Moderated by Bindu Menon
Session Coordinator: Davinder Sandhu

Presentation 1 - STEP-1 Going Pass-Fail: Seizing a Curricular Opportunity    
Andrew Binks    
Virginia Tech Carilion School of Medicine

Purpose
In response to USMLE STEP-1 scoring transitioning to pass/fail and a decline in classroom attendance, we have developed a novel, lecture-free, basic science curricular model. The model framework is based in dual-processing theory and aims to begin the transition from novice (Type 2) to expert (Type 1) processing in the pre-clinical years to enhance clerkship and USMLE STEP-2 performance and so strengthen residency applications.

Methods
Kern's 6-steps of curriculum design identified problems of grade-orientated learning, a diminished role of faculty in exam-preparation and undervalued classroom activities. To enhance clerkship preparation, the needs of a new curricular model were 1) exposure to Type-1 processing, 2) earlier development of cognitive networks, 3) harnessing social learning and positive team dynamics, 3) maintain time for autonomous learning, and 5) provide new opportunities for authentic assessment.

Results
To promote the transition from Type 2 to Type 1 processing a three-part, case-based approach included 1) learners developing a differential diagnosis in parallel with an expert clinician, 2) Illness scripting 3-4 signs/symptoms of the case and 3) concept mapping the case to instigate integrated, cognitive network development and deeper learning. The activities were performed in small groups to promote social learning and team dynamics. The activities were restricted to four cases per course (total 16-hours) to allow time for continued autonomous learning. A specifications grading schema provided learner autonomy and included assessment of the illness scripts and concept maps, as well as the group's dynamics.

Conclusion
We have embraced change in STEP-1 scoring as an opportunity to develop a novel, contemporary medical curriculum to supports our learners' transition to expert, team-orientated physicians. By facilitating this transition and by providing a more diverse assessment of learning we have aimed to generate competitive residency candidates and learned, expert physicians.

Presentation 2 - Utilizing Medical Curricula to Enhance Acceptance Into Medical Schools    
David S. Franklin    
Tulane University School of Medicine

Purpose
Three critical medical school admission parameters include GPA, MCAT scores, and Extracurricular activities (research, clinical, community). We utilize existing medical school curriculum in a Masters (MS) program designed to enhance all three parameters, improving MS graduates credentials applying to medical schools. This abstract describes the MS program and outcomes.

Methods
The Tulane SOM Biochemistry and Molecular Biology Department One-Year MS program provides a non-thesis MS degree. Students are assessed upfront in all three parameters (GPA, MCAT, Extracurriculars). Medical school-equivalent interdepartmental (biochemistry, physiology, microbiology, immunology, pathobiology) courses are prioritized, stressing MCAT preparation, team study, time-management learning strategies, and increasing Extracurriculars activities. Periodic advising emphasizes each student's individual educational plan. Postgraduate advising involves LORs, timing for retaking the MCAT/submitting applications, generating competitive school lists, personal statements and mock interviews.

Results
Over the past decade, we graduated 173 MS students (100% graduation rate). We examined 145 graduates who completed at least 1 medical school admission cycle post-graduation. 47% attempted at least 1 unsuccessful medical school admission cycle prior to MS program enrollment. Mean undergraduate GPA was 3.39. Mean graduating MS GPA improved to 3.8. Mean entering MCAT was 503. Mean graduating MS MCAT improved to 509. Extracurricular activities were enhanced. Medical faculty LORs were obtained. MS graduates significantly improved medical school applications, with 88% obtaining interviews AND at least 1 medical school acceptance. 10% are improving one or more parameters before reapplying. 2% used their MS degree to obtain work. We will breakdown how MS GPA and MCAT calculated potential for interviews and acceptances within one or more medical admissions cycles.

Conclusion
Utilizing medical school-equivalent curriculum, MCAT preparation, extracurricular activities, critical advising, MS graduates increased both admission interviews and acceptance, especially if both GPA and MCAT scores increased to MS mean averages (or greater)."

Presentation 3 - Proactive Curricular Approach to Improving USMLE Step 1 Scores for Students At Risk of Exam Failure or Delay    
Edith H. Wang    
University of Washington, School of Medicine    

Purpose
At our institution, students complete preclinical work in December of Year 2 and are required to take Step 1 prior to beginning core clerkships in late March. Students increasingly fail to meet the Step 1 deadline, which disrupts and negatively impacts their progression in the curriculum, and increases clerkship logistical and capacity demands. This abstract describes a course designed to reduce the number of USMLE Step 1 failures and unanticipated delays to the start of clerkships and the outcomes.

Methods
Since January 2019, we have offered a Comprehensive Basic Sciences Review (CBSR) course for students at risk of Step 1 failure due to low performance in pre-clerkship courses and the Comprehensive Basic Sciences Exam (CBSE). This optional, invitation-only course reviews fundamental content using a question-based approach. CBSR students have a more structured and extended Step 1 study period, beginning clerkships in summer rather than spring. To evaluate the effectiveness of this intervention, we compared Step 1 performance of CBSR students with controls matched by academic performance, MCAT, and CBSE. We also will analyze time to graduation for the matched cohorts.

Results
Students enrolled in CBSR (n = 50) had significantly higher mean scores on Step 1 (212.7 vs 202.1, p < 0.001) than their matched controls. Matched CBSR students also had a higher passing rate (82.0 vs 74.0%), although this was not statistically significant. This novel intervention was associated with significantly higher Step 1 scores for at-risk students. The impact on unanticipated delays into clerkship will be determined. We cannot exclude that unmeasured characteristics of those who accepted the CBSR intervention may contribute to these findings.

Conclusion
The challenge to support students struggling with Step 1 is widespread; we believe that early identification and targeted support with programs such as CBSR may improve outcomes for students at other institutions.

Presentation 4 - An Analysis of Admission Criteria and Student Performance Metrics to Predict Academic Success in Preclinical Coursework and Performance on USMLE STEP 1 & 2    
Falicia Harvey    
University of SC Columbia School of Medicine    

Purpose
The literature reports mixed reviews regarding the usefulness of admission criteria to predict academic success in medical school. The purpose of our study was two-fold. First, we wanted to investigate the relationship between admission data, and performance in the preclinical courses, to students' performance on national examinations (CBSE and USMLE). Second, we wanted to use the data to see if we could predict which students might be at risk for poor performance on the national examinations, and therefore, identify those students who may benefit from early academic guidance/intervention. Furthermore, the data was used to identify high performance characteristics for the purpose of disseminating that information to improve all students' performance.

Methods
A retrospective analysis of admission data (MCAT, GPA, major, institution etc.) was conducted for students graduating 2019-2025 to see if specific preadmission criteria predicted academic success. Additionally, a retrospective analysis of students' performance on M1 and M2 coursework as well as CBSE and USMLE examinations was conducted to identify trends in high performing students and to identify "at risk" students. 

Results
MCAT scores strongly correlated with performance in M1 physiology, anatomy &amp; biochemistry blocks. Undergraduate GPA had no such correlation. A gap-year did not improve student performance. High performance on physiology content for M1's correlated most strongly with higher performance in M2 courses. Performance on Year 1 & 2 NBME exams correlated with higher STEP 1 & 2 scores. 

Conclusion
MCAT score is a useful admission criterion to predict academic performance. Mastering physiology content is important for success in M2 courses. Academic intervention for students struggling with physiology content may improve overall M2 performance. NBME exams prepare students to score well on STEP exams. Additional academic support for students that perform poorly on NBME exams may improve STEP scores.