Improving ABIM Pass Rates

1. Improving ABIM Pass Rates Group 1 Faculty Mentor: Dr. BinduSwaroop Arpna Patel Shyam Rao Michael Eskander Farid Jalali Yung Lyou Betsy Lin

2. FOCUS • F – finding the problem • O – organize resources • C – clarify goals • U – understand objectives • S – select a plan

3. Background • Scheduling restraints • Little preparedness for ABIM boards • Board pass rates lowered

4. 2012-2013 PGY-3 Schedule • Average # of inpatient blocks: • Overall: 9 • In the 2nd half of the academic year: 4 • In the last three months: 2

5. Finding the Problem • Board pass rates are falling • How do we fix it?

6. Parties and Resources Involved • Norma Hardgrove – collect ITE scores for last 3 years • Dr. Swaroop – collect ABIM board scores • Chief Residents – organize an intervention • Residents – respond to intervention

7. Clarify Goals • Improving board pass rate • But was it possible? • Improving resident knowledge and preparedness • Resident-driven • Active learning

8. Understanding Obstruction • Finding an intervention that would be feasible for busy residents and also promote active learning • Getting residents to participate in the intervention • Implementing an intervention with the time constraints of the project

9. Opportunity Statement • An opportunity exists to improve ABIM board scores • The process should be improved because board score and the pass rate affect both residents and the program • We will know our project has been successful when we see an improvement in resident knowledge, study skills, and eventually improvement in board pass rate

10. Select a Plan • We brainstormed different intervention options including: • Digital MKSAP reviewed by clinic attendings

11. Select a Plan • We brainstormed different intervention options including: • Digital MKSAP reviewed by clinic attendings • Changing resident schedule during 3rd year

12. Select a Plan • We brainstormed different intervention options including: • Digital MKSAP reviewed by clinic attendings • Changing resident schedule during 3rd year • Targeting specific residents who would benefit the most from additional board review practice

13. Select a Plan • We brainstormed different intervention options including: • Digital MKSAP reviewed by clinic attendings • Changing resident schedule during 3rd year • Targeting specific residents who would benefit the most from additional board review practice • Changing board review format

14. Select a Plan • Based on group consensus we decided on a final project: • Introducing changes to Friday Academy to change to a resident-driven session

15. PDCA • Plan • Do • Check • Act

16. Friday Academy • 3 hour protected time for residents on outpatient, elective, and research blocks

17. Friday Academy • 3 hour protected time for residents on outpatient, elective, and research blocks • Consists of 3 major parts • Board review: • 8-10 questions selected by Chief Residents • Led by chief residents • Audience participation in answering questions

18. How important is the friday academy board review to didactic experience?

19. Friday Academy • Resident driven topic selection

20. Friday Academy • Resident driven topic selection • Promote studying of selected topic

21. Friday Academy • Resident driven topic selection • Promote studying of selected topic • Non-intimidating environment

22. Friday Academy • Resident driven topic selection • Promote studying of selected topic • Non-intimidating environment • Monitored attendance

23. Friday Academy • Resident driven topic selection • Promote studying of selected topic • Non-intimidating environment • Monitored attendance • Widespread learning

24. Friday Academy • Resident driven topic selection • Promote studying of selected topic • Non-intimidating environment • Monitored attendance • Widespread learning • ACTIVE learning

25. Plan • Information gathering • Post-intervention survey

26. Information Gathering

27. Do • Discussed with PD and chief residents regarding implementation of this idea

28. Do • Discussed with PD and chief residents regarding implementation of this idea • Designed the post-intervention survey

29. Do • Discussed with PD and chief residents regarding implementation of this idea • Designed the post-intervention survey • Started asking residents to present board review during Friday Academy

30. Check • 74% improvement in “overall experience”

31. Check • 74% improvement in “overall experience” • 52% improvement in “preparedness for ITE and board exams” • True Preparedness = ?

32. Check • 74% improvement in “overall experience” • 52% improvement in “preparedness for ITE and board exams” • True Preparedness = ? • 44% improvement in “understanding of the topic and questions”

33. 59% 37% 70% 56% 44% 44% 55% 66% 52% 41% 78% 59% 74%

34. Do you like the new approach of resident-driven board review?

35. Have you attended at least one session of the new resident-driven board review?

36. Act • Overall improvement in the Board Review experience for residents • Improved knowledge • Improved preparedness for ITE, ABIM boards • Permanent Addition • Sustainability • Mandatory during certain blocks

37. Reflect • Ambitious idea • Time constraints • Data gathering • Subjective • Resident involvement

38. Question ? Thank You to all Residents, Chiefs, and Program Director for participating in this effort. Thank you for your attention.