Taking the United States Medical Licensing Examination (USMLE) Step 1 exam is the marquee event of the second year of medical school, and with that comes a weighty reputation.
“For a lot of students it’s very anxiety provoking,” said Kaitlyn O'Connor, a second-year medical student at East Carolina University’s Brody School of Medicine (ECU), a member school of the AMA Accelerating Change in Medical Education Consortium. “You don’t really know what to expect. All you hear from other students is how terrible [the exam prep] is and how terrible the test is.”
A group study program at ECU, in which students are both the learners and the teachers, is helping to take the isolation out of the USMLE preparation process. Thus far, it’s yielding encouraging results.
Run with limited faculty involvement, ECU’s Aim Higher program is part game show, part workshop. Taught by second-year medical students who volunteer as facilitators, the program presents participants with multiple-choice, USMLE-style questions which they answer using clickers. After each question a larger group—typically between 20 and 30 students—discuss why an answer was right or wrong.
Aim Higher meets about every six weeks throughout the academic year, offering students exposure to USMLE prep well in advance of the designated study period. O'Connor is the program’s lead facilitator for the 2017–18 academic year.
“Studying for the USMLE is so different for each student,” she said. “It’s a very independent process. The way that I study is very different from how somebody else might study. Aim Higher helps with bringing together some of those differences, because when we are going through the practice questions as a group, I can explain to somebody how I went about answering a question and the keywords that I saw and the different answer choices I saw and they can tell me how they viewed the question differently.”
As far as results, the sample size for the Aim Higher program is limited. But thus far, it is yielding some positive data. In studying USMLE results of students in ECU’s classes of 2017 and 2018, those who attended more than 75 percent of Aim Higher sessions scored, on average, seven points higher than those who did not enroll in the program while students who attended 50 to 75 percent of sessions scored three points higher.
Aim Higher offers students a structure that isn’t always present in a group study situation, and when there is an absence of a formal structure, there is room for group study to be less productive.
Lisa Rebecca Medoff, PhD—a learning specialist at the Stanford University School of Medicine—advises that students who want to collaboratively study with others should consider studying with people who aren’t necessarily friends but who bring a new perspective a group study session.
No matter who you are studying with, Medoff believes, setting ground rules is of paramount importance to succeeding with group study.
“Are you a person who needs to study with other people?” she said. “If so, I encourage [students] to find a study partner or a small study group but to also set the rules based on their needs or preferences.”
“You need to set the rules of the study group. Do we come together and we each prepare something to teach each other or do we each come with questions and problems that we are working through?”
The success an individual will have in study group is going to vary on a case-by-case basis. In most instances, there is going to be a need for study time outside of a group setting for a medical student to get the most out of their studying.
“Everyone once in a while, a friend and I will get together before a test and go over all the material from a particular class,” O'Connor said. “So I like to learn things independently and use group study to solidify my knowledge. Whether that’s in the format of me teaching someone, or having someone quiz me. I use it more to [reinforce] knowledge than as an initial learning process.”