemented the fmCASES National Examination as a 100-question pretest and formative assessment tool. Co16 USU students served as the control cohort, and Co17 USU students served as the intervention/comparison group. Participants included students from the class of 2016 (Co16) and 2017 (Co17) who completed the 6-week family medicine clerkship at the Uniformed Services University (USU). This was a retrospective cohort study comparing outcomes of students from two different medical school classes. The specific aims were: (1) to assess if implementation of the fmCASES National Examination as a tool for formative assessment decreased group overall failure rates on the end-of-clerkship NBME examination, and (2) to assess if fmCASES pretest scores correlate with student NBME scores. Our study extended the application of fmCASES National Examination outside of its use as an end-of-clerkship evaluation. 17-20 Evidence also exists to suggest that the fmCASES National Examination provides accurate and valid assessments of student clinical knowledge in family medicine, and are comparable to the use of NBME examinations. 16 Increased student engagement in the online fmCASES is associated with improved student performance on end-of-clerkship examinations, and use of the virtual cases is comparable to traditional textbook learning. 6-13įmCASES are online case-based modules originally created to meet the Society of Teachers of Family Medicine’s National Clerkship Curriculum Objectives, 14 and were found to “foster self-directed and independent study” and “emphasize and model clinical problem-solving.” 15 During the time of this initiative, 146 medical schools in the United States utilized fmCASES to teach or assess student learners. 4-5 General education concepts show that practice tests can contribute to improved performance on standardized tests via comprehension calibration, study plan development, and application of metacognitive strategy. Previous studies demonstrate the ability of clerkship practice tests to predict performance on NBME subject examinations, but show mixed results of the impact on student performance improvement. ![]() ![]() 1-3 Thus, student preparation and performance on gateway NBME subject examinations can potentially provide a foundation for future successful licensing examination performance. Previous studies suggest a strong correlation between National Board of Medical Examiners (NBME) subject examinations and subsequent United States Medical Licensing Examination (USMLE) scores. Standardized knowledge-based examinations are the standard by which medical professionals must demonstrate a minimum competence in order to earn a medical license and achieve specialty-based credentials. 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. Higher pretest scores correlated with higher NBME examination scores (r=0.55, P<0.001).Ĭonclusions: fmCASES National Examination is helpful as a formative assessment tool for students beginning their family medicine clerkship. The overall failure rate for the intervention group was 8.1% compared to 17.5% for the control group ( P=0.01). 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. Chi-square analysis, Pearson correlation, and receiver operating curve analysis were used to evaluate the effectiveness and correlations for the intervention. 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. 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. 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. fmCASES is an existing validated examination used widely in family medicine clerkships throughout the country. Background and Objectives: Pretests have been shown to contribute to improved performance on standardized tests by serving to facilitate development of individualized study plans. ![]()
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