Changes to the Step 2 Clinical Skills (CS) examination
Posted: December 15, 2011
One of the recommendations emerging from the Comprehensive Review of USMLE (CRU) process is that USMLE consider ways to further enhance the testing methods used in the Step 2 Clinical Skills (CS) examination. As previously announced in the 2012 Bulletin of Information, these enhancements are scheduled for implementation in mid-2012. These changes will be introduced in Step 2 CS for examinations delivered beginning June 17, 2012.
The reporting schedule for examinees testing from June 17, 2012 through November 3, 2012 will be 2-3 weeks longer than for examinees testing during other periods.
More information about the Step 2 CS score reporting dates for examinations delivered in 2012 is provided in the Step 2 CS Score Reporting Schedule.
Changes to the assessment of Communication and Interpersonal Skills (CIS)
The CIS subcomponent of Step 2 CS has been redesigned to assess a fuller range of competencies. Background information about these changes is provided on pages 5-6 of the Fall 2010/Winter 2011 NBME Examiner. The new approach divides communication skills into a series of functions. These functions have been further divided into sub-functions. Beginning June 17, 2012, the Communication and Interpersonal Skills (CIS) scale will focus on five functions:
1. Fostering the relationship
2. Gathering information
3. Providing information
4. Making decisions: basic
5. Supporting emotions: basic
Several additional functions are still under development; these include making decisions: advanced; supporting emotions: advanced; and helping patients with behavior change. A list of the functions and sub-functions is available.
Changes to the patient note
Also beginning June17, 2012, a new patient note will be introduced. The patient note is completed by the Step 2 CS examinee after the encounter with the standardized patient. In the new note, examinees will continue to be asked to document relevant history and physical examination findings and to list initial diagnostic studies to be ordered. Examinees will also be asked to create a reasoned, focused differential (maximum of three diagnoses) listed in order of likelihood and to indicate the evidence obtained from the history and physical examination that supports each potential diagnosis. The new patient note provides examinees with an opportunity to document their analysis of a patient's possible diagnoses. A sample of the new patient note is available for review.
Updated practice materials for Step 2 CS will be posted to the USMLE website in March 2012. These include the Step 2 CS Content Description and General Information Booklet, onsite orientation video, sample patient notes, and a simulation of the program for typing patient notes.
Transition of test content to DSM-5 criteria and terminology
Posted: November 04, 2013
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was released at the American Psychiatric Association’s Annual Meeting in May 2013. USMLE test content will be impacted by changes in criteria and terminology.
Because USMLE content pools are large, the transition from DSM-IV to DSM-5 criteria and terminology will need to be gradual and will likely take place over several years. The following principles will guide this transition:
- The highest priority has been given to test content assessing diagnoses that do not appear in DSM-5. This content has already been removed from USMLE examinations.
- USMLE will begin to transition content to include both DSM-IV and DSM-5 terminology. This process will begin in 2014. Start and end dates for this transition will vary by exam.