Borman Karen R
Department of Surgery, University of Mississippi Medical Center, Jackson, Mississippi 39216-4505, USA.
Curr Surg. 2006 Nov-Dec;63(6):367-72. doi: 10.1016/j.cursur.2006.06.007.
To assess the impact of a focused academic support program on American Board of Surgery In-Training Examination (ABSITE) scores and Qualifying Examination (QE) outcomes.
A mandatory intervention program was begun in April 2001 for residents with ABSITE Total Test (TT) percentiles <31. Program elements included: 1) individual faculty mentoring and personal learning plan 2) QE videotape review sessions 3) Surgical Education and Self-Assessment Program (SESAP) 4) monthly rotation evaluations, and 5) quarterly status feedback. A free medical evaluation was offered. Mock orals participation, educational psychologist consultation, and voluntary followup mentoring were added later. Study data were reviewed for 2003-2005 Chief Residents including ABSITE scores, QE results, conference attendance, rotation Overall Performance ratings, and resident surgeon case volumes. Results were compared for the academic intervention (AI) and no intervention (NI) groups.
Fifteen residents graduated during the study period. Eight residents completed nine interventions; seven returned to TT percentiles >30 (7/8, 88%). First post-intervention ABSITE gains were large compared to NI and national peer groups. Standard Score (SS) TT gains were maintained until residency completion by four AI residents. Median AI PGY-5 TT percentile was 32 and three scores were <or=25. Six AI residents (6/8, 75%) and all NI residents (7/7, 100%) passed the QE on their first attempts. AI and NI groups were similar for conference attendance, rotation evaluations, and operative log totals.
A focused academic support intervention for residents with marginal ABSITE TT percentiles can produce immediate substantial gains. Gains are variably maintained through remaining residency years. PGY-5 TT percentiles <or=25, seen with three AI residents (3/8, 38%), are associated with a 40% first QE failure rate. Therefore, our 75% QE first-time pass rate for AI residents argues for intervention success.
评估一项针对性学术支持计划对美国外科委员会住院医师培训考试（ABSITE）成绩及资格考试（QE）结果的影响。
2001年4月开始对ABSITE总分百分位低于31的住院医师实施一项强制性干预计划。计划内容包括：1）个人导师指导及个人学习计划；2）QE录像回顾课程；3）外科教育与自我评估计划（SESAP）；4）每月轮转评估；5）每季度状态反馈。提供一次免费医学评估。之后增加了模拟口试参与、教育心理学家咨询及自愿后续指导。回顾了2003 - 2005年总住院医师的研究数据，包括ABSITE成绩、QE结果、会议出席情况、轮转总体表现评分及住院医师外科手术病例量。对学术干预（AI）组和无干预（NI）组的结果进行比较。
研究期间有15名住院医师毕业。8名住院医师完成了9项干预措施；其中7人ABSITE总分百分位回升至>30（7/8，88%）。与NI组及全国同行组相比，首次干预后ABSITE成绩提升显著。4名AI组住院医师直至住院医师培训结束时，标准分（SS）总分提升得以维持。AI组PGY - 5总分百分位中位数为32，有3个分数≤25。6名AI组住院医师（6/8，75%）和所有NI组住院医师（7/7，100%）首次尝试即通过QE。AI组和NI组在会议出席情况、轮转评估及手术记录总数方面相似。
针对ABSITE总分百分位处于边缘水平的住院医师实施的针对性学术支持干预可立即带来显著提升。在剩余住院医师培训年份中，提升情况各异。3名AI组住院医师（3/8，38%）出现PGY - 5总分百分位≤25的情况，这与首次QE不及格率40%相关。因此，AI组住院医师75%的首次QE通过率表明干预取得了成功。
