Novel Strategies to Optimize Individual Performance on the In-Service Training Exam: A Case Series

Obstetrics and gynecology residents in the United States take the Council on Residency Education in Obstetrics and Gynecology (CREOG) in-service training exam on an annual basis. Performance on the exam is essential to assess any deficits in a resident's knowledge as well as to evaluate the probability of passing the American Board of Obstetrics and Gynecology (ABOG) qualifying board exam. Given the substantial number of residents who experience performance issues during the exam, residency programs and individual learners benefit from the development of personalized learning plans to ensure trainee success. Test-taking anxiety is a big part of these performance issues. Eye movement desensitization and reprocessing (EMDR) therapy is a psychological method used to treat trauma symptoms and to also improve performance anxiety. Thus far, there have not been reports in literature of utilizing EMDR in residency programs to help learners struggling with test anxiety.

We describe a series of cases in which EMDR therapy was utilized to enhance learner performance. The first case describes a resident who started with a CREOG score in lowest percentile, but with additional support, including EMDR therapy, improved their score to 60% in their second year and improved to 70% in their third year. In the second case, a resident with very inconsistent CREOG scores passed their qualifying exam on the first attempt after EMDR therapy. In the third case, a resident had consistently declining CREOG scores throughout their program, but with the help of an EMDR therapist ultimately passed the ABOG qualifying exam on the first attempt.

This article highlights that EMDR can be an effective strategy to improve CREOG scores for residents with poor performance. The results we have seen in our residency program validate that EMDR is a successful tool for learners who experience test anxiety.