Effect of electronic versus print format and different reading resources on knowledge acquisition in the third-year medicine clerkship

Background: Many medical students have access to electronic and print resources. It is not known if the format or the choice of resources effects knowledge acquisition over an entire clerkship. Purpose: To determine if the format (electronic or print) or choice of reading materials is associated with knowledge acquisition during the 3-year internal medicine clerkship. Methods: This was a prospective cohort study. During the last week of the clerkship, students took the National Board of Medical Examiners (NBME) exam and completed a survey ranking the reading materials used. Results: One hundred and fourteen 3rd-year internal medicine clerkship students participated. The most commonly reported resources were UpToDate® (99%), a review or question book (93%), and Harrison's Principles of Internal Medicine (82%). Multivariate analysis showed a significant beneficial effect of any use of Harrison's (linear regression, p < .04, absolute difference 3 points, SD = 1.4) on NBME score. The format of the most important resource-electronic (61%) or print (39%) - did not predict the NBME score, p > .80. Conclusions: The format (electronic or print) of resources did not appear to effect NBME score in the medicine clerkship. A secondary analysis showed the use of Harrison's textbook was associated with improved knowledge acquisition.