SHARP (SHort Answer, Rationale Provision): A New Item Format to Assess Clinical Reasoning.

PROBLEM: Many non-workplace-based assessments do not provide good evidence of a learner's problem representation or ability to provide a rationale for a clinical decision they have made. Exceptions include assessment formats that require resource-intensive administration and scoring. This article reports on research efforts toward building a scalable non-workplace-based assessment format that was specifically developed to capture evidence of a learner's ability to provide a justification for a clinical decision that they had made. APPROACH: The authors developed a 2-step item format called SHARP (SHort Answer, Rationale Provision), referring to the 2 tasks that comprise the item. In collaboration with physician-educators, the authors integrated short-answer questions into a patient medical record-based item starting in October 2021 and arrived at an innovative item format in December 2021. In this format, a test-taker interprets patient medical record data to make a clinical decision, types in their response, and pinpoints medical record details that justify their answers. In January 2022, a total of 177 fourth-year medical students, representing 20 U.S. medical schools, completed 35 SHARP items in a proof-of-concept study. OUTCOMES: Primary outcomes were item timing, difficulty, reliability, and scoring ease. There was substantial variability in item difficulty, with the average item answered correctly by 44% of students (range, 4%-76%). The estimated reliability (Cronbach α) of the set of SHARP items was 0.76 (95% CI, 0.70-0.80). Item scoring is fully automated, minimizing resource requirements. NEXT STEPS: A larger study is planned to gather additional validity evidence about the item format. This study will allow comparisons between performance on SHARP items and other examinations, the examination of group differences in performance, and possible use cases for formative assessment purposes. Cognitive interviews are also planned to better understand the thought processes of medical students as they work through the SHARP items.

A Comparison of Remote vs In-Person Proctored In-Training Examination Administration for Internal Medicine.

PURPOSE: In response to COVID-19, the American College of Physicians provided residents the option to complete the 2020 Internal Medicine In-Training Examination (IM-ITE) via in-person and remote proctoring. This study evaluated the extent to which scores obtained from both testing modalities were comparable. METHOD: Data were analyzed from residents from all U.S.-based Accreditation Council for Graduate Medical Education-accredited IM residency programs and participating Canadian and international programs who completed the IM-ITE in 2020. The final sample contained 27,115 IM residents: 9,205 postgraduate year (PGY) 1, 9,332 PGY-2, and 8,578 PGY-3. Testing modality, gender, PGY, time spent on assessment, and native language were used to predict percent-correct scores in a multilevel regression model. This model included all main effects and all 2-way interactions between testing modality and each resident-level demographic variable, allowing those effects to be controlled for. RESULTS: Of 27,115 residents studied, 11,354 (42%) tested remotely and 15,761 (58%) in person. Across the parameters of interest (main effect of testing modality and 2-way interactions), the only statistically significant effects were the interaction effects between testing mode (interaction effect: -0.61; 95% confidence interval [CI], -1.01 to -0.21) and PGY (interaction effect: -0.54; 95% CI, -0.95 to -0.13) ( P = .002). Differences between in-person and remote predicted scores were slightly larger for PGY-1 than for PGY-2 and PGY-3 residents, but the magnitude of these differences across residency training was well under one percentage point. Because these statistically significant effects were deemed educationally nonsignificant, the study concluded that performance did not substantively differ across in-person and remote examinees. CONCLUSIONS: Residents taking the 2020 IM-ITE performed similarly across in-person and remote proctoring. This study provides evidence of score comparability across the 2 testing modalities and supports continued use of remote proctoring for the IM-ITE.

A Clear Cell Sarcoma Case: A Diagnostic and Treatment Challenge, with a Promising Response to Trabectedin.

Introduction: Clear cell sarcoma (CCS) is a rare and aggressive soft tissue sarcoma. CCS is characterized by the translocation t(12;22) (q13;q12), involving the fusion of EWSR1 and ATF1 genes, and less frequently the fusion gene EWSR1-CREB1. Usually, CCSs are considered poorly responsive to conventional chemotherapy. However, trabectedin has shown activity against translocation-related sarcomas. Furthermore, preclinical results suggest that trabectedin is a promising antitumor agent for CCS, potentially inducing melanocytic differentiation. Case Presentation: We report the case of a challenging anatomopathological diagnosis in a patient with an aggressive metastatic CCS. Following the diagnosis of CCS, the patient experienced a clinical and radiological tumor response to trabectedin after four lines of treatment. Conclusion: This is a novel report of CCS treated with trabectedin that resulted in a partial response and suggests the need for further research on trabectedin as a therapeutic option for CCS.

