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Radiology ExamWeb: development and implementation of a national web-based examination system for medical students in radiology

Lewis, Petra J; Chen, Jim Y; Lin, Dana J; McNulty, Nancy J
RATIONALE AND OBJECTIVES/OBJECTIVE:Faculty are often limited in time, knowledge, and resources to develop efficient, effective, and valid computer-based examinations to evaluate students. Our purpose was to develop a web-based pool of standardized National Board of Medical Examiners (NBME)-format, peer-reviewed, and peer-tested questions based on the Alliance of Medical Student Educators in Radiology (AMSER) National Medical Student Curriculum to evaluate the radiologic knowledge of medical students. MATERIALS AND METHODS/METHODS:Members of the AMSER Electronics Committee submitted questions they had written for their institutions and later developed a 113-question standardized examination. Questions were edited by 24 subspeciality editors and then further edited by the authors to NBME recommendations. Software was developed using commercially available software (www.ExamWeb.com) with extensive modifications and additions following initial deployment. Students take examinations online and receive their scores immediately. Items were validated by identifying those answered >30 times and analyzing the following: number of times deployed, number of times correctly answered, distractor-specific breakdown, difficulty level (P), and point biserial coefficient (rbi). RESULTS:Radiology ExamWeb (REW) is available online with 3500 registered students from 65 institutions and 1800 active questions. Instructors can create examinations or use "shared examinations" made by another instructor but enabled for other institutions to administer or modify. More than 300 shared examinations have been developed. The AMSER curriculum was converted into database format and crosschecked with question items to ensure that the question pool adequately covered the spectrum of the curriculum. An AMSER standardized examination has been developed and deployed within REW. CONCLUSIONS:REW has provided medical student educators with the means to evaluate students in a systematic way, using a nationally edited and regularly reviewed web-based process.
PMID: 23452473
ISSN: 1878-4046
CID: 3372852

Multidisciplinary approach to diagnosis and management of intraductal papillary mucinous neoplasms of the pancreas

Sahani, Dushyant V; Lin, Dana J; Venkatesan, Aradhana M; Sainani, Nisha; Mino-Kenudson, Mari; Brugge, William R; Fernandez-Del-Castillo, Carlos
Intraductal papillary mucinous neoplasms have gained recognition in recent years as premalignant precursors to pancreatic cancer that enable early detection and often are found incidentally at imaging. Accurate diagnosis and optimal, finely tuned management of these lesions are important and require collaboration across various disciplines, including radiology, endoscopy, surgery, and pathology. Several imaging modalities can visualize these lesions adequately, each with specific advantages and disadvantages. Multidetector computed tomography and magnetic resonance cholangiopancreatography are generally the first-line imaging modalities; endoscopic imaging such as endoscopic ultrasound and endoscopic retrograde cholangiopancreatography are beneficial when the former 2 modalities are equivocal. Surgical candidates generally include patients with main duct lesions or branch duct lesions greater than 3 cm or any possessing a solid component. A management algorithm indicating when surgery should be pursued is proposed. For nonsurgical and postsurgical patients, follow-up management is important to monitor growth and recurrence, and risks from repeated radiation exposure should be taken into account. Furthermore, issues of multifocality and increased predisposition of the pancreas to ductal adenocarcinoma must be addressed at follow-up evaluation. A follow-up management algorithm also is proposed in this review.
PMID: 19121413
ISSN: 1542-7714
CID: 3372842