Article review: Conference attendance ≠ better test scores

Not all learners should be expected
to have the same learning style.

This is exemplified in a recent multicenter study, which addresses whether attendance at weekly residency conferences correlates with a better in-service training examination (ITE) score. The ITE score was used as an outcome measure, because it correlates with the resident's likelihood for passing the official ABEM Board Exams. Both tests draw from questions in the Model of the Clinical Practice of Emergency Medicine.

Methodology
In this multicenter (4-site), retrospective cohort study, data from 405 residents were collected. Regression analysis was done for the entire data set, and also breaking down the data by PGY-training year. This latter step was done in case training level showed a different correlation between conference attendance and ITE score.

Results
There was no correlation between conference attendance rate and the ITE score, whether you look at the entire data set or whether you looked in a year-by-year analysis. The study, however, did find 2 significant predictors of ITE score:

• USMLE step 1 score (Median of all residents = 220; IQR = 209-234)
  
• Female sex (sorry, guys)
  

Comments

• This was a retrospective study. A better study would be to do this prospectively.
• Each residency program has a different conference curriculum. This may have confounded the data.
• Data was not collected on the residents' self-study or other educational practices.
• Because the RRC-EM standards require at least 70% conference attendance, the data only looks at residents with ≥70% attendance. What would the ITE scores have been for residents who had, for instance, 0% attendance rates? Now THAT would be interesting.
  

My opinion
I personally believe that residency conferences has only a minimal-to-modest impact on how residents perform on their ITE exam and even how they perform clinically. Conference time does serve a good function though. It allows residents and faculty to socialize and provides residents with a little escape from the day-to-day clinical duties. This could just as well be accomplished by weekly or monthly "wellness sessions" where all residents are excused from clinical services.

Based on results from this study, perhaps we should re-look at the RRC-EM requirement for 70% minimum attendance at the 5 hours/week conference curriculum. For me, I'd like to see more time and resources spent towards providing a variety of learning tools for the residents. This would accommodate the residents' various learning styles and afford residency programs more flexibility in custom-tailoring education for each individual.

My blog review of a CORD consensus article which discusses alternatives and improvements for the current EM residency conference requirement.


Reference
Hern HG, et al. Conference attendance does not correlate with emergency medicine residency in-training examination scores. Acad Emerg Med. 209; 16:S63-S66.