Text messaging to improve resident knowledge: a randomized controlled trial

Advances in technology present opportunities to develop and test innovative teaching methods. We sought to evaluate whether text messaging could improve medical resident knowledge in musculoskeletal medicine.

Eleven U.S. family medicine residency programs with a total of 269 residents participated in this randomized, controlled trial. Residents were invited to complete a pretest to assess musculoskeletal medicine knowledge. The residents randomized to the intervention group were then offered to receive text messages termed electronically Generated Educational Messages (eGEMs) three times per week during a 12-week period. The primary outcome was change in pretest and posttest scores among residents in an intervention group (those who received text messages) as compared to a control group (those who did not receive the text messages). Focus groups were conducted to assess resident acceptability and usefulness of text messaging as a teaching tool.

Sixty-three residents completed the pretests and posttests. The intervention group's score improved from 55% of questions answered correctly to 64%; the control group improved from 56% to 61%. While these pretest/posttest changes each were statistically significant, the difference in improvement between the two groups was not. Focus groups revealed that participants liked the intervention, but suggestions for improvement included ability to tailor the eGEMs.

The use of eGEMs as initially developed did not increase resident knowledge based on exam scores. Further study is needed to determine if a more tailored intervention is effective.