American Board Of Surgery In-Training Examination Performance Research Articles

Navigating the American Board of Surgery In-Training Examination (ABSITE) Success: Insights From Pre-assessment Practices in Preparing Surgical Residents for Competitive Sub-specialties.

Introduction The American Board of Surgery In-Training Examination (ABSITE) is a critical tool in assessing surgical residents' readiness for board certification and clinical practice. While various factors influencing ABSITE performance have been examined, the impact of innovative educational resources, such as TrueLearn, remains underexplored. TrueLearn's adaptive learning algorithms and comprehensive question banks offer a promising adjunct to traditional study methods. This study investigates the relationship between TrueLearn utilization and ABSITE performance among general surgery residents. Methods This retrospective study, ethically approved by the Marshall University Institutional Review Board (IRB No. 2097669-1), analyzed the performance of general surgery residents at Marshall University from 2014 to 2022. Data were collected on ABSITE scores. Additionally, quiz percentages (Quiz %) and scores from two mock exams (Exam 1 and Exam 2), all provided by the TrueLearn platform, were included in the analysis. Descriptive statistics summarized the sample characteristics. Linear mixed models were employed to examine the associations between TrueLearn engagement and ABSITE performance, accounting for the correlated nature of the data and addressing any missing data at random. Statistical analyses were conducted using the Statistical Analysis System (SAS, version 9.4; SAS Institute Inc., Cary, NC), with significance defined as a p-value < 0.05. Results The study cohort included 58 residents from 2016 to 2022. Linear mixed model analysis revealed significant positive correlations between TrueLearn Quiz %, Exam 1 scores, and Exam 2 scores with ABSITE performance. A 1% increase in Quiz % was associated with a 0.77-point rise in ABSITE scores (95% CI: 0.65, 0.89; p < 0.0001). For Exam 1, each point increase corresponded to a 6.36-point increase in ABSITE scores (95% CI: 5.01, 7.7; p < 0.0001), while Exam 2 scores showed a 3.8-point increase per point (95% CI: 2.74, 4.86; p < 0.0001). Discussion and conclusion Our findings underscore the significant impact of TrueLearn engagement on ABSITE performance, with higher quiz percentages and mock exam scores predictive of better ABSITE outcomes. This suggests that regular use of TrueLearn's educational resources enhances residents' knowledge and exam readiness. These results advocate for the integration of innovative educational tools such as TrueLearn into surgical training programs to optimize study strategies and improve exam performance. However, the study's retrospective design and single-institution focus limit the generalizability of the findings. Future research should explore these relationships in diverse settings and specialties and consider additional factors influencing ABSITE performance. This study highlights the positive association between TrueLearn utilization and ABSITE performance among general surgery residents, emphasizing the importance of innovative educational resources in surgical training. By enhancing engagement with platforms such as TrueLearn, surgical programs can improve residents' readiness for high-stakes examinations, ultimately contributing to the development of proficient surgical practitioners.

Preliminary Development of a Program ABSITE Dashboard (PAD) to Guide Curriculum Innovation

Medical Knowledge for general surgery residents' is assessed by the American Board of Surgery In- Training Examination (ABSITE). ASBITE score reports contain many metrics residency directors can utilize to assess resident progress and perform program evaluation. The purpose of this study was to develop a framework to evaluate program effectiveness in teaching specific subtest and subtopic areas of the ABSITE, using ABSITE score reports as an indicator. The aim is to demonstrate the identification of topic areas of weakness in program-wide performance on the ABSITE to guide proposed modification of the general surgery residency program curriculum, and to initiate development of a data visualizing dashboard to communicate these metrics. A single institution retrospective study was performed utilizing ABSITE score reports from general surgery residents at a large academic training program from 2017 to 2020. ABSITE performance metrics from 320 unique records were entered into a database; statistical analysis for linear trends and variance were conducted for standard scores, subtest standard scores, and incorrect subtest topics. Deviation from national average scores were calculated by subtracting the national average score from each subtest score for each trainee. Data were displayed as medians or proportions and are displayed to optimize visualization as a proof-of-concept for the development of a program dashboard. Trends and variance in general surgery program and cohort performance on various elements of the ABSITE were visualized using figures and tables that represent a prototype for a program dashboard. Figure A1 demonstrates one example, in which a heatmap displays the median deviation from national average scores for each subtest by program year. Boxplots show the distribution of the deviation from national average, range for national average scores, and the recorded scores for each subtest by program year. Trends in median deviation from the national average scores are displayed for each program year paneled by subtest or for each exam year paneled by cohort. Median change in overall test scores from one program year to another in a cohort is visualized as a table. Bar graphs show the most often missed topics across all program years and heatmaps were generated showing the proportion of times each topic was missed for each subtest and exam year. We demonstrate use of ABSITE reports to identify specific thematic areas of opportunities for curriculum modification and innovation as an element of program evaluation. In this study we demonstrate, through data analysis and visualization, feasibility for the creation of a Program ABSITE Dashboard (PAD) that enhances the use of ABSITE reports for formative program evaluation and can guide modifications to surgery program curriculum and educational practices.

