Retention of basic science information by senior medical students

Acad Med. 2008 Oct;83(10 Suppl):S82-5. doi: 10.1097/ACM.0b013e318183e2fc.


Background: Studies of retention of basic science information have commonly demonstrated a knowledge decline as students progress through medical education. This study examined item characteristics influencing patterns of retention.

Method: A large content and statistically representative sample of basic science items from 2004-2005 forms of United States Medical Licensing Examination (USMLE) Step 1 was included in unscored sections of 2004-2005 USMLE Step 2 Clinical Knowledge (CK) test forms, and the performance of 15,000+ first-time examinees from U.S. and Canadian schools was analyzed to identify item characteristics affecting retention.

Results: Across the 502 study items, the mean item difficulty on Step 1 was 76.1%; on Step 2 CK, this value declined to 69.7%. Performance declines were largest in Biochemistry (17.5%) and Microbiology (12.6%). Improvement was only observed for Behavioral Sciences items (8.7%).

Conclusions: Shifts in examinee performance in this study were similar to those observed in previous research, although the magnitude of the overall decline was somewhat larger.

MeSH terms

  • Biological Science Disciplines / education*
  • Canada
  • Cohort Studies
  • Education, Medical, Undergraduate*
  • Educational Measurement
  • Humans
  • Licensure, Medical
  • Retention, Psychology*
  • Retrospective Studies
  • Time Factors
  • United States