How Has the COVID-19 Pandemic Influenced Board Examination Results?

• In Event: Loss or Gain? Evaluating the Impact of the COVID-19 Pandemic Across the Medical Education Continuum

Abstract

Purpose
At the beginning of the pandemic, schools transitioned into online teaching. After school programs and sports activities were canceled, parents tended not to bring their children to hospitals or clinics if they only had mild symptoms or injuries. The majority of pediatric training programs reported a significant decrease in the patient census. Most programs provide education through a virtual learning platform. As a result, many pediatric training programs have experienced decreased learning on common illnesses and less procedural experience. The study is to explore the influence of the COVID-19 pandemic on pediatric residency training, reflected in the in-training examination (ITE) and certifying examination.

Perspectives
The five-year first-time taker’s pass rate of the certifying examination shows the 2021 pass rate is significantly lower than in previous years. The ITE exam in 2021 also showed a noticeable decrease in residents’ scores. With no significant changes to the exams, we suspect the negative impact on residency training may have reflected on the performance on Board exams. A previous study (Du, Y., 2015) showed that trainees’ knowledge rises steadily, and significant group differences in knowledge growth trajectory between gender. The study also found the difference between trainees who are American medical school graduates (AMGs) and those who are international medical school graduates (IMGs). In this study, we also included trainees’ training pathways to investigate the factors that could impact the certifying exam performance. About 10% of trainees were in the combined pediatric and internal medicine training pathway.

Methods
The study included test-takers who took their first certifying examinations between 2019 and 2022 (2022 data will be added before the conference) and took the certifying exam the same year they completed their training. The trainees were grouped by their first certification exam year as a cohort. Their ITE scores at each training year and first certifying exam are times their knowledge was assessed. The Linear Mixed Model with maximum likelihood estimation in SAS was used to study the knowledge growth during pediatric residency. This method models individual change over time, determines the shape of the growth curves, explores the systematic difference in change, and examines the effects of covariates on group differences in the rate of growth Gender, medical school, and the training type were included in the models to evaluate group differences in change over time.

Results
The descriptive statistics show that the trainees’ knowledge growth appears to be negatively influenced during the pandemic, especially for the cohort 2021, whose 50% of training was during the pandemic. They started with the highest ITE scores at the beginning of the training but with the lowest certifying exam scores. The pattern is similar for trainees of different training pathways, gender subgroups, and AMGs and IMGs. The Linear mixed model will check the statistical significance of the findings.

Significance
The study findings will provide valuable feedback to residency training programs regarding the impact of the pandemic on trainees and help programs identify groups of trainees who have been impacted more than others.

Authors

• Ying Du, American Board of Pediatrics
  Presenting Author

• Ukhyun Cho, University of North Carolina - Greensboro
  Non-Presenting Author