The success of a weekly medical quiz. Test-based medical education.

BACKGROUND Clinical images and tests are considered useful tools to enhance the memorisation of facts and information in medical education. Therefore, we initiated a weekly medical quiz for our department of Internal Medicine. METHODS Every week, a new case on a single slide with relevant information and a representative image, is sent by e-mail to staff, residents and others. All are requested ona voluntary basis to e-mail the presumed diagnosis within one week. RESULTS After two years, 100 cases were presented to 452 registered participants. On average, only 33 of 452 (range 14 to 59) participants (7.3%; 95% CI 4.9 to 9.7) responded per case. Most presumed diagnoses were submitted on the same day the case was sent (OR 0.81; 95% CI 0.69 to 0.94; p<0.01). Cases with a high response rate were associated with relatively more correct answers than cases with a low response rate. In addition, it was striking that participants in some subspecialities, particularly specialists in infectious diseases, were much more likely to respond to cases in their own subspecialty. CONCLUSION Our experience with a weekly medical quiz demonstrates rather low response rates. This could be due to time restraints, but could also be due to the fact that doctors do not like to be wrong, and are afraid to fail among their peers. Hence, although images and tests may be helpful learning tools, the success and contribution of such clinical-based quizzes to medical education are difficult to determine.