Assessment for Learning: Investigating the Utility of the Family Medicine and Emergency Medicine Self-assessments for Subject Examination Preparation

Medical students use self-assessments to assess their knowledge and identify areas for additional study before taking a summative examination at the end of their clinical education segment. This study extended previous research on the NBME Clinical Science Mastery Series self-assessments to investigate the utility of recently released self-assessments for students completing Family Medicine clerkships and Emergency Medicine sub-internships and preparing for summative assessments. The dataset included 12,200 Family Medicine and 3919 Emergency Medicine students who took the self-assessment and corresponding subject examination from the implementation of the self-assessments in 2017 through January 2020. Like other self-assessments, students typically took the self-assessment within a week of their Family Medicine or Emergency Medicine subject examination using the standard-paced testing mode. The proportion of variance in subject examination scores explained by self-assessment scores was slightly higher for the standard-paced group than for the self-paced group for Family Medicine, (R2 = .26 and .23, respectively); however, the pattern was reversed for Emergency Medicine (R2 = .29 and .32). Further, the two pacing groups had significantly different sets of regression parameter estimates. The Family Medicine and Emergency Medicine self-assessments allow students to prepare for their summative subject examinations using formative assessments that mirror the content and pacing of the subject examinations. Students can also opt to use the self-paced mode to leverage the self-assessment as an educational tool. Although the standard-paced mode often provides better prediction of subsequent subject examination scores, the self-paced mode is also consistent with an assessment for learning framework.