Work

Specialty-associated differences in intensive care unit rotation exit examination performance: a single-center retrospective cross-sectional study

Year: 2026

Type: article

Abstract: Background: Intensive care unit (ICU) rotations bring together residents from multiple specialties. Comparisons of exit performance may be distorted when departments differ in postgraduate-year (PGY) composition and when non-equivalent examination forms are used across PGY levels. Methods: We conducted a retrospective cross-sectional analysis of ICU exit examination records from 412 residents at a tertiary teaching hospital in China between November 2025 and April 2026. Three 100-item, 60-min examinations containing four question types were administered according to PGY. Departmental differences were evaluated using four complementary strategies: a same-examination subgroup of 227 PGY-2 residents, within-examination standardization, analysis of covariance adjusting for the combined PGY/form grouping, and hierarchical regression. Item characteristics, version-specific reliability, and exploratory differential item functioning were assessed retrospectively. Results: = 77; 95% CI 73.9-78.0). Department explained an additional 7.6% of total-score variance after adjustment for PGY/form. The descriptive attenuation ratio was 21.3% for total scores, ranging from 7.3% for case-series items to 80.2% for basic-knowledge items. These ratios do not identify separate training-year or examination-version effects. The largest negative case-analysis gaps occurred in surgery and anesthesiology. Conclusion: Specialty-associated differences in examination performance were observed within this single-center educational setting and using this assessment instrument. The absence of baseline scores and incomplete evidence of cross-form comparability preclude causal or inherent-specialty interpretations; prospective baseline-controlled studies are needed before specialty-tailored interventions are adopted.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2026.1960270

Authors: Yanche Lu, Ruijie Lin, Qian Yu, Qiuyu Zheng, Lianmin Ye

Institutions: Wenzhou Medical University, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou Medical University Renji College, First Affiliated Hospital of Wenzhou Medical University

Language: English

Topic: Innovations in Medical Education

Subfield: Education

Field: Social Sciences

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801