Trainee Utilization of the SCORE Curriculum is Associated With Improved ABSITE Performance: A Multi-institutional Study

The Surgical Council on Resident Education's (SCORE) structured educational curriculum for general surgery residents uses a 2-year repeating cycle of modules and quizzes called "This Week in SCORE" (TWIS) to organize and sequence the curricular content on the SCORE portal. The purpose of this study was to evaluate the impact of using the SCORE content and TWIS curriculum on American Board of Surgery In-Training Examination (ABSITE) performance. To date, no multi-institutional studies have examined this effect. Eight residency programs participated, including university and community-based programs. SCORE usage overall, TWIS usage, and ABSITE percentile scores (adjusted for post-graduate year [PGY]) were analyzed for the academic years 2017 to 2020. SCORE usage was defined as number of SCORE logins annually per resident with "low usage" ≤10 times and "high usage" >10 times. TWIS usage was defined as "low usage" (no TWIS quizzes done) or "high usage" (≥1 TWIS quiz per year). Four hundred and twenty-eight trainees were evaluated. Trainees with high SCORE and TWIS usage consistently achieved a higher ABSITE percentile score. This difference was maintained in subgroup analysis by PGY with the greatest impact in PGY-1 and PGY-2 levels. Utilization of multiple aspects of SCORE content appears to have a significant positive impact on ABSITE performance across all levels of postgraduate training. This multi-institutional study of a large number of users is the first to demonstrate that increased usage of SCORE content appears to be a predictor of ABSITE performance success.

Learning to Read: Successful Program-Based Remediation Using the Surgical Council on Resident Education (SCORE) Curriculum

The Surgical Council on Resident Education (SCORE) curriculum is aligned with the American Board of Surgery (ABS) objectives. Our program adopted the SCORE curriculum in 2015 after poor ABS In-Training Examination (ABSITE) performance and lowest quartile ABS Certifying Exam (CE) and Qualifying Exam (QE) first-time pass rates. We examined the association of SCORE use with ABSITE performance and ABS board exam first-time pass rate. At a single institution, a retrospective review of surgery residents' SCORE metrics and ABSITE percentile was conducted for academic years 2015 to 2019. Metrics analyzed on the SCORE web portal were mean total minutes and total visits per resident for all residents using SCORE that year. First-time pass rates of the ABS QE and CE were examined from 2013 to 2019. Chi-square and linear regression analysis were performed, and a 95% level of confidence was assumed (alpha= 0.05). Yearly data from categorical general surgery residents showed a significant increase in total minutes, total visits, and ABSITE percentile. Combined first time pass rates for the ABS QE and CE significant increased from 70.8% in 2013 to 2015 to 93.9% in 2016 to 2019 (p= 0.018). Increased longitudinal use of the SCORE curriculum was associated with programmatic improvements in ABSITE performance and ABS board exam first-time pass rate.

Spaced Education With ABSITE Quest Resulting in Improved American Board of Surgery In-Training Examination Performance

The American Board of Surgery In-Training Examination (ABSITE) is an annual exam taken by general surgery residents as a cognitive assessment of the knowledge gained throughout each year of training. Several question banks are available for ABSITE preparation. However, ABSITE Quest (AQ) utilizes a method called spaced education which has been demonstrated to help with retaining information longer and improve exam performance. This study hypothesizes that using this method will help residents improve their ABSITE performance. Retrospective survey data was collected from residents who participated in AQ, including postgraduate year (PGY) level, as well as 2019 and 2020 ABSITE percentiles. AQ user data was used to match respondent's total number of questions completed and daily engagement level to the survey data. Paired, single-tailed student's t test was used to evaluate the significance of ABSITE percentile change between 2019 and 2020 among AQ users. ChristianaCare, Newark, DE, United States. Nonclinical. All ABSITE Quest users were surveyed (n = 390), of which 104 responded. 21 responses were from PGY1 residents and were excluded, resulting in a total of 83 responses. The mean percentile difference of AQ users from 2019 to 2020 was +15.8 (p < 0.00001). When categorizing by the total number of questions completed, high users demonstrated a mean percentile difference of +15.3 (p = 0.00002), average users had a difference of +19.1 (p = 0.00029), and low users showed a percentile difference of +1.2 (p = 0.45244). When categorizing by daily engagement level, high users demonstrated a mean percentile difference of +17.9 (p < 0.00001), low users had a mean percentile difference of +15.3 (p = 0.00124), and minimal users showed a mean percentile change of -5.7. The use of the spaced education method with ABSITE Quest, especially in users with a greater number of questions completed and high levels of daily engagement, correlated with a significant improvement on ABSITE performance.