Potential energy surfaces for singlet and triplet states of the LiH2+ system and quasi-classical trajectory cross sections for H + LiH+ and H+ + LiH.

A new set of six accurate ab initio potential energy surfaces (PESs) is presented for the first three singlet and triplet states of LiH2+ (1,21A', 11A'', 1,23A', and 13A'' states, where four of them are investigated for the first time), which have allowed new detailed studies gaining a global view on this interesting system. These states are relevant for the study of the most important reactions of lithium chemistry in the early universe. More than 45 000 energy points were calculated using the multi-reference configuration interaction level of theory using explicitly correlated methods (ic-MRCI-F12), and the results obtained for each individual electronic state were fitted to an analytical function. Using quasiclassical trajectories and considering the initial diatomic fragment in the ground rovibrational state, we have determined the integral cross sections for the H + LiH+(X2Σ+, C2Π) and H+ + LiH(X1Σ+, B1Π) reactions. In these calculations all available reaction channels were considered: the chemically most important H or H+ transfer/abstraction as well as atom exchange and collision induced dissociation for up to 1.0 eV of collision energy.

An experimental comparison of multiple-choice and short-answer questions on a high-stakes test for medical students.

Recent advances in automated scoring technology have made it practical to replace multiple-choice questions (MCQs) with short-answer questions (SAQs) in large-scale, high-stakes assessments. However, most previous research comparing these formats has used small examinee samples testing under low-stakes conditions. Additionally, previous studies have not reported on the time required to respond to the two item types. This study compares the difficulty, discrimination, and time requirements for the two formats when examinees responded as part of a large-scale, high-stakes assessment. Seventy-one MCQs were converted to SAQs. These matched items were randomly assigned to examinees completing a high-stakes assessment of internal medicine. No examinee saw the same item in both formats. Items administered in the SAQ format were generally more difficult than items in the MCQ format. The discrimination index for SAQs was modestly higher than that for MCQs and response times were substantially higher for SAQs. These results support the interchangeability of MCQs and SAQs. When it is important that the examinee generate the response rather than selecting it, SAQs may be preferred. The results relating to difficulty and discrimination reported in this paper are consistent with those of previous studies. The results on the relative time requirements for the two formats suggest that with a fixed testing time fewer SAQs can be administered, this limitation more than makes up for the higher discrimination that has been reported for SAQs. We additionally examine the extent to which increased difficulty may directly impact the discrimination of SAQs.

Exploring the Validity Based on Internal Structure of the Oldenburg Burnout Inventory - Medical Student (OLBI-MS).

CONSTRUCT: The study gathers validity evidence for the use of the Oldenburg Burnout Inventory - Medical Student (OLBI-MS), a 16-item scale used to measure medical student burnout. The 16 items on the OLBI-MS are split to form two subscales, disengagement and exhaustion. BACKGROUND: Medical student burnout has been empirically linked to several detrimental professional and personal consequences. In recognition of the high prevalence of medical student burnout, one recommendation has been to regularly measure burnout using standardized measures that have strong validity evidence for their intended use. The OLBI-MS, a frequently used measure of medical student burnout, was adapted from the Oldenburg Burnout Inventory (OLBI). The OLBI has been studied in many occupational settings and been found to have a two-factor solution in majority of these populations, but there is limited validity evidence available that supports the use of the OLBI-MS subscales in a medical student population. APPROACH: Two years of Association of American Medical College Year 2 Questionnaire data (n = 24,008) were used in the study for a series of exploratory and confirmatory factor analyses. The data from the first year (n = 11,586) was randomly split into a confirmatory and exploratory sample, with the data from the second year (n = 12,422) used as a secondary confirmatory sample. Because the questionnaire is administered to medical students during their second year of undergraduate medical education, we consider this a study as providing validity evidence specifically for the measure's use with that population. FINDINGS: The two-factor structure of the OLBI-MS was not empirically supported in the second year medical-student population. Several of the items had low inter-item correlations and/or moderate correlations with unexpected items. Three modified versions of the OLBI-MS were tested using subsets of the original items. Two of the modified versions were adequate statistical explanations of the relationships in the data. However, it is unclear if these revised scales appropriately measure all aspects of the construct of burnout and additional validity evidence is needed prior to their use. CONCLUSIONS: The use of the OLBI-MS is not recommended for measuring second-year medical student burnout. It is unclear if the OLBI-MS is appropriate for medical students at all, or if different measures are necessary at different stages in a medical student's professional development. Additional research is needed to either improve the OLBI-MS or use it as a foundation for a new measure.Supplemental data for this article is available online at at www.tandfonline.com/htlm .

