Licensing Examination Research Articles

Out-of-Hospital Birth in Medical Education: A Thematic Analysis of Question Banks for Medical Licensing Examinations in the United States.

This study assessed the content of US Medical Licensing Examination question banks with regard to out-of-hospital births and whether the questions aligned with current evidence. Three question banks were searched for key words regarding out-of-hospital births. A thematic analysis was then utilized to analyze the results. Forty-seven questions were identified, and of these, 55% indicated a lack of inadequate, limited, or irregular prenatal care in the question stem. Systematic studies comparing prenatal care in out-of-hospital births versus hospital births are nonexistent, leading to the potential for bias and adverse outcomes. Adjustments to question stems that accurately portray current evidence are recommended.

Medical Student’s Attitudes towards Implementation of National Licensing Exam (NLE) – A Qualitative Exploratory Study

The introduction of the post-qualification National Licensing Examination (NLE) in Pakistan has been met with resistance from the medical students. They are the main stakeholders of medical colleges. Objective: To explore the opinions of medical students regarding the feasibility of NLE. Methods: An exploratory, qualitative study was conducted at Riphah International University, Islamic international medical college, Rawalpindi and Gomal Medical College, D.I. Khan, KP using in-depth interviews. A sample of 12 medical students from different medical colleges in Pakistan was included. The recorded interviews transcribed verbatim. Thematic analysis was then conducted using NVivo V2 and coded into nodes and daughter nodes, of which 5 themes and 17 subthemes emerged. Results: A total of five themes and 17 themes were created. NLE was deemed as a good standardization tool for assessing the competence of medical graduates. Students believed that current MBBS assessment lacks in clinical skills assessment and did not prepare to treat patients upon graduation. However, they did not want to take another exam after the professional exams especially when no incentives are offered to graduates upon clearing. They suggested NLE should be used as a means of constructive feedback for institutions and students to allow them to work on weak areas. Conclusions: There were mixed opinions regarding the acceptance of the exam. If medical institutions across the country focus their curricula on developing clinical skills and incentives are provided to the doctors upon clearing, the students would readily accept the exam

The performance evaluation of artificial intelligence ERNIE bot in Chinese National Medical Licensing Examination.

The performance evaluation of artificial intelligence ERNIE bot in Chinese National Medical Licensing Examination.

High Total Failures of the North American Pharmacist Licensure Examination (NAPLEX) Warrant Monitoring of Professional Pharmacy Programs

From 2021 to 2023, 7978 graduates of pharmacy programs failed the North American Pharmacist Licensure Examination on the first attempt. Presently, the Accreditation Council for Pharmacy Education monitors programs with a passage rate of ≥ 2 SDs below the national mean pass rate. In 2023, this should lead to monitoring 7 programs that produced 140 failures out of the total of 2472 failures (5.7 %). In our view, this is neither equitable nor demonstrative of sufficient accountability. Analysis of failure counts among the 144 programs reported by the National Association of Boards of Pharmacy demonstrates a distribution curve highly skewed to the right. The evaluation of average failure counts across all programs suggests that schools with absolute failures ≥ 2 SDs higher than the average number of failures should be identified for monitoring, in addition to those falling ≥ 2 SDs below the national mean pass rate. Based on the 2023 data, this additional criterion corresponds to ≥ 35 failures/program. This threshold would prompt monitoring of 18 programs and 36.5 % of the total failures. Of the 7 programs that will be monitored based on the current Accreditation Council for Pharmacy Education criteria, only 1 would be captured by the ≥ 35 failure method of selection; the remaining 6 contribute 85 total failures to the pool. Thus, if both criteria were to be applied, ie, ≥ 35 failures and ≥ 2 SDs below the national mean pass rate, a total of 24 programs would be monitored (16.6 % of the 144 programs) that contribute 987 of the total failures (39.9 %).

Developing a competency model for Chinese general practitioners: a mixed-methods study.

