Comprehensive Basic Science Examination Research Articles

Advising Orthopaedic Hopefuls in the Wake of a Pass/Fail US Medical Licensing Examination Step 1: A Proposed Method for Predicting US Medical Licensing Examination Step 2 Clinical Knowledge Outcomes.

Matching into orthopaedic residency has become difficult, and the US Medical Licensing Examination Step 1 transition to pass/fail scoring has complicated the process. Advisors' ability to mentor students has decreased, and program directors may rely on Step 2 Clinical Knowledge (CK) scores in selecting which candidates to interview. This study aims to offer a method to predict Step 2 CK outcomes based on preadmission and preclinical performance. The study investigated 486 students from a US medical school who enrolled in 2017 and 2018. Data on demographics, preadmission, and preclinical performance were collected. Before model creation, it was found that sex, Medical College Admission Test scores, Comprehensive Basic Science Examination performance, and preclinical curriculum performance produced optimal models. Multivariate ordinal logistic regression models were built to predict probabilities of four outcome levels of Step 2 CK: <235, 235 to 249, 250 to 265, and >265. Finally, nomograms were created to visualize probability calculations. Each model's odds ratios revealed that female sex, higher MCAT scores, and better Comprehensive Basic Science Examination and preclinical performance were associated with an increased likelihood of being in higher Step 2 CK scoring groups. Preclinical performance had a profound effect, especially for those in the top 1/3. Models were successful in assigning higher probabilities to students in higher Step 2 CK scoring groups in more than 80% of instances. Nomograms presented provide examples of how to apply these models to an individual student. This study presents a novel method for predicting probabilities of Step 2 CK outcomes that can be used to mentor students at a time point when Step 1 previously filled this role. It may assist in identifying orthopaedic hopefuls at risk of performing poorly on Step 2 CK and can foster the development of individualized guidance and mitigation strategies.

Current Utilization of the Comprehensive Basic Science Examination (CBSE) Score in the Evaluation of Applicants to Oral and Maxillofacial Surgery (OMS) Programs

Current Utilization of the Comprehensive Basic Science Examination (CBSE) Score in the Evaluation of Applicants to Oral and Maxillofacial Surgery (OMS) Programs

Is the Comprehensive Basic Science Examination Still Useful in the Oral and Maxillofacial Surgery Residency Application Process?

For any dental student interested in pursuing a career in oral and maxillofacial surgery (OMS), perhaps the biggest barrier to overcome is passing the Comprehensive Basic Science Examination (CBSE), a 200-question multiple choice test written by the National Board of Medical Examiners designed to prepare medical students for the United States Medical Licensing Examination (USMLE) Step 1.1 Prior to having the CBSE as a requirement for OMS residency applications, board scores from National Board Dental Examination (NBDE) were considered as a benchmark to compare applicants across all dental schools.

Score Gains on the NBME Subject Examinations in Internal Medicine Among Clerkship Students: a Two-Year Longitudinal Study from the United Arab Emirates.

The impact of clinical proficiency on individual student scores on the National Board of Medical Examiners (NBME) Subject Examinations remains uncertain. We hypothesised that increasing the length of time spent in a clinical environment would augment students' performance. Performance on the NBME Subject Examination in Internal Medicine (NBME-IM) of three student cohorts was observed longitudinally. Scores at the end of two unique internal medicine clerkships held at the third and fourth years were compared. The score differences between the two administrations were compared using paired t-tests, and the effect size was measured using Cohen's d. Moreover, linear regression was used to assess the correlation between the NBME-IM score gains and performance on a pre-clinical Comprehensive Basic Science Examination (CBSE). A two-tailed p-value <0.05 was considered significant. Of the 236 students enrolled during the third year, age, gender, CBSE, and NBME-IM scores were similar across all cohorts. The normalised score gain on the NBME-IM at the fourth year was 9.5% (range -38 to +45%) with a Cohen's d of 0.47. However, a larger effect size with a Cohen's d value of 0.96 was observed among poorly scoring students. Performance on the CBSE was a significant predictor of score gain on the NBME-IM (R 0.51, R 2 0.26, p-value < 0.001). Despite the increased length of clinical exposure, modest improvement in students' performance on repeated NBME-IM examination was observed. Medical educators need to reconsider how the NBME-IM is used in clerkship assessments.

