Implementation of an Objective Testing System in Noninvasive Cardiac Imaging for Evaluation of Pediatric Cardiology Fellows

Abstract

Current evaluation of pediatric cardiology fellow performance is subjective and qualitative. More objective tools are recommended by credentialing boards and may provide more effective evaluation and education. A series of training level-specific multiple-choice tests were developed and evaluated for their effectiveness as evaluation and educational tools for pediatric cardiology fellows. Imaging tests were created by 3 attending physicians and one sonographer with combined expertise in echocardiography, cardiac magnetic resonance imaging, and cardiac computed tomography. Test content was derived from educational materials, textbooks, journal articles, and lectures previously given to the fellows. The tests were computerized and installed on the hospital intranet. After completion of each test, a posttest session was conducted between the fellow and the director of echocardiography to review concepts surrounding incorrect answers. A survey of the test use was then completed by each fellow. Four progressively more difficult tests corresponding to each 1-month image rotation and an advanced fifth test for fellows intending to subspecialize in noninvasive cardiac imaging were created. Fifteen fellows took 39 tests (test 1, 15 fellows; test 2, 9 fellows; test 3, 9 fellows; test 4, 4 fellows; and test 5, 2 fellows). The difficulty level of the tests was similar relative to fellow academic level. The majority of fellows welcomed more objective data provided by the tests and 93% of the fellows stated the posttest session was educational. Implementation of a fellow testing system using training level-specific computerized questions and images provides objective data for fellow performance evaluations and is a unique and beneficial educational tool.