Limits...
A nomogram to predict the probability of passing the American Board of Internal Medicine examination.

Brateanu A, Yu C, Kattan MW, Olender J, Nielsen C - Med Educ Online (2012)

Bottom Line: Of the 194 Cleveland Clinic graduates used for the nomogram development, 175 (90.2%) successfully passed the ABIM certification examination.A simple user-friendly predictive tool, based on readily available data, was developed to predict the probability of passing the ABIM exam for internal medicine residents.This may guide program directors' decision-making related to program curriculum and advice given to individual residents regarding board preparation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Cleveland Clinic, Cleveland, Ohio 44195, USA. abratean@ccf.org

ABSTRACT

Background: Although the American Board of Internal Medicine (ABIM) certification is valued as a reflection of physicians' experience, education, and expertise, limited methods exist to predict performance in the examination.

Purpose: The objective of this study was to develop and validate a predictive tool based on variables common to all residency programs, regarding the probability of an internal medicine graduate passing the ABIM certification examination.

Methods: The development cohort was obtained from the files of the Cleveland Clinic internal medicine residents who began training between 2004 and 2008. A multivariable logistic regression model was built to predict the ABIM passing rate. The model was represented as a nomogram, which was internally validated with bootstrap resamples. The external validation was done retrospectively on a cohort of residents who graduated from two other independent internal medicine residency programs between 2007 and 2011.

Results: Of the 194 Cleveland Clinic graduates used for the nomogram development, 175 (90.2%) successfully passed the ABIM certification examination. The final nomogram included four predictors: In-Training Examination (ITE) scores in postgraduate year (PGY) 1, 2, and 3, and the number of months of overnight calls in the last 6 months of residency. The nomogram achieved a concordance index (CI) of 0.98 after correcting for over-fitting bias and allowed for the determination of an estimated probability of passing the ABIM exam. Of the 126 graduates from two other residency programs used for external validation, 116 (92.1%) passed the ABIM examination. The nomogram CI in the external validation cohort was 0.94, suggesting outstanding discrimination.

Conclusions: A simple user-friendly predictive tool, based on readily available data, was developed to predict the probability of passing the ABIM exam for internal medicine residents. This may guide program directors' decision-making related to program curriculum and advice given to individual residents regarding board preparation.

Show MeSH

Related in: MedlinePlus

Screenshot of nomogram Web site.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3475012&req=5

Figure 0002: Screenshot of nomogram Web site.

Mentions: The graphic nomogram derived from the final regression model is presented in Fig. 1. To predict the probability of passing the ABIM examination, the nomogram is used by initially locating the scores on each of the ‘ITE 1, 2, 3’ and ‘number of call months’ horizontal scales and drawing vertical lines up to the uppermost ‘points’ scale. When the points generated from each of the four factors are added together, the sum is then plotted on the lower ‘total points’ scale, and the predicted probability is found on the corresponding lowermost scale by drawing a vertical line down to the ‘predicted probability of passing ABIM’ scale. An online predictive tool (http://rcc.simpal.com/RCEval.cgi?RCID=LbGdeA) (Fig. 2) was created to facilitate the automatic calculation of the predicted probability for easier use.


A nomogram to predict the probability of passing the American Board of Internal Medicine examination.

Brateanu A, Yu C, Kattan MW, Olender J, Nielsen C - Med Educ Online (2012)

Screenshot of nomogram Web site.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475012&req=5

Figure 0002: Screenshot of nomogram Web site.
Mentions: The graphic nomogram derived from the final regression model is presented in Fig. 1. To predict the probability of passing the ABIM examination, the nomogram is used by initially locating the scores on each of the ‘ITE 1, 2, 3’ and ‘number of call months’ horizontal scales and drawing vertical lines up to the uppermost ‘points’ scale. When the points generated from each of the four factors are added together, the sum is then plotted on the lower ‘total points’ scale, and the predicted probability is found on the corresponding lowermost scale by drawing a vertical line down to the ‘predicted probability of passing ABIM’ scale. An online predictive tool (http://rcc.simpal.com/RCEval.cgi?RCID=LbGdeA) (Fig. 2) was created to facilitate the automatic calculation of the predicted probability for easier use.

Bottom Line: Of the 194 Cleveland Clinic graduates used for the nomogram development, 175 (90.2%) successfully passed the ABIM certification examination.A simple user-friendly predictive tool, based on readily available data, was developed to predict the probability of passing the ABIM exam for internal medicine residents.This may guide program directors' decision-making related to program curriculum and advice given to individual residents regarding board preparation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Cleveland Clinic, Cleveland, Ohio 44195, USA. abratean@ccf.org

ABSTRACT

Background: Although the American Board of Internal Medicine (ABIM) certification is valued as a reflection of physicians' experience, education, and expertise, limited methods exist to predict performance in the examination.

Purpose: The objective of this study was to develop and validate a predictive tool based on variables common to all residency programs, regarding the probability of an internal medicine graduate passing the ABIM certification examination.

Methods: The development cohort was obtained from the files of the Cleveland Clinic internal medicine residents who began training between 2004 and 2008. A multivariable logistic regression model was built to predict the ABIM passing rate. The model was represented as a nomogram, which was internally validated with bootstrap resamples. The external validation was done retrospectively on a cohort of residents who graduated from two other independent internal medicine residency programs between 2007 and 2011.

Results: Of the 194 Cleveland Clinic graduates used for the nomogram development, 175 (90.2%) successfully passed the ABIM certification examination. The final nomogram included four predictors: In-Training Examination (ITE) scores in postgraduate year (PGY) 1, 2, and 3, and the number of months of overnight calls in the last 6 months of residency. The nomogram achieved a concordance index (CI) of 0.98 after correcting for over-fitting bias and allowed for the determination of an estimated probability of passing the ABIM exam. Of the 126 graduates from two other residency programs used for external validation, 116 (92.1%) passed the ABIM examination. The nomogram CI in the external validation cohort was 0.94, suggesting outstanding discrimination.

Conclusions: A simple user-friendly predictive tool, based on readily available data, was developed to predict the probability of passing the ABIM exam for internal medicine residents. This may guide program directors' decision-making related to program curriculum and advice given to individual residents regarding board preparation.

Show MeSH
Related in: MedlinePlus