Students used a heterogenous mix of study strategies and resources ( Tables 2, ,3, 3, and and4). We performed hierarchical multiple regression analysis to evaluate whether any specific study strategies and resources continued to be positively associated with Step 2 CK score, after controlling for Step 1 score, MCAT score percentile, and entry pathway into medical school. We initially intended to analyze the relationships between study approaches and passing or failing the Step 2 CK and CS exams, but the relatively small sample size, and the small number of failures, prohibited these analyses. We analyzed results descriptively, using counts and proportions. We used Pearson correlations for linear variables, and independent samples t tests for dichotomous variables. We analyzed Step 2 CK preparation strategies and the use of specific resources to determine their relationship with Step 2 CK scores. The study was exempted from review by the Michigan State University Institutional Review Board. Responses were linked to demographic and academic performance information using the college’s honest broker process to deidentify data before analysis. The survey included 102 multiple-choice and short-answer items. Survey invitations were sent on a rolling basis to students approximately 2 weeks after completing their exam. The average USMLE Step scores for respondents was 232 on Step 1 and 248 on Step 2 CK. Fifty-one students responded (25% response rate). 9 Two hundred-five students in the class of 2020 at a single public, allopathic US medical college were invited to participate in a survey focused on preparation for the Step 2 CK exam. 8 Students engaged in self-directed learning to diagnose their learning needs, formulate goals, identify resources, implement learning strategies, and evaluate outcomes. The humanist framework of self-directed learning theory guided this research. This study aimed to describe what approaches and resources medical students utilized when preparing for the Step 2 CK exam and investigate the relationship(s) between various resources and strategies on Step 2 CK performance. While prior research has examined the utility of various academic indicators to predict student performance on the USMLE exams, 6, 7 no significant scholarly effort has been conducted to investigate students’ Step 2 CK study approaches. Thus, additional Step 2 CK preparation may be necessary. 3 – 5 Moreover, because of the changes planned for scoring Step 1, students may not have learned and implemented effective exam preparation strategies previously. 1, 2 With the 2020 announcement that score reporting for Step 1 will move to pass/fail, students will likely experience increased pressure to achieve a competitive score on their Step 2 CK exam. Over time, the pressure on students to perform optimally on this exam has increased due to the importance of exam scores in the residency selection processes. Academic advisors counsel medical students on study approaches and resources that promote student success on the United States Medical Licensing Examinations (USMLE) Step 2 Clinical Knowledge (CK) exam.
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