1 / 58

Question Writing Guide ABNM SAM Questions

Question Writing Guide ABNM SAM Questions. J. Anthony Parker, MD PhD Associate Executive Director, ABNM Beth Israel Deaconess Medical Center Boston, Massachusetts Tony_Parker@BIDMC.Harvard.edu. Caveat Lector. Psychometrics Origin for Questions Writing Rules.

malaya
Download Presentation

Question Writing Guide ABNM SAM Questions

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Question Writing GuideABNM SAM Questions J. Anthony Parker, MD PhD Associate Executive Director, ABNM Beth Israel Deaconess Medical Center Boston, Massachusetts Tony_Parker@BIDMC.Harvard.edu Caveat Lector

  2. PsychometricsOrigin for Questions Writing Rules Psychometrics is the field of study concerned with the theory and technique of psychological measurement, which includes the measurement of knowledge, abilities, attitudes, personality traits, and educational measurement. The field is primarily concerned with the construction and validation of measurement instruments such as questionnaires, tests, and personality assessments. – Wikipedia

  3. Test Goal is to Measure Ability Logistic regression where the probability of a correct answer is a function of Fn, the ability of person, n bi, the difficulty of question, i Difficulty of question, i, bi Probability Ability 0.3 Wikipedia Ability of person , n, Fn

  4. Can Also Measure Question Difficulty Logistic regression where the probability of a correct answer is a function of Fn, the ability of person, n bi, the difficulty of question, i Ability of person , n, Fn Probability Difficulty 0.3 Wikipedia Difficulty of question, i, bi

  5. Question Discrimination The slope determines how well a question discriminates between candidate abilities ai, ability discrimination log-odds correct answer = ai• (Fn - bi) Ability of person , n, Fn = 0.3 Slope, ai Discrimination Probability Difficulty 0.3 Wikipedia Difficulty of question, i, bi

  6. ABNM Procedure Assume questions are good and correctly keyed Measure candidate tentative ability Using tentative abilities measure question difficulty Discard questions that are too hard or too easy Also measure question-ability discrimination Correct wrong keys Discard questions that not correlated with ability Using improved test, measure final candidate ability Adjust to standard independent of candidates and test

  7. Writing Good Questions:Questions that Correlate with Ability Psychometricians have developed rules for writing good questions Rules are based on question performance Bad questions test abilities unrelated to the test goal

  8. Some Rules for Good Questions No negatives (not, except, none) No absolutes (always, never, all, every, only, must) No overlapping ranges No “all of the above” or “none of the above” No mutually exclusive answers (one is correct) Logical order (numerical, alphabetical, category) Single concept per question No multiple true / false questions

  9. Which of the following is truein Nuclear Medicine? MIBG is used to image somatostatin receptors A photon is completely absorbed during a Compton interaction 18F-FDG is transported into cells by GLUT Lymphoma is never FDG-avid Multiple true / false “which is true?” Multiple unrelated concepts “Never” is an absolute

  10. With regard to the thyroid which is correct? Pentetreotide is taken up in the parafollicular cells Follicular cells are non-iodine-avid Stromal cells take up iodide Pentetreotide is not taken by the thyroid Multiple true / false “which is correct?” First and last answers are mutually exclusive One of them must be correct “Non” and “not” are negatives

  11. In the thyroid, pentetreotide istaken up MOST avidly in: parafollicular cells (C cells) follicular cells colloid stroma

  12. parafollicular cells (C cells) follicular cells colloid stroma In the thyroid, pentetreotide istaken up MOST avidly in:

  13. Which of the following isnotcorrect? 11C-acetate is metabolized in the the TCA cycle 11C-choline can be used for prostate cancer 18F-fluorodexoyglucose (FDG) is not phosphorylated in the cell 18F-fluorothymidine (FLT) is correlated with cellular proliferation Not in stem and in 3rd answer Multiple true / false “which is correct?” Multiple unrelated concepts

  14. MOST closely correlatedwith proliferation? 11C-acetate 11C-choline 18F-fluorodexoyglucose (FDG) 18F-fluorothymidine (FLT)

  15. MOST closely correlatedwith proliferation? 11C-acetate 11C-choline 18F-fluorodexoyglucose (FDG) 18F-fluorothymidine (FLT) Good distractors are often partially true, but not the best answer

  16. What is the BEST administered dose to use for a 18F-FDG PET pediatric scan? ≤ 1 MBq/kg (≤ 0.03 mCi/kg) 1 - 4 MBq/kg (0.03 - 0.11 mCi/kg) 4 - 16 MBq/kg (0.11 - 0.43 mCi/kg) 10 - 64 MBq/kg (0.27 - 1.73 mCi/kg) Overlapping ranges 4-16 and 10-64 both include 10-16 1-4 and 4-16 both include 4

  17. What is the BEST administered dose to use for a 18F-FDG PET pediatric scan? 1 MBq/kg (0.03 mCi/kg) 4 MBq/kg (0.11 mCi/kg) 16 MBq/kg (0.43 mCi/kg) 64 MBq/kg (1.73 mCi/kg)

  18. What is the BEST administered dose to use for a 18F-FDG PET pediatric scan? 1 MBq/kg (0.03 mCi/kg) 4 MBq/kg (0.11 mCi/kg) 16 MBq/kg (0.43 mCi/kg) 64 MBq/kg (1.73 mCi/kg) Gelfand: Pediatric radiopharmaceutical administered Doses: 2010 north american consensus guidelines. J Nucl Med 2011;52:318

