Retention of Biomedical Knowledge in Medical Students Predicts USMLE Step 1 Scores

This article was migrated. The article was marked as recommended. Introduction Medical students are tasked with learning a vast amount of medical knowledge prior to sitting for the USMLE Step 1 exam, a portion of which is either forgotten or becomes inaccessible to memory following each exam. In this study we examined whether accessibility and retention of 1 ^st-year biochemistry content predicts performance on high stakes exams such as USMLE Step1. Methods First-year medical students were retested on a subset of biochemistry final exam items 10.5 months after sitting for the original exam. Retention was measured as a percentage of the original final exam score. Availability of information was measured with cued recall (i.e., selecting from a list the multiple-choice distractors), while accessibility of information was captured through free recall (without the aid of multiple choice distractors). Results As expected, we found that free recall rates were much lower than cued recall rates, but that students who scored higher on Step 1 had a smaller gap between cued and free recall scores, demonstrating a greater ability to access information than lower-scoring students. Importantly, we also demonstrate that higher-scoring students retained a higher percentage of the original biochemistry material than lower-performing students after 10.5 months, and that the amount information retained in memory was associated with higher scores on Step 1, demonstrating the potential importance of teaching medical school content with the intention of making it stick, especially in students who are not as strong academically. Conclusion The methods employed in this study are straightforward and can be used to compare retention and accessibility of information across medical school courses, and may serve as a guide to curriculum and pedagogical improvements.