Inservice: Overblown and Overhyped

[bulgethetwine]

I know I'm going to sound like the anti-christ, but when I heard on another thread that a few people at another residency program (and I won't repeat it here so as not to prepetuate the myth/drama) tried to disseminate some questions from past years by after-exam recall, I think....

WHO CARES ?!?!

The in-service is what it is : A tool in our learning. It might give you an INDICATION of how you're going to do on your boards, but it's not the actual board exam. Why does the college treat the questions like a top secret exam? Hell, I would argue that they do us all a disservice by NOT releasing the questions and answers every year!

The exam is overhyped, over-dramatized, and, quite frankly, laughably unimportant in the overall grand scheme of things. I would hate to think that some residents were running afoul because they were trying to help in their year over year learning by copying questions from a meaningless exam.

Good luck today, but your self worth is not tied to this exam. Enjoy a day of learning where no matter what you do, you won't be hurting any patients.

My .02

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[macdaddy23]

I completely agree.
What I dislike more is I believe you could learn a lot from the test and wish they would post answers at a later date.
Most questions are very well written and I would have liked to have gone over it afterwards to learn a lot more. Granted you can always look up the ones you remembered but you won't remember every one.

 

[whasupmd2]

Last year, some people posted some of these things, is that against the rules?

 

[BKN]

I know I'm going to sound like the anti-christ, but when I heard on another thread that a few people at another residency program (and I won't repeat it here so as not to prepetuate the myth/drama) tried to disseminate some questions from past years by after-exam recall, I think....

WHO CARES ?!?!

The in-service is what it is : A tool in our learning. It might give you an INDICATION of how you're going to do on your boards, but it's not the actual board exam. Why does the college treat the questions like a top secret exam? Hell, I would argue that they do us all a disservice by NOT releasing the questions and answers every year!

The exam is overhyped, over-dramatized, and, quite frankly, laughably unimportant in the overall grand scheme of things. I would hate to think that some residents were running afoul because they were trying to help in their year over year learning by copying questions from a meaningless exam.

Good luck today, but your self worth is not tied to this exam. Enjoy a day of learning where no matter what you do, you won't be hurting any patients.

My .02

The reason to care is that it takes a lot of money and faculty time to write the questions. Still more time and money to test the questions and establish validity. If the questions get out and become generally known, than the predictive validity to the ABEM part 1 is lost. You and your faculty then have no way to judge your needs to become a better Doc.

My point is that the test is for you. Good luck everybody. Even though luck has nothing to do with it.

 

[jashanley]

Anyone else think a good number of the questions were poorly written?

 

[odoreater]

Anyone else think a good number of the questions were poorly written?

OK, so because Apollyon made me nervous below I edited my post.

 

[Jeff698]

Actually, I thought the questions on the exam were very well written. The were much more relevant than anything on PEER VII (yeah, I know...not saying much).

Sure there were some stinker questions but the vast majority, I thought, were pretty high quality. Doesn't mean I knew the answers, of course, just that I almost always knew what I was being asked.

Take care,
Jeff

 

[Lola713]

Yes I agree the inservice was full of lots of bizarre questions-some not very relevant at all to emergency medicine! But oh well-that is how all standardized tests are!!!

 

[EctopicFetus]

Inservice exams are fun.. luckily the test was easy and a little angel entered my ear and gave me all the answers! Yipee!

Note lola didnt say that but I thought it would be funny if she did!

Def some of the questions were straight from my 2nd yr path class. Squiggly lines on the EKG (edit) Do I Care? I thought there were a fair number of "this question has no bearing on any treatment I would ever perform in the ED". I thought it was pretty hard but Im just a pgy-1. Some of them I wish I could find the answer to easily with explanations.

 

[roja]

The reason to care is that it takes a lot of money and faculty time to write the questions. Still more time and money to test the questions and establish validity. If the questions get out and become generally known, than the predictive validity to the ABEM part 1 is lost. You and your faculty then have no way to judge your needs to become a better Doc.