Educational Outcomes of a 4-Year MD-MPH Dual-Degree Program: High Completion Rates and Higher Likelihood of Primary Care Residency.

In 2007, University of Texas Health Science Center Houston School of Public Health at San Antonio (UTHealth SPH) and UT Health San Antonio Long School of Medicine (LSOM) designed and implemented a 4-year dual MD and Master of Public Health (MPH) program. Dual MD-MPH programs wherein students can receive both degrees within 4 years are unique, and programmatic evaluation may have generalizable implications for accredited MD-MPH programs. Demographic information was collected from UTHealth SPH and LSOM student data. The primary outcome variable was MD-MPH program completion in 4 years. Comprehensive Basic Science Examination (CBSE) scores, United States Medical Licensing Examination Step 1 and Step 2 scores, and successful primary care residency match data were compared between MD-MPH and MD-only students. Family medicine, internal medicine, obstetrics-gynecology, and pediatrics were considered primary care residencies, and an analysis excluding obstetrics-gynecology was also conducted. Of 241 MD-MPH students enrolled 2007-2017, 66% were women, 22% Hispanic, and 10% African American. Four-year MD-MPH program completion occurred for 202 (93% of eligible) students; 9 (4.1%) received MD only, 3 (1.4%) received MPH only; and 4 (1.8%) received neither. MD-MPH students' median CBSE score was 2 points lower than for MD-only students (P = .035), but Step 1 and 2 scores did not differ. Primary care residency match was more likely compared with MD-only students, both including and excluding obstetrics-gynecology (odds ratio [OR]: 1.75; 95% confidence interval [CI]: 1.31, 2.33; and OR: 1.36; 95% CI: 1.02, 1.82, respectively). The 4-year MD-MPH program retains and graduates a socioeconomically and racial/ethnically diverse group of students with a 93% success rate. MD-MPH graduates were more likely to pursue primary care residency than non-dual-degree students, which may have implications for addressing population health disparities.

Survey of Dental Anesthesiology program directors' preferences regarding the candidate application and interview process.

Dental Anesthesiology recently gained specialty recognition in 2019. Program directors' preferences for candidates applying to this newly recognized specialty are not well known. This study sought to assess these preferences by surveying the program directors of advanced dental education programs in Dental Anesthesiology. The survey consisted of eleven questions on candidate qualities, academic application criteria, standardized examinations, shadowing, externships, sedation experience, and interview format. The survey achieved a response rate of 100% with all nine program directors completing the survey. The study found that program directors tended to rank integrity, interpersonal/communication skills, assumes responsibility, team player, and reliability among the top five candidate qualities. Program directors tended to rank professional evaluations, institutional evaluations, externship, shadowing (a practicing anesthesiologist), and standardized tests among the top five academic application criteria. Program directors largely preferred differentiating candidates with a standardized examination, such as the Comprehensive Basic Science Examination (CBSE) or the creation of a new examination specific for Dental Anesthesiology application. Program directors largely recommended shadowing and externships but were largely indifferent to a candidate's experience or certification in sedation. All nine program directors opted for virtual interviews in 2020. The findings of this descriptive, cross-sectional study may have significant implications for the candidate application and interview process into the field of Dental Anesthesiology.

Wright State University Boonshoft School of Medicine.

Wright State University Boonshoft School of Medicine.

East Tennessee State University James H. Quillen College of Medicine.

East Tennessee State University James H. Quillen College of Medicine.

The Brody School of Medicine at East Carolina University.

The Brody School of Medicine at East Carolina University.

Dell Medical School at the University of Texas, Austin.

Dell Medical School at the University of Texas, Austin.

Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso.

Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso.

Does a Difference Exists in Comprehensive Basic Science Examination Scores of 4-Year versus 6-Year Oral-Maxillofacial Surgery Residents?

