A multilevel analysis of the relationships between selected examinee characteristics and United States Medical Licensing Examination Step 2 Clinical Knowledge performance: Revisiting old findings and asking new questions

Background This study examines: (1) the relationships between examinee characteristics and United States Medical Licensing Examination Step 2 Clinical Knowledge (CK) performance; (2) the effect of gender and examination timing (time per item) on the relationship between Steps 1 and 2 CK; and (3) the effect of school characteristics on the relationships between examinee characteristics and Step 2 CK performance. Method A series of hierarchical linear models (examinees-nested-in-schools) predicting Step 2 C K scores was fit to the data set. The sample included 54,487 examinees from 114 U.S. Liaison Committee on Medical Education-accredited medical schools. Results Consistent with past examinee-level research, women generally outperformed men on Step 2 CK, and examinees who received more time per item generally outperformed examinees who received less time per item. Step 1 score was generally more strongly associated with Step 2 CK performance for men and for examinees who received less time per item. School-level characteristics (size, average Step 1 performance) influenced the relationship between Steps 1 and 2 CK. Conclusion Both examinee-level and school-level characteristics are important for understanding Step 2 CK performance.