Orthopedic In-Training Examination: A Performance Review Based on Program- and Resident-Specific Characteristics.
OBJECTIVE
The orthopedic in-training examination (OITE) is the most common and objective method used to assess resident knowledge in the United States. As such, residents and programs use a number of strategies to maximize OITE performance. The purpose of this work was to better understand what strategies were being implemented and to determine which program-specific and resident-specific characteristics best correlate with improved scores.


METHODS
A national survey of orthopedic residents and program directors (PDs) was performed to better understand OITE performance and correlate scores with various test preparation strategies.


METHODS
Mayo Clinic, Rochester, MN.


METHODS
The survey was completed by 33 of 48 (68.8%) PDs and 341 of 878 (38.8%) eligible residents.


RESULTS
The most commonly used program-wide strategies were as follows: negative consequences for poor performance (72.7%), formal OITE prep program (54.5%), and purchase of OITE test prep material for residents (51.5%). The program-specific characteristics that had the strongest correlation with increased scores were negative consequences for poor performance (p < 0.001), high value placed on the OITE by PD and residents (p < 0.001), excusing residents from clinical duties the evening prior (p < 0.001), having residents take the examination on different days (p = 0.012), and allowing residents to lead a review course (p = 0.047). The resident-specific characteristics that correlated most with score were increased study time leading up to the test (p = 0.031) and attendance at their program's OITE prep program (p = 0.062).


CONCLUSIONS
Although programs and residents looking to improve knowledge acquisition and OITE scores use a number of techniques, a few distinct strategies correlate with the greatest increases in OITE performance. These may be appropriate methods to consider for those looking to improve their performance in coming years.
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address: camp.christopher@mayo.edu.
Christopher L
CL
Camp
Department of Orthopedic Surgery, Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York.
Ryan M
RM
Degen
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Norman S
NS
Turner
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Arlen D
AD
Hanssen
Department of Orthopedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Matthew D
MD
Karam
Department of Orthopedic Surgery, Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York.
Joshua S
JS
Dines
D004503:Education, Medical, Graduate; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D007396:Internship and Residency; D009985:Orthopedics / Q000193:education*; D011795:Surveys and Questionnaires; D014481:United States
Medical Knowledge; OITE; Practice-Based Learning and Improvement; education; orthopedic in-training examination; resident