Abstract: The prediction models for the United States Medical Licensure Examination (USMLE) Steps 1 and 2 performances were constructed by the Monte Carlo simulation modeling approach via linear regression. The purpose of this study was to build robust simulation models to accurately identify the most important predictors and yield the valid range estimations of the Steps 1 and 2 scores. The application of simulation modeling approach was deemed an effective way in predicting student performances on licensure examinations. Also, sensitivity analysis (a/k/a what-if analysis) in the simulation models was used to predict the magnitudes of Steps 1 and 2 affected by changes in the National Board of Medical Examiners (NBME) Basic Science Subject Board scores. In addition, the study results indicated that the Medical College Admission Test (MCAT) Verbal Reasoning score and Step 1 score were significant predictors of the Step 2 performance. Hence, institutions could screen qualified student applicants for interviews and document the effectiveness of basic science education program based on the simulation results.
Abstract: During the post-Civil War era, the city of Nashville,
Tennessee, had the highest mortality rate in the United States. The
elevated death and disease rates among former slaves were
attributable to lack of quality healthcare. To address the paucity of
healthcare services, Meharry Medical College, an institution with the
mission of educating minority professionals and serving the
underserved population, was established in 1876.
Purpose: The social ecological framework and partial least squares
(PLS) path modeling were used to quantify the impact of
socioeconomic status and adverse health outcome on primary care
professionals serving the disadvantaged community. Thus, the study
results could demonstrate the accomplishment of the College’s
mission of training primary care professionals to serve in underserved
areas.
Methods: Various statistical methods were used to analyze alumni
data from 1975 – 2013. K-means cluster analysis was utilized to
identify individual medical and dental graduates in the cluster groups
of the practice communities (Disadvantaged or Non-disadvantaged
Communities). Discriminant analysis was implemented to verify the
classification accuracy of cluster analysis. The independent t-test was
performed to detect the significant mean differences of respective
clustering and criterion variables. Chi-square test was used to test if
the proportions of primary care and non-primary care specialists are
consistent with those of medical and dental graduates practicing in
the designated community clusters. Finally, the PLS path model was
constructed to explore the construct validity of analytic model by
providing the magnitude effects of socioeconomic status and adverse
health outcome on primary care professionals serving the
disadvantaged community.
Results: Approximately 83% (3,192/3,864) of Meharry Medical
College’s medical and dental graduates from 1975 to 2013 were
practicing in disadvantaged communities. Independent t-test confirmed the content validity of the cluster analysis model. Also, the
PLS path modeling demonstrated that alumni served as primary care
professionals in communities with significantly lower socioeconomic
status and higher adverse health outcome (p < .001). The PLS path
modeling exhibited the meaningful interrelation between primary
care professionals practicing communities and surrounding
environments (socioeconomic statues and adverse health outcome),
which yielded model reliability, validity, and applicability.
Conclusion: This study applied social ecological theory and
analytic modeling approaches to assess the attainment of Meharry
Medical College’s mission of training primary care professionals to
serve in underserved areas, particularly in communities with low
socioeconomic status and high rates of adverse health outcomes. In
summary, the majority of medical and dental graduates from Meharry
Medical College provided primary care services to disadvantaged
communities with low socioeconomic status and high adverse health
outcome, which demonstrated that Meharry Medical College has
fulfilled its mission. The high reliability, validity, and applicability of
this model imply that it could be replicated for comparable
universities and colleges elsewhere.