Download ACVECC Board Certification Examination

ACVECC Board Certification
Examination
Maureen McMichael, DVM, DACVECC
Chair, AVECC Examination Committee
Introduction
• This presentation will be posted on the
ACVECC website under “Updates for
Residents”
• http://www.acvecc.org
Introduction
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Old Exam Format
New Exam Format
How to study
Example questions
Examination Format - Old
• Oral Examination
• Practical
Examination
• Essay Questions
• Multiple Choice
Examination Format - New
• General Multiple
Choice
• Species Specific
Multiple Choice
• Clinical Exam
Exam Committee Preparation
• Each member must read
a comprehensive
question writing guide
• All questions must be;
• Unambiguous
• Valid
• Defensible
Exam Committee Preparation
• All questions must be;
• Reviewed
• Edited
• Updated
• Approximately 1 hour to
write each MC question
Exam Committee Preparation
• Exam Committee is made up of 25
members
• Small Animal: 16 members
• Large Animal: 7 members
• Ex officio and adjunct: 2 members
Question Writing
• Each general MC question reviewed by
~10-12 diplomates (LA reviews general
MC)
• Each species specific MC question
reviewed by 7-12 diplomates
Question Writing
• All questions re-reviewed after final
edits
• All questions reviewed by additional
diplomate (question bank)
• All MC questions referenced
• All questions weighted based on topics
Subject area
Approximate % points
Sepsis/Infectious disease/Therapeutics 9%
Fluid/electrolyte/acid-base/renal
9%
Cardiovascular
9%
Shock
9%
Monitoring
8%
Trauma
6%
Pulmonary
6%
Subject area
Approximate % points
Coagulation/Transfusion medicine/Hematology
Environmental emergencies (burns, heatstroke,
hypothermia, snakebite etc.)
Gastrointestinal/metabolic/endocrine
Toxicology
CPCR
5%
3%
3%
4%
4%
Subject area
Anesthesia/analgesia
Nutrition
Reproductive/urogenital
Diagnostic imaging
Neurology/Ophthalmology
Surgical principles
Pharmacology
Oncology
Approximate % points
4%
3%
3%
3%
3%
3%
3%
3%
Modified Angoff Scoring
• After exam each question is assessed
by >25 diplomates (not from exam
committee) as to validity and difficulty
(>10 required)
• Each question is rated as to the
probability that a minimally acceptable
candidate will get the answer correct
• Angoff score gives pass point
Modified Angoff Scoring
• Angoff scorers give feedback
• Questions culled based on feedback
and on stats (most people got it wrong)
Exam Scoring
• Clinical Exam is graded in committee by
at least 6-7 (large animal) to 12-16
(small animal) diplomates
• MC OpScan forms are machine graded
at least 2X
• Questions missed by many are reevaluated
Exam Scoring
• All grading is in favor of the candidate
(clinical)
• Questionable answers – give credit
• All “bad” questions removed – all
candidates given full credit for each one
Statistical Analysis
• Professional Testing Company
• Using Angoff scores determine a 90, 95,
99% CI
• 99% is most liberal – gives the lowest
passing score with the highest # of
passing candidates
Statistical Analysis
• 99% CI means the chance of a
minimally qualified candidate failing the
exam based on our scoring method is <
0.5%
Statistical Analysis
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2006 Exam
10/200 questions culled from gen MC
9/200 culled from SA MC
All examinees received full credit for
culled questions
• Angoff scores gave pass point
• CI lowered it by approximately 6-8
points
Examination Schedule
Sunday, Sept 23- Tues, Sept 25
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Day 1, 8a-12n, 1p-5p
Clinical exam
Day 2, 8a-12n, 1p-5p
General MC exam
Day 3, 8a-12n, 1p-5p
Species Specific MC exam
Clinical Examination
• Two types of questions
• Graphical format (picture, graph,
chart, etc.) used to ask a question
• Patient vignette (signalment, history,
PE, lab data, etc.)
• Short answers
Clinical Examination
• Types of Answers
• One word
• One-phrase
• List
• Formula
• Calculation
• Graph
• Short answer
Clinical Vignette
• 4 yr old, MC, mixed breed K9, 30kg
• Hx: normal one hour prev, outside
unattended. Found laterally recumbant
and obtunded in owner’s unfenced front
yard near the street
Physical Exam
• Obtunded – responds to deep pain
stimulus
• HR 200 bpm, no murmur, NSR
• RR 60 bpm, increased effort
• 4 quadrant breath sounds on left (up
side), ventral and dorsal sounds heard
on right (down side). No stridor or
crepitation.
Physical Exam
• MM pale, CRT 4 seconds
• Non palpable dorsal pedal pulses, weak
femoral pulses
• Epistaxis, abrasion right side of head
• Hyphema, miosis, OS
• Deep abdominal palpation – painful, no
other abnormalities
• No apparent broken bones
Laboratory data
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PCV 36%
TS 5.4 g/dl (54 g/L)
Glucose 280 mg/dl (13.4 mmol/L)
Blood Urea Nitrogen 36 mg/dl
(13.8mmol/L)
• Sodium 150 mEq/L
• Chloride 110 mEq/L
• Potassium 5 mEq/L
Sample Questions
• One word answer
• What is the neurologic term that best
describes this dog’s level of
consciousness?
• Stupor
Sample Questions
• One Phrase Answer
• What is Oxyglobin?
• An ultrapurified, stroma-free,
polymerized, plasma-phase, boving
hemoglobin oxygen carrying solution
Sample Questions
• List Answer
• Consolidate the history, physical exam
and laboratory findings into this patient’s
three most important major problems
• Respiratory distress
• Shock
• Head trauma
Sample Questions
• Formula Answer
• What is the formula for cerebral
perfusion pressure?
• CPP=MAP-ICP
Sample Questions
• Calculation Answer
• What is the estimated serum osmolality
of this patient?
• 178 mOsm/L
Sample Questions
• Graphical Answer
• Draw an intracranial compliance curve
Sample Questions
• Short Answer
• Would performing a test for positional
nystagmus (doll’s eye reflex) be a
reasonable part of this patient’s
neurologic exam at this time?
Sample Questions
• Short Answer
• No, the test requires lifting and moving
the head and neck which is
contraindicated in a patient with head
trauma and poor perfusion, and a
possible cervical injury.
General MC Question
• Regarding pulmonary function which of
the following is true?
• A. The reason that PTE has a high
fatality rate is because the lung has no
local fibrinolytic system to lyse clots.
• B. Surfactant is synthesized by type I
alveolar cells and maturation is
accelerated by glucocorticoids
General MC Question
• C. Resistance is the pressure difference
required for a unit of air flow and is a
dynamic measurement
• D. Compliance is the change in lung
volume per unit change in airway
pressure and is a dynamic
measurement
Regarding pulmonary function
which of the following is true?
• C. Resistance is the pressure difference
required for a unit of air flow and is a
dynamic measurement
• Answer C
• Reference: Review of Medical
Physiology, Ganong, 21st ed. Chapter
34 Pulmonary Function
Exam Preparation
• Take 4-8 weeks off
to study
• Organize review
materials
• Know the literature
Exam Preparation
• Follow the topic
charts (sepsis/infect
9%)
• Do not waste time
researching
committee members
– important with
essays, oral
Exam Preparation
• Get on Exam
Committee after
passing!
• Get involved in
YOUR College!
Good Luck!