Structured emergency medicine board review and resident in-service examination scores

To determine whether the institution of a structured board review program is associated with improved in-service examination scores by residents at an emergency medicine (EM) residency program.

A retrospective, historical control analysis of the association of a board review program and in-service examination scores at one EM residency program was performed. A structured board review consisting of monthly reading assignments in "classic" EM textbooks followed by a graded multiple-choice written examination was instituted in 1987. Percentile scores on the American Board of Emergency Medicine (ABEM) in-service examination before (1985-1986) and after (1987-1994) initiation of the board review process were compared by resident level (EM-1, 2, or 3).

The EM-1 mean percentile score before review was 50.7 and rose to 68.9 after the institution of the board review program (p = 0.039). Mean EM-2 scores (66.8 vs 65.4) and EM-3 scores (74.4 vs 67.4) decreased slightly; these decreases were not statistically significant. Due to the large increase in EM-1 scores, the mean scores for the total program increased slightly (63.4 vs 67.4; p = NS).

In this study, EM-1 in-service scores improved in association with the institution of a structured board review program. This formalized didactic program may increase the knowledge base and test performance of EM-1 residents. A favorable effect on EM-2 and EM-3 resident scores was not seen.