USMLE Scores and Clinical Rotation Role in Predicting ABSITE Performance Among Surgery Interns

BackgroundThe American Board of Surgery In-training Examination (ABSITE) is an important marker of medical knowledge. It is unclear what factors predict or improve these scores. We evaluated demographics, United States Medical Licensing Examination (USMLE) step 1 and 2 scores, and surgical rotations during the intern year to determine if there were any correlations with the ABSITE performance. MethodsThis was a multicenter retrospective review during a 6-y period, investigating the correlation and association of demographics, USMLE scores, and types of rotations on the ABSITE percentile score of interns. Demographics included age, gender, race/ethnicity, U.S. versus international/foreign medical graduate for stratified analyses. Descriptive analysis was performed with ANOVA, correlation was evaluated with 95% confidence interval, and significance was defined as P < 0.05. ResultsComplete records obtained on 89 interns from six different general surgery programs over 6 y revealed that there was a significant correlation between USMLE 1 and 2 with the ABSITE. USMLE 2 correlation was the strongest (r = 0.44, 95% confidence interval = [0.25-0.60], P < 0.05). There was a significant difference in ABSITE performance (mean score difference of 17.3 percentile, P = 0.01) of interns who had an intensive care unit rotation before examination. Other surgical rotations were not associated with an ABSITE difference. Demographic factors such as age, gender, race/ethnicity, or medical graduate background status were not associated with ABSITE scores. ConclusionsUSMLE step 2 scores had a higher correlation with intern ABSITE performance. An intensive care unit rotation before taking the ABSITE was associated with a significant difference in their percentile scores. Demographic factors were not correlated with ABSITE performance.

The Impact of a Comprehensive Resident Curriculum and Required Participation in “This Week in SCORE” on General Surgery ABSITE Performance and Well-Being

This Week in SCORE (TWIS) is a biennial, general surgery curriculum comprised of weekly online modules, readings, and multiple-choice quizzes. In this study, we examined the impact of required TWIS on American Board of Surgery In-Training Examination (ABSITE) scores and well-being among categorical general surgery residents. TWIS quiz completion became required in 2017. Residents attended weekly lectures, and ABSITE performance was incentivized with educational stipends. Surveys were distributed to assess study preferences, learning styles, burnout, and grit. Thirty-six categorical general surgery residents who took ABSITE in both 2017 and 2018 were evaluated in a paired-sample, retrospective analysis. After requiring TWIS, median ABSITE percentile increased by 12% (65%-77%, p = 0.001). Weekly TWIS completion (59% vs 89%, p < 0.001) and quiz results (62% vs 69%, p = 0.005) also improved. During this time, emotional exhaustion and depersonalization declined significantly, yet overall burnout scores did not change. Of 21 survey respondents, 66.7% (n = 14) increased weekly study time by a median of 2.5 hours. However, less than half used Surgical Council on Resident Education as their primary study tool. Only 23.8% (n = 5) reported that mandatory TWIS modified their study behavior, while 90.4% (n = 19) felt the culture of education had improved. After TWIS participation became required, ABSITE performances improved. Formalized curriculum with frequent assessment may foster accountability among residents, enhancing educational climate, well-being, and test performance.

Faculty evaluations of resident medical knowledge: can they be used to predict American Board of Surgery In-Training Examination performance?

BackgroundThe American Board of Surgery In-Training Examination (ABSITE) offers annual assessment of resident medical knowledge. We sought to determine if ongoing end-of-rotation evaluations by faculty of residents' medical knowledge correlate with ABSITE performance. MethodsRetrospective cross-sectional study was conducted over 3 years at 2 institutions. Faculty rated residents' clinical knowledge as part of a global summative evaluation. The intraclass correlation coefficient and convergent validity between faculty evaluations and ABSITE performance were assessed. ResultsA total of 1,562 faculty evaluations were completed for about 147 residents. There was poor agreement among faculty for each resident, with intraclass correlation coefficients of less than 0.2. Spearman's correlation coefficient was calculated for evaluations and ABSITE scores and were found to be weakly correlative at one institution and not correlated at all at the other. Finally, evaluations across quartiles of resident ABSITE scores were examined and show no correlation. ConclusionFaculty evaluations of resident medical knowledge correlate poorly with resident ABSITE performance, and should not be used as an ongoing predictive tool.

