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

Authors Shah R, Johnstone C, Rappaport D, Bilello LA, Adamas-Rappaport W

Received 8 May 2018

Accepted for publication 16 July 2018

Published 25 September 2018 Volume 2018:9 Pages 707—711


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Md Anwarul Majumder

Raj Shah,1 Cameron Johnstone,2 Douglas Rappaport,3 Leslie A Bilello,4 William Adamas-Rappaport5

1University of Arizona College of Medicine, Tucson, AZ, USA; 2University of Arizona College of Medicine, Tucson, AZ, USA; 3Department of Emergency Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA; 4Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA; 5Department of Surgery, University of Arizona College of Medicine, Tucson, AZ, USA

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

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