Exploring Radiation Oncology Representation on the National Board of Medical Examiners (NBME) Official Practice Material for the Undergraduate United States National Standardized Medical Board Examinations

Abstract

Background The portrayal of oncology-related topics on the National Board of Medical Examiners (NBME) published practice material for undergraduate medical education (UGME) standardized examinations including the United States Medical Licensing Exams (USMLE) Step 1, Step 2 Clinical Knowledge (CK), and NBME Clinical Science Subject Examinations ('Shelf') is largely unknown. The goal of this study is to explore the presence and characterization of radiation oncology topics, including radiation therapy (RT), on these practice examinations. Methods All current and commercially accessible NBME published self-assessments and sample questions for the aforementioned examinations will be queried for content pertaining to oncology and associated treatment modalities of RT, surgery, and systemic therapy. The total volume of oncology-related questions and its distribution across all 3 major practice examination types will be recorded. The questions will be cataloged by selected attributes including context, treatment modality appearing as the correct answer for "next best step" (NBS) prompt, and answers appearing as the incorrect answer for NBS prompt. Results 1320 USMLE Step 1 practice questions are available for analysis. In preliminary analysis, minimal questions about RT were noted; all appearing to involve concepts of associated toxicity. 920 USMLE Step 2CK practice questions are available for analysis. RT-related questions appeared with higher frequency on the clinical science preparation material (n=10) compared to basic science (n=4), while also notably appearing as a listed answer choice for NBS prompt against other treatment modalities. 1325 practice questions from relevant NBME shelf examinations were available. RT appeared sparingly on the practice NBME shelf examinations of Surgery (n=5), Medicine (n=4), Ob/Gyn (n=2), and Clinical Neurology (n=2). RT questions were absent from Pediatrics, Emergency Medicine, and Family Medicine Shelf practice examination material. In the final analysis of these practice questions from all 3 major examination types, we seek to conduct a comparative analysis to other treatment modalities. Discussion This work represents the first attempt, to our knowledge, to characterize RT topic appearance within the NBME published practice questions and their accompanying explanations for the USMLE Step 1, Step 2CK, and select NBME shelf examinations. Our analysis is important in assessing the presence of RT topics on medical student board preparation material, a potential avenue of RT content exposure in UGME. Careful review and comparative analyses of all oncology-related content can provide important insight for UGME-related RT education. Our anticipated analyses and future discussion may identify areas for improvements in the important education of oncology-related topics in UGME. The portrayal of oncology-related topics on the National Board of Medical Examiners (NBME) published practice material for undergraduate medical education (UGME) standardized examinations including the United States Medical Licensing Exams (USMLE) Step 1, Step 2 Clinical Knowledge (CK), and NBME Clinical Science Subject Examinations ('Shelf') is largely unknown. The goal of this study is to explore the presence and characterization of radiation oncology topics, including radiation therapy (RT), on these practice examinations. All current and commercially accessible NBME published self-assessments and sample questions for the aforementioned examinations will be queried for content pertaining to oncology and associated treatment modalities of RT, surgery, and systemic therapy. The total volume of oncology-related questions and its distribution across all 3 major practice examination types will be recorded. The questions will be cataloged by selected attributes including context, treatment modality appearing as the correct answer for "next best step" (NBS) prompt, and answers appearing as the incorrect answer for NBS prompt. 1320 USMLE Step 1 practice questions are available for analysis. In preliminary analysis, minimal questions about RT were noted; all appearing to involve concepts of associated toxicity. 920 USMLE Step 2CK practice questions are available for analysis. RT-related questions appeared with higher frequency on the clinical science preparation material (n=10) compared to basic science (n=4), while also notably appearing as a listed answer choice for NBS prompt against other treatment modalities. 1325 practice questions from relevant NBME shelf examinations were available. RT appeared sparingly on the practice NBME shelf examinations of Surgery (n=5), Medicine (n=4), Ob/Gyn (n=2), and Clinical Neurology (n=2). RT questions were absent from Pediatrics, Emergency Medicine, and Family Medicine Shelf practice examination material. In the final analysis of these practice questions from all 3 major examination types, we seek to conduct a comparative analysis to other treatment modalities. This work represents the first attempt, to our knowledge, to characterize RT topic appearance within the NBME published practice questions and their accompanying explanations for the USMLE Step 1, Step 2CK, and select NBME shelf examinations. Our analysis is important in assessing the presence of RT topics on medical student board preparation material, a potential avenue of RT content exposure in UGME. Careful review and comparative analyses of all oncology-related content can provide important insight for UGME-related RT education. Our anticipated analyses and future discussion may identify areas for improvements in the important education of oncology-related topics in UGME.