  19. Parallel Answers / Avoid Teaching Answers should be parallel in construction and length Good test takers know that “teachers like to teach” The correct answer is often the longest Tendency to make correct answer exactly correct For testing, avoid teaching

  20. Urinary excretion of FDG is related to: FDG concentration overwhelms GLUT renal GLUT has low affinity for FDG both of the proximal and distal convoluted tubule sodium glucose transporters (SGLT1 & SGLT2 respectively)have low affinity for FDG there is little hexokinase in the kidney Asymmetric answers Teaching

  21. Urinary excretion of FDG is related to: FDG concentration overwhelms GLUT renal GLUT has low affinity for FDG SGLT1/2 have low affinity for FDG there is little hexokinase in the kidney

  22. Urinary excretion of FDG is related to: FDG concentration overwhelms GLUT renal GLUT has low affinity for FDG SGLT1/2 have low affinity for FDG there is little hexokinase in the kidney

  23. Glucose Reuptake in the Kidney

  24. Stem (Question) 1. Ask a question Given …, what is the MOST likely diagnosis? 2. Give and incomplete statement Given …, the BEST next step is: 3. Describe a situation followed #1 or #2 A one-year-old girl had jaundice and a 5 x 6 cm mass in the porta. Total bilirubin is 7 mg/dL. …

  25. Stem (Question) Put most of the content in stem Answers short Move common words in answers to stem Remove unnecessary words or sentences

  26. In a 73-year-old man with metastaticmelanoma, what is the MOST likely causeof the FDG uptake shown in the figure? prostate cancer melanoma normal bladder normal urethra

  27. In a 73-year-old man with metastaticmelanoma, what is the MOST likely causeof the FDG uptake shown in the figure? prostate cancer melanoma normal bladder normal urethra

  28. Distractors (Incorrect Answers) Should be plausible Logical misconceptions Common misunderstandings Reasonable not the BEST answer not the MOST likely answer

  29. Testing vs. Teaching Wright Map Testing distinguish candidates difficult items judgment required low passing % Teaching help learning easier items emphasize key points candidates items more able hard less able easy

  30. Question Taxonomy Recall (fact) The energy of 99mTc is: Interpretive (diagnosis) A patient with … had an FDG-PET/CT shown in the figure. The MOST likely diagnosis is: Problem solving (management, judgment) A patient with … had an FDG-PET/CT shown in the figure. The BEST next step is:

  31. Higher Taxonomy Preferred Often involve more advanced reasoning More complex medical task Still single clinical concept Distractors may be easier to write Some topics require lower taxonomy questions

  32. Stable iodine (SSKI or Lugol’s solution) should be administered prior to: pentetreotide (Octreoscan®) iobenguane (MIBG) a contrast FDG-PET/CT ibritumomab tiuxetan (Zevalin®)

  33. Stable iodine (SSKI or Lugol’s solution) should be administered prior to: pentetreotide (Octreoscan®) iobenguane (MIBG) a contrast FDG-PET/CT ibritumomab tiuxetan (Zevalin®) Recall question pentetreotide confused with MIBG ibritumomab tiuxetan confused with tositumomab

  34. Based on the electrocardiogram, whatis the BEST diagnosis? Difficult to come up with 4 plausible diagnoses

  35. A 45 y/o diabetic man with weakness and shortness of breath for 3 days presents for exercise MPI. The pre-exercise ECG is shown.

  36. What should be done next? Obtain right precordial leads. Use dipyridamole stress instead. Accompany the patient to the EW. Proceed as planned.

  37. What should be done next? Obtain right precordial leads. Use dipyridamole stress instead. Accompany the patient to the EW. Proceed as planned.

  38. Writing Distractors Difficulty writing reasonable distractors Change taxonomy Management distractors often easier to write

  39. The BEST diagnosis is:

  40. The BEST diagnosis is: normal thymus mediastinal metastases ? ? Diagnostic question

  41. The uptake in the chest is related to:

  42. The uptake in the chest is related to: the Na / I symporter somatostatin receptor, type 2 brown fat metastases Diagnosis & biodistribution

  43. A syringe of 90Y-ibritumomab tiuxetan (Zevalin ®) measuring 1025 MBq (27.7 mCi) needs to be discarded due to QC failure. After transfer to a vial, measurements are vial: 815 MBq (22.0 mCi), syringe: 15 MBq (0.4 mCi). What should be done next? Declare a medical event Survey the area Call the radiation safety officer (RSO) Store for decay

  44. A syringe of 90Y-ibritumomab tiuxetan (Zevalin ®) measuring 1025 MBq (27.7 mCi) needs to be discarded due to QC failure. After transfer to a vial, measurements are vial: 815 MBq (22.0 mCi), syringe: 15 MBq (0.4 mCi). What should be done next? Declare a medical event Survey the area Call the radiation safety officer (RSO) Store for decay

  45. Which Isotope is MOST Difficult toAccurately Measure in a Dose Calibrator? 18F 90Y 99mTc 111In

  46. Which Isotope is MOST Difficult toAccurately Measure in a Dose Calibrator? 18F 90Y 99mTc 111In

  47. 99mTc-pertechnetate 67Ga-citrate 111In-pentetreotide 123I-MIBG What radiopharmaceutical was administered?

  48. 99mTc-pertechnetate 67Ga-citrate 111In-pentetreotide 123I-MIBG What radiopharmaceutical was administered?

  49. What’s the Radiopharmaceutical?Stupid Questions, but I Use Them Should know normal and common variant biodistribution at organ, cell, and receptor level To be able to identify abnormal biodistribution identify radiopharmaceutical QC understand unusual findings

More Related