The Chinese government has formulated a series of policies and strengthened training of general practitioners (GPs) to support their role as "gatekeepers" of residents' health. This study aimed to explore the core competencies of Chinese GPs and develop a competency framework in line with China's actual conditions, which can provide a more scientific basis for the education, training, and evaluation of GPs. Literature analysis and behaviour event interviews were conducted to build the competency dictionary and the initial version of the competency model. Two rounds of Delphi were performed to gain consensus on the final model. The questionnaire survey was carried out in 10 provinces (municipalities, autonomous regions) of China, and GPs were invited to score the importance of each competency item. The total sample was randomly divided into two groups. One group was for exploratory factor analysis (EFA), and the other was for confirmatory factor analysis (CFA) to examine the scale's reliability and validity. The dictionary of general practitioners' competency including 107 competency items was constructed. After two rounds of Delphi, a consensus was reached on 60 competencies in 6 domains. A total of 1917 valid questionnaires were obtained in the nationwide survey. The average importance score of all second-level indicators is 4.53 ± 0.45. The Cronbach's α coefficient is 0.984. The results of the five factors extracted by EFA showing the 68.16% cumulative explained variance variation is considered to be consistent with the six dimensions obtained by Delphi after thorough discussion. The model fitness indexes obtained by CFA were acceptable (χ2/df = 4.909, CFI = 0.869, NFI = 0.841, RMSEA = 0.065). The values of the composite reliability (CR) of the six dimensions were all greater than 0.7 (0.943, 0.927, 0.937, 0.927, 0.943, 0.950), and the average of variance extracted (AVE) were all greater than 0.5 (0.562, 0.613, 0.649, 0.563, 0.626, 0.635). The results showed that the model has good reliability and validity. A competency model for GPs suited to China has been developed, which may offer guidance for future training and medical licensing examinations of GPs.

Does higher performance in a national licensing examination predict better quality of care? A longitudinal observational study of Ethiopian anesthetists.

Ethiopia made a national licensing examination (NLE) for associate clinician anesthetists a requirement for entry into the practice workforce. However, there is limited empirical evidence on whether the NLE scores of associate clinicians predict the quality of health care they provide in low-income countries. This study aimed to assess the association between anesthetists' NLE scores and three selected quality of patient care indicators. A multicenter longitudinal observational study was conducted between January 8 and February 7, 2023, to collect quality of care (QoC) data on surgical patients attended by anesthetists (n = 56) who had taken the Ethiopian anesthetist NLE since 2019. The three QoC indicators were standards for safe anesthesia practice, critical incidents, and patient satisfaction. The medical records of 991 patients were reviewed to determine the standards for safe anesthesia practice and critical incidents. A total of 400 patients responded to the patient satisfaction survey. Multivariable regressions were employed to determine whether the anesthetist NLE score predicted QoC indicators. The mean percentage of safe anesthesia practice standards met was 69.14%, and the mean satisfaction score was 85.22%. There were 1,120 critical incidents among 911 patients, with three out of five experiencing at least one. After controlling for patient, anesthetist, facility, and clinical care-related confounding variables, the NLE score predicted the occurrence of critical incidents. For every 1% point increase in the total NLE score, the odds of developing one or more critical incidents decreased by 18% (aOR = 0.82; 95% CI = 0.70 = 0.96; p = 0.016). No statistically significant associations existed between the other two QoC indicators and NLE scores. The NLE score had an inverse relationship with the occurrence of critical incidents, supporting the validity of the examination in assessing graduates' ability to provide safe and effective care. The lack of an association with the other two QoC indicators requires further investigation. Our findings may help improve education quality and the impact of NLEs in Ethiopia and beyond.

Letters of Reference in the Current Era.

Letters of reference (LORs) are a common component of the application process for residency training programs. With the United States Medical Licensing Examination Step 1 transitioning to pass/fail grading and with the increasing use of holistic review, the potential role of LORs is rising in importance. Among some key benefits are the ability to provide a broader and more holistic view of applicants, which can include highlighting elements of experiences or skills that could be missed in their application, as well as providing a third-party assessment of the applicant external to their rotation experiences. However, LORs also face issues, including variation in quality, challenges with comparability, and risk of bias. In this article, the authors discuss the unique benefits, limitations, and best practice recommendations for LORs in academic medicine. The authors also discuss future directions, including the role of artificial intelligence, unblinded, and co-created LORs.

