How is the Step 2 CS exam scored?
Examinees are scored in three separate subcomponents: Integrated Clinical Encounter (ICE), Communication and Interpersonal Skills (CIS), and Spoken English Proficiency (SEP). Each of the three subcomponents must be passed in a single administration in order to achieve a passing performance on Step 2 CS.
How could I have performed poorly in Data Gathering, but yet performed well in the Patient Notes section? Wouldn’t I have had to gather sufficient data to write good patient notes?
The Data Gathering and Patient Note components measure separate sets of skills and are scored independently. It is certainly possible for an examinee to do well in one area and not do as well in the other (and vice versa).
It is possible that you have managed to make well-written patients notes but you were not able to execute the proper data gathering procedure. Deficiencies in either area can cause an examinee to fail.
I did not pass the CIS subcomponent. How do you ensure that the standardized patient provided you with accurate feedback upon which to base my score?
The standardized patient (SP) training process is extensive. The scoring of CIS is monitored through our Quality Assurance program to ensure that SPs maintain a high level of quality. The rating scales used in scoring CIS are intended to capture the opinions of multiple SPs on an examinee’s ability to effectively gather and share information, and to establish a professional rapport with the SP.
What can you tell me about the individuals who rate my patient notes?
Your patient notes are scored by trained physician raters. These individuals are licensed physicians, and have experience in medical education. The physician note raters undergo rigorous training to apply a standard scoring instrument, and their ratings are monitored as part of the Step 2 CS quality assurance program.
Can you tell me a little more about interpreting the performance profile on my score report?
Performance profiles are intended to give examinees a very general sense of relative strengths and weaknesses in the major subcomponents of Step 2 CS; they should not be over-interpreted.
“Borderline performance” is an approximate representation of where the scores of high failers and low passers would fall in the profile.
The width of the bands is based upon the idea of measurement precision, and is intended to reflect the approximate variation in scores, both higher and lower, that would be expected to occur if an examinee were tested repeatedly using comparable sets of clinical skills cases.
If a subcomponent is failed, but the band of X’s extends into or beyond the “borderline performance” area, this does not reflect a mistake in scoring but does indicate that it represents a relatively high failing performance.
What does the CS score recheck process consist of? Are videos used in the rescoring process?
The Step 2 CS recheck process involves retrieval of the ratings that the examinee received from the SPs and from the physician note raters. These values are re-summed and re-converted into final scores, in order to confirm that the reported pass/fail outcome was accurate. There is no re-rating of the original encounter or of the patient note.
Videos are not used in the score recheck process. Video records of encounters are not precise enough to rescore examinees. Videos are primarily used for general quality control purposes.
The possibility of a score change is extremely remote, due to the many verification and quality assurance procedures built into the scoring process.