Abstract
Objective:
Several aspects of medical training may contribute to the ultimate goal of producing excellent physicians whose patients will have the best possible outcomes. However, the relative importance of education, evaluation and feedback, duty hours, practice structure, and program culture in achieving this goal is unclear. This study assessed associations among in-training exam performance, Accreditation Council for Graduate Medical Education (ACGME) Resident Survey responses, and American Board of Medical Specialties (ABMS) national board exam performance.
Methods:
Residency training programs at a university teaching hospital were classified as having 5-year first-time ABMS pass rates above (n=12) or below (n=3) the national average for their specialty. These groups were compared by ACGME Resident Survey data and in-training exam performance.
Results:
Surveys were collected from 484/543 eligible residents (89%), including 177 surveys from programs with below-average board pass rates and 307 surveys from programs with aboveaverage board pass rates. In-training exam performance was similar between groups. Aboveaverage programs had stronger agreement with statements that their culture reinforced patient safety (4.72 vs. 4.30, p=0.006) and that information was not lost during transitions of care (4.14 vs. 3.63, p=0.001). Although the occurrence of interprofessional teamwork was similar between groups, above-average programs had stronger agreement with the statement that interprofessional teamwork was effective (4.60 vs. 4.17, p=0.003).
Conclusion:
Residency programs emphasizing patient safety and effective interprofessional teamwork had above-average first-time national board pass rates.
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References
Tamblyn R, Abrahamowicz M, Dauphinee D, Wenghofer E, Jacques A, Klass D, et al. Physician scores on a national clinical skills examination as predictors of complaints to medical regulatory authorities. JAMA. 2007;298(9):993–1001.
Silber JH, Kennedy SK, Even-Shoshan O, Chen W, Mosher RE, Showan AM, et al. Anesthesiologist board certification and patient outcomes. Anesthesiology. 2002;96(5):1044–52.
Norcini J, Lipner R, Kimball H. The certification status of generalist physicians and the mortality of their patients after acute myocardial infarction. Acad Med. 2001;76(10 Suppl):S21–3.
Sharp LK, Bashook PG, Lipsky MS, Horowitz SD, Miller SH. Specialty board certification and clinical outcomes: the missing link. Acad Med. 2002;77(6):534–42.
O'Neill TR, Li Z, Peabody MR, Lybarger M, Royal K, Puffer JC. The predictive validity of the ABFM's in-training examination. Fam Med. 2015;47(5):349–56.
Rollins LK, Martindale JR, Edmond M, Manser T, Scheld WM. Predicting pass rates on the American Board of Internal Medicine certifying examination. J Gen Intern Med. 1998;13(6):414–6.
Webb LC, Juul D, Reynolds CF 3rd, Ruiz B, Ruiz P, Scheiber SC, et al. How well does the psychiatry residency in-training examination predict performance on the American Board of Psychiatry and Neurology. Part I. Examination? Am J Psychiatry. 1996;153(6):831–2.
Goodman JC, Juul D, Westmoreland B, Burns R. RITE performance predicts outcome on the ABPN Part I examination. Neurology. 2002;58(8):1144–6.
Baumgartner BR, Peterman SB. Relationship between American College of Radiology in-training examination scores and American Board of Radiology written examination scores. Acad Radiol. 1996;3(10):873–8.
Althouse LA, McGuinness GA. The in-training examination: an analysis of its predictive value on performance on the general pediatrics certification examination. J Pediatr. 2008;153(3):425–8.
Jeffe DB, Andriole DA. Factors associated with American Board of Medical Specialties member board certification among US medical school graduates. JAMA. 2011;306(9):961–70.
Counselman FL, Kowalenko T, Marco CA, Joldersma KB, Korte RC, Reisdorff EJ. The relationship between ACGME duty hour requirements and performance on the American Board of Emergency Medicine Qualifying Examination. J Grad Med Educ. 2016;8(4):558–62.
Jain G, Dzara K, Mazhar MN, Punwani M. Do regulated resident working hours affect medical graduate education? Trends in the American psychiatry board pass rates pre- and post-2003 duty hours regulations. Psychiatr Bull (2014). 2014;38(6):299–302.
Bohm KC, Hill BW, Braman JP, Ly TV, Van Heest AE. Orthopedic residency: are duty hours predictive of performance? J Surg Educ. 2016;73(2):281–5.
Drolet BC, Schwede M, Bishop KD, Fischer SA. Compliance and falsification of duty hours: reports from residents and program directors. J Grad Med Educ. 2013;5(3):368–73.
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Loftus, T.J., Hall, D.J., Malaty, J.Z. et al. Associations Between National Board Exam Performance and Residency Program Emphasis on Patient Safety and Interprofessional Teamwork. Acad Psychiatry 43, 581–584 (2019). https://doi.org/10.1007/s40596-019-01106-x
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DOI: https://doi.org/10.1007/s40596-019-01106-x