The Comprehensive Basic Science Examination (CBSE) scores have significant effects on the applications of oral-maxillofacial surgery (OMS) residency candidates. However, a comparison of the scores of residents that match to 4-year versus 6-year programs is lacking. The present study compared the CBSE scores of OMS residency candidates who had matched to 4-year and 6-year tracks in the 2018-2019 application cycle. In the present cross-sectional analysis, an anonymous questionnaire was sent electronically to program directors of all OMS residency programs in the United States using the online survey engine Survey Monkey. Data were collected on the CBSE scores of their postgraduate year 1 categorical residents and whether the resident was on a 4-year or 6-year track. The CBSE scores were summarized overall and by the type of residency program (4 vs 6year) using the mean, standard deviation, median, mode, minimum, and maximum. In addition, the 2-sample t test was used to compare the mean CBSE score between the 4-year programs (4YPs) and 6-year programs (6YPs). A total of 37 scores were received from the 4YPs and 31 from the 6YPs. The overall mean CBSE score was 68.9. Using the 2-sample t test, the mean CBSE score differed significantly between the 4YPs and 6YPs (t=-6.59; df=66; P<.0001). Candidates matching into 6-year positions showed significantly higher mean scores on the CBSE examination compared with those matching into 4-year positions.

Is There a Correlation Between Comprehensive Basic Science Examination and United States Medical Licensure Examination Step 1 Performance Among Oral and Maxillofacial Surgery Residents?

Oral and maxillofacial surgery (OMS) applicant Comprehensive Basic Science Examination (CBSE) scores are scrutinized by residency programs and medical schools because of their perceived predictive value for United States Medical Licensure Examination (USMLE) Step 1 performance. The purpose of this study was to answer the following question: Is there a correlation between the OMS applicant's CBSE score and his or her later USMLE Step 1 score? We e-mailed all current 45 dual-degree OMS residency programs to request participation in the study. Participating programs submitted residents' CBSE scores and USMLE Step 1 scores. Of 45 United States-based, dual-degree OMS residency programs, 23 (51%) enrolled in the study, including data for 152 residents from 2012 to 2018.The mean CBSE score was 71 (range, 47 to 99). The mean USMLE Step 1 score was 220 (range, 177 to 266). The Pearson correlation coefficient for the relationship between the CBSE and USMLE Step 1 scores was 0.36. The overall USMLE pass rate was 97%. On the USMLE Step 1, OMS residents outperformed their translated CBSE score by an average of 15 points. Of the 50 residents (33%) with a translated CBSE score below the passing level, 94% passed the USMLE Step 1. Residents who had a translated passing CBSE score outscored residents with a translated failing score by 14 points when taking the USMLE Step 1 (225 vs 211). Although no statistically significant difference in the USMLE Step 1 pass rates was found between OMS residents with a translated passing CBSE score and those with a translated failing CBSE score, a weak positive correlation was noted between CBSE and USMLE Step 1 scores. These data do not support the use of a certain cutoff CBSE score for OMS applications by OMS program directors, especially as it pertains to interview offers.

An Institutional Review: Which Metrics Correlate With a Successful United States Medical Licensing Examination Step 1 Score?

Since the introduction of the Comprehensive Basic Science Examination (CBSE) as an entrance examination in 2012, no studies have been performed correlating its relationship with passing rates on United States Medical Licensing Examination (USMLE) Step 1 in dental students. This study was designed to determine the impact of the CBSE score, dental grade point average (GPA), and undergraduate GPA on USMLE Step 1 performance and develop a CBSE cutoff score that correlates with a passing USMLE score. A single-blinded, retrospective, cross-sectional study was designed. Data were collected from University of Alabama at Birmingham oral-maxillofacial surgery residents who had matriculated from 2014 to 2018.The primary predictor variable was the CBSE score. The primary outcome variable was the USMLE Step 1 score. Additional predictor variables included undergraduate and dental school GPAs. Bivariate statistics were calculated using a 2-tailed Pearson correlation (P=.05). Confounders were investigated using multivariate linear regression (P=.05). A bivariate linear regression was created using the variables of CBSE and USMLE scores. Dental school GPA and CBSE score correlated with USMLE Step 1 score (P<.05). Bivariate linear regression between CBSE and USMLE scores yielded a predictive equation of USMLE score=2.02×CBSE score+ 66.2 (R2=0.30). When second-attempt scores were included, this equation became USMLE score=2.08×CBSE score+ 67 (R2=0.49). The positive predictive value for a CBSE cutoff score of 61 reached 100% on repeated USMLE attempts. A CBSE score for dental students of 61 or greater correlates with a passing USMLE score and should be implemented to screen for dual-degree oral-maxillofacial surgery candidates.

