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A Low-Resource Intervention to Improve Emergency Medicine NBME Scores: Risk Notification and Study Plan Submission
Rachel L Day1, Nicholas Harrison1, Malia J Moore1
1Indiana University School of Medicine Indianapolis Indiana USA.
AEM Education and Training
|June 8, 2026
Summary
Medical students at risk of failing the Emergency Medicine (EM) National Board of Medical Examiners (NBME) shelf exam improved their scores after being asked to create a personalized study plan. This simple intervention enhanced performance on the final examination.
Area of Science:
- Medical Education
- Assessment and Evaluation
Background:
- Medical students at risk of failing clerkship examinations require effective support strategies.
- The National Board of Medical Examiners (NBME) shelf exam is a critical assessment in medical education.
Purpose of the Study:
- To investigate if requiring students to create a study plan improves performance on the Emergency Medicine (EM) NBME shelf exam.
- To assess the impact of a self-directed study plan intervention on medical student examination outcomes.
Main Methods:
- A quasi-experimental design comparing two academic years (AY-2023 vs. AY-2024) involving 700 medical students.
- Students scoring 65 or below on a practice EM NBME exam in AY-2024 were mandated to create a study plan.
- Mixed modeling regression was used to analyze the relationship between practice and final NBME scores, adjusting for confounders.
Main Results:
- Implementation of the study plan requirement in AY-2024 led to increased overall NBME shelf exam scores.
- The rate of High Pass or Honors on the final NBME exam significantly rose after the intervention.
- The score gap between students who failed and passed the practice exam diminished post-intervention.
Conclusions:
- A simple intervention requiring students who fail the practice exam to develop a study plan improves final NBME scores.
- This strategy is effective regardless of the specific study methods or resources chosen by the student.
- Personalized study plan creation can be a valuable tool for supporting at-risk medical students.
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