Limvorapitak Wasithep
J Med Assoc Thai. 2016 Jul;99 Suppl 4:S10-5.
Internal medicine (IM) residency training program aims to train competent internists to provide healthcare services to community. Examination is usually done during and at the end of training. Data regarding effect of curricular activity attendance on examination performance are conflicting. This study aims to determine the effect of curricular activity attendance of IM residents on their examination scores and the correlation between in-training examination (ITE) and board certifying examination scores.
Activity attendance of IM residents was prospectively tracked during a 6-month period (June to November 2014) prior to ITE. Multivariate regression analysis was used to identify correlation between attendance and examination scores. Correlation between ITE and board certifying examination scores was also examined.
The subjects included were 11 and 8 residents in their 2nd and 3rd year of training, respectively. Age, sex and medical school GPA were the same between groups. During the study period, 34 lecture-type activities and 81 case-based non-lecture sessions were provided to residents. Multivariable regression analysis showed that non-lecture activity attendance of more than 65% improve score in clinical skills part of ITE by 10.53% (p-value = 0.003), while every 1.0 point increment in medical school GPA improve clinical knowledge part of ITE by 19.24% (p-value = 0.009). The study showed moderate-to-strong correlation between ITE and board certifying examination scores (clinical knowledge r = 0.72, p-value <0.001; clinical skills r = 0.94, p-value <0.001).
Attendance to curricular activities, especially to case-based, non-lecture activities, is beneficial to IM residents as measured by ITE. There was a strong correlation between ITE and board certifying examination scores.
内科住院医师培训项目旨在培养有能力的内科医生，为社区提供医疗服务。考核通常在培训期间及结束时进行。关于参加课程活动对考核成绩影响的数据存在矛盾。本研究旨在确定内科住院医师参加课程活动对其考核分数的影响，以及培训期间考核（ITE）与委员会认证考试分数之间的相关性。
在ITE前的6个月期间（2014年6月至11月）前瞻性地跟踪内科住院医师的活动参与情况。采用多变量回归分析来确定参与情况与考核分数之间的相关性。还检查了ITE与委员会认证考试分数之间的相关性。
纳入的研究对象分别为11名二年级和8名三年级的住院医师。两组之间的年龄、性别和医学院平均绩点相同。在研究期间，为住院医师提供了34次讲座式活动和81次基于病例的非讲座课程。多变量回归分析表明，参加超过65%的非讲座活动可使ITE临床技能部分的分数提高10.53%（p值=0.003），而医学院平均绩点每增加1.0分，可使ITE临床知识部分的分数提高19.24%（p值=0.009）。研究表明ITE与委员会认证考试分数之间存在中度至高度相关性（临床知识r = 0.72，p值<0.001；临床技能r = 0.94，p值<0.001）。
以ITE衡量，参加课程活动，尤其是基于病例的非讲座活动，对内科住院医师有益。ITE与委员会认证考试分数之间存在很强的相关性。
