The effect of prior night call status on the American Board of Surgery in-training examination scores: eight years of data from a single institution.
OBJECTIVE
Despite recent attention to resident duty hours, little data evaluate the effect of being on-call the night before taking an in-training examination on examination performance. The few previous studies evaluated single-year test scores, from heterogeneous cohorts, with inconsistent findings. The purpose of this study was to determine the effect of being on-call the night before taking the American Board of Surgery In-Training Examination (ABSITE) on resident scores at a single institution over a duration of several years.


METHODS
Overall percentile rank, standard scores, and prior night call status were recorded for all residents (categorical and preliminary) taking the ABSITE at our institution from 1999 to 2006. A 2-way ANOVA was performed to determine whether (1) the standard scores varied significantly between residents not on-call and those who were on-call, 2) performance varied significantly by PGY level, and 3) there was a significant interaction between call status and PGY level. Percentile rank of residents on-call the night before the examination were compared with those off-call using the Mann-Whitney U-test. For residents with scores from multiple years, standard scores from years on-call were compared with years off-call using the Wilcoxon signed rank test.


RESULTS
A total of 282 ABSITE results were recorded with 69 (24%) residents taking in-house call the night before the examination. A 2-way analysis of variance indicated that although standard score performance varied significantly by PGY level (p < 0.001), no significant differences were found in scores at any PGY level attributable to being on-call (p = 0.70). This analysis was also performed on only categorical general surgery residents' scores. Again, no significant differences were attributable to being on-call. Similarly, a Mann-Whitney U-test indicated no statistical difference in percentile scores based on call status (p = 0.43). Matched resident scores from year to year did not differ significantly based on call status (p = 0.21).


CONCLUSIONS
Based on several analytic models, being on-call the night before the ABSITE does not significantly affect resident performance.
Department of Surgery, University of Kentucky College of Medicine, Lexington, Kentucky 40536, USA. djmini@uky.edu
David
D
Minion
Margaret
M
Plymale
Michael
M
Donnelly
Eric
E
Endean
D000704:Analysis of Variance; D003072:Cognition Disorders / Q000209:etiology; D004521:Educational Measurement; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D009551:Night Care; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D012892:Sleep Deprivation / Q000150:complications; D018709:Statistics, Nonparametric; D016526:Workload