Dear Program Director: An Evaluation of Implicit Bias in Letters of Recommendation for Neurosurgery Residency.

Despite comprising half of medical students, women represent only 29.6% of neurosurgery applicants and 17% of residents, suggesting a "leak" in the career pipeline for women neurosurgeons. Surveys persistently show that neurosurgery programs identify United States Medical Licensing Examination (USMLE®) Step 1 score and letters of recommendation (LORs) as the most important factors in selecting applicants to interview. A previous study in neurosurgery found no differences in LORs. However, multiple studies in other specialties have demonstrated implicit gender bias in LORs, which may influence resident selection. Our objective is to evaluate neurosurgery residency LORs for evidence of implicit gender bias. Retrospective analysis of LORs for interviewed neurosurgery applicants at a single institution during the 2014 to 2020 National Residency Matching Program (NRMP®) match cycles. Letters were evaluated using Linguistic Inquiry & Word Count (LIWC) software (Pennebaker Conglomerates), and additional applicant data were obtained from candidate applications. LIWC (Pennebaker Conglomerates) output data included custom dictionary categories and terms that were analyzed using Prism 10 and Rstudio. Two hundred eighteen applications were reviewed for a total of 827 letters. LIWC (Pennebaker Conglomerates) analysis showed significant differences in word count (331 vs 297, difference = 34, 95% CI: 9-61, P = .008). LORs for applicants who were men were more likely to mention Alpha Omega Alpha Honor Medical Society (1.17 vs 0.778, difference = 0.4, 95% CI: 0.13-0.67, P = .023). USMLE® Step 1 scores were significantly lower for women (241 vs 247, difference = 6, 95% CI: 2-10, P = .004). There was no significant difference between letters for men and women for all categories evaluated in the linguistic evaluation. LORs are vital to the neurosurgical residency application process. The data exhibit some differences between the men and women applicants but few differences in their LORs, consistent with the results of the previous neurosurgical study.

Evaluating ChatGPT-4 in medical education: an assessment of subject exam performance reveals limitations in clinical curriculum support for students

This study evaluates the proficiency of ChatGPT-4 across various medical specialties and assesses its potential as a study tool for medical students preparing for the United States Medical Licensing Examination (USMLE) Step 2 and related clinical subject exams. ChatGPT-4 answered board-level questions with 89% accuracy, but showcased significant discrepancies in performance across specialties. Although it excelled in psychiatry, neurology, and obstetrics and gynecology, it underperformed in pediatrics, emergency medicine, and family medicine. These variations may be potentially attributed to the depth and recency of training data as well as the scope of the specialties assessed. Specialties with significant interdisciplinary overlap had lower performance, suggesting complex clinical scenarios pose a challenge to the AI. In terms of the future, the overall efficacy of ChatGPT-4 indicates a promising supplemental role in medical education, but performance inconsistencies across specialties in the current version lead us to recommend that medical students use AI with caution.

Basic science knowledge underlies clinical science knowledge and clinical problem solving: evidence from veterinary medicine.

Medical sciences education emphasizes basic science learning as a prerequisite to clinical learning. Studies exploring relationships between achievement in the basic sciences and subsequent achievement in the clinical sciences generally suggest a significant positive relationship. Basic science knowledge and clinical experience are theorized to combine to form encapsulated knowledge- a dynamic mix of information that is useful for solving clinical problems. This study explores the relationship between basic science knowledge (BSK), clinical science knowledge (CSK), and clinical problem-solving ability, as measured within the context of four veterinary colleges using both college-specific measures and professionally validated, standardized measures of basic and clinical science knowledge and problem-solving ability. Significant correlations existed among all variables. Structural equation modeling and confirmatory factor analysis were used to produce models showing that newly acquired BSK directly and significantly predicted BSK retained over time and newly acquired CSK, as well as indirectly predicted clinical problem-solving ability (mediated by newly acquired CSK and BSK retained over time). These findings likely suggest a gradual development of schema (encapsulated knowledge) and not an isolated development of biomedical versus clinical knowledge over time. A broader implication of these results is that explicitly teaching basic science knowledge positively and durably affects subsequent clinical knowledge and problem-solving ability independent of instructional strategy or curricular approach. Furthermore, for veterinary colleges specifically, student performance as measured by both course-level and standardized tests are likely to prove useful for predicting subsequent academic achievement in classroom and clinical settings, licensing examination performance, and/or for identifying students likely in need of remediation in clinical knowledge.

