In November 2019, NBME (National Board of Medical Examiners) announced “Beginning in mid-2020, the Step 1 and Step 2 Clinical Knowledge (CK) examinations will include an increased number of questions assessing communication skills, system-based practice and patient safety, and legal/ethical skills and professionalism.“
Medical schools now must decide how to address this change and prepare students for the increased number of questions in those content areas. Some schools have already been preparing a curriculum structure and tracking process that more easily supports changes to USMLE content. They implement systems that track teaching and learning in 3 curriculum mapping phases:
Phase 1: Curriculum – Identify what we are teaching.
New and progressive medical schools are mapping course content to the USMLE Content Outline in order to identify gaps and overlaps in course instruction. This also allows them to rebalance the amount of course instruction in specific content areas to address changes in Step 1 and Step 2 examination content.
Phase 2: Assessment – Test student’s knowledge.
Test questions are also mapped to the USMLE Content Outline to ensure that the schools are measuring student knowledge based on classroom instruction. This allows them to evaluate the effectiveness of the curriculum and make adjustments as needed to improve knowledge based performance.
Phase 3: Application – Assess student’s application of knowledge.
After ensuring students have mastered the USMLE Content knowledge-wise, this learning is reinforced through application based assessment and evaluation. Some schools utilize OSCE style exams tied to the USMLE Content Outline along with the standard performance based evaluations in the clinical setting. These assessments are designed around and mapped to USMLE Content areas.
The 3-Phase mapping process allows these schools to adjust their curriculum and assessment instruments to better track and emphasize specific content areas such as communication skills, systems-based practice, patient safety, legal/ethical issues, and professionalism.