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How much do differences in medical schools influence student performance? A longitudinal study employing hierarchical
1Medical Education Research Unit, University of Calgary, Calgary, Alberta, Canada. kghecker@ucalgary.ca
Teaching and Learning in Medicine
|April 30, 2008
Summary
Student differences, not school curricula, largely explain variations in United States Medical Licensing Examination (USMLE) scores. Medical school educational policies have minimal impact on student learning outcomes.
Area of Science:
- Medical Education Research
- Educational Policy Analysis
- Student Performance Metrics
Background:
- Medical school curricula have evolved significantly over the past 50 years.
- Limited evidence exists on the impact of curricula and policies on student learning after accounting for prior performance and school-specific factors.
Purpose of the Study:
- To analyze the influence of medical school variables on United States Medical Licensing Examination (USMLE) Step 1-3 scores.
- To examine score variations over an 11-year period (1994-2004).
Main Methods:
- Utilized longitudinal data from 116 medical schools via the Association of American Medical Colleges and USMLE.
- Employed hierarchical linear modeling to assess school-level effects on USMLE Steps 1-3 performance.
Main Results:
- Unadjusted between-school variance in USMLE scores ranged from 10.50% to 14.74%.
- After including student covariates, between-school variation decreased to under 5%.
- Student characteristics accounted for 16.37%-36.51% of performance variance, while school-level variables showed no consistent predictive power.
Conclusions:
- Individual student differences are the primary drivers of USMLE performance variation.
- Between-school variations and curriculum/educational policies contribute minimally to score differences.
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