Licensing Exam Research Articles

Analysis of the krok1 and histology subtests dynamics of students of Dnipropetrovsk medical academy

Оbjective control of the level of knowledge in medical universities is the basis for guaranteeing the quality of education. There are a lot of examples of universal systems designed to evaluate medical students in different countries, including USMLE, IFOM and others; particularly in Ukraine Krok 1 licensed exam is conducted since 2005. Results of Krok 1 are also used for ranking medical universities at the national level. The purpose of our work was to conduct a comparative analysis of the results of the licensing exam Krok 1, in particular, a histology subtest, among students of specialties 221 “Dentistry” and 222 “Medicine” and different languages of education (Ukrainian, Russian, English) in Dnipropetrovsk medical academy. We have revealed that all the analyzed contingents of students (DMA as well as Ukrainian) in the majority of observation periods from 2014 to 2019 had lower average results on histology compared to average Krok 1 results. This could be explained by low quota of histological tests for students of specialty 222 “Medicine” which is 4-6%, and absence of the threshold level for doing each particular subject. These conditions do not motivate students of the third course to recollect a complicated discipline that ended more than a year ago. Another problem is in the content of anchor questions in Krok 1 booklets: the number of such questions are distributed unevenly among booklets of different years and different languages of study. As a result, students with different languages of study are put in unequal conditions. In addition, the variation in the number of anchor tests from year to year, the lack of a declared quota of such tests disorients students and makes it difficult to develop algorithms for preparing for Krok 1.

Remediation for NCLEX-RN success in high-risk nursing students

Background: The National Council Licensure Exam (NCLEX-RN) pass rate is often used as a measurement to determine a successful undergraduate nursing program. Students that are not successful in the first attempt of taking this exam are statistically unlikely to pass on the second attempt.Purpose: To determine if the implementation of a prescribed remediation protocol would improve undergraduate baccalaureate predictor scores for passing the NCLEX-RN exam on the first attempt for high-risk students.Methods: A retrospective cohort study design was used to compare scores of nursing students after a prescribed remediation protocol was instituted.Results: A one-way ANOVA test was conducted to compare the effect of a remediation policy on nursing students enrolled in an undergraduate nursing program. Remediation had a significant effect at the p < 0.05 level for six cohorts consisting of F (5,232) = 9.90 and a p value of 0.0000000133. Post hoc comparisons using the Tukey HSD test indicated that the comprehensive predictor exam mean score for those that received remediation was significantly different than those that did not receive remediation in like cohorts.Conclusion: A prescribed remediation protocol assisted students in achieving the necessary scores on the Comprehensive Predictor exam to increase their likelihood of success on NCLEX.

Predictors of emotional wellbeing in osteopathic medical students in a COVID-19 world.

In March 2020, the World Health Organization declared the novel coronavirus disease 2019 (COVID-19) outbreak a pandemic. Due to the rapid spread, strong contagion, high incidence of lethality in severe cases, and the lack of a pharmaceutical prevention or cure, COVID-19 has posed a serious threat to human life and health. It has also had a tremendous impact on mental health, including fear and worry, difficulty sleeping or concentrating, and increased use of poor coping mechanisms. Osteopathic medical students have had additional concerns regarding the interruption of their studies, closing of clinical rotations, and postponed licensing exams. To date, few reports have focused on osteopathic medical students and their reactions to the outbreak. To assess resilience, coping, health behaviors, and emotional wellbeing of osteopathic medical students during the onset of the COVID-19 pandemic. In this cross-sectional study, we distributed an anonymous online survey to all medical students enrolled at Nova Southeastern University in May 2020 (n=1,310) via an e-mail invitation using the institution's student listservs. Our major study variables were based on published reports and anecdotal evidence; we subsequently developed the Emotional Wellbeing in Healthcare Professions Students Questionnaire (EWB-Q). This EWB-Q contained validated scales to assess the contribution of levels of coping strategies used, personal resilience, and health behaviors on the emotional wellbeing of osteopathic medical students. Multiple linear regression and other statistical analyses were conducted using SPSS v0.26. Of the 1,310 students invited to participate, 335 (25.5%) surveys were returned. Of those, 133 had more than 33% of the necessary data missing and were removed, resulting in 202 (15.4%) completed questionnaires. The mean age of the participants was 26.7 years. About half (n=92; 45.5%) were in the clinical phase (years 3 and 4) of their medical school training (in rotations). A significant regression equation was found (F[4,171]=17.481, p<0.000, R2 =0.290, R2adjusted=0.274), indicating that levels of coping, personal resilience, and health behaviors (i.e.,not sleeping more than usual, not exercising less than usual) accounted for a significant amount of the variance in emotional wellbeing scores in osteopathic medical students. Higher levels of resilience, greater use of coping strategies, not sleeping more than usual, and not exercising less than usual were predictors of emotional wellbeing. Cultivating positive mental health should be a high priority for medical educators as they develop and implement curriculum-based initiatives to help medical students bolster their personal resilience and to encourage healthy coping behaviors during times of crisis and beyond. A proactive position that assists with building personal resilience and developing stress management habits is paramount in assisting students who are grappling not only with the challenges of rigorous medical training, but also with the uncertainty and stress that exists during any major global health or socioeconomic crisis.

