Putting In-Training Exams to the Test

For years, residents have taken either the DXIT™ or TXIT™ exam. Soon one of them will be going digital.in training tests

The past few years have been a period of extraordinary change for radiology exams. In 2008, the ABR announced that it would be altering the board exams given to residents beginning in the fall of 2013.

(See "Introducing the New Boards," October 2010 ACR Bulletin.) Then, in 2009, the ACR announced that the "In-Training Examination for Diagnostic Radiology Residents" (DXIT™) will be available electronically starting in 2012. Such tests at DXIT and its counterpart, the "In-Training Examination for Radiation Oncology Residents" (TXIT™), have become valuable tools for residents to polish their skills and program directors to benchmark their program's impact against others.

"I think [DXIT's] transition will be a positive one," says Cheri L. Canon, M.D., chair of the ACR's Committee on Residency Training in Diagnostic Radiology and newly appointed chair of the ACR Commission on Education. "It's important that the test reflects what residents-in-training are expected to know as radiologists. The test in electronic format better simulates real radiology," she says, adding that the quality of the images will be superior to those currently printed in the test booklet.

Room for Improvement

Both the DXIT and TXIT exams serve two specific purposes. The first is to provide a self-evaluation. The TXIT exam, for example, is "intended to assess [residents'] fund of knowledge for clinical information and management, biology, and physics," notes Marie E. Taylor, M.D., FACR, chair of ACR's Committee on Residency Training in Radiation Oncology.

The second purpose is to enable program directors to gauge how their residents perform relative to their peers how groups within residency programs compare to other groups nation-wide. According to Canon, the exam helps residency programs meet requirements set by the Radiology Review Committee of Accreditation Council for Graduate Medical Education (http://bit.ly/bg9Cqh) to demonstrate training in the general competencies and identify areas that need improvement within their curricula.

For many residents, DXIT and TXIT serve unofficially as practice and preparation for the board exams. The result is that many fourth-year residents don't take the ACR's in-training tests because by that point, they have already taken the ABR's written exam and may believe that tests are unnecessary. Canon sees significant problems with this practice. "If they aren't in the pool, it's hard to assess the program without them," she says.

In an era of online testing, moving the DXIT exam to a digital platform will help residents and program directors meet their respective goals. To learn more about ACR's in-training exams, visit http://rfs.acr.org/#/Exams.

By Brett Hansen

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