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Acad Med. 2008 Oct;83(10 Suppl):S82-5. doi: 10.1097/ACM.0b013e318183e2fc.

Retention of basic science information by senior medical students.

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Test Development Associate II, National Board of Medical Examiners, 3750 Market Street, Philadelphia, PA 19104, USA.



Studies of retention of basic science information have commonly demonstrated a knowledge decline as students progress through medical education. This study examined item characteristics influencing patterns of retention.


A large content and statistically representative sample of basic science items from 2004-2005 forms of United States Medical Licensing Examination (USMLE) Step 1 was included in unscored sections of 2004-2005 USMLE Step 2 Clinical Knowledge (CK) test forms, and the performance of 15,000+ first-time examinees from U.S. and Canadian schools was analyzed to identify item characteristics affecting retention.


Across the 502 study items, the mean item difficulty on Step 1 was 76.1%; on Step 2 CK, this value declined to 69.7%. Performance declines were largest in Biochemistry (17.5%) and Microbiology (12.6%). Improvement was only observed for Behavioral Sciences items (8.7%).


Shifts in examinee performance in this study were similar to those observed in previous research, although the magnitude of the overall decline was somewhat larger.

[Indexed for MEDLINE]

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