An analysis of core EPAs reveals a gap between curricular expectations and medical school graduates\u2019 self-perceived level of competence

BackgroundEntrustable Professional Activities (EPAs) are being implemented worldwide as a means to promote competency-based medical education. In Switzerland, the new EPA-based curriculum for undergraduate medical education will be implemented in 2021. The aim of our study was to analyze the perceived, self-reported competence of graduates in 2019. The data represent a pre-implementation baseline and will provide guidance for curriculum developers.MethodsTwo hundred eighty-one graduates of the Master of Human Medicine program of the University of Zurich who had passed the Federal Licensing Exam in September 2019 were invited to complete an online survey. They were asked to rate their needed level of supervision (“observe only”, “direct, proactive supervision”, “indirect, reactive supervision”) for 46 selected EPAs. We compared the perceived competence with the expected competence of the new curriculum.ResultsThe response rate was 54%. The need for supervision expressed by graduates varied considerably by EPA. The proportion of graduates rating themselves at expected level was high for “history taking”, “physical examination” “and documentation”; medium for “prioritizing differential diagnoses”, “interpreting results” and “developing and communicating a management plan”; low for “practical skills”; and very low for EPAs related to “urgent and emergency care”.ConclusionsCurrently, there are significant gaps between the expectations of curriculum developers and the perceived competences of students. This is most obvious for practical skills and emergency situations. The new curriculum will either need to fill this gap or expectations might need to be revised.

One Institution\u2019s evaluation of family medicine residency applicant data for academic predictors of success

BackgroundFamily Medicine residencies are navigating recruitment in a changing environment. The consolidation of accreditation for allopathic and osteopathic programs, the high volume of applicants, and the forthcoming transition of the United States Medical Licensing Exam (USMLE) Step 1 to pass/fail reporting all contribute. This retrospective cohort study evaluated which components of a student’s academic history best predict readiness for residency.MethodsIn 2020, we analyzed applicant data and initial residency data for program graduates at a single residency program between 2013 and 2020. This included undergraduate education characteristics, medical school academic performance, medical school academic problems (including professionalism), STEP exams, location of medical school, and assessments during the first 6 months of residency. Of 110 matriculating residents, assessment data was available for 97 (88%).ResultsPre-matriculation USMLE data had a positive correlation with initial American Board of Family Medicine (ABFM) in-training exams. Pre-matriculation exam data did not have a positive correlation with resident assessment across any of the six Accreditation Council for Graduate Medical Education (ACGME) competency domains. A defined cohort of residents with a history of academic struggles during medical school or failure on a USMLE exam performed statistically similarly to residents with no such history on assessments across the six ACGME competency domains.ConclusionsApplicants with a history of academic problems perform similarly in the clinical environment to those without. While a positive correlation between pre-matriculation exams and the ABFM in-training exam was found, this did not extend to clinical assessments across the ACGME competency domains.

Once in the Door, Grit May Matter More: An Evaluation of Grit in Medical Students.

