Effect of a review course on emergency medicine residents' self-confidence

Several organizations offer review courses designed to guide final-year (postgraduate year five) residents' study for their certification examination. The effect of these courses on residents' confidence is unknown. Self-confidence has been positively linked with examination performance. The present study measures the impact of a review course on fifth-year emergency medicine residents' overall confidence and confidence in their: (i) knowledge and its application; (ii) planned study strategies to master the knowledge/application; and (iii) recognition that mastery of knowledge/application had been achieved.

Before/after study. Over the initial 2 years, 46 postgraduate year five residents from all 12 Canadian emergency medicine programmes attended the course. They prospectively completed a pre-/post-course questionnaire on the above-listed aspects of self-confidence, for each of 22 clinical domains. A 5-point Likert-type scale was used for each question. Pre-/post-course means were compared using t-tests for matched pairs.

Data were complete for 36 participants (78%). The course significantly increased residents' overall self-confidence (mean difference 0.38, standard error of the mean [SEM] 0.06, P < 0.001), confidence in knowledge/application (mean difference 0.28, SEM 0.06, P < 0.001), in their study strategies to master knowledge/application (mean difference 0.48, SEM 0.08, P < 0.001) and in their recognition of knowledge/application mastery (mean difference 0.45, SEM 0.11, P < 0.001). Domains showing increased self-confidence did not match domains specifically addressed in the course, suggesting that the course effects extend beyond the selected topics.

A review course increased emergency medicine residents' self-assessed confidence in their knowledge/application, in their study strategies and in their recognition of mastery, beyond the course specifics.