The United States Medical Licensing Exam Step 2 Clinical Skills Examination: Potential Alternatives During and After the COVID-19 Pandemic

Fatima, Rawish; Assaly, Ahmad R; Aziz, Muhammad; Moussa, Mohamad; Assaly, Ragheb

doi:10.2196/25903

Cited by 8 publications

(3 citation statements)

References 5 publications

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“…(7) We may add another survey to be completed after the students receive feedback on their templated PNs to assess their response to the feedback. (8) When COVID-19 restrictions ease, we plan to return to a fully in-person OSCE, although the standardized video interview remains an appealing alternative when in-person assessment is not possible [ 13 ]. (9) We may incorporate the templated PN-writing exercise into multiple OSCEs across the curriculum to track students’ performance over time.…”

Section: Discussionmentioning

confidence: 99%

Applying a validated scoring rubric to pre-clerkship medical students’ standardized patient notes: a pilot study

2023

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Background With the elimination in 2021 of the United States Medical Licensing Examination Step 2 Clinical Skills test, it is incumbent upon U.S. medical schools to develop local validated assessments of clinical reasoning. While much attention has been paid to summative exams for graduating students, formative exams for pre-clerkship students have not been well studied. Methods We applied the University of Illinois at Chicago College of Medicine (UIC-COM) Patient Note (PN) Scoring Rubric to templated PNs written by 103 pre-clerkship students for two cases in an objective structured clinical examination (OSCE) at the Yale School of Medicine. The rubric consists of four section scores (Documentation, Differential Diagnosis, Justification, and Workup, each scored 1 to 4) and a composite score (scaled 23 to 100). We calculated item discrimination for each section score and Cronbach’s alpha for each case. We surveyed students about their experience writing the templated PN. Results Mean Documentation, Differential Diagnosis, Justification, Workup, and composite scores for case A were 2.16, 1.80, 1.65, 2.29, and 47.67, respectively. For case B, the scores were 2.13, 1.21, 1.60, 1.67, and 40.54, respectively. Item discrimination ranged from 0.41 to 0.80. Cronbach’s alpha for cases A and B was 0.48 and 0.25, respectively. A majority of the students felt that the exercise was useful and appropriate to their level of training. Conclusions Despite performing poorly, pre-clerkship students found the note-writing task beneficial. Reliability of the scoring rubric was suboptimal, and modifications are needed to make this exercise a suitable measure of clinical reasoning.

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Section: Discussionmentioning

confidence: 99%

Applying a validated scoring rubric to pre-clerkship medical students’ standardized patient notes: a pilot study

2023

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“…Although it is too early to see what exact effect the COVID-19 pandemic had on medical students, residents, and attending physicians, clues presage its negative impact. National evaluation examinations such as USMLE Step 2 CS have been urgently discontinued to minimize exposure to the new coronavirus [20]. Also, clinical rotations have been modified to adjust to the new reality [18,19].…”

Section: Discussionmentioning

confidence: 99%

Abdominal Pain and Examination of Hernial Orifices: The Forgotten Art of Physical Diagnosis

Doukas¹,

Doukas²,

Upadrasta³

et al. 2021

Cureus

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Introduction: Acute abdominal pain can be the first manifestation of a hernial pathology. The estimated risk of incarcerated hernia is 1%-3% over a person's lifetime. Therefore, hernial orifice examination should be conducted routinely, especially in cases of abdominal pain. We hypothesized that physical examination of hernial orifices is not routinely performed and documented in patients presenting with acute abdominal pain.Methods: A retrospective chart review of 100 patients who were evaluated for abdominal pain over a threemonth time frame at our institution.Results: From the 100 reviewed cases, the hernial orifice examination was performed in two cases by an Internal Medicine or Emergency Medicine physician (2%). Out of the eight cases with General Surgery consultation, only one case had hernial orifices examination (12.5%). In the 10 cases with Gastroenterology consultation, not a single case had hernial orifice examination. Conclusion:We demonstrate that hernial examination is infrequently performed in clinical practice and suggest that emphasis should be placed on the efficient performance of physical examination and maintain the art of physical diagnosis.

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“…Although the gap left with the discontinuation of the exam in the United States could be expected to be filled by medical schools in the United States, ECFMG certification requires evaluation of IMGs' clinical skills and English proficiency. Thus, ECFMG needed to rapidly implement a new certification system to reassure GME program directors and the public that IMGs are qualified [9][10][11] and to allow IMGs to continue to participate in the U.S. physician workforce and provide essential patient care.…”

Section: The Educational Commission Formentioning

confidence: 99%

Evolution of Educational Commission for Foreign Medical Graduates Certification in the Absence of the USMLE Step 2 Clinical Skills Examination

Mladenovic¹,

Zanten²,

Pinsky³

2022

Academic Medicine

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The United States Medical Licensing Examination Step 2 Clinical Skills (CS) was paused in 2020 because of the ongoing COVID-19 pandemic and discontinued in 2021. Step 2 CS was an important tool to assess readiness of international medical graduates (IMGs) to enter graduate medical education (GME) in the United States. This article describes the Educational Commission for Foreign Medical Graduates' (ECFMG's) response to the discontinuation of Step 2 CS. ECFMG certifies IMGs who seek eligibility for GME and licensure in the United Please see the end of this article for information about the authors.

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The United States Medical Licensing Exam Step 2 Clinical Skills Examination: Potential Alternatives During and After the COVID-19 Pandemic

Cited by 8 publications

References 5 publications

Applying a validated scoring rubric to pre-clerkship medical students’ standardized patient notes: a pilot study

Applying a validated scoring rubric to pre-clerkship medical students’ standardized patient notes: a pilot study

Abdominal Pain and Examination of Hernial Orifices: The Forgotten Art of Physical Diagnosis

Evolution of Educational Commission for Foreign Medical Graduates Certification in the Absence of the USMLE Step 2 Clinical Skills Examination

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