Health professions educators seek understanding of the process of learner performance and achievement. Grit, defined as passion and perseverance for long-term goals, has been implicated in this process. Research suggests that effort counts twice in achievement: skill times effort equals skill and, subsequently, skill times effort equals achievement. Research also suggests that an individual's interest influences job performance and satisfaction. Grit, composed of Perseverance of Effort and Consistency of Interest, has been shown to positively correlate with performance and achievement in various disciplines. Limited research reveals Grit negatively correlates with resident attrition and physician burnout. This study evaluates relationships between Grit and medical student performance measures. We gather validity evidence for Grit scale use among medical students and, subsequently, use this data to evaluate for differences in Grit score by gender and assess whether there is a relationship between Grit and standardized exam scores. We hypothesize that Grit will not vary with gender and that it will be positively associated with standardized examination scores. Enrolled students receive the 12-item Grit survey. An exploratory factor analysis evaluates validity evidence of Grit. Descriptive statistical analysis, Pearson correlation, and moderation analysis evaluate if Grit score differs by gender and if there are relationships with standardized exams. The survey response rate is 59% (412/698) and exploratory factor analysis replicates the two-factor structure of Grit found in other fields-Perseverance of Effort and Consistency of Interest. Average Grit scores do not significantly differ by gender. Grit weakly correlates with United States Medical Licensing Exam Step 1 (r = 0.10, = 0.36) and United States Medical Licensing Exam Step 2 Clinical Knowledge (r = 0.12, P=0.29). Grit weakly and negatively correlates with Medical College Admission Test score (r = - 0.18, P<0.05). Grit is not a significant moderator of the relationship between Medical College Admission score and Step exams scores. Exploratory factor analysis results provide preliminary validity evidence for Grit scale use in medical students. Grit does not significantly moderate the Medical College Admission Test-Step score relationship. Grit correlates negatively with Medical College Admission Test scores. Though the correlations in this study were not significant, the results showed that Grit may tend to positively correlate with Step 1 and Step 2 Clinical Knowledge examinations. Given that these three exams are taken at different levels of training, the stepwise progression towards positive correlation may suggest that the theory "effort counts twice" applies to medical training.

Classic clinical descriptions of disease: curing medical education with a dose of the past

The importance of clinical skills, including obtaining patient history and performing physical examination, has been de-emphasized in the modern medical school curriculum. With advancements in diagnostic technologies, the clinical presentation of diseases in medical textbooks has been simplified, diminished, and largely replaced with detailed pathophysiology and laboratory findings. The implementation of the United States Medical Licensing Exam (USMLE) Step 1 has also contributed in pushing medical education toward classroom-based learning rather than emphasizing clinical experience. Clinical skills competency is crucial to accurately diagnose patients and simultaneously lowers health care costs by not relying on unneeded diagnostic tests. To address this gap in medical knowledge, a group of students at Texas Tech University Health Sciences Center, Lubbock, Texas, have created a website documenting classic clinical disease descriptions written by some of the renowned physicians from the 19th and 20th centuries, including Osler, Flint, Gowers, etc. This website will continue to grow and will be a useful tool for professors, physicians, and medical students.

Radiology Medical Student Education 2020: Surveys of the Alliance of Medical Student Educators in Radiology and Medical Students

Rationale and ObjectivesThe coronavirus disease 2019 (COVID-19) pandemic has resulted in significant changes to medical student education by disrupting clinical rotations, licensing exams, and residency applications. To evaluate the pandemic's impact and required modifications of radiology medical student courses, the authors developed and administered surveys to Alliance of Medical Student Educators in Radiology (AMSER) faculty and enrolled medical students. The surveys requested feedback and insight about respondents’ experiences and innovations.Materials and MethodsAnonymous twenty-question and seventeen-question surveys about the pandemic's impact on medical student education were distributed via email to AMSER members and medical students. The surveys consisted of multiple choice, ranking, Likert scale, and open-ended questions. Differences in the Likert score agreement was performed using one-sided Wilcoxon-Mann-Whitney tests. Survey data were collected using SurveyMonkey (San Mateo, California). This study was IRB exempt.ResultsThe AMSER survey indicated 96% of institutions cancelled medical student courses and 92% resumed with virtual courses, typically general radiology. A total of 64% of faculty enjoyed online teaching, although 82% preferred on-site courses. A total of 62% of students felt an online radiology course was an excellent alternative to an on-site rotation, although 27% disagreed. A total of 69% of students who completed both on-site and online courses preferred the on-site format. Survey-reported innovations and free response comments have been collated as educational resources.ConclusionFaculty were able to adapt radiology courses to the online environment utilizing interactive lectures, self-directed learning, flipped classroom sessions, and virtual readouts, which were effective for student respondents. Hybrid rotations with on-site and online elements may offer the best of both worlds.

