title: The impact of timing changes on examinee pacing on the USMLE Step 2 exam.
abstract: OBJECTIVE
  To examine the impact of a timing change on pacing behavior and perceptions in a high-stakes multiple-choice examination.
  
  
  METHODS
  Two samples of standard-time examinees were analyzed: (1) 29,796 examinees that completed the examination prior to the timing change, and (2) 28,373 examinees that completed the examination after the change. Subgroups of examinees were identified and compared within and across samples with respect to perceptions, accuracy, and pacing.
  
  
  RESULTS
  After the timing change, more examinees reported having sufficient time to complete examination sections; a small improvement in overall accuracy was observed, and there was a shift in the time-per-item strategy, though examinees continued to use more than the average amount of time available per item at the beginning of sections.
  
  
  CONCLUSIONS
  Examinees are more satisfied with the new timing constraints, although an effect due to the time limit continues to impact performance at the end of test sections.
authors.affiliation: NBME, Philadelphia, PA 19104, USA. kswygert@nbme.org
authors.forename: Kimberly
authors.initials: K
authors.lastname: Swygert
authors.forename: Eric
authors.initials: E
authors.lastname: Muller
authors.forename: Brian E
authors.initials: BE
authors.lastname: Clauser
authors.forename: Gerard F
authors.initials: GF
authors.lastname: Dillon
authors.forename: David B
authors.initials: DB
authors.lastname: Swanson
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D002983:Clinical Competence; D015331:Cohort Studies; D004501:Education, Medical; D004521:Educational Measurement; D005550:Foreign Medical Graduates; D006801:Humans; D007393:International Educational Exchange; D008007:Licensure, Medical; D010549:Personal Satisfaction; D013997:Time Factors; D017748:Time Management; D014481:United States