Use of the NBME Comprehensive Basic Science Examination as a progress test in the preclerkship curriculum of a new medical school

Abstract

In the present study, we describe the innovative use of the National Board of Medical Examiners (NBME) Comprehensive Basic Science Examination (CBSE) as a progress test during the preclerkship medical curriculum. The main aim of this study was to provide external validation of internally developed multiple-choice assessments in a new medical school. The CBSE is a practice exam for the United States Medical Licensing Examination (USMLE) Step 1 and is purchased directly from the NBME. We administered the CBSE five times during the first 2 yr of medical school. Student scores were compared with scores on newly created internal summative exams and to the USMLE Step 1. Significant correlations were observed between almost all our internal exams and CBSE scores over time as well as with USMLE Step 1 scores. The strength of correlations of internal exams to the CBSE and USMLE Step 1 broadly increased over time during the curriculum. Student scores on courses that have strong emphasis on physiology and pathophysiology correlated particularly well with USMLE Step 1 scores. Student progress, as measured by the CBSE, was found to be linear across time, and test performance fell behind the anticipated level by the end of the formal curriculum. These findings are discussed with respect to student learning behaviors. In conclusion, the CBSE was found to have good utility as a progress test and provided external validation of our new internally developed multiple-choice assessments. The data also provide performance benchmarks both for our future students to formatively assess their own progress and for other medical schools to compare learning progression patterns in different curricular models.

Use of the National Board of Medical Examiners^® Comprehensive Basic Science Exam: survey results of US medical schools

“…The finding that schools use the NBME CBSE to identify students performing below expectations is not surprising given the fact that the NBME CBSE has been reported to be a tool capable of identifying “students at risk for failing the USMLE Step 1” in established medical schools4 and predicting performance on the USMLE Step 1 in new medical schools 5,8. It is interesting that eight schools out of the total 36 that administered the NBME CBSE did not use this NBME CBSE to identify students performing below expectations and provide intervention strategies.…”

“…For example, one new school reported using the NBME CBSE as a progress test in an effort to provide external validation of the internal assessments; however, now that validation of the internal measurements has been completed, students have recommended reducing the number of administrations from five to two 5. There is merit in using externally validated exams in all new and existing medical schools as it has been reported that internally developed examinations are of low quality and the quality of the exam can be improved by providing formal training to the writers of test items 16…”

“…The NBME CBSE is strongly correlated with USMLE Step 1 performance4–7 and has been shown to identify students “at increased risk for poor performance on the USMLE Step 1” 7. The NBME CBSE has also been used to provide external validation of internal assessments within new US medical schools5,8 and effectiveness of revised medical education curricula at an established medical school 9. Although there have been reports of how the NBME CBSE has been used at individual medical schools,4–6,8,9 its utilization across US medical schools, to our knowledge, has not been reported.…”

Is There an Association Between Comprehensive Basic Science Examination Score and Acceptance into an Oral and Maxillofacial Surgery Residency Program?

“…3 In addition, we have observed that many dental schools do not assign students a grade point average (GPA) or class rank, removing those measures as ways to eval-uate applicants. 5 The CBSE has been found to be strongly correlated with USMLE Step 1 performance [6][7][8] and was adopted by AAOMS beginning with the 2013 American Dental Education Association Postdoctoral Application Support Service (ADEA PASS) application cycle as an objective tool to assess an applicant's knowledge base or at least an applicant's ability to prepare adequately for this exam, even though its focus remains controversial. 4 Additionally, for OMFS residency programs offering integrated training with a medical degree, an applicant's passing the USMLE is a major consideration since residents must pass this exam to progress in the program, and failure would have negative consequences for the program as well as the resident.…”

“…4 Additionally, for OMFS residency programs offering integrated training with a medical degree, an applicant's passing the USMLE is a major consideration since residents must pass this exam to progress in the program, and failure would have negative consequences for the program as well as the resident. 5 The CBSE has been found to be strongly correlated with USMLE Step 1 performance [6][7][8] and was adopted by AAOMS beginning with the 2013 American Dental Education Association Postdoctoral Application Support Service (ADEA PASS) application cycle as an objective tool to assess an applicant's knowledge base or at least an applicant's ability to prepare adequately for this exam, even though its focus remains controversial. 4 Due to the value of the CBSE score, we have observed that OMFS program directors often place major emphasis on it as a screening threshold for applicants to their programs.…”