Assessing the validity of test scores using response process data from an eye-tracking study: a new approach.

Understanding the response process used by test takers when responding to multiple-choice questions (MCQs) is particularly important in evaluating the validity of score interpretations. Previous authors have recommended eye-tracking technology as a useful approach for collecting data on the processes test taker's use to respond to test questions. This study proposes a new method for evaluating alternative score interpretations by using eye-tracking data and machine learning. We collect eye-tracking data from 26 students responding to clinical MCQs. Analysis is performed by providing 119 eye-tracking features as input for a machine-learning model aiming to classify correct and incorrect responses. The predictive power of various combinations of features within the model is evaluated to understand how different feature interactions contribute to the predictions. The emerging eye-movement patterns indicate that incorrect responses are associated with working from the options to the stem. By contrast, correct responses are associated with working from the stem to the options, spending more time on reading the problem carefully, and a more decisive selection of a response option. The results suggest that the behaviours associated with correct responses are aligned with the real-world model used for score interpretation, while those associated with incorrect responses are not. To the best of our knowledge, this is the first study to perform data-driven, machine-learning experiments with eye-tracking data for the purpose of evaluating score interpretation validity.

COP2ING With a New Normal: Navigating the Return to Society for Older Adults With Dementia and Their Caregivers.

COVID-19 has stressed the healthcare system in ways our society has not seen before. Less visibly, elderly patients and their caregivers have been stressed as well, both by the virus and by the public health measures required to slow its spread. After months of isolating, patients with dementia and their caregivers are worried about reentering a society with different rules and expectations. Although an extremely complex topic, the re-entry of individuals with cognitive impairment back into society is critical for both the wellbeing of the person as well as the caregiver. Successful re-entry into society will vary based on a person's interests and baseline cognition, however, the ability to participate in activities and events that previously provided joy and stimulation is the first step. This paper, written by practicing geriatricians and palliative clinicians, offers some concrete counseling strategies and tips for caregivers to help navigate re-entry into society with their loved ones.

A Natural-Language-Processing-Based Procedure for Generating Distractors for Multiple-Choice Questions.

One of the most challenging aspects of writing multiple-choice test questions is identifying plausible incorrect response options-i.e., distractors. To help with this task, a procedure is introduced that can mine existing item banks for potential distractors by considering the similarities between a new item's stem and answer and the stems and response options for items in the bank. This approach uses natural language processing to measure similarity and requires a substantial pool of items for constructing the generating model. The procedure is demonstrated with data from the United States Medical Licensing Examination (USMLE®). For about half the items in the study, at least one of the top three system-produced candidates matched a human-produced distractor exactly; and for about one quarter of the items, two of the top three candidates matched human-produced distractors. A study was conducted in which a sample of system-produced candidates were shown to 10 experienced item writers. Overall, participants thought about 81% of the candidates were on topic and 56% would help human item writers with the task of writing distractors.

Urinary bladder lipoma: an illustrative case.

Urinary bladder lipomas are rare neoplasms. Therefore, very few of them have been reported in the literature. We present a case that illustrates the typical features that allow radiologists to diagnose this entity: a solid lesion that arises from the urinary bladder wall, showing an endophytic growth and homogeneous hypoattenuation. After its surgical resection, the diagnosis was confirmed by anatomo-pathological analysis. In the discussion we describe other neoplasms that should also be considered when a submucosal bladder neoplasm is detected on computed tomography or other imaging techniques.

Correlations Between the USMLE Step Examinations, American College of Physicians In-Training Examination, and ABIM Internal Medicine Certification Examination.

