Purpose
In recent years, the pass rate for the United States Medical Licensing Examination Step 1 has declined, raising concerns among both faculty and students. The Comprehensive Basic Science Exam (CBSE) is one metric to indicate readiness for Step 1. Most medical students, and some medical schools, supplement the formal curriculum with external resources to prepare for these high-stakes exams. To support students’ preparation, the University of South Carolina School of Medicine Greenville offers ScholarRx, and students take the CBSE three times, with the final time at the end of the pre-clerkship curriculum. The present study investigates whether students’ usage of ScholarRx resources statistically relates to CBSE scores at the conclusion of the pre-clerkship curriculum.

Methods
ScholarRx usage data, average course grades, and final CBSE scores from a cohort of second-year medical students within a US medical school were matched, deidentified, and analyzed (n=102). Multiple linear regression was conducted with CBSE score as the dependent variable. Independent variables included average course grades and four specific metrics of ScholarRx utilization: QMAX (practice questions), bricks (online learning modules), videos, and flashcards. A t-test was used to compare QMAX between learners who took Step 1 on time and those who delayed. This project was reviewed by the Institutional Review Board.

Results
The regression revealed a positive significant relationship between CBSE scores and student completion of ScholarRx QMAX questions (p<0.01), but not bricks, videos, or flashcards (p>0.05). Average course grades also significantly predicted CBSE scores (p < 0.001). Those who took Step 1 on time had completed more QMAX questions than those who had to delay (p = 0.01).

Conclusion
This correlative study suggests that ScholarRx QMAX practice questions may be a useful tool to support medical students’ academic success and advancement.