The Impact of Process-Oriented Preparation on High-Stakes Testing in Medical School

Introduction: High-stakes testing is deeply engrained within current medical education. The United States Medical Licensing Exams (USMLE) significantly impact medical student promotion in the United States. Studies have demonstrated varied impact of content-enriching programs on Step 1 performance. This study investigates the impact of process-oriented preparation on such high-stakes testing. Materials and Methods: A retrospective multivariate analysis was conducted after implementation of a peer-led seminar series on process-oriented preparation. Age, gender, ethnicity, medical college admission test scores (MCAT), and USMLE Step 1 scores were collected. Results: 557 students were included, 210 before and 347 after course implementation. Median Step 1 scores were 216 before and 223 after (p=0.19). When stratified by pre-enrollment MCAT score, students performing in the 25th–75th percentile showed significant improvement in Step 1 scoring (215 versus 223, p=0.016), which was not observed for students scoring below the 25th or above the 75th percentiles (p=0.53 and p=0.32, respectively). Discussion: Overall, Step 1 scores did not significantly differ for the pre- and post-seminar groups. There is suggestion of an impact on performance in certain student subgroups but further evaluation is necessary. Results from this study suggest that peer-led coaching can impact performance for some. © 2013, Springer International Publishing.