title: Analysis of References on the Plastic Surgery In-Service Training Exam.
abstract: BACKGROUND
  The Plastic Surgery In-Service Training Exam is a knowledge assessment tool widely used during plastic surgery training in the United States. This study analyzed literature supporting correct answer choices to determine highest yield sources, journal publication lag, and journal impact factors.
  
  
  METHODS
  Digital syllabi of 10 consecutive Plastic Surgery In-Service Training Exam administrations (2006 to 2015) were reviewed. The most-referenced articles, journals, and textbooks were determined. Mean journal impact factor and publication lag were calculated and differences were elucidated by section.
  
  
  RESULTS
  Two thousand questions and 5386 references were analyzed. From 2006 to 2015, the percentage of journal citations increased, whereas textbook references decreased (p < 0.001). Plastic and Reconstructive Surgery was cited with greatest frequency (38.5 percent), followed by Clinics in Plastic Surgery (5.6 percent), Journal of Hand Surgery (American volume) (5.1 percent), and Annals of Plastic Surgery (3.8 percent). There was a trend toward less publication lag over the study period (p = 0.05), with a mean publication lag of 9.1 ± 9.0 years for all journal articles. Mean journal impact factor was 2.3 ± 4.3 and lowest for the hand and lower extremity section (1.7 ± 2.8; p < 0.001). The highest yield textbooks were elucidated by section.
  
  
  CONCLUSIONS
  Plastic surgery faculty and residents may use these data to facilitate knowledge acquisition during residency.
authors.affiliation: Philadelphia, Pa.; and Boston, Mass.|From the Perelman School of Medicine at the University of Pennsylvania; and the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School.
authors.forename: Jason
authors.initials: J
authors.lastname: Silvestre
authors.affiliation: Philadelphia, Pa.; and Boston, Mass.|From the Perelman School of Medicine at the University of Pennsylvania; and the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School.
authors.forename: Alicia
authors.initials: A
authors.lastname: Zhang
authors.affiliation: Philadelphia, Pa.; and Boston, Mass.|From the Perelman School of Medicine at the University of Pennsylvania; and the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Lin
mesh_terms: D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D007318:Inservice Training / Q000379:methods*; D007396:Internship and Residency; D019651:Plastic Surgery Procedures / Q000193:education; D012014:Reference Books, Medical; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000193:education*; D014481:United States