Why the Delay? Factors Predicting Step 1 Delay

Few studies have examined Step 1 delay trends in active learning or identified other factors that could influence Step 1 delay, which could inform interventions for struggling students. Our study examines factors across an active learning curriculum that could potentially predict delaying Step 1. Using a multiple logistics regression model, we found that performance on NBME final exams in our major systems-based modules later in the curriculum correlated with the decision to delay, but that formative assessments were the earliest strong predictors. These findings indicate that successful participation in an active learning curriculum positions students for success in Step 1.