Virtual versus in-person teaching: analysis of the effect on medical residency exam scores

Abstract

Introduction: The shift towards virtual medical education modalities during the COVID-19 pandemic has sparked debates regarding their effectiveness compared to traditional face-to-face teaching.

Objective: To evaluate whether the virtual modality is associated with a higher score obtained in the ENARM, compared to the face-to-face modality.

Methods: A retrospective cohort study was conducted with doctors who entered the Peruvian medical residency between 2019 and 2022, comparing ENARM scores between those prepared virtually and in-person. Variables such as the mode of study, enrollment plan, and sociodemographic data were analyzed.

Results: Of the 837 doctors evaluated, 57.1% were women and 64.9% studied at private universities, with a majority choosing the virtual modality (60.5%) and the annual plan (69.3%). The average score on the ENARM was 52.8 ± 6.6. In the unadjusted exam score, the virtual modality outperformed the in-person modality (66.1 vs. 64.2; p <0.001). After adjusting for confounding variables, the virtual modality was associated with an average increase of 1.34 points in the ENARM score compared to in-person (aβ: 1.34; 95% CI: 0.46 to 2.21; p = 0.003), more evident in the annual plan (aβ: 1.31; 95% CI: 0.24 to 2.38; p = 0.017). In a sensitivity analysis, this association held, with an increase of 2.02 points for the virtual modality (aβ: 2.02; 95% CI: 1.08 to 2.96; p <0.001), particularly in the annual plan (aβ: 2.11; 95% CI: 0.97 to 3.25; p <0.001).

Conclusions: Peruvian doctors who prepared for the ENARM virtually achieved higher scores compared to those in face-to-face settings, with this advantage being more pronounced among those who followed an annual preparation plan.