Wednesday, July 1, 2015

Emergency Medicine Mock Oral Board Examination Simulation: Is Peer-Reviewed Simulation More Effective than Individual Simulation?

David Bullard, MD, MEd
The Cleveland Clinic

Background: While emergency medical education continues for an entire career, passing the oral board certification marks a transition point from being a resident to being an attending physician. There is limited evidence in the literature to guide emergency medicine training programs in the most effective and efficient way to train residents to pass the American Board of Emergency Medicine oral board examination. Most examinees find the content of the exam straightforward, but often struggle with the unfamiliar role-playing environment of the examination.

Aims: The purpose of this study is to compare two methods for oral board exam preparation, and to determine which method is more efficient educationally and which method simulates the actual exam with greater fidelity.

Methods: The Cleveland MetroHealth / Cleveland Clinic / Case Western Reserve University residency in emergency medicine has historically performed oral board case simulations confidentially in one-on-one resident and faculty sessions. A new preparation method introduced at our institution involves a resident performing a sample oral board case with a faculty member in front of a peer audience of residents and faculty members. Twelve PGY-3 emergency medicine residents were surveyed regarding their opinions of each type of oral board preparation methods, and the results were compared using a paired samples t-test.

Results: The residents found the peer-reviewed oral board simulations a more efficient use of their educational time compared to one-on-one simulations (p=0.02). The residents found the cases presented in front of the peer audience more realistic (p=0.02). The residents found the cases presented in front of the peer audience more helpful as a learning tool (p=0.02). Overall, the residents also rated the peer-reviewed mock oral board cases higher as part of the educational curriculum (p=0.01). The residents found no significant difference in anxiety levels between performing oral board cases in front of an audience of their peers versus performing cases one-on-one privately with a faculty member.

Conclusions: Performing peer-reviewed oral board case simulations is an efficient and realistic way for resident physicians to prepare for oral board examinations. Residents do not find a peer-audience more stressful or more anxiety provoking than practicing oral board cases privately.