Study Shows that Using the Aquifer Family Medicine Exam as a Pretest Improves NBME Performance

Aquifer is pleased to share the findings of a recent study relating to the Aquifer Family Medicine Exam (formerly the fmCASES National Examination). The study, “fmCASES National Examination as a Pretest in a Family Medicine Clerkship”, published in the February 2018 edition of Family Medicine, was conducted by Dana R. Nguyen, MD, of Uniformed Services University, and co-authored by Jessica T. Survey, MD and LaTraia S. Scoot, MD. Results showed that students who completed the Aquifer Family Medicine Exam as a pretest at the start of the family medicine clerkship failed the NBME final exam at significantly lower rates (8.1% compared to 17.5%) than students who did not take the pretest. The study also concludes that the Aquifer Family Medicine Exam is a valuable formative assessment tool. Pretest results provided students with clear feedback on content areas most in need of study and help to form individualized study plans.

“This study adds to our knowledge about the usefulness of the Aquifer Family Medicine Exam (formerly known as the fmCASES National Exam) and should inform clerkship and curriculum directors about the exam’s utility for improving learning,” said Alexander Chessman, Aquifer Academic Director of Curriculum. “A standard criticism of using pretest scores is that ANY exam could be effective for placing a student into a risk group; the old dictum is that a bad test-taker is a bad test-taker. But this study, after adjusting for MCAT score, and undergraduate GPA, still proved that using this exam as a pretest was informative. Thank you to the study team for this great and helpful work that adds to our understanding.”

Although the Aquifer Family Medicine Exam is designed as a summative end-of-clerkship evaluation to replace or enhance another cumulative exam, its uses extend beyond. The exam, included with an Aquifer Family Medicine subscription at no additional cost, is also being utilized for remediation, or, as this study suggests, as a pretest for the NBME.

Learn more about the Aquifer Family Medicine Exam.

View the full abstract and article.


Aquifer (formerly known as MedU) is a mission-driven 501 (c)(3) non-profit organization dedicated to delivering the best healthcare education through collaborative development and research into innovative, high-impact virtual teaching and learning methods. Aquifer develops trusted, award-winning, virtual case-based courses derived from national healthcare curricula. Since Aquifer’s founding in 2006, over 10,000,000 virtual cases have been completed by more than 300,000 students. Aquifer’s cases are created and maintained by more than 400 educators from 10 leading national organizations representing more than 120 academic institutions.