A Multi-Modal Remote Clinical Skills Mini-Course Utilizing a Teaching TeleOSCE.

In the setting of the coronavirus pandemic, medical schools across the world transitioned to a remote learning curriculum with the challenge of developing innovative methods to teach clinical skills. During the pandemic, we designed a 2-week remote clinical skills mini-course for third year medical students. The focus was on clinical reasoning, counseling, and the following the Association of American Medical Colleges (AAMC) Core Entrustable Professional Activities (EPAs): 1 (history and physical exam), 2 (prioritize a differential diagnosis), 3 (recommend and interpret diagnostic tests), and 5 (document a clinical encounter). A multi-modal approach included large and small group virtual case-based discussions, a teaching TeleOSCE (Objective Structured Clinical Examination), and feedback on patient note skills. Students were asked to self-assess their skills before and after the course based on the core EPAs, counseling skills, and overall preparedness for United States Medical Licensing Exam (USMLE) Step 2 Clinical Skills exam. Students demonstrated statistically significant increases in mean self-rated scores in all areas except interpreting results of basic studies. They found the teaching TeleOSCE and feedback on their notes the most useful. Future curricula will consider integration of peer-peer remote OSCE practice sessions as well as faculty feedback for individualized learning plans. Lessons learned will be useful for remote structured clinical skills courses in the setting of the pandemic.

Assessing sociology and psychology in UK undergraduate medical education: Square peg in a round hole?

This article was migrated. The article was marked as recommended. Background: Attention has turned in recent years to the broader inclusion of sociology and psychology in medical curricula. Despite this, there is limited published evidence about how best to assess these subjects. This lack of evidence is significant given that most medical schools are likely to include some form of assessment of sociology and psychology, and that sociology and psychology are included in areas examined in admissions tests and in licensing exams. Methods: We ran three one day workshops in the UK (London, Edinburgh and Manchester, June - July 2019), to consult with educators involved in sociology and psychology teaching in medicine on: what methods are being used to assess sociology and psychology in UK undergraduate medical education, and the challenges and opportunities experienced. 36 participants attended the workshops, representing 19 of the 33 UK medical schools. Following the workshops, we collated the notes and presentations in order to develop a summary of current assessment practices and synthesis of the main themes identified. Results: There were many examples of good practice and development of innovative assessments, particularly in the early years of the programmes. At the same time, participants raised several challenges and tensions in relation tothe method, timing, and placement of sociology and psychology assessment. Participants reported that many of these issues related to dominant assessment cultures in medical education. As a result, assessing sociology and psychology in medicine can seem like fitting a square peg into a round hole. Solutions to these challenges may require wider changes to assessment practices and cultures. Conclusion: The challenges shared by participants are evident; nonetheless, there are important opportunities. Our participants were unanimous in their desire to become involved in dialogue and consultation about assessment. This article, reporting on the views of UK SBS educators, is a positive step towards creating a more robust evidence base upon which to engage in these conversations and inform best practice in sociology and psychology assessment.

More Is More: Drivers of the Increase in Emergency Medicine Residency Applications.

IntroductionThe average number of applications per allopathic applicant to emergency medicine (EM) residency programs in the United States (US) has increased significantly since 2014. This increase in applications has caused a significant burden on both programs and applicants. Our goal in this study was to investigate the drivers of this application increase so as to inform strategies to mitigate the surge.MethodsAn expert panel designed an anonymous, web-based survey, which was distributed to US allopathic senior applicants in the 2017–2018 EM match cycle via the Council of Residency Directors in Emergency Medicine and the Emergency Medicine Residents Association listservs for completion between the rank list certification deadline and release of match results. The survey collected descriptive statistics and factors affecting application decisions.ResultsA total of 532 of 1748 (30.4%) US allopathic seniors responded to the survey. Of these respondents, 47.3% felt they had applied to too many programs, 11.8% felt they had applied to too few, and 57.7% felt that their perception of their own competitiveness increased their number of applications. Application behavior of peers going into EM was identified as the largest external factor driving an increase in applications (61.1%), followed by US Medical Licensing Exam scores (46.9%) – the latter was most pronounced in applicants who self-perceived as “less competitive.” The most significant limiter of application numbers was the cost of using the Electronic Residency Application Service (34.3%).ConclusionA substantial group of EM applicants identified that they were over-applying to residencies. The largest driver of this process was individual applicant response to the behavior of their peers who were also going into EM. Understanding these motivations may help inform solutions to overapplication.