Interventions That Affect Resident Performance on the American Board of Surgery In-Training Examination: A Systematic Review

To systematically review the published literature on the effectiveness of interventions intended to improve residents' American Board of Surgery In-Training Examination (ABSITE) performances. A systematic review was conducted by 2 independent investigators to identify all publications that examined the effect of specific interventions on residents' ABSITE performances from 1975 to 2013. Overall, 26 published articles met study criteria. Structured reading programs and setting clear expectations with mandatory remedial programs were consistently effective in improving ABSITE performance, whereas the effect of didactic teaching conferences and problem-based learning groups was mixed. There was marked heterogeneity in the usage of study designs and reporting of results. Structured reading programs and mandatory remedial programs appear to be consistently effective measures that can improve residents' ABSITE performances. There is a need for improved study design and reporting in future research conducted in this field.

A Survey of Study Habits of General Surgery Residents

To understand the study habits of general surgery residents as well as their motivating factors for study. A survey was mailed to general surgical residents. Performance on the American Board of Surgery In-Training Examination (ABSITE) was correlated with reported study habits using the Pearson's correlation coefficient. Massachusetts General Hospital and Brigham and Women's Hospital, 2 urban tertiary referral academic training institutions in Boston, Massachusetts. Fifty-eight general surgical residents of all training levels (including research). On average, surgical residents studied for 3 ± 1 days per week, the average duration of each study session being 1.3 ± 0.6 hours. The average total number of study hours per week was 3.4 ± 2.3. There were strong positive correlations between increased study frequency and high overall ABSITE score (Pearson's r = 0.339; p = 0.02) and between the total number of study hours per week and high overall ABSITE score (Pearson's r = 0.423; p < 0.005). Only 10% and 3% reported complete satisfaction with current study materials and routine, respectively. Most residents (96%) reported a willingness to try a new type of study method and 75% were willing to enroll in a trial comparing study methods. Increased study frequency and overall increased study duration are positively correlated with ABSITE performance. Dissatisfaction with current study materials and study routine is high, as is willingness to adopt new methods and enroll in investigational trials comparing study methods.

Improving Surgical Resident's Performance In the American Board of Surgery in Training Examination (ABSITE) — Do Review Courses Help? The Program Directors' Perspective

The implementation of the 80-hour week compounded by the need for the current trainee to be well versed technically with the newer developments in surgery has resulted in limited time for didactic education. Commercial American Board of Surgery in Training examination (ABSITE) review courses are flourishing and may seem to be filling the gap in didactic education. This study ascertained the opinion of the general surgery program directors across the country on the role of the review courses in the ABSITE performance of a surgical resident. A questionnaire was designed and sent out to all program directors using online survey. Sixty-five of 242 program directors completed the questionnaire. Fifty-seven percent belonged to university-based surgical residency programs. Seventy-two percent used ABSITE performance as a measure while evaluating the resident for promotion. Although 60% agreed that review courses help the performance of the residents, 80% did not have any institutional or regional review courses. Ninety percent allowed their residents to attend commercial review courses but 60% did not reimburse them. Program directors do feel that ABSITE by itself is important in evaluating the progression of surgical residents and has a correlation with the boards' pass percentile. Due to the limited hours available for didactics in current surgical residency, intensive review course over a 2- to 3-day period may help the surgical residents to perform better. In the current economy, review courses offered by a consortium of programs geared toward improving ABSITE performance and conducted by the surgical faculty may be of essence.

How Important Are American Board of Surgery In-Training Examination Scores When Applying for Fellowships?

The American Board of Surgery In-Training examination (ABSITE) first was administered in 1975 to evaluate a resident's general knowledge as well as the deficiencies within the resident and surgical program. The added importance of this examination in recent years stems from a correlation between ABSITE performance and performance on the American Board of Surgery qualifying examination. However, data are lacking in regard to how fellowship programs view ABSITE scores when considering applicants. Thus, this study was initiated to determine the importance of the ABSITE for surgical residents applying to fellowships. Program coordinators and directors of various surgical fellowships were sent a short survey in regard to the ABSITE. The data then were analyzed. One hundred forty-eight surveys were completed, with 74.8% of the programs ranking the importance of ABSITE scores as 3 or 4 (on a scale of 1 through 5). Most programs (78.9%) reported no minimum percentile requirement. Those that did required a mean percentile of 54.4. Of the programs, 57.8% placed a greater emphasis on the senior examination versus the junior examination (p = 0.06). When compared with other application factors, the ABSITE score ranked 3rd behind letters of recommendation and a candidate's residency program. Colon and rectal surgery placed the highest importance on ABSITE scores, whereas transplant surgery placed the lowest importance. The ABSITE score is an important factor for residents applying to surgical fellowship; however, more weight is given to candidates' letters of recommendation and his or her residency program. Applicants should aim to score above the 50th percentile to be competitive for most fellowship programs.

