Data show performance on the NBME-CAS microbiology exam items (n = 60) by students who were taught with the microbiology modules developed by the RWJF collaborative (2015–2016) compared with past Step 1 test takers (i.e., Step 1 reference group). Higher item difficulty values correspond with a greater number of students answering the items correctly. The item difficulty value shown for the Step 1 reference group (black bar) is based on performance of first-time takers from LCME-accredited schools. Abbreviations: NBME-CAS indicates National Board of Medical Examiners–Customized Assessment Services; RWJF, Robert Wood Johnson Foundation; Step 1, United States Medical Licensing Examination Step 1; LCME, Liaison Committee on Medical Education; Duke, Duke University School of Medicine; Stanford, Stanford University School of Medicine; UCSF, University of California, San Francisco, School of Medicine; UW, University of Washington School of Medicine.