PURPOSE: To assess the correlations between United States Medical Licensing Examination (USMLE) performance, American College of Physicians Internal Medicine In-Training Examination (IM-ITE) performance, American Board of Internal Medicine Internal Medicine Certification Exam (IM-CE) performance, and other medical knowledge and demographic variables. METHOD: The study included 9,676 postgraduate year (PGY)-1, 11,424 PGY-2, and 10,239 PGY-3 internal medicine (IM) residents from any Accreditation Council for Graduate Medical Education-accredited IM residency program who took the IM-ITE (2014 or 2015) and the IM-CE (2015-2018). USMLE scores, IM-ITE percent correct scores, and IM-CE scores were analyzed using multiple linear regression, and IM-CE pass/fail status was analyzed using multiple logistic regression, controlling for USMLE Step 1, Step 2 Clinical Knowledge, and Step 3 scores; averaged medical knowledge milestones; age at IM-ITE; gender; and medical school location (United States or Canada vs international). RESULTS: All variables were significant predictors of passing the IM-CE with IM-ITE scores having the strongest association and USMLE Step scores being the next strongest predictors. Prediction curves for the probability of passing the IM-CE based solely on IM-ITE score for each PGY show that residents must score higher on the IM-ITE with each subsequent administration to maintain the same estimated probability of passing the IM-CE. CONCLUSIONS: The findings from this study should support residents and program directors in their efforts to more precisely identify and evaluate knowledge gaps for both personal learning and program improvement. While no individual USMLE Step score was as strongly predictive of IM-CE score as IM-ITE score, the combined relative contribution of all 3 USMLE Step scores was of a magnitude similar to that of IM-ITE score.

Effects of Moving the United States Medical Licensing Examination Step 1 After Core Clerkships on Step 2 Clinical Knowledge Performance.

PURPOSE: To investigate the effect of a change in the United States Medical Licensing Examination Step 1 timing on Step 2 Clinical Knowledge (CK) scores, the effect of lag time on Step 2 CK performance, and the relationship of incoming Medical College Admission Test (MCAT) score to Step 2 CK performance pre and post change. METHOD: Four schools that moved Step 1 after core clerkships between academic years 2008-2009 and 2017-2018 were analyzed. Standard t tests were used to examine the change in Step 2 CK scores pre and post change. Tests of differences in proportions were used to evaluate whether Step 2 CK failure rates differed between curricular change groups. Linear regressions were used to examine the relationships between Step 2 CK performance, lag time and incoming MCAT score, and curricular change group. RESULTS: Step 2 CK performance did not change significantly (P = .20). Failure rates remained highly consistent (pre change: 1.83%; post change: 1.79%). The regression indicated that lag time had a significant effect on Step 2 CK performance, with scores declining with increasing lag time, with small but significant interaction effects between MCAT and Step 2 CK scores. Students with lower incoming MCAT scores tended to perform better on Step 2 CK when Step 1 was after clerkships. CONCLUSIONS: Moving Step 1 after core clerkships appears to have had no significant impact on Step 2 CK scores or failure rates, supporting the argument that such a change is noninferior to the traditional model. Students with lower MCAT scores benefit most from the change.

Reporting Subscore Profiles Using Diagnostic Classification Models in Health Professions Education.

Learners and educators in the health professions have called for more fine-grained information (subscores) from assessments, beyond a single overall test score. However, due to concerns over reliability, there have been limited uses of subscores in practice. Recent advances in latent class analysis have made contributions in subscore reporting by using diagnostic classification models (DCMs), which allow reliable classification of examinees into fine-grained proficiency levels (subscore profiles). This study examines the innovative and practical application of DCM framework to health professions educational assessments using retrospective large-scale assessment data from the basic and clinical sciences: National Board of Medical Examiners Subject Examinations in pathology (n = 2,006) and medicine (n = 2,351). DCMs were fit and analyzed to generate subscores and subscore profiles of examinees. Model fit indices, classification (reliability), and parameter estimates indicated that DCMs had good psychometric properties including consistent classification of examinees into subscore profiles. Results showed a range of useful information including varying levels of subscore distributions. The DCM framework can be a promising approach to report subscores in health professions education. Consistency of classification was high, demonstrating reliable results at fine-grained subscore levels, allowing for targeted and specific feedback to learners.

Advancing Nutrition Education, Training, and Research for Medical Students, Residents, Fellows, Attending Physicians, and Other Clinicians: Building Competencies and Interdisciplinary Coordination.

