Randomized Trial of a Year-Long USMLE Step 1 Preparation Near-Peer Teaching Program

Near-peer teaching (NPT) is a peer-assisted learning method that has been adopted by medical schools as studies have reported benefits to both tutors and tutees. Published studies suggest students may benefit from NPT programs when preparing for the US Medical Licensing Examination (USMLE) Step 1 exam, but they did not use a randomized controlled trial methodology. To determine the impact of a year-long NPT preparation program for the Step 1 examination, we conducted a randomized-controlled trial among second-year medical students at New York Medical College during the 2017-2018 and 2018-2019 academic years. Students who enrolled in the study were invited to complete a post-exam survey, and Step 1 examination scores of intervention and control groups were compared, controlling for preexisting academic differences and demographic traits. While the majority of students reported NPT program participation was a valuable use of their time, we found no significant difference in Step 1 scores between intervention and control groups. Notably, students identifying as female, underrepresented in medicine (UIM) or socioeconomically disadvantaged (SED) enrolled in higher proportions compared to the combined M2 student body of the 2017-2018 and 2018-2019 academic years. Our results may highlight the limitations of NPT programs for board examination preparation and inform the future design of peer-assisted learning programs within medical schools.