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Related Experiment Videos

Medical Physiology Faculty Overpredict Assessment Question Complexity and Alignment with National Board Expectations.

Alex C S Shefflette¹, Irving Joshua¹, Michael J Metz²

¹University of Louisville, School of Medicine, Department of Physiology, Louisville, KY, USA.

Advances in Physiology Education

|July 2, 2026

Summary

This summary is machine-generated.

Physiology faculty overestimated their exam questions

Keywords:

Medical Physiology education assessment alignment board preparation curriculum design educational measurement multiple-choice questions

Related Experiment Videos

Area of Science:

Medical Education
Physiology
Assessment

Background:

Medical licensing exams assess foundational science application.
Board-style patient presentations are key.
Allopathic and osteopathic programs require this knowledge.

Purpose of the Study:

Assess alignment of Medical Physiology course questions with NBME Item-Writing Guide.
Evaluate faculty's perception versus reality of question style.

Main Methods:

Analyzed 316 practice and 187 course exam questions from five faculty.
Coded questions into basic science, clinical scenario, or NBME-style.
Compared course questions to NBME Step-1 practice exam questions.
Surveyed faculty on familiarity and estimation of NBME-style questions.

Main Results:

Faculty predicted 14% (practice) and 23% (exam) NBME-style questions.
Actual NBME-style questions: 3% (practice) and 7% (exam).
NBME Step-1 practice exam: 92% NBME-style questions.
Course exams had significantly lower word counts than Step-1 questions.

Conclusions:

Faculty significantly overpredict the NBME-style nature of their questions.
This discrepancy may impact student preparedness for Step-1 licensure exams.
Training on the NBME Item-Writing Guide is recommended for faculty.