Name
Early Risk Screening and Intervention Boost COMLEX Success Rates
Date & Time
Monday, June 8, 2026, 2:27 PM - 2:42 PM
Location Name
Oglethorpe F
Speakers
Authors
Cathryn Caudill, University of Pikeville Kentucky College of Osteopathic Medicine
Presentation Topic(s)
Student Support
Description
PURPOSE
We sought to identify academic and performance-related indicators that
predict COMLEX Level 1 failure and clinical rotation delays to develop an
early-intervention screening tool. Students identified through this tool were
enrolled in PASS, our institution’s Program for Academic Support and Success,
which provides advising and resources promoting COMLEX readiness. We further
evaluated whether early intervention improved first-time pass rates and
reduced rotation delays.
METHODS
A retrospective case-control study was conducted using pooled data from
three student cohorts (Classes of 2023–2025, n=398). Variables included GPA
and MCAT thresholds, preclinical block exam and course failures, commercial
question bank use, and performance on benchmark assessments. Odds Ratios
(ORs) with 95% confidence intervals (CIs) were calculated to identify the
strongest predictors of COMLEX Level 1 failure for inclusion in a screening
tool. Two subsequent cohorts (n=269) were then screened with this tool, and
at-risk students enrolled in PASS. First-time pass rates and rotation delay
rates were compared across cohorts and among students with one-, two-, or
three-month delays.
RESULTS
GPA and MCAT indicators were not associated with COMLEX failure, whereas
performance-based indicators, such as preclinical block exam failures and
benchmark assessment deficits, were strong predictors. Logistic modeling
showed that each additional risk factor more than doubled the odds of failure
(OR = 2.24; 95% CI 1.58–3.18). Students with more than one risk factor
demonstrated a 3-5x increased risk of failure and rotation delay.
Implementation of early PASS counseling improved our institution’s first-time
pass rate by 13 percentage points and increased first-time pass rates among
at-risk delayed students from an average of 47% to 93%.
CONCLUSIONS
A performance-based screening tool effectively identifies students at
elevated risk for COMLEX Level 1 failure and rotation delay. Early targeted
intervention improves readiness, improves first-time pass rates, and reduces
downstream academic delays.
We sought to identify academic and performance-related indicators that
predict COMLEX Level 1 failure and clinical rotation delays to develop an
early-intervention screening tool. Students identified through this tool were
enrolled in PASS, our institution’s Program for Academic Support and Success,
which provides advising and resources promoting COMLEX readiness. We further
evaluated whether early intervention improved first-time pass rates and
reduced rotation delays.
METHODS
A retrospective case-control study was conducted using pooled data from
three student cohorts (Classes of 2023–2025, n=398). Variables included GPA
and MCAT thresholds, preclinical block exam and course failures, commercial
question bank use, and performance on benchmark assessments. Odds Ratios
(ORs) with 95% confidence intervals (CIs) were calculated to identify the
strongest predictors of COMLEX Level 1 failure for inclusion in a screening
tool. Two subsequent cohorts (n=269) were then screened with this tool, and
at-risk students enrolled in PASS. First-time pass rates and rotation delay
rates were compared across cohorts and among students with one-, two-, or
three-month delays.
RESULTS
GPA and MCAT indicators were not associated with COMLEX failure, whereas
performance-based indicators, such as preclinical block exam failures and
benchmark assessment deficits, were strong predictors. Logistic modeling
showed that each additional risk factor more than doubled the odds of failure
(OR = 2.24; 95% CI 1.58–3.18). Students with more than one risk factor
demonstrated a 3-5x increased risk of failure and rotation delay.
Implementation of early PASS counseling improved our institution’s first-time
pass rate by 13 percentage points and increased first-time pass rates among
at-risk delayed students from an average of 47% to 93%.
CONCLUSIONS
A performance-based screening tool effectively identifies students at
elevated risk for COMLEX Level 1 failure and rotation delay. Early targeted
intervention improves readiness, improves first-time pass rates, and reduces
downstream academic delays.