ABSITE preparation: what do we know?

IntroductionScores from the American Board of Surgery In-Training exam (ABSITE) are an important metric for assessment of resident knowledge, gaging resident readiness for board examinations, and differentiating candidates for fellowship. Educational resources, such as the TWIS-SCORE curriculum and question banks, in addition to program-specific strategies, exist to aid preparation. Despite this, there is currently no unified national ABSITE preparatory strategy. Our aim was to synthesize published literature pertaining to the ABSITE and determine whether this evidence could guide best practice recommendations.MethodsLiterature search was performed with a trained librarian to identify all articles pertaining to ABSITE in PubMed, EMBASE and Web of Science. Title and abstract screening were performed. Inclusion criteria were all articles describing ABSITE practices between 1 Jan 2014 and 25 Aug 2021. Following full-text screening, data were extracted from included articles on: date of publication, aspect of ABSITE performance investigated, number/type of residents or faculty involved, MERSQI score (Medical Education Research Study Quality Instrument), and outcomes.ResultsInitial search identified 77 articles and 49 articles underwent full-text review. Twenty-seven manuscripts met inclusion criteria. Most (81.4%) were published between 2018 and 2021. Mean adjusted MERSQI scores ranged between 7.5 and 11.5. Articles described 2106 participants (15 program directors, 2091 residents). Four themes of studies pertaining to ABSITE were identified: effect of educational strategies, intrinsic and extrinsic factors affecting score, and score prediction.ConclusionDespite the importance of the ABSITE for programs and residents, published literature demonstrates little unity in exam preparation recommendations, describing heterogeneous pedagogies and models that limit wider assessment of utility. Future work should focus on better understanding of the relationship between ABSITE and clinical performance, understanding of the current uses of the ABSITE including for resident remediation, as well as investigation of preparation strategies, which improve ABSITE performance to better guide utilization of ABSITE scores.