FROM NOTHING TO SOMETHING: TALE OF UNRAVELING THE SECRET TO SUCCESS OF A NEOPHYTE CRIMINOLOGIST IN TAKING LICENSURE EXAM

This phenomenological study aimed to fathom the tale of unravelling the secret to the success of neophyte criminologists in passing the licensure examination. The study utilized a qualitative research design using a phenomenological approach, with 18 criminologists from Ramon Magsaysay Memorial College, General Santos City, chosen through purposive sampling. Thematic analysis was used as a data analysis tool. In light of this, results revealed the themes developed wherein this also discovered that the secret to the success of criminologists in taking and passing the CLE where they experienced mixed emotions, very challenging, stressful phenomena, feelings of nervousness, lack of preparation, frustrating events, remaining hopeful and positivism helps. In addition, criminologists experienced challenges like time constraints, financial problems, no face-to-face review, sleepless nights, anxiety situations and restrictions during the pandemic. On the coping mechanisms, criminologists pray harder, seek help, manage time well, rest when necessary, study hard, boost self-esteem, enrol in a review centre and practice the elimination methods. Furthermore, criminologists’ insights or realization revealed that preparation is necessary: take the review seriously, join a group study, give your best shot, surpass trials, increase faith and prioritize well-being. Taking a criminologist licensure exam requires extensive preparation and perseverance as they will encounter many challenges before they pass it. The insights learned by the neophyte criminologists make them more competent as professionals in their field of specialization.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0787/a.php" alt="Hit counter" /></p>

Exploring the usage of learning resources by medical students in the basic science stage and their effect on academic performance

BackgroundThe United States Medical Licensing Examination (USMLE) step 1 is one of the two examinations written after completion of the first two years (basic science stage) of medical school to be eligible to apply for residency training in the USA. A huge number and types of study materials are available to prepare for the exam which might confuse students choosing a resource.We investigated learning resources being used by the third and fifth-semester medical students and their association with academic performance. We also compared learning resources and exam scores of high-performing and low-performing students.MethodsData collection was done using structured (quantitative study) and semi-structured (qualitative study) questionnaires during a face-to-face interview. This article is about the quantitative part which was designed as a correlational study. Single factor one-way analysis of variance (ANOVA), Pearson correlation coefficient test, T-test, and Fisher’s exact test were used to analyze the data.ResultsAbout half of all students used three or more commercial resources dealing with the same content. A weak negative correlation was observed between the number of commercial resources and the exam scores, especially when the number of these resources was three or more (r = -0.26). The mean exam score of textbook users was statistically significantly higher than the mean score of textbook non-users (p = 0.01). The usage of textbooks was statistically significantly higher in the cohort of top performers in comparison to the rest of the students (p = 0.006). In addition to less usage of textbooks, the mean number of review books was higher in the group of weakest students (2.84 versus 3.7; p = 0.75).ConclusionsMost students did not use professional textbooks and about half used too many commercial review resources. While the former fact was significantly associated with poor academic performance, the later fact had weak negative correlation with exam score.Pedagogical interventions are urgently needed to make the right type of learning resources available by making professional textbooks more USMLE-oriented and helping the students choose the best and right number of resources for optimum academic performance. By fulfilling the observed needs of the students in this way, they might feel empowered because of self-determination which will motivate studies.