Predicting performance on the United States Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge using results from previous examinations.

BackgroundFinding early specific indicators of failure in the United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) could be used to develop early interventions that could solve deficiencies and help at-risk students to ultimately attain a passing score. This study was aimed at determining if the National Board of Medical Examiners (NBME) Comprehensive Basic Science Examination (CBSE) could predict a passing score during the USMLE Step 1. We also assessed if the NBME Medicine Clinical Science Subject Examination (CSSE) or the USMLE Step 1 could predict passing scores during the USMLE Step 2 CK.MethodsGender and scores from 724 students who took the USMLE Step 1 were linked and analyzed with the scores of the NBME CBSE, the NBME Medicine CSSE, and the USMLE Step 2 CK using IBM-SPSS.ResultsThere were significant correlations between the scores from NBME CBSE and USMLE Step 1 (r=0.73, P≤0.001), between the scores from the NBME Medicine CSSE and the USMLE Step 2 CK (r=0.572, P≤0.001), and between the scores from the USMLE Step 1 and Step 2 CK (r=0.698, P≤0.001). Students with scores <66 in the NBME CBSE were less likely to approve the USMLE Step 1 on their first attempt (P≤0.00001). There was a significant correlation (r=0.684, P≤0.0001) between a score of ≥208 in the USMLE Step 1 and passing the Step 2 CK on the first attempt.ConclusionA score <66 in the NBME CBSE might indicate failure during the USMLE Step 1 first take. Similarly, a score <208 in the USMLE Step 1 might predict failure in the USMLE Step 2 CK.

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

Sparse data exist regarding the association between applicants' Comprehensive Basic Science Examination (CBSE) scores and acceptance into an oral and maxillofacial surgery (OMFS) residency program. The aims of this study were to assess the association between applicants' CBSE scores and acceptance into one OMFS residency program; to determine the association between other applicant-related variables and acceptance into the program; and to identify the mean CBSE score of accepted applicants by their dental schools' American Association of Oral and Maxillofacial Surgeons (AAOMS) district. For this retrospective data analysis conducted in 2017, the study sample consisted of applicants to the University of Illinois at Chicago OMFS residency program for the application cycles of 2013-14, 2014-15, and 2015-16. The primary predictor variable was CBSE score. The primary outcome variable was acceptance to the program. A total of 477 applicants were in the sample. In the multivariate analysis, CBSE score was found to be significantly associated with an increased chance of acceptance into the program (OR=1.11, 95% CI: 1.08, 1.15; p<0.001). Other variables associated with acceptance, though to a non-significant degree, were age (p=0.01), dental school grade point average (GPA) (p=0.01), and number of externships completed prior to application (p=0.02). These findings may be useful for both applicants and program directors.

Relationship Between Dental Students' Pre-Admission Record and Performance on the Comprehensive Basic Science Examination.

The Comprehensive Basic Science Examination (CBSE) is the entrance examination for oral and maxillofacial surgery, but its implementation among dental students is a relatively recent and unintended use. The aim of this study was to examine the relationship between pre-admission data and performance on the CBSE for dental students at the Columbia University College of Dental Medicine (CDM). This study followed a retrospective cohort, examining data for the CDM Classes of 2014-19. Data collected were Dental Admission Test (DAT) and CBSE scores and undergraduate GPAs for 49 CDM students who took the CBSE from September 2013 to July 2016. The results showed that the full regression model did not demonstrate significant predictive capability (F[8,40]=1.70, p=0.13). Following stepwise regression, only the DAT Perceptual Ability score remained in the final model (F[1,47]=7.97, p<0.01). Variations in DAT Perceptual Ability scores explained 15% of the variability in CBSE scores (R2=0.15). This study found that, among these students, pre-admission data were poor predictors of CBSE performance.

