An Effective Evidence-Based Student Run Near-Peer Support Group for the USMLE Step 1 Exam

Background: Despite the existence of data describing student factors and test-taking habits associated with success, preclinical medical students preparing for the USMLE Step 1 exam face the challenges of creating a study plan and selecting between study-aid resources while preparing for this high-stakes test. This is often an expensive and anxiety-provoking experience. Methods: A near-peer support group for second year medical students studying for the USMLE Step 1 exam at the Albert Einstein College of Medicine (Einstein) provided evidence-based recommendations with goals of facilitating study planning and raising scores. An annual survey evaluating study habits and group perception was collected to identify study habits associated with higher Step 1 scores, evaluate group effectiveness, and refine the evidence-based recommendations for optimal exam preparation. Results: Over a 3-year period, 302 students responded to the survey. After simultaneous adjustment for factors associated with Step 1 performance in bivariate analyses, preclinical medical school performance (P < 0.01), initiation of study 6 months prior to the test date (P < 0.01), and completion of >4000 practice questions (P = 0.05) remained independently associated with Step 1 scores. There was a significant increase in the average Step 1 score from 226.8 to 230.5 (P = 0.002) after the group began providing evidence-based advice to students. Over 90 % of respondents were aware of the group and 64 % followed the group’s advice. Sixty-seven percent would recommend the group to subsequent students and 79 % found the near-peer format useful. Conclusions: A student run near-peer support group was a popular and effective mechanism to assist students preparing for the USMLE Step 1 exam by accumulating and disseminating evidence-based study habit recommendations. Certain habits including a start date approximately 6 months in advance and completion of >4000 test-like practice questions may be beneficial in preparing for the Step 1 exam. The increase in average Step 1 score at Einstein may be in part due to this intervention or may represent part of a national trend.