Gender differences in learning and study strategies impact medical students’ preclinical and USMLE step 1 examination performance

BackgroundEvaluation of students’ learning strategies can enhance academic support. Few studies have investigated differences in learning strategies between male and female students as well as their impact on United States Medical Licensing Examination® (USMLE) Step 1 and preclinical performance.MethodsThe Learning and Study Strategies Inventory (LASSI) was administered to the classes of 2019–2024 (female (n = 350) and male (n = 262)). Students’ performance on preclinical first-year (M1) courses, preclinical second-year (M2) courses, and USMLE Step 1 was recorded. An independent t-test evaluated differences between females and males on each LASSI scale. A Pearson product moment correlation determined which LASSI scales correlated with preclinical performance and USMLE Step 1 examinations.ResultsOf the 10 LASSI scales, Anxiety, Attention, Information Processing, Selecting Main Idea, Test Strategies and Using Academic Resources showed significant differences between genders. Females reported higher levels of Anxiety (p < 0.001), which significantly influenced their performance. While males and females scored similarly in Concentration, Motivation, and Time Management, these scales were significant predictors of performance variation in females. Test Strategies was the largest contributor to performance variation for all students, regardless of gender.ConclusionGender differences in learning influence performance on STEP1. Consideration of this study’s results will allow for targeted interventions for academic success.

Factors affecting the passing rate of licensure examination for teachers at Sulu State College

This study was a descriptive-correlational study that analyzed the perceptions on the factors affecting the passing rate of students in Licensure Exams for Teachers (LET) in Sulu State College (SCC). Quota sampling (n=100) was used to sample the participants from different school/college/departments in SCC. The primary participants were faculties from School of Education, School of Arts and Sciences, SSC Senior High School, SSC Laboratory High School, Other SCC departments with License for Public Teachers (LPT). A survey questionnaire was developed to elicit the responses from the faculty and staff with four scales—(i) Student-related factors, (ii) School-related factors, (iii) Home-related factors, and (iv) Teacher-related factors. Findings indicated that for SCC faculty and staff, the student-related factors, school-related factors, home-related factors, and teacher-related factors most likely influenced the student’s outcomes in LET. There were also significant correlations observed between the variables from high (home-teacher factors), moderate (student-school, home-school, teacher-school factors), and low (student-home, teacher-student factors) correlation levels. Recognizing the salience of student-related challenges, such as socio-economic backgrounds, motivation, and study habits, underscores the importance of providing targeted support mechanisms to address these issues. Similarly, focusing on enhancing school-related factors, such as curriculum design, teaching quality, and support services, can contribute to creating conducive learning environments conducive to students' success.

Factors influencing the success in Nurse Licensure Examination among Bachelor of Science in Nursing graduates in Jolo

Factors influencing the success in Nurse Licensure Examination among Bachelor of Science in Nursing graduates in Jolo

Influencing variables on teacher education graduates’ performance in the licensure examination for teachers

Influencing variables on teacher education graduates’ performance in the licensure examination for teachers

Thorns of Failures: Views of Non-Passers of Criminology Board Examination

Philippine Regulation Commission (PRC) records show that the national passing percentage in the Criminologist Licensure Examination (CLE) is deteriorating. The number of unlicensed Criminology graduates throughout the country is increasing. This study explored the lived experiences of non-passers of the Criminologist Licensure Examination (CLE) through a qualitative research method. The informants of this study were 10 board exam flunkers throughout the Province of Cebu. Four informants were used for the in-depth interview, and six were used for the focus group discussion. Eight (8) emergent themes described the positive and negative experiences of the informants before, during, and after the board exam. For the positive experiences, four (4) themes were developed, namely: Take a Trip Down Memory Lane, Licensure Examination: The Main Event, Acceptance and Moving Forward and Contingency Plan: Look for a Job. For the negative experiences, four (4) themes were formulated, namely: The Chronicles of Review, Test Anxiety: The Feeling of Taking the Licensure Examination, Board Exam Result: A Flunker’s Nightmare and Mission Unsuccessful. For the plights of the informants before, during, and after taking the licensure examination, eight (8) emergent themes were formulated, namely: Procrastination and Idleness, Indiscretion of Reviewees, Financial Struggle: A Dilemma to Board Exam Takers, Family Problems: A Heavy Load to Carry, The Answer Sheet: A Fragile Piece of Paper, Bad Luck: In the Wrong Place at the Wrong Time, Examinee’s Inability to Comprehend Questions: A Tough Assignment, The Fallen Leaves, and Disappointments and Failure to Meet Expectations: Adding Insult to Injury. For the reasons of the informants for not retaking the exam, two (2) themes were developed, namely: Age Limit in the Tri-Bureau: Crashing the Flunker’s Aspirations and Making a Fresh Start.

