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Utility of AAOS OITE Scores in Predicting ABOS Part I OutcomesAAOS Exhibit Selection
David Swanson, PhD1; J. Lawrence Marsh, MD2; Shepard Hurwitz, MD3; G. Paul DeRosa, MD3; Kathleen Holtzman, BS1; S. Deniz Bucak, BA1; Amy Baker, MA1; Carol Morrison, PhD1
1 National Board of Medical Examiners, 3750 Market Street, Philadelphia, PA 19104. E-mail address for D. Swanson: DSwanson@nbme.org
2 Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, University of Iowa, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242-1009
3 American Board of Orthopaedic Surgery, 400 Silver Cedar Court, Chapel Hill, NC 27514
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Investigation performed at the National Board of Medical Examiners, Philadelphia, Pennsylvania

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 Jun 19;95(12):e84 1-8. doi: 10.2106/JBJS.L.00457
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Residency programs commonly use performance on the Orthopaedic In-Training Examination (OITE) developed by the American Academy of Orthopaedic Surgeons (AAOS) to identify residents who are lagging behind their peers and at risk for failing Part I of the American Board of Orthopaedic Surgery (ABOS) Certifying Examination. This study was designed to investigate the utility of the OITE score as a predictor of ABOS Part I performance.


Results for 3132 examinees who took Part I of the ABOS examination for the first time from 2002 to 2006 were matched with records from the 1997 to 2006 OITE tests; at least one OITE score was located for 2852 (91%) of the ABOS Part I examinees. After OITE performance was rescaled to place scores from different test years on comparable scales, descriptive statistics and correlations between ABOS and OITE scores were computed, and regression analyses were conducted to predict ABOS results from OITE performance.


Substantial increases in the mean OITE score were observed as residents progressed through training. Stronger correlations were observed between OITE and ABOS performance during later years in training, reaching a maximum of 0.53 in years 3 and 4. Logistic regression results indicated that residents with an OITE score below the 10th percentile were much more likely to fail Part I compared with those with an OITE score above the 50th percentile.


OITE performance was a good predictor of the ABOS score and pass-fail outcome; the OITE can be used effectively for early identification of residents at risk for failing the ABOS Part I examination.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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