title: Factors associated with medical knowledge acquisition during internal medicine residency.
abstract: BACKGROUND
  Knowledge acquisition is a goal of residency and is measurable by in-training exams. Little is known about factors associated with medical knowledge acquisition.
  
  
  OBJECTIVE
  To examine associations of learning habits on medical knowledge acquisition.
  
  
  METHODS
  Cohort study of all 195 residents who took the Internal Medicine In-Training Examination (IM-ITE) 421 times over 4 years while enrolled in the Internal Medicine Residency, Mayo Clinic, Rochester, MN.
  
  
  METHODS
  Score (percent questions correct) on the IM-ITE adjusted for variables known or hypothesized to be associated with score using a random effects model.
  
  
  RESULTS
  When adjusting for demographic, training, and prior achievement variables, yearly advancement within residency was associated with an IM-ITE score increase of 5.1% per year (95%CI 4.1%, 6.2%; p < .001). In the year before examination, comparable increases in IM-ITE score were associated with attendance at two curricular conferences per week, score increase of 3.9% (95%CI 2.1%, 5.7%; p < .001), or self-directed reading of an electronic knowledge resource 20 minutes each day, score increase of 4.5% (95%CI 1.2%, 7.8%; p = .008). Other factors significantly associated with IM-ITE performance included: age at start of residency, score decrease per year of increasing age, -0.2% (95%CI -0.36%, -0.042%; p = .01), and graduation from a US medical school, score decrease compared to international medical school graduation, -3.4% (95%CI -6.5%, -0.36%; p = .03).
  
  
  CONCLUSIONS
  Conference attendance and self-directed reading of an electronic knowledge resource had statistically and educationally significant independent associations with knowledge acquisition that were comparable to the benefit of a year in residency training.
authors.affiliation: General Internal Medicine-Hospital Internal Medicine, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA. mcdonald.furman@mayo.edu
authors.forename: Furman S
authors.initials: FS
authors.lastname: McDonald
authors.forename: Scott L
authors.initials: SL
authors.lastname: Zeger
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Kolars
mesh_terms: D000328:Adult; D002983:Clinical Competence; D015331:Cohort Studies; D003194:Computer-Assisted Instruction; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D007858:Learning; D008297:Male; D008910:Minnesota; D014163:Transfer, Psychology