Investigation of answer changes on the USMLE® Step 2 Clinical Knowledge examination

BMC Medical Education

Table 3 Response change patterns and outcomes by score change for block 4

	Score Gain (n = 8461)		Score Loss (n = 5263)		No Score Change (n = 5212)
	Mean number of items	%	Mean number of items	%	Mean number of items	%
Items with revisits	18.6	42.3%	17.8	40.4%	13.8	31.3%
Items with revisits and no response change	16.4	88.2%^a	15.8	88.8%^a	13.1	94.8%^a
Items with revisits and response change	2.2	11.8%^a	2.0	11.2%^a	0.7	5.1%^a
W-R	1.55		0.14
R-W	0.16		1.36
R-R	0.04		0.04
W-W	0.45		0.44
W-R/R-W ratio	9.69		0.10
Mean score change	0.032		−0.028

W-R wrong to right response changes, R-W right to wrong response changes, W-W wrong to wrong response changes, R-R right to right response changes
^aPercentage is calculated based on items with revisits

ISSN: 1472-6920