Structured Emergency Medicine Board Review and Resident In‐service Examination Scores

ABSTRACT Objective: To determine whether the institution of a structured board review program is associated with improved in‐service examination scores by residents at an emergency medicine (EM) residency program. Methods: A retrospective, historical control analysis of the association of a board review program and in‐service examination scores at one EM residency program was performed. A structured board review consisting of monthly reading assignments in “classic” EM textbooks followed by a graded multiple‐choice written examination was instituted in 1987. Percentile scores on the American Board of Emergency Medicine (ABEM) in‐service examination before (1985 — 1986) and after (1987–1994) initiation of the board review process were compared by resident level (EM‐1, 2, or 3). Results: The EM‐1 mean percentile score before board review was 50.7 and rose to 68.9 after the institution of the board review program (p = 0.039). Mean EM‐2 scores (66.8 vs 65.4) and EM‐3 scores (74.4 vs 67.4) decreased slightly; these decreases were not statistically significant. Due to the large increase in EM‐1 scores, the mean scores for the total program increased slightly (63.4 vs 67.4; p = NS). Conclusion: In this study, EM‐1 in‐service scores improved in association with the institution of a structured board review program. This formalized didactic program may increase the knowledge base and test performance of EM‐1 residents. A favorable effect on EM‐2 and EM‐3 resident scores was not seen.