Presented By: Joshua Roshal, University of Texas Medical Branch

Introduction
The Surgical Council on Resident Education (SCORE) web portal is an e-learning platform that delivers a standardized, comprehensive curriculum for surgical residents. Engagement with SCORE content correlates with higher performance on the American Board of Surgery In-Training Examination (ABSITE), which subsequently correlates with first-time pass rates on the written examination component for board certification. In 2019, the American Board of Surgery (ABS) merged with SCORE, and in 2022 the ABS announced the transition to an entrustable professional activities (EPA) training model. The potential of SCORE to guide surgical residents in EPA-based competency evaluation remains undetermined. This study analyzes SCORE web portal modules using evidence-based multimedia design principles that have informed effective e-learning in a variety of settings and proposes suggestions to enhance content delivery.

Methods
Based on the Central Limit Theorem, 30 core general surgery modules were randomly chosen from the SCORE web portal to ensure a representative sample. The analysis focused on the main webpage content and omitted supplementary sidebar materials. 2 raters assessed the modules using 12 evidence-based principles from the 4th edition of e-Learning and the Science of Instruction by Ruth C. Clark and Richard E. Mayer.

Results
The majority of SCORE modules analyzed (57%) contained text only and did not adhere to the basic principles for e-learning multimedia design. Of the remaining modules that incorporated both text and graphics, 62% included overly complex graphics, 54% had graphics not positioned near their corresponding text, and none featured audio explanations or virtual coaches.

Conclusion
SCORE modules do not adequately reflect contemporary e-learning multimedia design principles. To improve content delivery and learning outcomes, future modules should feature graphics, audio explanations, and virtual coaches.