National Board of Medical Examiners and Curriculum Change: What Do Scores Tell Us? A Case Study at the University of Balamand Medical School

Mode Al Ojaimi; Megan Khairallah; Rayya Younes; Sara Salloum; Ghania Zgheib

doi:10.1177/2382120520925062

National Board of Medical Examiners and Curriculum Change: What Do Scores Tell Us? A Case Study at the University of Balamand Medical School

J Med Educ Curric Dev. 2020 Jul 24:7:2382120520925062. doi: 10.1177/2382120520925062. eCollection 2020 Jan-Dec.

Authors

Mode Al Ojaimi¹, Megan Khairallah², Rayya Younes², Sara Salloum², Ghania Zgheib²

Affiliations

¹ Faculty of Medicine, University of Balamand, Balamand, Lebanon.
² Department of Education, University of Balamand, Balamand, Lebanon.

Abstract

Objectives: This study describes the results of NBME (National Board of Medical Examiners) implementation in Balamand Medical School (BMS) from 2015 to 2019, after major curricular changes were introduced as of 2012. BMS students' performance was compared with the international USMLE step 1 (United States Medical Licensing Examination, herein referred to as step 1) cohorts' performances. The BMS students' NBME results were analyzed over the successive academic years to assess the impact of the serial curricular changes that were implemented.

Methods: This longitudinal study describes the performance of BMS preclinical second year medicine (Med II) students on all their NBME exams over 4 academic years starting 2015-2016 to 2018-2019. These scores were compared with the step 1 comparison group scores using item difficulty. The t test was computed for each of the NBME exams to check whether the scores' differences were significant.

Results: Results revealed that all BMS cohorts scored lower than the international USMLE step 1 comparison cohorts in all disciplines across the 4 academic years except Psychiatry. However, the results were progressively approaching step 1 results, and the difference between step 1 scores and BMS students' NBME scores became closer and not significant as of year 4.

Conclusions: The results of the study are promising. They show that the serial curricular changes enabled BMS Med II students' scores to reach the international cohorts' scores after 4 academic years. Moreover, the absence of statistical difference between cohort 4 scores and step 1 cohorts is not module dependent and applies to all clinical modules. Further studies should be conducted to assess whether the results obtained for cohort 4 can be maintained.

Keywords: National Board of Medical Examiners; USMLE step 1 results; assessment of analytical reasoning skills; medicine II curricular changes; multiple-choice questions.