Assessing the Validity of the USMLE Step 2 Clinical Knowledge Examination through an Evaluation of its Clinical Relevance

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To assess the validity of the USMLE Step 2 Clinical Knowledge (CK) examination by addressing the degree to which experts view item content as clinically relevant and appropriate for Step 2 CK.


Twenty-seven experts were asked to complete three survey questions related to the clinical relevance and appropriateness of 150 Step 2 CK multiple-choice questions. Percentages, reliability estimates, and correlation coefficients were calculated and ordinary least squares regression was used.


Results showed that 92% of expert judgments indicated the item content was clinically relevant, 90% indicated the content was appropriate for Step 2 CK, and 85% indicated the content was used in clinical practice. The regression indicated that more difficult items and more frequently used items are considered more appropriate for Step 2 CK.


Results suggest that the majority of item content is clinically relevant and appropriate, thus providing validation support for Step 2 CK.

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