title: Performance on the adult rheumatology in-training examination and relationship to outcomes on the rheumatology certification examination.
abstract: OBJECTIVE
  The American College of Rheumatology (ACR) Adult Rheumatology In-Training Examination (ITE) is a feedback tool designed to identify strengths and weaknesses in the content knowledge of individual fellows-in-training and the training program curricula. We determined whether scores on the ACR ITE, as well as scores on other major standardized medical examinations and competency-based ratings, could be used to predict performance on the American Board of Internal Medicine (ABIM) Rheumatology Certification Examination.
  
  
  METHODS
  Between 2008 and 2012, 629 second-year fellows took the ACR ITE. Bivariate correlation analyses of assessment scores and multiple linear regression analyses were used to determine whether ABIM Rheumatology Certification Examination scores could be predicted on the basis of ACR ITE scores, United States Medical Licensing Examination scores, ABIM Internal Medicine Certification Examination scores, fellowship directors' ratings of overall clinical competency, and demographic variables. Logistic regression was used to evaluate whether these assessments were predictive of a passing outcome on the Rheumatology Certification Examination.
  
  
  RESULTS
  In the initial linear model, the strongest predictors of the Rheumatology Certification Examination score were the second-year fellows' ACR ITE scores (β = 0.438) and ABIM Internal Medicine Certification Examination scores (β = 0.273). Using a stepwise model, the strongest predictors of higher scores on the Rheumatology Certification Examination were second-year fellows' ACR ITE scores (β = 0.449) and ABIM Internal Medicine Certification Examination scores (β = 0.276). Based on the findings of logistic regression analysis, ACR ITE performance was predictive of a pass/fail outcome on the Rheumatology Certification Examination (odds ratio 1.016 [95% confidence interval 1.011-1.021]).
  
  
  CONCLUSIONS
  The predictive value of the ACR ITE score with regard to predicting performance on the Rheumatology Certification Examination supports use of the Adult Rheumatology ITE as a valid feedback tool during fellowship training.
authors.affiliation: University of Kentucky College of Medicine, Lexington.
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Lohr
authors.affiliation: National Board of Medical Examiners (NBME), Philadelphia, Pennsylvania.
authors.forename: Amanda
authors.initials: A
authors.lastname: Clauser
authors.affiliation: Hess Consulting, Montreal, Quebec, Canada.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Hess
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Allan C
authors.initials: AC
authors.lastname: Gelber
authors.affiliation: University of South Florida Morsani College of Medicine, Tampa.
authors.forename: Joanne
authors.initials: J
authors.lastname: Valeriano-Marcet
authors.affiliation: American Board of Internal Medicine (ABIM), Philadelphia, Pennsylvania.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Lipner
authors.affiliation: National Board of Medical Examiners (NBME), Philadelphia, Pennsylvania.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Haist
authors.affiliation: National Board of Medical Examiners (NBME), Philadelphia, Pennsylvania.
authors.forename: Janine L
authors.initials: JL
authors.lastname: Hawley
authors.affiliation: American College of Rheumatology (ACR), Atlanta, Georgia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Zirkle
authors.affiliation: Massachusetts General Hospital, Boston.
authors.forename: Marcy B
authors.initials: MB
authors.lastname: Bolster
mesh_terms: D002568:Certification; D002983:Clinical Competence; D004521:Educational Measurement; D006801:Humans; D012219:Rheumatology / Q000193:education*