The cardiovascular in-training examination: development, implementation, results, and future directions.

Area of Science:

• Cardiovascular Medicine
• Medical Education
• Competency-Based Assessment

Background:

• The American College of Cardiology (ACC) developed the first standardized In-Training Examination (ITE) for cardiovascular disease fellows-in-training (FITs).
• This examination, in collaboration with the National Board of Medical Examiners (NBME), utilizes ACC Curricular Milestones for competency-based feedback.
• The ACC ITE has been administered over 5,000 times since 2011.

Purpose of the Study:

• To report the initial experience with the ACC ITE.
• To assess the feasibility and reliability of its development and implementation.
• To evaluate its ability to provide useful feedback in key content areas.

Main Methods:

• Annual web-based, secure, multiple-choice examination administered to US cardiovascular disease fellowship programs since 2011.
• Questions developed by cardiovascular disease specialists and quality-assured by the NBME.
• Scores were equated and standardized; detailed feedback provided on knowledge gaps.

Main Results:

• The ITE was administered 5,118 times, with 1,969 fellows from 194 programs participating in 2013.
• Consistent examination scores were observed across three training years.
• Total test scores and content area scores increased with fellowship year, showing statistically significant improvement.

Conclusions:

• The ACC ITE is a valuable tool for assessing medical knowledge in cardiovascular disease training programs.
• It provides robust, timely feedback to address individual knowledge gaps.
• The examination can serve as a foundation for enhancing training curricula.