Impact of the USMLE Step 1 and COMLEX Level 1 transition to Pass/Fail on osteopathic medical student stress levels and board preparation.

CONTEXT: The United States Medical Licensing Examination (USMLE) Step 1 and Comprehensive Osteopathic Medical Licensing Exam (COMLEX) Level 1 transitioned from a numeric scoring system to a Pass/Fail designation in 2022. This transition intended to decrease stress, improve medical student well-being, and encourage residency program directors to emphasize other aspects of residency applications. Pass/Fail score transitions in the undergraduate medical education curriculum have improved medical student psychological well-being and satisfaction; whether these same benefits translate to the board examination period is unknown. OBJECTIVES: The objectives of this study are to assess the impact of USMLE Step 1 and COMLEX Level 1 grade scale transition on medical student stress, wellness, board preparation decisions, and future residency selection processes. Investigators hypothesized that students under the Pass/Fail designation would experience less stress during the intensive study period leading up to USMLE Step 1 and COMLEX Level 1 and devote more time to other aspects of their residency applications. METHODS: To examine the impact on osteopathic medical student (OMS) stress and approach to board preparation, two surveys were administered to Rocky Vista University College of Osteopathic Medicine (RVU-COM) students before (Class of 2023) and after (Class of 2024) the transition to a Pass/Fail designation. All students within the RVU-COM Classes of 2023 and 2024 were invited to participate. The Cohen Perceived Stress Scale (PSS-10) was administered at the beginning of the focused board study period in May 2021 and 2022 to the Class of 2023 and 2024, respectively. The investigator-designed Licensing Exam Questionnaire (LEQ), meant to capture board preparation patterns, residency application perspectives, and wellness during examination preparation, was administered immediately after the board examination deadline in July 2021 and 2022 to the Class of 2023 and 2024, respectively. Statistical analysis included the use of independent t tests (numeric variables) and chi-square tests (categorical data). This project was considered exempt from full Institutional Review Board review. RESULTS: Approximately one-third of the Class of 2023 (PSS-10: n=86; LEQ: n=93) and 2024 (PSS-10=89; LEQ: n=92) responded. No difference was detected in mean PSS-10 score, 20.14 (SD=7.3) compared to 19.92 (SD=6.56) for the Class of 2023 and 2024 (p=0.84), respectively. The Class of 2023 reported more weeks studying (mean 6.27 weeks, SD=0.79) vs. the Class of 2024 (mean 5.44 weeks, SD=0.007), p<0.001, more practice examinations taken X 2 (1, n=182)=13.75, p<0.001, and a greater proportion scheduled examinations after June 20 X 2 (1, n=182)=29.01, p<0.001. No difference existed in hours studying per day, sequence of Step 1/Level 1, time between examinations, money spent, or type of study resources utilized. CONCLUSIONS: The transition of USMLE Step 1 and COMLEX Level 1 to a Pass/Fail designation did not reduce stress for OMSs at a single, multicampus COM. Respondents, however, altered board preparation practices in meaningful ways. As student behaviors and board-study patterns emerge, these insights must be connected to outcomes in the future.

Correction to: IAMSE Meeting Report: Student Plenary at the 24th Annual Conference of the International Association of Medical Science Educators.

[This corrects the article DOI: 10.1007/s40670-020-01087-9.].

A Multi-Institutional Study Demonstrating Undergraduate Medical Student Engagement with Question-Type Facebook Posts.

Facebook is the social media platform used most by both medical educators and students, but there is scant literature investigating effective ways to use the platform across multiple institutions. This multi-institutional study compared student engagement between an official curricular Facebook page and a supplemental Facebook page. While a greater proportion of students were reached by the official course page, greater post engagement was achieved with the supplemental page. We attribute this to the abundance of question-type posts on the supplemental page and show that question-type posts achieve higher engagement with students than statement-type posts, regardless of page type.

Early-Phase Satellite Cell and Myonuclear Domain Adaptations to Slow-Speed vs. Traditional Resistance Training Programs.

The purpose of this investigation was to identify adaptations in satellite cell (SC) content and myonuclear domain (MND) after 6-week slow-speed vs. "normal-speed" resistance training programs. Thirty-four untrained females were divided into slow speed (SS), traditional strength (TS), traditional muscular endurance (TE), and nontraining control (C) groups. Three sets each of leg press, squat, and knee extension were performed 2 days per week for the first week and 3 days per week for the following 5 weeks. The SS group performed 6-10 repetition maximum (6-10RM) for each set with 10-second concentric (con) and 4-second eccentric (ecc) contractions for each repetition. Traditional strength and TE performed 6-10RM and 20-30RM, respectively, at "normal" speed (1-2 seconds per con and ecc contractions). Traditional muscular endurance and SS trained at the same intensity (40-60% 1RM), whereas TS trained at 80-85% 1RM. Pretraining and posttraining muscle biopsies were analyzed for fiber cross-sectional area, fiber type, SC content, myonuclear number, and MND. Satellite cell content of type I, IIA, IIAX, and IIX fibers significantly increased in TS. However, SC content of only type IIAX and IIX fibers increased in SS, and there was no change in TE or C. Myonuclear number did not change in any group. Myonuclear domain of type I, IIA, IIAX, and IIX fibers increased in TS, whereas MND of only type IIA fibers increased in SS, and there was no change in TE or C. In conclusion, slow-speed resistance training increased SC content and MND more than training with a similar resistance at normal speed. However, high-intensity normal-speed training produced the greatest degree of fiber adaptation for each variable.