title: Contrast effects in the USMLE Step 2 Clinical Skills examination.
abstract: BACKGROUND
  As with any examination using human raters, it is possible that human subjectivity may introduce measurement error. An examinee's performance might be scored differently on the basis of the quality of the preceding performance(s) (contrast effects). This research investigated the presence of contrast effects, within and across test sessions, for the communication and interpersonal skills component of the United States Medical Licensing Examination Step 2 Clinical Skills (CS) examination.
  
  
  METHODS
  Data from Step 2 CS examinees were analyzed using hierarchical and general linear modeling procedures.
  
  
  RESULTS
  Contrast effect was significant for the communication and interpersonal skills score, both within and across test sessions. The effect was found to have a nontrivial impact on the overall score.
  
  
  CONCLUSIONS
  The presence of contrast effects suggests that scores for an examinee are influenced by the performance of other examinees. More research is needed to fully understand these effects.
authors.forename: Chaitanya
authors.initials: C
authors.lastname: Ramineni
authors.forename: Brian E
authors.initials: BE
authors.lastname: Clauser
authors.forename: Polina
authors.initials: P
authors.lastname: Harik
authors.forename: David B
authors.initials: DB
authors.lastname: Swanson
mesh_terms: D002983:Clinical Competence; D015331:Cohort Studies; D003142:Communication; D005260:Female; D006801:Humans; D008007:Licensure, Medical; D016014:Linear Models; D008297:Male; D015588:Observer Variation; D010808:Physical Examination; D010817:Physician-Patient Relations; D012189:Retrospective Studies; D014481:United States