Validation of the General Medicine in-Training Examination Using the Professional and Linguistic Assessments Board Examination Among Postgraduate Residents in Japan.

Purpose: In Japan, the General Medicine In-training Examination (GM-ITE) was developed by a non-profit organization in 2012. The GM-ITE aimed to assess the general clinical knowledge among residents and to improve the training programs; however, it has not been sufficiently validated and is not used for high-stake decision-making. This study examined the association between GM-ITE and another test measure, the Professional and Linguistic Assessments Board (PLAB) 1 examination.
Methods: Ninety-seven residents who completed the GM-ITE in fiscal year 2019 were recruited and took the PLAB 1 examination in Japanese. The association between two tests was assessed using the Pearson product-moment statistics. The discrimination indexes were also assessed for each question.
Results: A total of 91 residents at 17 teaching hospitals were finally included in the analysis, of whom 69 (75.8%) were women and 59 (64.8%) were postgraduate second year residents. All the participants were affiliated with community hospitals. Positive correlations were demonstrated between the GM-ITE and the PLAB scores ( r = 0.58, p < 0.001). The correlations between the PLAB score and the scores in GM-ITE categories were as follows: symptomatology/clinical reasoning ( r = 0.54, p < 0.001), physical examination/procedure ( r = 0.38, p < 0.001), medical interview/professionalism ( r = 0.25, p < 0.001), and disease knowledge ( r = 0.36, p < 0.001). The mean discrimination index of each question of the GM-ITE (mean ± SD; 0.23 ± 0.15) was higher than that of the PLAB (0.16 ± 0.16; p = 0.004).
Conclusion: This study demonstrates incremental validity evidence of the GM-ITE to assess the clinical knowledge acquisition. The results indicate that GM-ITE can be widely used to improve resident education in Japan.
Competing Interests: YN received an honorarium from the JAMEP as the GM-ITE project. YT and TO were responsible for the JAMEP director. KN received an honorarium from the JAMEP as a reviewer of GM-ITE. HK received an honorarium from the JAMEP as a speaker of the JAMEP lecture. TS, YY, and RM received an honorarium from the JAMEP as an examination preparer of GM-ITE. The authors report no other conflicts of interest in this work.
(© 2021 Nagasaki et al.)