A group of researchers looked at how giving less time for cases in a simulated medical-exam setting affects how well physician-candidates do. They took real case-simulation data from the portion of the USMLE Step 3 called Computer‑Based Case Simulations (CCS), and then artificially re-scored those cases as if examinees had less time by cutting off the “clock” at different earlier points. What they found was straightforward but important: when time was shortened, performance dropped. Also, the shorter the time, the less the new scores matched the original ones. In other words: compressing the clock makes the exam measure something different not just “how good a doctor you are,” but “how quickly you act,” or “how well you perform under pressure.”

That matters because CCS is designed to test clinical decision-making and patient-management skills. The authors argue that if the allotted time gets shortened, the exam may start favoring speed over careful, realistic decision-making. Which means that reducing time limits could undermine the fairness and validity of the exam possibly penalizing test-takers who think methodically instead of rushing, or who deal better with deliberation rather than time pressure. So before shortening time for such simulations, exam designers should think carefully about what kind of skills they really want to measure.