期刊论文详细信息
BMC Medical Education
Impact of subspecialty elective exposures on outcomes on the American board of internal medicine certification examination
Michael Adams1  Mihriye Mete2  Sameer Desale2  Sean McNish3  Amber Schilling3  Katina Tsagaris1  Victoria K Shanmugam3 
[1] Department of Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Road, NW Washington, DC, 20007, USA;Division of Biostatistics and Epidemiology, MedStar Health Research Institute, 6525 Belcrest Road, Suite 700, Hyattsville, MD, 20782, USA;Division of Rheumatology, Immunology and Allergy, MedStar Georgetown University Hospital, 3800 Reservoir Road, NW Washington, DC, 20007, USA
关键词: Graduate medical education;    Subspecialty;    Elective;    Gender;    Resident education;   
Others  :  1153287
DOI  :  10.1186/1472-6920-12-94
 received in 2012-08-23, accepted in 2012-10-05,  发布年份 2012
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【 摘 要 】

Background

The American Board of Internal Medicine Certification Examination (ABIM-CE) is one of several methods used to assess medical knowledge, an Accreditation Council for Graduate Medical Education (ACGME) core competency for graduating internal medicine residents. With recent changes in graduate medical education program directors and internal medicine residents are seeking evidence to guide decisions regarding residency elective choices. Prior studies have shown that formalized elective curricula improve subspecialty ABIM-CE scores. The primary aim of this study was to evaluate whether the number of subspecialty elective exposures or the specific subspecialties which residents complete electives in impact ABIM-CE scores.

Methods

ABIM-CE scores, elective exposures and demographic characteristics were collected for MedStar Georgetown University Hospital internal medicine residents who were first-time takers of the ABIM-CE in 2006–2010 (n=152). Elective exposures were defined as a two-week period assigned to the respective subspecialty. ABIM-CE score was analyzed using the difference between the ABIM-CE score and the standardized passing score (delta-SPS). Subspecialty scores were analyzed using percentage of correct responses. Data was analyzed using GraphPad Prism version 5.00 for Windows.

Results

Paired elective exposure and ABIM-CE scores were available in 131 residents. There was no linear correlation between ABIM-CE mean delta-SPS and the total number of electives or the number of unique elective exposures. Residents with ≤14 elective exposures had higher ABIM-CE mean delta-SPS than those with ≥15 elective exposures (143.4 compared to 129.7, p=0.051). Repeated electives in individual subspecialties were not associated with significant difference in mean ABIM-CE delta-SPS.

Conclusions

This study did not demonstrate significant positive associations between individual subspecialty elective exposures and ABIM-CE mean delta-SPS score. Residents with ≤14 elective exposures had higher ABIM-CE mean delta-SPS than those with ≥15 elective exposures suggesting there may be an “ideal” number of elective exposures that supports improved ABIM-CE performance. Repeated elective exposures in an individual specialty did not correlate with overall or subspecialty ABIM-CE performance.

【 授权许可】

   
2012 Shanmugam et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Holt KD, Miller RS, Philibert I, Heard JK, Nasca TJ: Residents’ perspectives on the learning environment: data from the accreditation council for graduate medical education resident survey. Acad Med 2010, 85(3):512-518. 510.1097/ACM.1090b1013e3181ccc1091db
  • [2]Frank JR, Snell LS, Cate OT, et al.: Competency-based medical education: theory to practice. Med Teach 2010, 32(8):638-645.
  • [3]Holmboe E, Bowen J, Green M, et al.: Reforming internal medicine residency training. a report from the Society of General Internal Medicine’s task force for residency reform. J Gen Intern Med 2005, 20(12):1165-1172.
  • [4]Nasca TJ, Philibert I, Brigham T, Flynn TC: The Next GME Accreditation System — Rationale and Benefits. N Engl J Med 2012, 366(11):1051-1056. Epub 2012 Feb 22
  • [5]Chaudhry S, Holmboe E, Beasley B: The state of evaluation in internal medicine residency. J Gen Intern Med 2008, 23(7):1010-1015.
  • [6]O’Dell JR: In-training examination in internal medicine. Ann Intern Med 1995, 122(1):73-74.
  • [7]Holmboe ES, Hawkins RE: Methods for Evaluating the Clinical Competence of Residents in Internal Medicine: A Review. Ann Intern Med 1998, 129(1):42-48.
  • [8]McDonald FS, Zeger SL, Kolars JC: Associations of Conference Attendance With Internal Medicine In-Training Examination Scores. Mayo Clin Proc 2008, 83(4):449-453.
  • [9]McDonald F, Zeger S, Kolars J: Factors Associated with Medical Knowledge Acquisition During Internal Medicine Residency. J Gen Intern Med 2007, 22(7):962-968.
  • [10]Haponik EF, Bowton DL, Chin R, et al.: Pulmonary Section Development Influences General Medical House Officer Interests and ABIM Certifying Examination Performance. Chest 1996, 110(2):533-538.
  • [11]O’Dell JR, Klassen L, MOore G: The use of outcome measures to evaluate clincial rheumatology curriculum changes. J Rheumatol 1993, 20(6):1033-1036.
  • [12]Hellmann D, Flynn J: Development and evaluation of a coordinated, ambulatory rheumatology experience for internal medicine residents. Arthritis Care Res 1999, 12(5):325-330.
  • [13]Mathis B, Warm E, Schauer D, Holmboe E, Rouan G: A multiple choice testing program coupled with a year-long elective experience is associated with improved performance on the internal medicine in-training examination. J Gen Intern Med 2011, 26(11):1253-1257.
  • [14]Iobst WF, Sherbino J, Cate OT, et al.: Competency-based medical education in postgraduate medical education. Medical Teacher 2010, 32(8):651-656.
  • [15]Jones R, Panda M, Desbiens N: Internal medicine residents do not accurately assess their medical knowledge. Advances in Health Sciences Education 2008, 13(4):463-468.
  • [16]Norcini J, Webster G, Grosso L, Blank L, Benson JJ: Ratings of residents’ clinical competence and performance on certification examination. J Med Educ 1987, 62(6):457-462.
  • [17]Hall FR, Mikesell C, Cranston P, Julian E, Elam C: Longitudinal trends in the applicant pool for U.S. medical schools, 1974–1999. Acad Med 2001, 76(8):829-834.
  • [18]Levinson W, Lurie N: When most doctors are women: what lies ahead? Ann Intern Med 2004, 141(6):471-474.
  • [19]West CP, Shanafelt TD, Kolars JC: Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA 2011, 306(9):952-960.
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