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ABR Core Examination Preparation

Rationale and Objectives

A survey was administered to fourth-year radiology residents after receiving their results from the first American Board of Radiology (ABR) Core examination in 2013. The purpose was to gather information regarding resources and study strategies to share with program directors and future resident classes.

Materials and Methods

An online survey was distributed to examinees nationwide. The survey included free-response and multiple choice questions that covered examination results, perceived value of enumerated study resources, case-based and didactic teaching conferences, board reviews, study materials for noninterpretive skills, multidisciplinary conference attendance, and free-form comments.

Results

Two hundred sixty-six of 1186 residents who took the Core examination responded to the survey. Some resources demonstrated a significant difference in perceived value between residents who passed the examination and residents who failed, including internal board reviews (1.10, P < .01), daily didactic conferences (1.51, P < .01), and daily case conferences (1.43, P < .01). Residents who passed reported that conferences and review sessions at their institutions were modified with multiple choice questions, audience response, and integration of clinical physics and patient safety topics compared to residents who failed.

Conclusions

Radiology residents and residency programs have adapted their preparations for the ABR Core examination in a variety of ways. Certain practices and study tools, including daily conferences and internal board reviews, had greater perceived value by residents who passed the examination than by residents who failed. This survey provides insights that can be used to assess and modify current preparation strategies for the ABR Core examination.

Standardized examinations are an integral component of a radiologist’s educational journey. The Medical College Admission Test, United States Medical Licensing Examinations, and the American Board of Radiology (ABR) examinations are requisite steps in a trainee’s career. Over the past two decades, the ABR has actively discussed the principles guiding its examinations . The traditional board certification model consisted of a three-step process, which included a physics examination, a written examination, and a certifying oral examination. In 2007, the ABR announced the decision to transition from this historical board certification model to an image-rich computerized examination administered in two parts: the Core examination and the certifying examination .

Fourth-year radiology residents comprised the first cohort to take the new qualifying ABR Core examinaion in October 2013. Residents, program directors, and faculty expressed similar concerns regarding how best to prepare for the new examination format. In response to this need, members of the Association of Program Directors in Radiology (APDR), American Alliance of Academic Chief Residents in Radiology (A 3 CR 2 ), and Association of Program Coordinators in Radiology (APCR) collaborated on a survey of fourth-year radiology residents who took the first installment of the new Core examination in October 2013 to identify effective study tools, review methods, and best practices for preparation for the ABR Core examination, and to provide feedback to the ABR. The results of this survey were presented at the 2014 Association of University Radiologists Annual Meeting on April 3, 2014.

Materials and methods

Survey Design

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Data Analysis

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Results

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Preparatory Tools

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Table 1

Usefulness of Study Resources for the ABR Core Examination, Rated on Scale of 1–5

Resource Pass ( n = 239) Fail ( n = 23) Difference_P_ Value External physics review, % ( n ) 4.17 (157) 4.11 (18) 0.05 .56 RADPrimer, % ( n ) 4.01 (207) 3.05 (20) 0.96.03 Internal board review, % ( n ) 3.90 (201) 2.80 (20) 1.10<.01 RSNA/AAPM physics modules, % ( n ) 3.76 (232) 3.70 (23) 0.07 .63 RadCases, % ( n ) 3.75 (135) 3.41 (17) 0.34 .21 DVD review lectures, % ( n ) 3.73 (162) 3.40 (20) 0.33 .12 Case review series, % ( n ) 3.66 (217) 3.14 (21) 0.52.03 Daily didactic conferences, % ( n ) 3.42 (231) 1.91 (23) 1.51<.01 Daily case conferences, % ( n ) 3.39 (113) 1.96 (15) 1.43<.01 External board review, % ( n ) 3.39 (230) 3.27 (22) 0.12 .62 Internal physics review, % ( n ) 3.10 (206) 2.50 (20) 0.60 .08 ABR practice questions, % ( n ) 3.05 (213) 2.26 (23) 0.79<.01 ACR contrast manual, % ( n ) 2.77 (180) 2.76 (17) 0.01 .98 Journal articles, % ( n ) 2.58 (192) 2.74 (19) −0.15 .54 ABR noninterpretive skills resource guide, % ( n ) 2.52 (179) 2.20 (20) 0.32 .26 ACR appropriateness criteria, % ( n ) 2.40 (199) 2.35 (17) 0.04 .81 ABR sample content, % ( n ) 2.31 (222) 1.57 (23) 0.74<.01 ACR case-in-point, % ( n ) 2.29 (158) 2.45 (11) −0.16 .62 AIRP iPad app, % ( n ) 2.22 (152) 2.17 (18) 0.06 .99 ABR study guide, % ( n ) 1.63 (228) 1.23 (22) 0.40.04 ABR blueprints, % ( n ) 1.60 (141) 1.26 (19) 0.34 .12

AAPM, American Association of Physicists in Medicine; ABR, American Board of Radiology; ACR, American College of Radiology; AIRP, American Institute for Radiologic Pathology; Case review series, Elsevier; DVD, digital versatile disc; iPad, Apple Inc.; RadCases, Thieme RadCases; RADPrimer, RADPrimer ( www.radprimer.com ); RSNA, Radiological Society of North America.

1 = Least helpful, 5 = most helpful. Pass = average rating of usefulness among respondents who passed ( n = number of responses); fail = average rating of usefulness among respondents who failed ( n = number of responses); difference = difference between the mean rating of usefulness of passing versus failing residents (>0 = passing residents found the resource more useful than failing residents, <0 = passing residents found the resource less useful than failing residents); P value = statistical significance of the difference ( P < .05 was considered significant, and significant values are highlighted in bold.)

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Table 2

Discriminant Function Analysis of Study Resources Versus Examination Success

Classification Results Pass = 1/Fail = 0 Predicted Group Membership Total Fail Pass Core examination result Fail 14 8 22 Pass 1 238 239 Ungrouped cases 1 Percent Fail 63.6 36.4 Pass 0.4 99.6

Respondents’ ratings of the study resources are used as a predictor to determine if they would pass or fail the examination to a 96.6% accuracy rate (238 of 239 passing respondents and 14 of 22 failing respondents). Regarding the entries in the table, 14 = respondents predicted to fail, who failed; 8 = respondents predicted to fail, who passed; 1 = respondent predicted to pass, who failed; and 238 = respondents predicted to pass, who passed. The single ungrouped case could not be reliably grouped based on the data provided on the survey.

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Teaching and Multidisciplinary Conferences

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Board Reviews

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Physics Reviews

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Free Responses

Factors or Tools That Were Helpful

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Factors Creating Difficulty

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Core Examination Advice for Future Residents

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General Advice for Future Residents

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Discussion

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Conclusions

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Acknowledgments

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Appendix

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References

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