Differences in Language Used to Describe Racial Groups in Emergency Medicine Standardized Letter of Evaluation

Background:The NBME Advanced Clinical Examination (ACE) in EM is a critical component of assessment in EM education.Scores on this exam are compared with a nationally representative cohort and the material is traditionally more challenging than on other NBME "shelf" clinical exams.Previous literature has shown that both resident-led and structured curricula have improved shelf exam scores in other fields; however, there is scant literature describing interventions to improve EM-ACE scores.This project investigates the impact of a near-peer-run monthly review session on NBME EM-ACE performance.Objective: To assess whether a study group intervention improves ACE scores amongst medical students on an EM rotation.Methods: A pre-and post-intervention study was conducted with 20 cohorts of EM clerkship students from August 2022 to August 2024.The intervention consisted of a single near-peer-led study group session during a 4-week clerkship.Material taught in this session was targeted towards content that was covered less during standard clerkship curriculum.Exam averages, highest, and lowest scores were collected from 10 cohorts before and 10 after the intervention.Results: In the pre-intervention group (n=134), the mean ACE score was 77 (SD 7, IQR 8.25).In the post-intervention group (n=117), the mean ACE score was 80 (SD 7, IQR 10).There was a statistically significant increase in postintervention scores (p = 0.014).This difference exceeds the difference expected based on analysis from administration comparing graded component scores from pandemic-induced disruption and conversion to pass-fail grading.Discussion: The current EM-ACE exam is targeted at final-year medical students and is commensurately challenging.Pre-intervention, our team had noted a trend toward lower scores in students taking the clerkship earlier in their training along with temporal trends associated with pandemic-related disruptions and changing grade schemas.The intervention significantly improved scores in all learners, indicating its potential as an effective educational strategy.More research is needed to assess long-term benefits and broader applicability.