The Competitive Edge: Improving American Board of Surgery In-Training Examination Scores Through a Team-Based Competition.

Abstract

Background: The American Board of Surgery (ABS) In-Training Examination (ABSITE) scores are predictive of passing the ABS qualifying exam and have become a marker of residency education success. A competitive team-based approach to encourage self-studying and didactic participation is a novel method of ABSITE preparation. We aimed to determine if this method significantly improves residents' percentile performances on the ABSITE.

Methods: Retrospective review of ABSITE percentile scores were compared before and after implementation of a purchased online question bank (TrueLearn LLC, Mooresville, NC), a team-based competition, and a virtual format of the team-based competition.

Results: The median ABSITE percentile at the program level increased from 40.0 (IQR 21.0-67.0) in 2011 to 77.0 by 2022 (IQR 60.0-91.0) (P < 0.0001). After implementation of the team-based competition, ABSITE median percentile rose significantly from 67.0 (IQR 31.5-85.5) to 84.5 (IQR 60.8-91.0) (P = 0.026). This did not change significantly after a transition to a virtual format of the team-based competition in 2021 (P = 0.146) and 2022 (P = 0.335). There was no significant relationship between the number of TrueLearn questions taken and ABSITE scores specifically before and after implementation of the team-based competition (AUC = 0.0002, Spearman's r (67) 0.064, P = 0.605). Furthermore, the team-based competition was well received by residents and was believed to be beneficial to their studying.

Discussion: The team-based competition is easy to implement and improves ABSITE performance through means other than encouraging residents to take more practice questions. The team-based competition is well-received by residents and may prove beneficial to board examination preparation and pass rates.