Impact of Moodle-Based Online Curriculum on Thoracic Surgery In-Training Examination Scores.
BACKGROUND
The feasibility and efficacy of a web-based curriculum in supplementing thoracic surgical training was previously shown. However, the impact of curricular participation on validated knowledge tests remains unknown. We compared in-service training examination (ITE) results among trainees, stratified by curricular use.


METHODS
The national online curriculum was implemented in August 2013. We retrospectively reviewed trainees who participated in thoracic surgical training programs in both 2012 to 2013 and 2013 to 2014. Scores from the 2013 and 2014 ITEs were obtained, and curricular usage data were collected from site analytics. Trainees were separated into three groups according to 2013 ITE scores; within each group, changes in score for high- versus low-volume users were compared.


RESULTS
187 trainees took the ITE both years, with exposure to the online curriculum during only the second year. High-volume users' scores trended toward greater improvement than scores of low-volume users (+18.2% versus +13.0%, p = 0.199). When stratified by 2013 score, the lowest scoring quartile improved substantially, and the highest scoring quartile improved modestly, regardless of curricular use. However, for those individuals who achieved mid-range scores in 2013, there was a trend toward much greater improvement in score with heavier use of the curriculum (+17.0% versus +7.0%, p = 0.094).


CONCLUSIONS
Among trainees who had access to the novel online curriculum during the second of 2 consecutive years, we evaluated the impact of curricular participation on ITE scores. The effect appears to be most pronounced in individuals with mid-range scores, in whom high curricular use led to the greatest improvement.
Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: mbantonoff@mdanderson.org.
Mara B
MB
Antonoff
Division of Cardiothoracic Surgery, University of Washington, Seattle, Washington.
Edward D
ED
Verrier
Department of Surgery, Mayo Clinic, Rochester, Minnesota.
Mark S
MS
Allen
Joint Council on Thoracic Surgery Education, Chicago, Illinois.
Lauren
L
Aloia
Department of Cardiothoracic Surgery, University of Southern California Keck School of Medicine, Los Angeles, California.
Craig
C
Baker
Department of Cardiothoracic Surgery, Stanford University Medical Center, Stanford, California.
James I
JI
Fann
Division of Thoracic Surgery, East Carolina Heart Institute at East Carolina University, Greenville, North Carolina.
Mark D
MD
Iannettoni
Division of Thoracic Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Stephen C
SC
Yang
Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas.
Ara A
AA
Vaporciyan
D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D020407:Internet; D007396:Internship and Residency / Q000379:methods*; D012189:Retrospective Studies; D013903:Thoracic Surgery / Q000193:education*; D019616:Thoracic Surgical Procedures / Q000193:education*