title: Assessing the underlying structure of the United States Medical Licensing Examination Step 2 test of clinical skills using confirmatory factor analysis.
abstract: BACKGROUND
  The purpose of the present study was to assess the fit of three factor analytic (FA) models with a representative set of United States Medical Licensing Examination (USMLE) Step 2 Clinical Skills (CS) cases and examinees based on substantive considerations.
  
  
  METHODS
  Checklist, patient note, communication and interpersonal skills, as well as spoken English proficiency data were collected from 387 examinees on a set of four USMLE Step 2 CS cases. The fit of skills-based, case-based, and hybrid models was assessed.
  
  
  RESULTS
  Findings show that a skills-based model best accounted for performance on the set of four CS cases.
  
  
  CONCLUSIONS
  Results of this study provide evidence to support the structural aspect of validity. The proficiency set used by examinees when performing on the Step 2 CS cases is consistent with the scoring rubric employed and the blueprint used in form assembly. These findings will be discussed in light of past research in this area.
authors.affiliation: National Board of Medical Examiners, 3750 Market Street, Philadelphia, Pennsylvania 19104, USA. adechamplain@nbme.org
authors.forename: André
authors.initials: A
authors.lastname: De Champlain
authors.forename: Kimberly
authors.initials: K
authors.lastname: Swygert
authors.forename: David B
authors.initials: DB
authors.lastname: Swanson
authors.forename: John R
authors.initials: JR
authors.lastname: Boulet
mesh_terms: D002983:Clinical Competence; D003142:Communication; D005163:Factor Analysis, Statistical; D006801:Humans; D007398:Interpersonal Relations; D008007:Licensure, Medical; D014481:United States