Abstract 14261: ASCeXAM at Sixteen

Abstract

On behalf of the National Board of Echocardiography and the National Board of Medical Examiners.

PURPOSE: To evaluate the robustness of the examination in assessing candidate training and experience in adult Echocardiography.

METHODS: Since the first ASCeXAM in 1996, data on the type of training, length of training in echocardiography, practice setting, and number of studies performed weekly, have been collected from each applicant. This study compared candidate scale scores (SS, adjusted for exam difficulty) over the 16 years to training and weekly studies interpreted.

RESULTS: Since inception 7890 (7063 cardiologists) have taken the exam. The number of applicants has increased from 373 to 890 per year. In 2004 there was a shift to applicants with 0 to 2 years in practice being the largest group (2074/4992). The passing rate has trended upward: 59%(1996), 75%(2011). Over the 16 years, SS are related to the studies interpreted/wk: 1-5, (SS±SD) 530±100; >20, 543±81 (F=24.1, p=.000). Training time is also related. All years: >3mo, 470±31; 3 to 6mo, 517±23, > 6mo, 528±14 (F=83, p=.000). Since 2004: >3mo, 470±26; 3 to 6mo, 535±19; >6mo, 538±10. (3 to 6 vs >6 mo, NS). With 200 questions the reliability coefficient of the exam has been >0.92 since 2003 meaning ∼ 10 applicants may be misclassified as Pass or Fail each year.

CONCLUSION: Objectively, passing ASCeXAM is related both to continued experience (maintenance of skills) and level of formal training. The first 16 years confirm that the exam, as designed, tests for expertise at about level 2 or above as suggested for interpretation by COCATS. The increase in SS suggests higher applicant quality. ASCeXAM has proven to be a highly reliable professional exam.