Effect of Repeat Examination on Family Medicine NBME Subject Scores

National Board of Medical Examiners (NBME) subject examinations are used by many schools to assess student clinical knowledge. Studies indicate that mean scores on NBME examinations improve as the clinical year progresses. Literature review revealed no studies investigating changes in individual student scores when end-of-block examinations were repeated at the end of the clinical year. This study investigated NBME family medicine subject examination score changes for students who opted to repeat the examination at the end of the academic year.

In 2014, students on a 4-week family medicine block clerkship took the NBME subject examination at the end of their clerkship block and were offered the opportunity to repeat this examination at the end of that clinical year; 25 of 80 students voluntarily repeated the examination. Paired t-tests were used to compare performance outcomes between the exam means at the end of the clerkship blocks to the means on the exam administration at the end of the academic year.

Results showed a statistically significant improvement in scores between the first and second examination administration. Examinations given immediately after the students' clinical experience yielded scaled scores ranging from 60 to 80 compared to the national mean of 71.9. Examinations given at the end of the clinical year yielded scaled scores ranging from 57 to 90 (t[24]=-2.66, P=0.0006).

Repeating the NBME subject examination at the end of the year led to slightly increased scores, suggesting that time spent during clerkships influences examination performance.