Determinants of Performance in the Licensure Examination for Fisheries Technologists of Western Philippines University Bachelor of Science in Fisheries Graduates

The students’ performance in licensure examinations is considered one of the reliable gauges of an institution’s efficiency and its students’ intellectual capacity. This study explored the factors that affected the performance in the 2019 Licensure Examination for Fisheries Technologists (LEFT) of the Western Philippines University (WPU) Bachelor of Science in Fisheries (BSF) graduates, using Stufflebeam’s (2014) CIPP evaluation model. The study analyzed the data from the 24 BSF graduates who joined the institutional review class for LEFT 2019. Findings revealed that the graduates’ LEFT performance was significantly influenced by their scores in the pre- and post-mock board examinations, employment, the length of time between graduation and examination, number of attempts in taking the board examination, and the number of the subject areas passed in the licensure exam. The review class offered by the College of Fisheries and Aquatic Sciences (CFAS) of WPU significantly improved the scores of students in the LEFT 2019. Further, several other variables that might be affecting the performance of students in the LEFT 2019 were also identified in this study. Recommendations and implications for improving the WPU-BSF and the CFAS review programs are presented in the conclusion. Keywords: Review class, board examination, PRC, program effectiveness

Development and national consensus finding on patient-centred high stakes communication skills assessments for the Swiss Federal Licensing Examination in Medicine

ObjectiveTo describe and evaluate a consensus finding and expert validation process for the development of patient-centred communication assessments for a national Licensing Exam in Medicine. MethodsA multi-professional team of clinicians and experts in communication, assessment and role-play developed communication assessments for the Swiss Federal Licensing Examination. The six-month process, informed by a preceding national needs-assessment, an expert symposium and a critical literature review covered the application of patient-centred communication frameworks, the development of assessment guides, concrete assessments and pilot-tests. The participants evaluated the process. ResultsThe multiple-step consensus process, based on expert validation of the medical and communication content, led to six high-stakes patient-centred communication OSCE-assessments. The process evaluation revealed areas of challenge such as calibrating rating-scales and case difficulty to the graduates’ competencies and integrating differing opinions. Main success factors were attributed to the outcome-oriented process and the multi-professional exchange of expertise. A model for developing high stakes patient-centred communication OSCE-assessments was derived. ConclusionsConsensus finding was facilitated by using well-established communication frameworks, by ensuring outcome-orientated knowledge exchange among multi-professional experts, and collaborative validation of content through experts. Practice implicationsWe propose developing high-stakes communication assessments in a multi-professional expert consensus and provide a conceptual model.

Practical advice for new graduate nurses

Practical advice for new graduate nurses

Identifying barriers impeding bilingual and ESL teacher candidates’ success on state licensure exams

ABSTRACT The need for highly qualified bilingual and English as a Second Language (ESL) teachers continues to rapidly increase. In this article, we share the results of a multi-year study that has aimed to determine what factors affect the performance of teacher candidates seeking bilingual education and ESL in a teacher preparation program in the Southwest. In this article, we focus on 89 teacher candidates’ performance on the Core Subject (TExES 291) test, as it represents one of the most important testing attempts these teacher candidates must pass in order to be on track toward certification. For this manuscript we explored both internal (e.g., gender, age group, ethnicity) as well as external factors (e.g., good test taker) to determine the extent to which these had a role (or otherwise) in their test performance. While our data confirm previous studies findings regarding the impact of internal factors such as gender, age, marital status, among others, teacher preparation can help mitigate some barriers for ESL and bilingual certification.

