UpToDate Use as a Predictor of Medical Student Success

Background Both practicing physicians and student learners prioritize speed of access and ease of use over most other criteria in choosing how to look up clinical information, with electronic resources far outpacing books for these reasons. While there are many variations of electronic reference materials available, UpToDate is one of, if not the most, frequently referenced clinical knowledge resources. It is professionally written and edited by practicing clinicians with frequent updates as new information or studies become available to inform care, allowing the learner to answer clinical questions rapidly, correctly, and fully. Given its proven popularity, the usefulness of UpToDate as a teaching tool must now be assessed against commonly agreed upon measures of medical student clinical competency. Methods We will measure the relationship between UpToDate usage, tracked as time logged as well as mouse clicks during each third-year clerkship, and several benchmarks commonly used to indicate medical student clinical competence. The four measures that will be used are (1) NBME clinical subject exam scores for each clerkship, reported as percent correct; (2) RIME score assigned at the end of each clerkship, which rate clinical skills on a scale from R (reporter) to I (interpreter) to M (manager) to E (educator); (3) USMLE Step 2 Clinical Skills score (if available), reported as pass/fail; and (4) USMLE Step 2 Clinical Knowledge score, reported on a scale from 1 to 300. We will control for pre-existing biomedical knowledge by using USMLE STEP 1 score as a control variable. UpToDate usage data is currently being matched to these datapoints for each student and anonymized before further analysis. Conclusion Assessing the utility of UpToDate as a teaching tool to reach validated endpoints of clinical skill will assist in curriculum design and instruction in medical schools and lead to a better prepared future physician workforce, thus benefiting both medical educators and society more broadly.