A Comparison of Remote vs In-Person Proctored In-Training Examination Administration for Internal Medicine.

Publication date: Jan 29, 2024

In response to COVID-19, the American College of Physicians provided residents the option to complete the 2020 Internal Medicine In-Training Examination (IM-ITE) via in-person and remote proctoring. This study evaluated the extent to which scores obtained from both testing modalities were comparable. Data were analyzed from residents from all U. S.-based Accreditation Council for Graduate Medical Education-accredited IM residency programs and participating Canadian and international programs who completed the IM-ITE in 2020. The final sample contained 27,115 IM residents: 9,205 postgraduate year (PGY) 1, 9,332 PGY-2, and 8,578 PGY-3. Testing modality, gender, PGY, time spent on assessment, and native language were used to predict percent-correct scores in a multilevel regression model. This model included all main effects and all 2-way interactions between testing modality and each resident-level demographic variable, allowing those effects to be controlled for. Of 27,115 residents studied, 11,354 (42%) tested remotely and 15,761 (58%) in person. Across the parameters of interest (main effect of testing modality and 2-way interactions), the only statistically significant effects were the interaction effects between testing mode (interaction effect: -0. 61; 95% confidence interval (CI): -1. 01, -0. 21) and PGY (interaction effect: -0. 54; 95% CI: -0. 95, -0. 13) (P = .002). Differences between in-person and remote predicted scores were slightly larger for PGY-1 than for PGY-2 and PGY-3 residents (controlling for the other predictors in the model), but the magnitude of these differences across residency training was well under a single percentage point. Because these statistically significant effects were deemed educationally nonsignificant, the study concluded that performance did not substantively differ across in-person and remote examinees. Residents taking the 2020 IM-ITE performed similarly across in-person and remote proctoring. This study provides evidence of score comparability across the 2 testing modalities and supports continued use of remote proctoring for the IM-ITE.

Concepts Keywords
American Examination
Canadian Interaction
Graduate Internal
Physicians Ite


Type Source Name
disease MESH COVID-19
disease VO time

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