My point is that the test is for you. Good luck everybody. Even though luck has nothing to do with it.

BKN-

I am curious, has the predictive validity actually been studied? pass rates of those that have taken the exam versus those that haven't?

these types of exams are very interesting to me (I'll keep my personal opinions about them quiet for now) and it seems that the actual utility of them is based on a large number of unstudied (albeit apparantly logical) assumptions.

 

[EC3]

Edit your posts and delete this information, as it is copywrited and zealously guarded by ABEM, and they WILL figure you out. (Hell, I've never even looked, EF, and I could find you in 1 minute, just from what you've posted here - and specifically - not just guessing.)

Strictly, you do NOT mention anything about the inservice to anyone, at risk of voiding your eligibility for board certification. It's not a joke.

And, as BKN said, it's about testing and reliability. Giving out inservice questions is counter-intuitive, as is studying for it. It's what you know - if you're prepping for it, then you aren't up to speed on the clinical medicine you need to know. The inservice is not "means to an end" like the steps - it's more of a progress report for you and your program director.

Overlord? Is that you?

Keep up the good work and make sure the workers know their place. A busy worker is a happy worker.

 

[GeneralVeers]

The inservice is a "no-stakes exam", yet it taps into the psychotic, residual, exam-taking mode that we got used to in med school. My colleagues who've studied for months for this damn thing, wouldn't even go out for a last dinner together on Tuesday night (most of us left today) because they wanted that extra 2-3 hours to study. When I inquired what they thought that would accomplish I was told "I just want to do well".

ACEP needs to distribute some serious ativan before the tests, or else not take the thing so seriously. Also Program Directors don't help the situation by bestowing chiefliness on the basis of inservice scores.

 

[EctopicFetus]

Edit your posts and delete this information, as it is copywrited and zealously guarded by ABEM, and they WILL figure you out. (Hell, I've never even looked, EF, and I could find you in 1 minute, just from what you've posted here - and specifically - not just guessing.)

Strictly, you do NOT mention anything about the inservice to anyone, at risk of voiding your eligibility for board certification. It's not a joke.

And, as BKN said, it's about testing and reliability. Giving out inservice questions is counter-intuitive, as is studying for it. It's what you know - if you're prepping for it, then you aren't up to speed on the clinical medicine you need to know. The inservice is not "means to an end" like the steps - it's more of a progress report for you and your program director.

Done.. but to be fair we werent told anything about these rules. other than the obvious no talking during the test type of stuff.

 

[EctopicFetus]

The inservice is a "no-stakes exam", yet it taps into the psychotic, residual, exam-taking mode that we got used to in med school. My colleagues who've studied for months for this damn thing, wouldn't even go out for a last dinner together on Tuesday night (most of us left today) because they wanted that extra 2-3 hours to study. When I inquired what they thought that would accomplish I was told "I just want to do well".

ACEP needs to distribute some serious ativan before the tests, or else not take the thing so seriously. Also Program Directors don't help the situation by bestowing chiefliness on the basis of inservice scores.

Our place isnt this way. hence I went and saw a movie last night with the mrs...

 

[EctopicFetus]

Deleted for BKN.. this wasnt on the in service.. just a question I had.. but I dont want to upset those who monitor us..

 

[BKN]

BKN-

I am curious, has the predictive validity actually been studied? pass rates of those that have taken the exam versus those that haven't?

I don't know that any programs have not required the inservice, so I wouldn't know if such a comparison could be made

these types of exams are very interesting to me (I'll keep my personal opinions about them quiet for now) and it seems that the actual utility of them is based on a large number of unstudied (albeit apparantly logical) assumptions.

Read my posts in the inservice-2006 thread that somebody bumped. Then talk the PD into showing you the report packet when the scores arrive. You'll see lots of charts for percentilies and scores by EM level. Most interesting is the graph showing pooled predictions by score and level vs passing part 1.

