1C.R. Runyon is senior measurement scientist, Growth and Innovation, National Board of Medical Examiners, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0003-1207-7390.

2M.A. Paniagua was a medical adviser, Test Development, National Board of Medical Examiners, Philadelphia, Pennsylvania, at the time of writing and is now vice president, Medical Education, American College of Physicians, and adjunct professor of medicine, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania.

3F.A. Rosenthal is senior editor, Test Development, National Board of Medical Examiners, Philadelphia, Pennsylvania.

4A.L. Veneziano is senior test development analyst, Test Development, National Board of Medical Examiners, Philadelphia, Pennsylvania.

5L. McNaughton is senior test development analyst, Test Development, National Board of Medical Examiners, Philadelphia, Pennsylvania.

6C.T. Murray was director, Test Materials Development, Computer-Based Case Simulations, National Board of Medical Examiners, Philadelphia, Pennsylvania, at the time of this writing and is now retired.

7P. Harik is director of research capabilities, Growth and Innovation, National Board of Medical Examiners, Philadelphia, Pennsylvania.

Correspondence should be addressed to Christopher Runyon, National Board of Medical Examiners, 3750 Market St., Philadelphia, PA 19104; telephone: (215) 495-1469; email: [email protected].

Supplemental digital content for this article is available at https://links.lww.com/ACADMED/B577.

Acknowledgments: The authors would like to thank the anonymous reviewers and editors who provided helpful feedback on an early version of the manuscript.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: The pilot study was approved as exempt by the American Institute of Research IRB, September 21, 2021, #EX00566.

Previous presentations: Portions of this research were presented at the Southern Group on Educational Affairs; March 28, 2022; virtual; Central Group on Educational Affairs; March 30, 2022; virtual; Western Group on Educational Affairs; April 2, 2022; Portland, Oregon; and Northeastern Group on Educational Affairs; May 11, 2022; virtual.

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