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ABA/ASA JOINT COUNCIL ON IN-TRAINING EXAMINATIONS. 2004 REPORT TO SAAC/AAPD Glenn P. Gravlee, MD Chair, Joint Council The Ohio State University Medical Center Department of Anesthesiology . ABA David Chestnut Douglas Coursin Glenn Gravlee Patricia Kapur Mark Rockoff (Jim DiNardo)

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aba asa joint council on in training examinations

ABA/ASA JOINT COUNCIL ON IN-TRAINING EXAMINATIONS

2004 REPORT TO SAAC/AAPD

Glenn P. Gravlee, MD

Chair, Joint Council

The Ohio State University Medical Center

Department of Anesthesiology

joint council members
ABA

David Chestnut

Douglas Coursin

Glenn Gravlee

Patricia Kapur

Mark Rockoff (Jim DiNardo)

Raymond Roy

Kenneth Tuman

ASA

Arnold Berry

John Cooper (John Rowlingson)

Jeffrey Gross (V.C.)

Philip Lebowitz

Charles Otto

Patricia Petrozza

Mark Rosen

JOINT COUNCIL MEMBERS
50 question writers

50 Question Writers

Title: Junior Editors

in training examination editors
IN-TRAINING EXAMINATION EDITORS

Steven Allen, Audree Bendo, James DiNardo, Carter Dodge, Sylvia Dolinski, John Ebert, John Emhardt, Robert Gaiser, Eric Kitain, Bruce Kleinman, Elliott Krane, Larry Krenis, Larry Kushins, Cynthia Lien, Vinod Malhotra, Donald Martin, Roger Mecca, John Moyers, Julia Pollock, Lindo Jo Rice, Robert Sladen, Richard Stypula, Richard Teplick, Helen Westman, Thomas Wolfe

in training examination
IN-TRAINING EXAMINATION
  • “3 exams in 1”
    • In-Training Exam
    • Requalifying Exam
    • ABA Written Exam
      • Subset of 300 questions from ITE
    • Plus: Recertification Exam
      • Well-performing A-types from ITE form the question pool
demographics of in training examinations
Demographics of In-Training Examinations

Total Number of Examinees

Registrants

exam content 340 questions 100 are links
Exam Content340 Questions ~ 100 are Links

15%

16%

4%

8%

9%

47%

Number of Questions

disease states breakdown 163 questions
Disease States Breakdown163 Questions

Number of Questions

7.2%

5.7%

5.7%

5.1%

4.9%

4.6%

4.6%

4.6%

4.3%

gaps in knowledge ca3s
Gaps in Knowledge – CA3s
  • 8 Surprising Gaps Identified
  • Report being sent by ASA office
examination registration behavior
Examination Registration/Behavior
  • Government Issue Picture ID
  • NO Cell Phones or Pagers
  • Calculators are NOT OK
  • Consequences of Cheating
  • Proctors are in charge
joint council finances
Joint Council Finances
  • Joint Oversight by ASA/ABA
  • Largely sustained by Exam fees
  • In the Red ($50-100K) when N was low
joint council finances15
Joint Council Finances
  • Still losing $20-50K/year with strong N: increased proctor compensation, NBME fees mainly
  • Exam cost @ $85 since 1996
  • Joint Council approved increase in exam fee to $100 effective for 2005 exam
content outline revision
Content Outline Revision
  • 1996 version used for 2004 Exam
  • 2003 version used for 2005 Exam
  • New Format: “Organocentric”
  • Both versions on ASA website
    • 2004 version disappears 12/31/04
    • www.asahq.org/publicationsandservices/contentoutlinerev2003
faqs future issues
FAQs/Future Issues
  • Computerized Exam?
  • Phase out K-types?
  • Introduce R-types and question clusters (G types) in 2005
q which of the following foods grows on trees
Q. Which of the following foods grows on trees?
  • Bananas
  • Tomatoes
  • Apples
  • Freedom (French) Fries

A:1,2,3 B:1,3 C:2,4 D:4 E:1,2,3,4

Answer: B

k type evolution
K-type evolution
  • Always on exam: approx 40% in 1970s and 1980s
  • Gradual decrease to current 20%
  • Elimination being considered: primary rationale for evaluating R-types
  • NBME dislikes, controversial among Joint Council members
disadvantages to k types
Disadvantages to K-types
  • No longer on USMLE
  • Take longer to answer (approx 60 vs 50 sec)
  • Slightly more difficult than A-types
  • Examinees dislike them
advantages to k types
Advantages to K types
  • Question performance has been good
    • Discriminates stronger vs weaker examinees pretty well, ideal K-type requires greater depth of understanding
  • Anesthesiology doesn’t always lend itself to single best answer
  • May take 3-4 A-types to test the same information as a single well-written K-type
k type interim conclusions
K-type (interim) conclusions
  • See how R-types perform
  • Hold the line at 15-20% for now, reassess over next two years
  • Let’s base K-type fate more upon the need for knowledgeable anesthesiologists than upon question popularity among examinees
    • Remember that they have 3-4 years to practice
extended matching r type
Acute DIC

Hemophilia A

Platelet function defect

Idiopathic thrombocytopenia purpura

von Willebrand’s disease

Antithrombin III deficiency

Extended Matching (R-type)

1. 70 year-old man undergoing CABG/AVR is oozing after CPB

  • A 70 year-old man undergoing CABG/AVR
  • develops a coagulopathy after CPB.

Answer: C

slide24

Extended Matching (R-type)

  • Acute DIC
  • Hemophilia A
  • Platelet function defect
  • Idiopathic thrombocytopenia purpura
  • von Willebrand’s disease
  • Antithrombin III deficiency

An active 30 year-old man with a history of hemarthroses

and excessive bleeding after small cuts presents for

appendectomy.

Answer: B

[Continue with additional questions]

r types and g types

R-types and G-types

Examples soon will appear on ASA Web site

nonstandard examinations
Nonstandard Examinations
  • Extended time, quiet room, reader, etc.
  • Application processing takes more time (4 months before exam)
  • Process described in ABA Booklet of Information, Section 7.01
  • Same process for ITE as ABA written exam
  • Once approved by ITE, ABA usually rubber-stamps it (same committee)
nonstandard exam concerns
Nonstandard Exam: Concerns
  • Numbers gradually increasing
  • Candidates often wait for ABA exam to request accommodation
  • Candidates/examinees often allow insufficient time
  • Candidates/examinees presume that a previous accommodation automatically merits an ABA/ASA or ABA accommodation
nonstandard exam concerns28
Nonstandard Exam Concerns
  • Recognize that A.D.D. does not automatically qualify for extended test time
  • Recognize that psychological testing must be <5 years old
  • Comments from candidates and from our expert consultants at times scare the Nonstandard Exams Committee
slide29
“When a resident fails to measure up to the academic standards and/or professional behavior expected, it is incumbent upon the program director to document these failures during the Residency Review Committee-mandated semiannual review.”

Miller SH, Plastic Reconst Surg 1990

communications

Communications

gravlee.1@osu.edu

614-293-9081

Therese O’Donnell-Leonard