Purpose
The National Board of Medical Educators (NBME) is influential in medical education. Our institution has utilized customized NBME exams since our inception. These exams require traditional exam proctoring measures and prohibit question discussion. Recently, NBME began offering customized practice quizzes (NCPQs) allowing the learner to asynchronously take quizzes and review the results. We sought to determine if incorporating weekly quizzes would improve exam outcomes.

Methods
NCPQs were collected by content experts and assembled by course directors. Quizzes were delivered weekly on content covered the prior week. Student averages on quizzes were compared with the subsequent exam grade. Relative risk (RR) was used to determine the likelihood of low performance. Historic exam outcomes were compared to the “quizzes” cohort. Class averages were statistically compared with previous cohorts. Students completed five quizzes ahead of their first exam. IRB#:2021-37

Results
The overall practice exam average (n=64) was 67.8% with a standard deviation (STDV) of 9.1. The first exam average was 82.3% (STDV=7.0) showing an average growth of 14 points. Exam outcomes compared to previous cohorts were subtle and not significant. The percentage of students below the predicted NBME average was modestly lower, particularly while drastically low performer numbers remained consistent. Students who missed at least one quiz had RR=4.5 (1.696,11.94) of performing in the bottom 10 percentile.

Conclusions
Preliminary results suggest NCPQs are beneficial for learners. Our findings suggest quizzes help acclimate learners to NBME-style questions ahead of the first exam. Students that skipped at least one quiz were more likely to be in the bottom 10% of performers suggesting NCPQs may serve as early interventional tool. Our outcomes are valuable for institutions considering to utilize NCPQs.