Relationship of Electronic Medical Knowledge Resource Use and Practice Characteristics with Internal Medicine Maintenance of Certification Examination Scores

BACKGROUND

Maintenance of certification examination performance is associated with quality of care. We aimed to examine relationships between electronic medical knowledge resource use, practice characteristics and examination scores among physicians recertifying in internal medicine.

METHODS

We conducted a cross-sectional study of 3,958 United States physicians who took the Internal Medicine Maintenance of Certification Examination (IM?CMOCE) between January 1, 2006 and December 31, 2008, and who held individual licenses to one or both of two large electronic knowledge resource programs. We examined associations between physicians?? IM?CMOCE scores and their days of electronic resource use, practice type (private practice, residency teaching clinic, inpatient, nursing home), practice model (single or multi-specialty), sex, age, and medical school location.

RESULTS

In the 365?days prior to the IM?CMOCE, physicians used electronic resources on a mean (SD, range) of 20.3 (36.5, 0?C265) days. In multivariate analyses, the number of days of resource use was independently associated with increased IM?CMOCE scores (0.07-point increase per day of use, p?=?0.02). Increased age was associated with decreased IM?CMOCE scores (1.8-point decrease per year of age, p?p?CONCLUSIONS Frequent use of electronic resources was associated with modestly enhanced IM?CMOCE performance. Physicians involved in residency education clinics and hospital inpatient practices had higher IM?CMOCE scores than physicians working in private practice settings.