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The value of a commercial test-preparation course on COMLEX Level 1 Performance Donald J. Sefcik, DO, MBA, Associate Dean, Midwestern University/CCOM C. Pat Obi, PhD, Professor of Finance and Statistics, Purdue University. Overview. Results. Conclusions.

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The value of a commercial test-preparation course on COMLEX Level 1 PerformanceDonald J. Sefcik, DO, MBA, Associate Dean, Midwestern University/CCOMC. Pat Obi, PhD, Professor of Finance and Statistics, Purdue University




  • Tests of significance revealed that there is no difference in the variability of COMLEX scores between students who participated in a commercial test-preparation course and those that did not. Further, a two-sample means test showed no statistical evidence that the average COMLEX Level 1 scores for participants in the review course were different from those of students that did not participate in the course.
  • Several of the students in MWU/CCOM’s Class of 2006:
    • paid approximately $550 each and
    • spent approximately 160 hours in weekend lectures
  • to participate in a commercial test-preparation review course that appeared not to have positively impacted their COMLEX Level 1 scores.
  • The findings of this study suggest that there is no statistical evidence that participation in a commercial test-preparation review course for the COMLEX Level 1 examination provides a positive return on investment with regard to students’ time and money.

To best position themselves for success, many osteopathic medical students expend significant resources, including time, money and emotions, preparing for their national licensing board examinations. A primary motivator is their concern that a high examination score will make them more desirable candidates for competitive residencies. This study was designed to determine whether the expenditure of these resources has a positive impact on COMLEX Level 1 examination scores.


The purpose of this study was to determine the relative value of participation in a commercial test-preparation course. This study was designed to determine if there was a statistically significant improvement in the average COMLEX Level 1 examination scores of osteopathic medical students that participated in a commercial COMLEX review course offered during the winter and spring of 2004.


The subjects of this study were the members of MWU/CCOM’s Class of 2006. Courses at MWU/CCOM use a numerical scale to rate student achievement; a score of 70 or greater is passing. The final grade for every course taken during the MS1 & MS2 years, as well as participation in the review course were analyzed. In preparation for their COMLEX Level 1 examination, 73 members of CCOM’s Class of 2006 participated in a well-marketed traditional board review course while 68 of their classmates prepared without the course.

To determine whether differences exist in the score characteristics of students who participated in the course versus those that did not, a 3-part statistical analysis was carried out. The initial analysis was designed to show whether the preparatory course created a more homogeneous aptitude level. To this end, an F-test of significance was used to test for difference in the variability of scores. Second, a 2-sample inference for mean scores was employed to determine whether average test scores differ between the groups. Finally, a test of correlation and regression analysis was conducted to determine whether a joint relationship exists between the COMLEX scores, review course participation and individual course performance.


Regression results (n = 141) reveled that a statistically significant relationship (p = 0.0000; R2 = 0.61; F-stat = 20.43) exists between the scores of students that participated in the review course and the specified explanatory variables jointly. Unfortunately, no individual assessment could be made regarding the individual impact of the variables due to an apparent collinearity. However, a test of correlation did reveal that the relationship between student participation in the review course and COMLEX performance was negative.

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