Effect of resident call status on ABSITE performance

Background. Long work hours that result in fatigue may adversely affect cognitive function. Chronically sleep-deprived surgical residents fear that being on call the night before sitting for a standardized test puts them at a potential disadvantage. We examined American Board of Surgery In-Training Examination (ABSITE) scores to assess the effect of call status on exam performance. Methods. Results of the 1994 ABSITE for 424 residents in 15 New England general surgery programs were collected. We compared standard scores of residents for the total test, clinical management, and basic science components with resident call status (on/off) for the night before the exam. Results. Differences were apparent in total test scores (mean: off, 496.1; on, 466.0; P <.03) and clinical management scores (mean: off, 504.3; on, 470.6; P <.02) (t test, Mann-Whitney U test). Multivariate analyses revealed that differences in postgraduate year level and training track were significant contributors to differences in scores in all test components (analysis of covariance). Call status was not a significant factor in score variation after adjusting for these 2 factors. Conclusions. Differences in ABSITE scores of residents were related to postgraduate year level and training track. Call status had no significant effect on ABSITE performance. (Surgery 2000;128:465–71.)

Special curriculum for surgery residents who fail the ABSITE

PurposeThe American Board of Surgery In-Training Examination (ABSITE) documents surgical residents’ acquisition of surgical knowledge. From 1995 to 1998, after merging two general surgical residencies, 10 residents had ABSITE scores below the 30th percentile. A special curriculum was designed to address these knowledge deficiencies. The purposes of this study were to determine: (1) whether the special curriculum was effective, as measured by the next ABSITE, (2) whether the evaluation score for the special curriculum predicts the next ABSITE performance, and (3) how the special curriculum can help manage the knowledge-deficient resident. MethodsEach resident filled out a questionnaire and met with the program director. The special curriculum ran from May 1 until the following March. Each resident presented a basic science conference and took the Association of Program Directors in Surgery Basic Science Course. Each resident studied a surgery textbook and took 4 examinations. Each resident was placed on probation but promoted to the next year in July. Their continuation in the residency depended on their performance in this special curriculum, clinical evaluations, and the next ABSITE. ResultsThe questionnaire responses were: stopped studying: 10, surprised with low score: 9, no review of questions: 8, personal problems: 6, and test anxiety: 5. Basic Science conferences were above average or excellent. Conference attendance was 40%–80%. Evaluation scores were 57 to 95.The mean ABSITE percentile scores were initial = 18 (±8) and final = 48 (±35). The mean improvement was 31 (±29). The mean ABSITE standard scores were initial = 438 (±72) and final = 542 (±107) with a mean improvement of 104 (±61). Six out of 10 residents scored over 30% from 34%–97%. Four residents scored from 4%–23%. Six of the 10 residents were retained whereas 4 residents resigned. ConclusionsThe special curriculum provides an effective method with a due process for dealing with residents who have a deficiency of knowledge. The curriculum evaluation scores predicted the ABSITE outcome in only 70% of the residents and failed to correlate in 30%. This special curriculum separated the residents into two groups: one group passed the ABSITE with scores of 34% or above, and the other group failed, with ABSITE scores of 23% or below.

Impact of programmed reading on ABSITE performance

To test the hypothesis that a program of regular reading and discussion would result in significant improvement in the surgical database as measured by the American Board of Surgery In-Training Examination (ABSITE), we conducted a 2-year prospective study. The study group, which was comprised of 40 residents, was compared with a control group of 44 residents enrolled in the residency during the 2 years that preceded the study period. Neither reading effort nor discussion group attendance correlated strongly with ABSITE performance among first-year residents. At this level, ABSITE scores correlated best with National Board of Medical Examiners Part I scores (r = 0.699, p = 0.002). In contrast, second-year through fifth-year residents showed a cumulative improvement across the residency (80 versus 180 standard score points, p = 0.048). Individual resident improvement correlated highly with reading effort (r = 0.79, p < 0.001). There was little measurable effect from attending discussion sessions. We conclude that the surgical database can be improved by a program of regular reading and that the magnitude of the improvement is directly proportional to the reading effort.