Does Pass/Fail on Medical Licensing Exams Predict Future Physician Performance in Practice? A Longitudinal Cohort Study of Alberta Physicians

ABSTRACT The purpose of this longitudinal study was to gather extrapolation evidence of validity by assessing whether performance on a national medical licensing exam, in addition to practice and socio-demographic variables, is predictive of future physician performance in practice. The study focused on a cohort of 3,404 physicians who were registered with the College of Physicians and Surgeons of Alberta (CPSA) and who completed the Medical Council of Canada Qualifying Examination (MCCQE) Parts I and II between 1992–2017. Separate multivariate quasi-Poisson regression models were run to assess the degree of relationship between first-time pass/fail status on the MCCQE I and II, and several CPSA socio-demographic variables and several CPSA socio-demographic variables, in addition to complaints/physician and various prescribing flags. Candidates who failed the MCCQE I on their first attempt had 27% more complaints lodged against them, compared to those who passed. Physicians who failed the MCCQE II on their first attempt prescribed 2+ benzodiazepines and 2+ opioids to 30% more patients than those who passed. Conclusions: Performance on the MCCQE Part I and II is an important predictor of physician performance. Combined with other critical variables, these measures provide important evidence to aid in risk modeling efforts and to guide educational interventions for physicians at an early stage of their careers.

Structured Educational Program and Peripheral Intravenous First-Time Insertion Rate in Saudi Arabia

Peripheral intravenous insertion (PIV) is one of the most common clinical procedures which nurses receive little formal training. It is said that more than a quarter of first-time insertion rate (FTIR) fail (Hess 2010), thus, patient experience is at risk if this is not performed by a trained staff. This study aimed to explore if a Structured Educational Program (SEP) was effective to increase a hospital’s FTIR which has a failing international benchmark scores. It used a quasi-experimental design and pre-experimental one-group pretest post-test to examine the pre and post-test data set among 160 respondents. It was found out that the most of respondents are Filipinos in their 30’s who have bachelor’s degree. They have a decade or less of experience; have had no PIV training in their home country; and have less than five daily insertions. It was revealed that the SEP was effective knowledge and skills improvement. Ages, nationality, years of experience, and specialization were found to be related to improve knowledge; while nationality, licensure exam ratings, frequency of PIV insertions, and relevant trainings were associated on an enhanced skill.

Red Flags, Geography, Exam Scores, and Other Factors Used by Program Directors in Determining Which Applicants Are Offered an Interview for Anesthesiology Residency.

ObjectiveThe goal of this study was to measure the most important factors in candidate applications that anesthesiology program directors (PDs) use to decide who to invite for an interview, and how that might change once the United States Medical Licensing Examination (USMLE) Step 1 is only reported as pass/fail.DesignBased on a literature review, a comprehensive list of 27 factors used by PDs to select candidates for the interview was developed. An anonymous survey link was emailed to PDs of all Accreditation Council for Graduate Medical Education (ACGME) accredited Anesthesiology residencies. The survey asked PDs to rank order the top 10 factors they currently consider for making interview invitation, and then to repeat the rank ordering as if the USMLE Step 1 score was instead reported as pass/fail as will be done beginning in 2022.ResultsForty-five of 159 (28%) PDs responded, with 82% disagreeing with changing the Step 1 score to pass/fail. 84% consider the Step 1 score (77% for Step 2) moderately or very important for selecting an applicant for an interview. The most frequently mentioned “red flags” were failure of a licensing exam, failure of a medical school course, gaps in education without explanation, and criminal history. 69% of PDs agreed that applicants coming from the medical school affiliated with their program would have an advantage over other applicants. Although, the three factors most commonly ranked in the top 10 in importance were the Step 1 score, followed by letters of recommendation, and then the Medical School Performance Evaluation, variability exists in how PDs ranked factors. For example, of the PDs that had Step 1 in the top 10, 27% had it ranked between the 6th and 10th most important. 9% of PDs did not have Step 1 score in the top 10. Core clinical clerkship grades were one of the top 5 factors by 49% of PDs, yet overall was the 6th most common top 10 factor as 36% of PDs did not have core clerkship grades at all in the top 10. Once Step 1 is reported only as pass/fail, PDs had letters of recommendation, Step 2, and the Medical School Performance Evaluation as the most frequently ranked factors in the top 10. 64% of the PDs supported restricting the number of programs a candidate can apply to, with the majority suggesting a limit of 15 to 20 programs per applicant.ConclusionVariability exists among anesthesiology PDs in the key criteria for offering an applicant an interview. Once Step 1 is reported as pass/fail, there will be an increased emphasis on Step 2 scores.

