The Implementation of Peer‐led Anatomy Review Sessions for USMLE Step 1 Examination Preparation

Abstract

Medical residency programs place significant emphasis on USMLE Step 1 scores when determining which students to invite for interviews and when ranking candidates for residency positions. While Brody School of Medicine (BSOM) students have historically scored at or above the national Step 1 average, discipline‐specific data revealed that the same students consistently performed below the national average in the area of gross anatomy and embryology (GAE). This below average performance may be attributed to the time lapse between completion of GAE coursework in the first year of medical school and when students sit for the USMLE Step 1 examination prior to the start the third year of medical school. To bridge the time gap, peer‐led GAE review sessions were created for second‐year medical students preparing to take the USMLE Step 1. These sessions focused on high‐yield, clinically correlated GAE topics, specifically in the upper and lower extremities, including nerve lesions and musculoskeletal injuries. Pilot study data were used to optimize session logistics prior to deployment in spring 2019. This study describes the implementation of these revised peer‐led GAE laboratory review sessions, assesses effectiveness of session on GAE knowledge acquisition, and evaluates student perceptions of the review sessions. Two, 60‐minute, peer‐led gross anatomy laboratory review sessions were offered to all BSOM second‐year medical students. Session 1 and 2 reviewed high‐yield upper extremity and lower extremity gross and clinical anatomy topics, respectively. Both sessions were offered in six time blocks and limited to 8 students (n= 33) per time block. Of the 33 participants, 30 took part in both sessions. Each session included a pre‐session knowledge assessment, a clinically‐focused interactive chalk‐talk, hands‐on prosection laboratory stations, and a post‐session knowledge assessment. Each session was facilitated by the same near‐peer teacher for consistency in delivery. The pre‐ and post‐session knowledge assessments consisted of 4–6 multiple‐choice, board‐style examination questions focused on content delivered during the session. Participants were asked to complete a survey, designed to assess learner perceptions of the review, both immediately after the review session and after completion of USMLE Step 1—approximately two months after the sessions. Average knowledge assessment scores improved by 57.1% and 68.4% following the upper and lower extremity review sessions, respectively. Participants perceived the review sessions positively, with 77.7% reporting improved confidence with musculoskeletal content. Additionally, 88.8% reported increased comfort answering anatomy board‐style questions, and that the sessions were an efficient use of study time. Results suggest that near‐peer‐led review sessions improved medical student knowledge, confidence and comfort with the presented content. Future studies will examine the effect of participation on discipline‐specific performance on Step 1. Improved scores could support the development and delivery of additional peer‐led basic science review sessions during dedicated Step 1 study time.