Abigail Schuch, Washington State University School of Medicine
Raghav Rajesh, Washington State University School of Medicine
Marissa Zhu, Washington State University School of Medicine
Purpose
This study explored the differences in Learning and Study Strategies Inventory (LASSI) scores between at-risk and non-at-risk medical students, alongside the relationship between these scores and Step 1 outcomes. These comparisons provide important insights into the cognitive and emotional factors influencing students’ preparedness and success on the USMLE Step 1.
Methods
A total of 298 medical students completed the 60-item LASSI questionnaire. Students were classified as at-risk (N = 39) or non-at-risk (N = 259) based on academic performance indicators such as course grades and practice exam scores. Welch’s t-tests were conducted to compare LASSI subscale scores between the two groups, with additional item-level analyses identifying significant question-level differences. Logistic regression, controlling for MCAT scores, Undergraduate GPA, and End-of-Segment scores, was used to evaluate the predictive value of LASSI subscales for passing Step 1.
Results
The analysis revealed significant differences in the Test Strategies and Anxiety subscales, with non-at-risk students demonstrating better test-taking strategies (p = 0.041) and lower anxiety (p = 0.002) than at-risk students. Moreover, both subscales predicted Step 1 outcomes across all students (p = 0.043 and p = 0.007). While no significant differences were found in the other LASSI subscales between students identified as at-risk and non-at-risk, item-level analysis revealed that at-risk students more strongly agreed with the statement, “In my opinion, what is taught in my courses is not worth learning” (p = 0.00006), suggesting notable differences in course value perception.
Conclusion
This study underscores the need for targeted interventions to improve medical student testing strategies, anxiety management, and course value perception to improve Step 1 success rates. Non-at-risk students had better test-taking strategies and lower anxiety, which were predictive of Step 1 outcomes. At-risk students perceived courses as less useful, indicating distinct learning behaviors and attitudes.