Presented By: Alexa Gandy, University of South Carolina School of Medicine Columbia
Co-Authors: Jeanette Fulton, University of South Carolina School of Medicine Columbia
Falicia Harvey, University of South Carolina School of Medicine Columbia

Purpose 
Nationwide pass rates have decreased as students transition to a pass/fail (P/F) Step 1 scoring system. The University of South Carolina School of Medicine Columbia (USC SOMC) has been monitoring this transition, along with a concurrent change from a discipline/course-based curriculum to a systems-based curriculum and a move to P/F grading. The purpose of this study is to evaluate the role of course-based versus systems-based curriculum on student performance to better inform curriculum delivery. 

Methods 
Student performance in coursework, course NBME exams, CBSE, and Step 1 were examined for two years each of course-based and systems-based curriculum. Individual student CBSE categorial data and institutional categorical Step 1 data were used as consistent measures across all four years. CBSE categorical data (percent correct) normalized to categorical national means, along with the percentage of students scoring at or above the national mean for Step 1 categorical data was examined. 

Results 
Analysis of the data shows a poorer performance in many categories of the CBSE in the first year of systems-based curriculum which corresponds with the simultaneous transition to a P/F Step 1 exam. The second year of systems-based curriculum shows significant improvement over the first year and often improvement over the old curriculum, with some exceptions. A review of Step 1 categorical data shows similar enhanced performance patterns with a systems-based curriculum, also with a few notable exceptions. 

Conclusion 
It can be difficult to isolate performance strengths and weaknesses given the multiple variables involved (COVID, curriculum change, Step 1 P/F, P/F grading). Differential performances based on the type of curriculum delivery and a review of the data will help inform the preclinical curriculum at USC SOMC.