USMLE Step III Exam (Day 2) Computer-Based Simulations - Scoring

USMLE Step III Exam (Day 2) Computer-Based Simulations - Scoring: The computer-based case simulations found on the USMLE Step III Exam are factored into the final two-digit and three-digit scaled scores that an individual will receive for the USMLE Step III Exam. The case simulations themselves are actually scored based on a point system calculated by the CCS program where points are awarded depending on how appropriate each method was to actually caring for the patient in an effective, efficient, and safe manner. The exact number of points awarded for each test, procedure, examination, or other method used to assess or care for the patient varies depending on the exact simulated patient. This variation in the number of points awarded is because each simulation is assigned a series of hidden objectives based on the simulated patient's needs that the individual's methods must complete in order to receive a high score for the simulation. The individual taking the exam will receive points for each action that he or she takes that aids in the patient's care, each action that aids in diagnosing the patient's condition, if the actions carried out by the exam-taker were at the right time, and if the actions carried out by the exam-taker were in the right order based on the condition of the patient. The individual taking the exam will not receive points or may even lose points for actions that are inappropriate, for actions that may actually be dangerous or even deadly for the patient, for actions carried out at inappropriate times or after the patient's condition has begun to deteriorate too far, and for actions that are not carried out in a logical order.

The exam-taker will also usually not receive points for actions that could be considered appropriate, but do not relate specifically to the care of the particular patient presented. For example, if the simulated patient appears to have some form of pneumonia and no apparent need for a specific diet, and the exam-taker writes dietary orders, these orders will most likely not be considered in the score for the simulation. This is because, even though writing specific dietary orders may actually be appropriate, it has no direct relation to the patient's condition or the patient's care. However, if the dietary orders had been appropriate and directly related to the patient's care, for example if the patient's potassium levels were too high as a result of the patient's condition and therefore the patient required a special low-potassium diet, the exam-taker would receive points for the action. It is also important to note that the exam-taker may also lose points for ordering tests and procedures that may help in diagnosing or treating the patient, but the cost of the procedures or the procedures themselves may be considered excessive when compared to what would normally be used under the circumstances set by the simulation.