Nutrition plays an important role in health promotion and disease prevention and treatment across the lifespan. Physicians and other healthcare professionals are expected to counsel patients about nutrition, but recent surveys report minimal to no improvements in medical nutrition education in US medical schools. A workshop sponsored by the National Heart, Lung, and Blood Institute addressed this gap in knowledge by convening experts in clinical and academic health professional schools. Representatives from the National Board of Medical Examiners, the Accreditation Council for Graduate Medical Education, the Liaison Committee on Medical Education, and the American Society for Nutrition provided relevant presentations. Reported is an overview of lessons learned from nutrition education efforts in medical schools and health professional schools including interprofessional domains and competency-based nutrition education. Proposed is a framework for coordinating activities of various entities using a public-private partnership platform. Recommendations for nutrition research and accreditation are provided.

Investigation of answer changes on the USMLE® Step 2 Clinical Knowledge examination.

BACKGROUND: Examinees often believe that changing answers will lower their scores; however, empirical studies suggest that allowing examinees to change responses may improve their performance in classroom assessments. To date, no studies have been able to examine answer changes during large scale professional credentialing or licensing examinations. METHODS: In this study, we expand the research on answer changes by analyzing responses from 27,830 examinees who completed the Step 2 Clinical Knowledge (CK) examination between August of 2015 and August of 2016. RESULTS: The results showed that although 68% of examinees changed at least one item, the overall average number of changes was small. Among the examinees who changed answers, approximately 45% increased their scores and approximately 28% decreased their scores. On average, examinees spent shortest time on the item changes from wrong to right and they were more likely to change their scores from wrong to right than right to wrong. CONCLUSIONS: Consistent with previous studies, these findings support the beneficial effects of answer changes in high-stakes medical examinations and suggest that examinees who are overly cautious about changing answers may put themselves at a disadvantage.

Moving the United States Medical Licensing Examination Step 1 After Core Clerkships: An Outcomes Analysis.

PURPOSE: Schools undergoing curricular reform are reconsidering the optimal timing of Step 1. This study provides a psychometric investigation of the impact on United States Medical Licensing Examination Step 1 scores of changing the timing of Step 1 from after completion of the basic science curricula to after core clerkships. METHOD: Data from four schools that recently moved the examination were analyzed in a pre-post format using examinee scores from three years before and after the change. The sample included scores from 2008 through 2016. Several confounders were addressed, including rising national scores and potential differences in cohort abilities using deviation scores and analysis of covariance (ANCOVA) controlling for Medical College Admission Test (MCAT) scores. A resampling procedure compared study schools' score changes versus similar schools' in the same time period. RESULTS: The ANCOVA indicated postchange Step 1 scores were higher compared with prechange (adjusted difference = 2.67; 95% confidence interval: 1.50-3.83, P < .001; effect size = 0.14) after adjusting for MCAT scores and rising national averages. The average score increase in study schools was larger than changes seen in similar schools. Failure rates also decreased from 2.87% (n = 48) pre change to 0.39% (n = 6) post change (P < .001). CONCLUSIONS: Results suggest moving Step 1 after core clerkships yielded a small increase in scores and a reduction in failure rates. Although these small increases are unlikely to represent meaningful knowledge gains, this demonstration of "noninferiority" may allow schools to implement significant curricular reforms.

Palliative Care Competencies and Readiness for Independent Practice: A Report on the American Academy of Hospice and Palliative Medicine Review of the U.S. Medical Licensing Step Examinations.

CONTEXT: It is unknown whether the palliative care (PC) content tested in the U.S. Medical Licensing Examination (USMLE) step examinations reflects the consensus-developed PC competencies. OBJECTIVES: To review the USMLE step examinations to determine whether they test the PC knowledge necessary for graduating medical students and residents applying for licensure. METHODS: Eight PC physicians reviewed three complete examination forms and a focused 509-item bundle of multiple-choice questions (MCQs) identified by the USMLE content outline as potentially assessing PC content. Reviewers determined MCQs to be PC items if the patient was seriously ill and PC knowledge was required to answer correctly. PC items' competency domains were determined using reference domains from PC subspecialty consensus competencies. RESULTS: Reviewers analyzed 1090 MCQs and identified 242 (22%) as PC items. PC items were identified in each step examination. Patients in PC items were mostly males (62.8%), older than 65 years (62%), and diagnosed with cancer (43.6%). Only 6.6% and 6.2%, respectively, had end-stage heart disease or multimorbid illness. Fifty-one percent of PC items addressed ethics (31%) or communication (19.8%), focusing on patient autonomy, surrogate decision makers, or conflict between decision makers. Pain and symptom management was assessed in 28.5% of PC items, and one-third of those addressed addiction or substance use disorder. CONCLUSION: We identified PC content in each step examination. However, heart disease and multimorbidity were under-represented in PC items relative to their prevalence. In addition, there was heavy overlap with ethics, a focus on conflict in assessing communication skills, and emphasis on addiction when testing pain management. Our findings highlight opportunities to enhance testing of clinical PC skills essential for all licensed physicians practicing medicine.

