To Wait or Two Weeks: The Relationship Between Step 2 CK Scores and the Length of Dedicated Study Time Within a Longitudinal Interleaved Clerkship Curriculum

Sabrina Antonio; Rachel A Kracaw; Wynona Dizon; Edward Simanton

doi:10.7759/cureus.26599

To Wait or Two Weeks: The Relationship Between Step 2 CK Scores and the Length of Dedicated Study Time Within a Longitudinal Interleaved Clerkship Curriculum

Cureus. 2022 Jul 5;14(7):e26599. doi: 10.7759/cureus.26599. eCollection 2022 Jul.

Authors

Sabrina Antonio¹, Rachel A Kracaw¹, Wynona Dizon¹, Edward Simanton^{1

2}

Affiliations

¹ Medical Education, Kirk Kerkorian School of Medicine at University of Nevada Las Vegas, Las Vegas, USA.
² University of Nevada Las Vegas, Office of Medical Education, Las Vegas, USA.

Abstract

Introduction: Graduate medical education program directors report that United States Medical Licensing Examination (USMLE) Step 2 CK exam scores will likely have greater importance in the future selection of residents due to USMLE Step 1 transitioning to a pass/fail score as early as January 2022. With emphasis moving to the Step 2 exam, it is important to examine factors that maximize student Step 2 CK performance, such as third-year curriculum models and exam timing. This study analyzes whether or not Step 2 performance is affected by a specific length of dedicated study time within a Longitudinal Interleaved Clerkship (LInC) curriculum.

Methods: A regression model was used to predict Step 2 scores for 102 students using previous performance measures. Actual and predicted scores were compared to indicate which students overperformed or underperformed on Step 2. A t-test was used to compare the mean difference between predicted and actual performance of students who had two weeks or less of dedicated study time for Step 2 CK versus students who had a longer dedicated study period. Results: Students who completed Step 2 with two weeks or less of dedicated study significantly overperformed (t(100)=2.06, p=0.042) on the exam (Mean=1.61, SD=9.21) compared to students who had more than two weeks of dedicated study (Mean=-1.67, SD=6.44) in a LInC curriculum.

Conclusion: Although studies of Step 2 preparation time have shown the importance of taking Step 2 soon after completion of clinical rotations, this study adds a specific timeframe. Our findings show that a dedicated study period of two weeks or less for Step 2 CK within a LInC curriculum is associated with better performance. This study was limited to a LInC curriculum and may not apply to other clinical year curricula.

Keywords: core clerkships; dedicated study; longitudinal integrated clerkship; longitudinal interleaved clerkship; step 1 pass/fail; step 2; step 2 ck; step 2 performance.