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The Relationship Between Communication Scores From the USMLE Step 2 Clinical Skills Examination and Communication Ratings for First-Year Internal Medicine Residents

Winward, Marcia L. MPhil; Lipner, Rebecca S. PhD; Johnston, Mary M. MA; Cuddy, Monica M. MA; Clauser, Brian E. EdD

Academic Medicine:
doi: 10.1097/ACM.0b013e31828b2df1
Research Reports
Abstract

Purpose: This study extends available evidence about the relationship between scores on the Step 2 Clinical Skills (CS) component of the United States Medical Licensing Examination and subsequent performance in residency. It focuses on the relationship between Step 2 CS communication and interpersonal skills scores and communication skills ratings that residency directors assign to residents in their first postgraduate year of internal medicine training. It represents the first large-scale evaluation of the extent to which Step 2 CS communication and interpersonal skills scores can be extrapolated to examinee performance in supervised practice.

Method: Hierarchical linear modeling techniques were used to examine the relationships among examinee characteristics, residency program characteristics, and residency-director-provided ratings. The sample comprised 6,306 examinees from 238 internal medicine residency programs who completed Step 2 CS for the first time in 2005 and received ratings during their first year of internal medicine residency training.

Results: Although the relationship is modest, Step 2 CS communication and interpersonal skills scores predict communication skills ratings for first-year internal medicine residents after accounting for other factors.

Conclusions: The results of this study make a reasonable case that Step 2 CS communication and interpersonal skills scores provide useful information for predicting the level of communication skill that examinees will display in their first year of internal medicine residency training. This finding demonstrates some level of extrapolation from the testing context to behavior in supervised practice, thus providing validity-related evidence for using Step 2 CS communication and interpersonal skills scores in high-stakes decisions.

Author Information

Ms. Winward is measurement scientist, National Board of Medical Examiners, Philadelphia, Pennsylvania.

Dr. Lipner is senior vice president, Evaluation, Research, and Development, American Board of Internal Medicine, Philadelphia, Pennsylvania.

Ms. Johnston is research associate, American Board of Internal Medicine, Philadelphia, Pennsylvania.

Ms. Cuddy is measurement scientist, National Board of Medical Examiners, Philadelphia, Pennsylvania.

Dr. Clauser is vice president, Measurement Consulting Services, National Board of Medical Examiners, Philadelphia, Pennsylvania.

Correspondence should be sent to Ms. Winward, National Board of Medical Examiners, 3750 Market St., Philadelphia, PA 19104; e-mail: mwinward@nbme.org.

© 2013 Association of American Medical Colleges