Comprehensive Reform and Greater Equity in Applying to Residency—Trainees' Mixed Responses to a Pass/Fail USMLE Step 1

ABSTRACT Background Pass/fail USMLE Step 1 score reporting may have varying implications for trainees of different demographic and training backgrounds. Objective To characterize the perspectives of a diverse cohort of trainees on the impact of pass/fail Step 1 score reporting. Methods In 2020, 197 US and international medical school deans and 822 designated institutional officials were invited to distribute anonymous electronic surveys among their trainees. Separate surveys for medical students and residents/fellows were developed based on the authors' prior work surveying program directors on this topic. Underrepresented in medicine (UiM) was defined in accordance with AAMC definitions. Descriptive and comparative analyses were performed, and results were considered statistically significant with P < .05. Results A total of 11 633 trainees responded (4379 medical students and 7254 residents/fellows; 3.3% of an estimated 285 000 US trainees). More students favored the score reporting change than residents/fellows (43% vs 31%; P < .001; 95% CI 0–24). Trainees identifying as UiM were more likely to favor the change (50% vs 34%; P < .001; 95% CI 0–32) and to agree it would decrease socioeconomic disparities (44% vs 25%; P < .001; 95% CI 0–38) relative to non-UiM trainees. Nearly twice as many osteopathic and international medical graduate students felt they would be disadvantaged compared to MD students because of pass/fail score reporting (61% vs 31%; P < .001; 95% CI 0–60). Conclusions Trainee perspectives regarding USMLE Step 1 score reporting are mixed. UiM trainees were more likely to favor the score reporting change, while osteopathic and international medical students were less in favor of the change.

PD-L1 expression as a predictive biomarker for immune checkpoint inhibitors: between a dream and a nightmare

PD-L1 is an important predictive biomarker for treatment by immune checkpoint inhibitors (ICIs). ICIs are now indicated for the treatment of various cancer depending on the level of expression of PD-L1 on tumor cells. PD-L1 testing is done using immunohistochemistry with five different assays approved as companion diagnostic for ICIs. However, these assays have different score reporting methods and do not accurately measure PD-L1 expression. Exosomal PD-L1 testing has recently emerged as an alternative for cell-surface PD-L1 testing however studies are still premature and more extensive knowledge about this new potential biomarker is needed.

State Assessment Score Reporting Practices for English Learner Parents

This study sought to investigate how states communicate results for academic achievement and English language proficiency (ELP) assessments to parents who are English learners (EL). This objective was addressed by evaluating: (a) whether score reports and interpretive guides for state academic achievement and ELP assessments in each state were translated for EL parents; and (b) if so, whether recommended score reporting guidelines were followed in practice. Results demonstrated that for state achievement tests, 29 states had translated score reports and 28 had translated interpretive guides. Nearly every state translated these materials for their ELP assessments in a wide variety of languages. Across ELP and state achievement assessments, most states were found to limit statistical jargon, utilize figures/graphics to communicate test results, and include follow-up information for parents. However, states rarely provided personalization, statements on intended score use, a student’s score history, or a direct link to their interpretive guide in their score reports. Improvements in a number of areas were observed from prior reviews. Recommendations on making score reports and interpretive guides more accessible and interpretable for EL parents are discussed.