# Early Exposure to Step 1-Style Questions in the Preclinical Curriculum: A Student-Led Initiative to Support Clinical Reasoning and United States Medical Licensing Examination (USMLE) Preparation

## TL;DR

First-year medical students used a student-led initiative with weekly board-style questions to improve their preparation for the USMLE Step 1 exam.

## Contribution

A student-led initiative introduced early exposure to USMLE Step 1-style questions during preclinical training.

## Key findings

- 90.3% of students used the weekly question sets.
- 92.3% felt more prepared for board-style questions.
- 73.2% reported increased confidence in answering such questions.

## Abstract

Preclinical medical students often face challenges transitioning to United States Medical Licensing Examination (USMLE) Step 1-style board questions due to differences in content emphasis and question format compared to traditional coursework. Through a student-led initiative, weekly AMBOSS question sets with explanatory videos were created to align with the University of Arizona College of Medicine - Tucson’s (UACOM-T) curriculum, with the goal of familiarizing first-year students with board-style questions early in their training. To assess the perceived usefulness and impact of this resource, a survey was distributed to preclinical students, which gathered feedback on engagement, perceived benefits, and suggestions for improvement after six months of use. Survey responses were collected from 93 first-year medical students (77% of the class of 2028, referring to students who began in 2024 and are expected to graduate in 2028), with 90.3% (95% CI: 82.6%-94.8%) of respondents using at least some of the weekly question sets. About 92.3% (95% CI: 85.3%-96.3%) of respondents felt more prepared for board-style questions because of these sets. And 73.2% (95% CI: 63.3%-81.1%) of respondents also stated that the sets increased their confidence in answering board-style questions. About 82.8% (95% CI: 73.9%-89.1%) also felt it enhanced their understanding of the preclinical curriculum. These initial results indicate that most first-year students engaged with the question sets and gained confidence in applying their preclinical knowledge to Step 1-style questions.