COMPARATIVE ANALYSIS OF STUDENTS’ ACADEMIC PERFORMANCE IN DISTANCE AND IN-CLASS LEARNING

COVID-19 pandemic has had immense impact on usual daily life and working activities, forced to adapt to new circumstances. The system of medical education has to solve a number of pressing issues on changing the mode of teaching and learning. Distance learning is often described as a flexible and effective system of non-stop professional education, sensitive to the needs of the society. Distance learning extensively uses internet technologies for communication through video conferences, emails, providing access to learning materials, including multimedia presentations, videos, visual aids, etc. However, this form of learning is not widespread in the training of medical professionals. Notwithstanding the advantages, distance learning needs constant improvement of all parties of educational process that is possible only after analyzing its shortcomings based on own experience and described in relevant reports. The study was aimed at compare the students’ academic performance demonstrated during distance learning and traditional in-class learning. The material of the study included the grades, which medical students got during distance learning and grades they got before the spring quarantine. We also used the data on students' grades for the identical periods of the 2018-2019 academic year. Distance learning during the quarantine was scheduled in accordance with the existing curriculum, and conducted by all educators of the Department of Pathological Anatomy with Autopsy Course and based on the combination of two online platforms: Zoom and Google classroom. During the video conferences at the Zoom platform, the faculty staff explained and discussed the theme material using multimedia presentations, engaged students into different learning activities. To monitor student’s understanding of important concepts, we created online quizzes with seven different question types which are graded automatically Google Classroom. Results can be viewed in a summary format, by individual respondents, or by specific question answers. Quizzes can be assigned to a Google Classroom class and quiz results can be exported to the Google Classroom group. Google classroom was widely used in training students to the national licensing exam “Krok 1. General Medicine”. Our study showed a decline in students’ academic performance through the online learning period. The comparison of students’ academic performance data for the same period of the previous academic year demonstrated that academic progress of students during distance learning decreased compared to the same period of the previous academic year. Thus, several questions arise: what causes this decline and whether it is possible to grant high-quality online learning on the course of pathomorphology. Since it was the first experience when higher medical educational setting faced such a challenge, we can find a clear answer only based on multifactorial analysis of students' academic performance. We can conclude on distance learning and analysis of students’ academic performance that this format did not provide high-quality knowledge acquisition in pathomorphology. Thorough study of all factors impacting students’ learning outcomes and ways to improve distance learning is of great importance in order to prevent any possible challenges in future.

Potential Impact of a Pass or Fail United States Medical Licensing Exam Step 1 Scoring System on Radiology Residency Applications

To assess the anticipated impact of the change in United States Medical Licensing Examination Step 1 scoring from numerical to pass or fail on the future selection of radiology residents. An anonymous electronic 14-item survey was distributed to 308 members of the Association of Program Directors in Radiology and included questions regarding the anticipated importance of various application metrics when Step 1 becomes pass or fail. Secondary analyses compared responses based on the current use of a Step 1 scoring screen. Eighty eight respondents (28.6% [88/308]) completed the survey. Most (64% [56/88]) noted that the United States Medical Licensing Examination Step 2 Clinical Knowledge (CK) score will likely be one of the top three most important factors in assessing applicants, followed by class ranking or quartile (51% [45/88]) and the Medical Student Performance Evaluation/Dean's Letter (42% [37/88]). Over 90% (82/88) of respondents anticipate potentially or definitively requiring Step 2 CK scores before application review, and 50% (44/88) of respondents anticipate extending interview invites at a later date to receive Step 2 CK scores. These results did not significantly differ between programs who currently use a Step 1 scoring screen and those who do not. As Step 1 transitions from a numerical score to pass or fail, radiology residency program directors will likely rely on Step 2 CK scores as an objective and standardized metric to screen applicants. Further investigation is needed to identify other objective metrics to evaluate applicants before Step 1 becomes pass or fail.