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No Medical Student Left Behind: A Study to Examine the Effects of Structured Step 1 Support within our Curriculum

Introduction: The University of Texas Southwestern Medical School (UT Southwestern) developed a required, pass/fail Step 1 preparation course in conjunction with their new curriculum to support students with structure, encouragement, and accountability. This study examined the Step 1 performance of students who have taken the prep course after completing pre-clinical coursework and factors which predicted outcomes. Methods: Data were collected between January 2017 and July 2018 from 453 2-year medical students enrolled in the six week course. Multilinear regression and Chi-squared analysis were performed to compare pre-clinical course performance with Step 1 readiness and outcomes. Results: Average course final exam scores and CBSSA results were significantly and directly associated with Step 1 scores. Pre-clinical exam performance, practice exam scores at the beginning of the Step 1 preparation period and an increase in practice exam scores over the study period correlated with Step 1 performance. The percent pass rates and mean scores in 2017 were at 97% and 235, but in 2018, no student failed Step 1 (100% pass rate), and the mean score rose to 239. Discussion and Conclusion: A structured Step 1 Prep Course was well-accepted by students. Exam performance can be predicted from pre-clerkship performance and progress made during the course on practice exams and early intervention for at-risk students can improve performance of at-risk students.