Progress testing in family medicine--A novel use for simulated office oral exams

Simulated office orals (SOOs) are used by the College of Family Physicians of Canada as a method to evaluate family medicine resident readiness for clinical practice. The use of SOOs as a progress test would provide residency programs with useful information to determine resident readiness for challenging the certification exam. The data from a progress test could then be easily manipulated to generate a risk assessment plot.

During a prospective cohort study conducted at the University of Ottawa, the feasibility of using practice SOO sessions, a structured clinical exam, as a progress test was explored. Twenty-three residents participated in all four practice SOO sessions and their results were entered into a risk assessment plot.

Repeated measures analysis of the data using ANOVA demonstrated that the residents' scores at each time point were statistically different from each other, generating an F(3, 66) = 27.52, p < 0.001, η(2) = 0.55.and that the relationship over time was linear with an F(1, 22) = 123.80, p < 0.001, η(2) = 0.85. At the final time point, a risk assessment resulted in no learners mapping to quadrants III or IV.

Our results demonstrate the feasibility of utilizing a SOO exam, a clinical exam, as a progress test. In addition, we propose generating a risk assessment plot, using the data from the Fall 2013 and Spring 2014 practice SOO sessions, as a means of identifying residents at risk. Further studies will be needed to confirm the utility of this analysis. Combined with other measures acquired during in-training evaluation, the utilization of practice SOOs as a progress test will provide program directors with valuable information on resident progression.