Reflections on a Learning Tool: MKSAP

Medical Knowledge Self Assessment Program (MKSAP) is a self-direct case-based learning program put forth by the American College of Physicians. MKSAP provides a review of internal medicine and its subspecialties. Regularly updated, it is currently in its 15^th iteration. The format of MKSAP consists of a basic syllabus on each of its 11 topics, ranging from internal medicine foundations to infectious disease to critical care, followed by multiple choice self-assessment questions and detailed well-referenced responses (Winter 2007).

For medical students, some of the benefits of supplementing our learning with MKSAP cases potentially includes rapid exposure to a variety of clinical scenarios, being guided through clinical reasoning, receiving immediate assessment and feedback on our decisions, and being connected with reputable references. I especially appreciate how questions are associated with an individual educational objectives so that we can see the relevance of each, otherwise disjointed, question and put them into context. I also like how the question discussions promote stepping back from the facts of the case so to cast a broader differential. For example, a stem like a “20-year-old man from Cambodia presenting with mild fever and neurological signs” in the Infectious Disease section may make us rightly suspicious of an infectious cause, but we should not forget about other important differentials like structural brain lesions and coagulation disorders.

There are certainly limitations to this format of learning. For one, these brief cases cannot fully mimic real clinical scenarios; rather, all the pertinent information is a little too nicely summarized. There is also, in these types of self-study cases, no opportunity for asking questions and clarification of responses. Finally, there is an odd lack of connection back to the syllabus for many of the questions, which may otherwise be useful.

Overall, MKSAP, with its myriad of cases, seems to be a good supplemental tool for learning. I hope to make more use of it in my studies in the future.

Winter DFJ. Review of MKSAP 14—Medical Knowledge Self-Assessment Program. Proceedings (Baylor University Medical Center) 2007;20(3):319-320.

-Jenny