This is one school’s experience with NBME assessments. Results or outcomes may vary and depend on factors beyond NBME’s control, such as student participation, individual study habits, faculty support and engagement, and/or variations in curriculum, among other things.

Marshall University saw students excelling on in-house assessments but struggling with standardized tests like the NBME® Clinical Science Subject Exams and United States Medical Licensing Examination® Step 1. They implemented curriculum changes, student support, and a robust assessment program. After these changes were implemented, they observed an increase in their USMLE Step 1 pass rates and also exceeded the national average for the past two years. 

Marshall University implemented strategic changes after discovering students did well on internal assessments but struggled with standardized exams. Their comprehensive curriculum redesign focused on four areas: adopting a vertically integrated model with extended clinical training, implementing self-directed learning approaches, developing robust student support systems, and creating a continuous assessment program.   

The enhanced assessment process incorporates NBME® examinations as promotion requirements, customized assessments aligned with their curriculum, and multiple practice opportunities. Students benefit from a data-driven support system featuring real-time performance tracking, early identification of at-risk students, and dedicated academic advising.  

Results from the strategic changes implemented have been substantial: USMLE® Step 1 pass rates now exceed national averages, Step 2 CK pass rates approach 100%, and remediation needs have significantly decreased. Students demonstrate stronger clinical performance and can focus more on patient care during rotations.  

“Our licensure examination pass rate, particularly for Step 1, was not where we would like it to be… It is now above the national average for the last two years consistently. We’re proud of that. We’re excited about that.”

Nitin Puri, MD, PhD, Senior Associate Dean for Medical Education

“The students have really excelled… I can honestly say we’ve seen significant improvement in the number of students who were struggling, having to remediate, or repeat a portion of a rotation.”

Marie Frazier, MD, Associate Dean for Academic Affairs

NBME PORTFOLIO PARTS USED

NBME® Self-Assessments

Marshall offers NBME Self-Assessment (Clinical Mastery Series) vouchers for each clerkship — with an average of two vouchers per student and more available on a case-by-case basis — to help students meet and exceed their goals with NBME-style exams. They also offer vouchers at least once before each Comprehensive Subject Exam.  

Customized Assessment Services (CAS)

During the pre-clerkship years, Marshall follows their in-house medium stakes assessments with a customized assessment from NBME. This allows them to create an exam tailored to their curriculum, while also giving students practice with USMLE®-style questions.

NBME Subject Exams

Marshall uses the Comprehensive Basic Science Exam (CBSE) as a promotion examination at the end of the pre-clerkship phase and the Comprehensive Clinical Science Exam (CCSE) at the end of the clerkship curriculum as a precursor to taking the USMLE Step 2. They also use the Clinical Science Subject Exams throughout the clerkship years 

SUPPORTING DATA

Peer-Reviewed Article: Gullo, C.A., McCarthy, M.J., Shapiro, J.I. et al. Predicting Medical Student Success on Licensure Exams. Med.Sci.Educ. 25, 447–453 (2015). https://doi.org/10.1007/s40670-015-0179-6 

Video: https://www.nbme.org/events/conversation-with-marshall-university  

Executive Summary Case Statement: PDF embedded in same link https://www.nbme.org/events/conversation-with-marshall-university  

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