P3.R344: Pediatric Emergency Medicine for $500: Gamification of Board Preparation for Fellows

Background: Board certification is a key milestone for physicians and is prioritized by employers and patients. Our Pediatric Emergency Medicine (PEM) fellowship program struggled with below average board pass rates, prompting a new strategy to stimulate studying and review test-taking skills. Liu et al reported residents’ desire for structured board preparation from the residency program, involving interactive learning and competition.

The objective of this innovation was to use gamification to implement a new method of board review for our PEM fellowship, with the goal of improving certifying exam pass rates for first-time takers.

Methods: We developed a monthly board review series in our fellowship using gamification. Each session is delivered in a game show format and incorporates questions from an online, subscription-based question bank with comprehensive board-style review for the ABP PEM certifying exam.

The two-year curriculum is developed and organized by our program leaders (Table). Five categories are covered per session based on chapters from Fleisher and Ludwig’s Textbook of Pediatric Emergency Medicine and covering ABP PEM content specifications. Each session concludes with a final question based on a real-life case written by the program leader. Before each session, the content is reviewed and updated to reflect current guidelines.

Using a flipped classroom model, fellows are expected to prepare for each session with assigned readings. During the board review game, each fellowship class competes as a team against the other classes. Program leaders discuss answers, and offer visual aids, mnemonics, and test-taking tips to facilitate learning. A new champion class is crowned at the end of the year, with names added to the championship trophy.

Since the COVID-19 pandemic, live virtual attendance at our fellowship didactics was initially a requirement and now continues to be an option, which has been utilized by faculty and recent graduates studying for the exam near and far.

We measured PEM certifying exam first-time taker passing rates before and after administration of this new review method, as well as satisfaction with the curriculum.

Results: Prior to the intervention, the three-year cumulative pass rate of the PEM certifying exam by our first-time takers was 58.3% (6 of 9 fellows). Since implementing our board review series from 2016 to 2019, the three-year rolling average is 100% (17 of 17 fellows). See Figure.

On post-graduate surveys, feedback from graduates has been positive. Comments include: “[The board review] is a unique way to motivate and capture an audience of competitive individuals. Learning points are easily translatable in clinical practice.” “It was invaluable to continue participating in a structured board review curriculum even after graduating.”

Conclusion: A board review series using a competitive and interactive game show format has been effective in improving board review participation and certifying exam pass rates.