Factors associated with medical knowledge acquisition during internal medicine residency.

McDonald FS, Zeger SL, Kolars JC. Factors associated with medical knowledge acquisition during internal medicine residency. J Gen Intern Med. 2007 Apr 28.

A study of internal medicine residents at the Mayo Clinic examined the impact of learning habits such as conference attendance and use of an electronic knowledge resource (UpToDate) on medical knowledge acquisition as measured by the Internal Medicine In-training Examination (IM-ITE). The IM-ITE assesses the medical knowledge of internal medicine residents during their three-year training program; scores increase with each year of residency reflecting the acquisition of medical knowledge during residency. Performance on the examination correlates with subsequent performance on the American Board of Internal Medicine Certification Examination. The authors correlated how much UpToDate was used by each resident (based upon usage logs) with IM-ITE scores. Using UpToDate for 20 minutes a day was associated with a comparable increase in IM-ITE scores as an entire year of residency. The model was fully adjusted and considered known covariates associated with performance on the IM-ITE, suggesting that use of UpToDate was an independent predictor of performance. A similar degree of benefit was also detected for regular conference attendance. The authors also cited a survey of 18,000 residents in which UpToDate was the most commonly used clinical resource for clinical information. These data (as well as previous studies involving UpToDate) suggest that it has an important role in medical education and in acquisition of medical knowledge.

  • Conference attendance and self-directed reading of an electronic knowledge resource had statistically and educationally significant independent associations with knowledge acquisition that were comparable to the benefit of a year in residency training.