Cassaro Sebastiano, Jarman Benjamin T, Joshi Amit R T, Goldman-Mellor Sidra, Hope William W, Johna Samir, Kaufman Theodor, Grannan Kevin J
Department of Surgery, Kaweah Delta Health Care District Medical Center, Visalia, California.
Department of Surgery, Gundersen Health System, Lacrosse, Wisconsin.
J Surg Educ. 2020 Mar-Apr;77(2):273-280. doi: 10.1016/j.jsurg.2019.09.012. Epub 2019 Sep 28.
Accreditation Council for Graduate Medical Education (ACGME) Surgery milestone ratings in the "Knowledge of Diseases and Conditions" (MK1) sub competency have been shown to correlate with American Board of Surgery In Training Examination (ABSITE) scores, and hypothesized to predict them. To better assess the predictive value of the MK1 milestone and avoid the potential bias caused by previous years' ABSITE scores, we designed a study including only first-year (PGY-1) residents and analyzed the correlation between their mid-year MK1 ratings and their scores in the ABSITE they took approximately a month later.
De-identified United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, mid-year MK1 milestone ratings and the subsequent ABSITE standard scores for the five academic years from 2014-2015 to 2018-2019 were collected and tabulated for 247 PGY-1 preliminary- and categorical-track residents from ten ACGME-accredited surgery residency programs.
The mid-year rating of PGY-1 residents' MK1 was predictive of their subsequent first ABSITE score for the entire cohort and for the categorical residents' subset. Notably, controlling for all other independent predictors, each half-point increase in MK1 rating was associated with a 25-point increase in ABSITE score. Preliminary residents performed significantly worse on the ABSITE, and their scores did not correlate significantly with their MK1 ratings.
The mid-year rating of PGY-1 residents' MK1 was predictive of their subsequent first ABSITE score for the entire cohort and for the categorical but not the preliminary residents. This finding suggests that evaluators correctly rated MK1 higher in the categorical residents who did perform better on the subsequent ABSITE.
研究生医学教育认证委员会(ACGME)外科学科“疾病与病症知识”(MK1)子能力领域的里程碑式评估结果已被证明与美国外科医师委员会住院医师培训考试(ABSITE)成绩相关,并且推测该评估结果可预测考试成绩。为了更好地评估MK1里程碑式评估的预测价值,并避免前几年ABSITE成绩造成的潜在偏差,我们设计了一项仅纳入一年级(PGY-1)住院医师的研究,并分析了他们年中MK1评估结果与大约一个月后参加的ABSITE考试成绩之间的相关性。
收集并整理了2014 - 2015年至2018 - 2019年五个学年来自10个经ACGME认证的外科住院医师培训项目的247名PGY-1预科和常规培训住院医师的匿名美国医师执照考试(USMLE)第一步和第二步成绩、年中MK1里程碑式评估结果以及随后的ABSITE标准分数。
PGY-1住院医师MK1的年中评估结果可预测整个队列以及常规培训住院医师亚组随后的首次ABSITE考试成绩。值得注意的是,在控制了所有其他独立预测因素后,MK1评估结果每提高0.5分,ABSITE成绩就会提高25分。预科住院医师在ABSITE考试中的表现明显较差,且他们的成绩与MK1评估结果无显著相关性。
PGY-1住院医师MK1的年中评估结果可预测整个队列以及常规培训住院医师而非预科住院医师随后的首次ABSITE考试成绩。这一发现表明,评估者对随后在ABSITE考试中表现更好的常规培训住院医师的MK1评估结果评分更高。