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Item Optimism and Step 1(2020-03-06) Schleinkofer, Nathan; Kochhar, Komal; Walvoord, Emily C.Optimism is a personality trait that correlates with improved coping skills, physical health, and emotional wellbeing. Various interventions have been shown to increase optimistic thinking. To date, there have been few investigations into the effect of optimism on academic performance. For medical students, the USMLE Step 1 exam is a significant stressor that has a large impact on future career options. Beginning on February 27th 2019, one week after completing their foundational sciences curriculum, 2nd year medical students (n=112) at the Indiana University School of Medicine completed the Life Orientation Test-Revised (LOT-R), which assesses dispositional optimism. The LOT-R includes six questions scored on a 5-point Likert Scale from “I disagree a lot” to “I agree a lot”. Higher scores indicate a higher level of optimism. Students were instructed to complete the LOT-R before sitting for the Step 1 exam between February 23rd and April 6th. The correlation between Optimism scores and Step 1 exam scores were examined. The study received approval from Indiana University’s Institutional Review Board. The Optimism scores ranged from 6 to 30, mean = 22. The mean for adults ages 18-30 is 22.1. Step 1 exam scores ranged from 189 to 268, mean = 236.4. There was a small positive correlation (Pearson 0.257) between Optimism scores and Step 1 exam scores (p=0.006). There were no gender differences in Optimism or Step 1 exam scores. These results indicate that optimism may be a potentially significant factor associated with medical student performance, specifically on the USMLE Step 1 exam. Further research should investigate if a causal relationship exists between the two factors. If such a relationship is found, interventions specifically targeted to increase optimism may prove useful for improving student academic performance and possibly their overall wellbeing.