Retakers Pledge: An Experiential Learning

The study explores the lived experiences of Criminology Licensure Examination re-takers. The text details the participants' experiences leading up to, during, and following the licensure examination. It explores how the Criminology Licensure Examination impacted the participants and discusses the adjustments they made to enhance their performance in the exam. It utilized the qualitative research method employing the phenomenological approach. Twelve participants of this study were re-takers of the criminology licensure examination. Three re-takers of the criminology licensure examination from the review center of Cebu City and nine re-takers of the criminology licensure examination from the review center in Mandaue City, Philippines. Nine individuals were selected for comprehensive interviews from a criminology review center in Mandaue City. In contrast, three were interviewed through Focused Group Discussion (FGD) from the criminology review center in Cebu City, Philippines. The participants were selected through purposive sampling, focusing on individuals registered for review classes at centers in Cebu City and Mandaue City. Seventeen themes were created to answer the sub-problems of this study. These were: Enlightenment is the Key to Success, Self-assurance Reaching Lifetime Goals, Strong Intimate Support, Time Constraints the Clue of Anxiety, Eagerness in Achieving Objectives, Assertive Attitude Produces Positive results, Infirmities Defeating the Purpose, Discomfort Runs into Trouble, Misconception Affects the Reality, Passion Reflects the Result, Unacceptable Moments in Life, Failures Ruins the Ambition, Dynamic Opening's in the Right Place and the Right Place, Linking's in Public and Private Service, Primary of Interest in Meeting the Purpose, Responsive Commitment in Achieving Goals, and Hard work is the Key to Success.

Case Study of a Graduate Nurse’s NCLEX-RN®Failure Experience

Graduate nurses who fail the National Council Licensure Examination for Registered Nurses (NCLEX-RN®) need multifaceted, trauma-reducing, complex strategies to support their future success. Nursing faculty and academic success coaches can facilitate recovery from the grief of not passing the RN licensing exam. Supportive interventions need to match each graduate nurse’s unique situation when pursuing NCLEX-RN success. This case study of a graduate nurse’s NCLEX-RN failure experience is framed by Watson’s theory of human caring applied to academic coaching interventions that may heal the grief experienced during the transition to sit again to take the NCLEX-RN.

Student Perspectives on the Undergraduate Medical Student Research Experience at a Single United States Allopathic Institution.

Introduction The purpose of this study was to identify student-reported institutional facilitators and barriers to successful research experiences at a single United States allopathic institution. Residency applications have increasingly become more competitive, and with the United States Medical Licensing Examination (USMLE) Step 1 exam's transition to pass/fail, factors such as research experience and outcomes may become more important to increase residency application competitiveness. This study sought to explore factors that impact successful research experiences leading to tangible outcomes for medical students at our medical school, the Joe R. & Teresa Lozano Long School of Medicine. Methods A cross-sectional survey was developed and administered via REDCap to 853 students in May 2022. Survey question domains included demographics, past and present research participation, perceived barriers/facilitators to research, tangible outcomes (e.g., publications and posters), and overall satisfaction with research comparing subjectively "best" and "worst" experiences. The Institutional Review Board (IRB) deemed this project as non-regulated research. Results We had a 24% (n = 204/853) response rate. The responses were distributed equally among the four classes. A big portion of the participants (71%, n = 59/83) identified a tangible outcome as the most important measure of success. Regarding facilitators, students identified having a mentor (89%, n = 165/184) and departmental connections (85%, n = 156/184) as the most important when looking for a project. Barriers included SMART goals (Specific, Measurable, Achievable, Relevant, and Time-Bound) lacking in 31% (n = 24/75) of worst projects, followed by a clear timeline in 29% (n = 22/76) and hours of commitment in 27% (n = 21/78). The best projects were more likely to have resulted in a publication (61% (27/44) vs. 32% (14/44)) or have a poster (64% (28/44) vs. 36% (16/44)). Conclusions Medical students are interested in participating in research, with important facilitators including mentorship and departmental connections. Modifiable variables include lack of clear timelines, well-defined roles and responsibilities, and time commitments. This information may be useful for faculty who mentor medical students or medical schools interested in designing medical student research programs.