Vibrational energy relaxation dynamics of diatomic molecules inside superfluid helium nanodroplets. The case of the I2 molecule.

The vibrational energy relaxation (VER) of a homonuclear diatomic molecule (X2) in a 4He superfluid nanodroplet (HeND; T = 0.37 K) was studied adapting appropriately a hybrid theoretical quantum approach recently proposed by us. In the first application the interesting case of the I2(X) molecule was examined and, as far as we know, this corresponds to the first theoretical investigation on the VER of molecules embedded in HeND. Vibrational relaxation of I2 takes place according to a cascade mechanism [sequential transitions between two consecutive vibrational levels (ν → ν - 1; ν - 1 → ν - 2; …; 2 → 1; 1 → 0), where an arbitrary relaxation, e.g., ν - 1 → ν - 2, can only occur once the previous relaxation has taken place, and so on]. The global relaxation from the initial excited state ν down to the ground state (ν = 0) happens on the nanosecond scale. Data on the VER of molecules in HeND are very scarce and a vibrational lifetime not far from the I2 one for ν = 1 has been estimated experimentally for Na3(24E') on HeND (a qualitatively similar 0 → 1 vibrational energy gap occurs in both species), but metastability has not been reported in the second case. The cascade mechanism was understood once the values of the coupling matrix elements were examined, and the time evolution of the populations of two consecutive vibrational levels was adequately described using a non-linear two-state Hamiltonian model for I2 in the HeND. According to the calculations, superfluid liquid helium is very efficient in releasing the excess of energy arising from the I2 vibrational de-excitation, as it should be. However, the number of He atoms evaporated is small compared to what is expected. We hope that this first theoretical work on the molecular VER dynamics in HeND will encourage researchers to investigate this important process about which we still know very little.

Testing and evaluation: the present and future of the assessment of medical professionals.

The aim of this review is to highlight recent and potential future enhancements to the United States Licensing Examination (USMLE) program. The USMLE program is co-owned by the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards. The USMLE includes four examinations: Step 1, Step 2 Clinical Knowledge, Step 2 Clinical Skills, and Step 3; every graduate of Liaison Committee on Medical Education-accredited allopathic medical schools and all international medical graduates must pass this examination series to practice medicine in the United States. From 2006 to 2009, the program underwent an indepth review resulting in five accepted recommendations. These recommendations have been the primary driver for many of the recent enhancements, such as an increased emphasis on foundational science and changes in the clinical skills examination, including more advanced communication skills assessment. These recommendations will continue to inform future changes such as access to references (e.g., a map of metabolic pathways) or decision-making tools for use during the examination. The NBME also provides assessment services globally to medical schools, students, residency programs, and residents. In 2015, >550,000 assessments were provided through the subject examination program, NBME self-assessment services, and customized assessment services.

Dynamics of the O + H2+ → OH+ + H, OH + H+ proton and hydrogen atom transfer reactions on the two lowest potential energy surfaces.

The dynamics of the title reaction was studied using mainly the quasiclassical trajectory (QCT) method on the ground 12A'' (OH+ channel) and first excited 12A' (OH channel) potential energy surfaces (PESs) employing ab initio analytical representations of the PESs developed by us. Both PESs correspond to exoergic reactions, are barrierless and present a deep minimum along the minimum energy path (MEP). Some extra calculations (cross sections) were also performed with the time dependent quantum real wave packet method at the centrifugal sudden level (RWP-CS method). A broad set of properties as a function of collision energy (Ecol ≤ 0.5 eV) was considered using the QCT method: cross sections, average fractions of energy, product rovibrational distributions, two- and three-vector properties, and the microscopic mechanisms analyzing their influence on the dynamics. The proton transfer channel dominates the reactivity of the system and significant differences between the two reaction channels are found for the vibrational distributions and microscopic mechanisms. The results were interpreted according to the properties of the ground and excited PESs. Moreover, the QCT and RWP-CS cross sections are in rather good agreement for both reaction channels. We hope that this study will encourage the experimentalists to investigate the dynamics of this interesting but scarcely studied system, whose two lowest PESs include the ground and first excited electronic states of the H2O+ cation.