Impact of Residency Training Redesign on Residents' Clinical Knowledge

Area of Science:

• Medical Education Research
• Family Medicine Residency Training
• Clinical Knowledge Assessment

Background:

• The In-training Examination (ITE) is a key tool for assessing family medicine residents' clinical knowledge.
• The Preparing the Personal Physician for Practice (P4) Project involved 14 family medicine residency programs.

Purpose of the Study:

• To compare family medicine ITE scores of P4 residents with national averages.
• To evaluate the impact of educational innovations on resident performance on the ITE.

Main Methods:

• ITE scores from 802 P4 residents (2007-2011) were analyzed.
• Scores were compared to national averages by academic year and postgraduate year (PGY).
• Secondary analyses examined scores based on program experiments with training length and individualized education.

Main Results:

• P4 residents consistently achieved higher ITE scores than the national average across all years and PGY levels.
• For example, in 2011, PGY1 P4 residents scored 401.2 vs. national 386; PGY2 scored 443.1 vs. national 427; PGY3 scored 477.0 vs. national 456.
• No significant difference in ITE scores was found between programs experimenting with training length or individualized education versus those that did not.

Conclusions:

• Substantial educational changes in family medicine residency programs did not negatively affect resident clinical knowledge, as indicated by ITE scores.
• Further research is warranted to explore the long-term effects of various residency training innovations on ITE performance.