Teaching Clinical Anatomy without Lectures in an Integrated Medical School Curriculum

With the wholesale push to move medical curricula toward integration and organ system‐based courses, many basic medical science disciplines have had to compensate for loss of didactic time. Anatomy has perhaps seen the most reduction overall due to the extensive hours used in traditional curricula dedicated to lecture and dissection labs. The lab portion of the anatomy curriculum has borne most of the reduction. Various solutions have been implemented to deal with this reduction (e.g., prosection). Here, we describe an approach whereby the majority of anatomy content is taught and assessed in lab rather than in lectures. We use a modified jigsaw approach within the lab to maximize the amount of content delivered in the curricular time allotted for anatomy. Each lab is split into small groups with different sets of learning objectives that fall under the larger session objectives. Instructors facilitate each group's topic during one hour of the lab session (learning hour). Each group must assemble a presentation prior to the next lab session. The presentation is no more than 10 minutes long while delivering the bulk of the learning objectives. During the first hour of the next lab session (teaching hour), each group member is responsible for teaching a subset of their peers for 10 minutes. After that, group members and peer learners rotate stations, so each member of a group spends 10 minutes teaching their peers, and then rotates to different stations learning from their peers over the remaining course of the teaching hour. The learning objectives are crafted to facilitate teaching via clinical applications. For example, a group responsible for the supraclavicular brachial plexus may teach some of the anatomical structures by describing the deficits noted in Erb's palsy. Following the teaching hour, we provide a brief review session with clicker‐style questions. At the end of the week, the course has formative quizzes that include one anatomy‐based clinical vignette question per group. We assess students via a traditional lab practical with 30 pinned and 15 follow‐up questions—follow‐ups are typically more clinically oriented than the pinned questions. The method outlined here has shown impressive results relative to the other techniques used in the curriculum (e.g., case‐, team‐based learning). Indeed, among practice tests (i.e., National Board of Medical Examiners' Comprehensive Basic Science Examination) and on the United States Medical Licensing Examination Step 1 examination, our students have performed better in anatomy than in any other basic science discipline. Despite the inevitable reduction in time for medical anatomy within integrated curricula, these results suggest that this method is a viable alternative focused on the lab‐based science of clinical anatomy.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

The Design and Development of Prediction Models for Maximizing Students’ Academic Achievement

To enable early identification and intervention for students at risk for academic failure and for failure on the USMLE Step 1 Examination, three predictive models (pre-matriculation, end of M1, and end of M2) were developed that include both behavioral attributes (Learning and Study Strategies Inventory: LASSI subscale scores) and performance measures (internal examinations and National Board of Medical Examiners [NBME] Comprehensive Basic Science Examination [CBSE] progress tests). Pearson product moment correlation coefficients and multivariate regression modeling were used to determine optimal combinations of independent variables. The pre-matriculation prediction model includes MCAT scores and undergraduate overall GPA. The end of M1 model includes the progress test scores on the NBME CBSE administered at the end of first year medical school (M1), LASSI subscale scores, and weighted performance on M1 internal examinations. Finally, the end of M2 model includes CBSE progress test scores at the end of M1 and second year medical school (M2), LASSI subscale scores, and weighted performance on M1 and M2 internal examinations. Our pre-matriculation, end of M1, and end of M2 models explain 24, 62, and 81% of the variation in USMLE Step 1 performance, respectively. The inclusion of LASSI subscale scores improves the end of M1 model from 60 to 62% and end of M2 model from 79 to 81% in explaining variation in USMLE Step 1 scores. Continuous monitoring of student performance based on these multiple measures supports a holistic perspective on progress, areas of ongoing weakness, and potentially, identification of yet-undetected weakness for targeted interventions.

The Comprehensive Basic Science Examination (CBSE) Reflects Dental Student Performance in a Medical Curriculum

The Comprehensive Basic Science Examination (CBSE) Reflects Dental Student Performance in a Medical Curriculum