title: Assessing the validity of the USMLE step 2 clinical knowledge examination through an evaluation of its clinical relevance.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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
  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.
  
  
  CONCLUSIONS
  Results suggest that the majority of item content is clinically relevant and appropriate, thus providing validation support for Step 2 CK.
authors.affiliation: NBME, Philadelphia, PA 19104, USA. mcuddy@nbme.org
authors.forename: Monica M
authors.initials: MM
authors.lastname: Cuddy
authors.forename: Gerard F
authors.initials: GF
authors.lastname: Dillon
authors.forename: Brian E
authors.initials: BE
authors.lastname: Clauser
authors.forename: Kathleen Z
authors.initials: KZ
authors.lastname: Holtzman
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Margolis
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: McEllhenney
authors.forename: David B
authors.initials: DB
authors.lastname: Swanson
mesh_terms: D002983:Clinical Competence / Q000592:standards; D004501:Education, Medical / Q000592:standards; D004521:Educational Measurement / Q000379:methods / Q000592:standards*; D005104:Expert Testimony; D005260:Female; D006801:Humans; D007600:Judgment; D008007:Licensure, Medical; D008297:Male; D015203:Reproducibility of Results; D014481:United States