 

[BKN]

EF, better edit # 9 and #16 as well.
Lola strike #8
Ap # 11

 

[EctopicFetus]

EF, better edit # 9 and #16 as well.
Lola strike #8
Ap # 11

Done.. thanks..I do want to be able to pay off my loans!

 

[GeneralVeers]

Don't piss off ABEM! They'll send you a certified overnight Fedex threatening letter. They sent one to each of our 30+ residents at $14 each.

 

[EctopicFetus]

at least the dues my program pays are going to good use..

 

[Apollyon]

Overlord? Is that you?

Hey, I'm trying to help people out. If you want to learn it's hot by being burned, have at it. I'm telling people before "the man" comes calling.

 

[EctopicFetus]

Hey, I'm trying to help people out. If you want to learn it's hot by being burned, have at it. I'm telling people before "the man" comes calling.

thx for the heads up i am all done with "expensive" learning experiences.. i now have a wife, a house, and loans that need paying... its not like im 16 anymore, or am I?

-Doogie

 

[southerndoc]

Don't piss off ABEM! They'll send you a certified overnight Fedex threatening letter. They sent one to each of our 30+ residents at $14 each.

You should post that letter to see how threatening ABEM can be (remove your name of course).

Unless you guys were selling it, it would be extremely difficult to prove that you were memorizing test questions.

 

[CS_22]

You should post that letter to see how threatening ABEM can be (remove your name of course).

Unless you guys were selling it, it would be extremely difficult to prove that you were memorizing test questions.

And if you are selling it... is there anyway you can hook me up for next year

(To the Powers that Be -- I'm sorry. I didn't mean that)

 

[docB]

You should post that letter to see how threatening ABEM can be (remove your name of course).

Unless you guys were selling it, it would be extremely difficult to prove that you were memorizing test questions.

I don't think ABEM sends out letters. I thought that two official types just appeared in your room one morning to tell you that you were charged but they couldn't tell you with what or when your trial might be.

 

[GeneralVeers]

You should post that letter to see how threatening ABEM can be (remove your name of course).

Unless you guys were selling it, it would be extremely difficult to prove that you were memorizing test questions.

I can't post it, because I've already "filed it appropriately".

 

[jashanley]

As an EM/IM that was my fifth in-service. Anyone have an idea of how close the in-service comes to the real thing? I just can't sit for that long anymore. I'm old and my joints stiffen up. I get all antsy too.
EM docs weren't meant to sit around for long periods of time.

 

[The White Coat Investor]

As an EM/IM that was my fifth in-service. Anyone have an idea of how close the in-service comes to the real thing? I just can't sit for that long anymore. I'm old and my joints stiffen up. I get all antsy too.
EM docs weren't meant to sit around for long periods of time.

My PGYIII score equalled my qualifying exam score. I think it comes pretty darn close to the real thing, but the real thing is a bit longer.

 

[deleted77919]

I don't think ABEM sends out letters. I thought that two official types just appeared in your room one morning to tell you that you were charged but they couldn't tell you with what or when your trial might be.

It's a plane ticket straight to Gitmo.

Unless of course you merit special attention in which case you are sent to undisclosed locations in places with even fewer laws prohibiting torture.

 

[bulgethetwine]

It's a plane ticket straight to Gitmo.

Unless of course you merit special attention in which case you are sent to undisclosed locations in places with even fewer laws prohibiting torture.

I agree -- if anyone has that letter and chose to post it with details removed etc., that would be great. I'd like to see how far they go with their language in terms of threatening people. There is no doubt that ABEM does a lot of good for us as a profession, but stories like these make me think that some checks and balances in the system should be appropriate.

Anyone care to post?

 

[12R34Y]

Yes I agree the inservice was full of lots of bizarre questions-some not very relevant at all to emergency medicine! But oh well-that is how all standardized tests are!!!

gotta disagree there.

i thought the test was well written and very pertinent bread and butter EM for the most part.

later

 

[GeneralVeers]

gotta disagree there.

i thought the test was well written and very pertinent bread and butter EM for the most part.

later

I don't understand the EMS questions. Why are they on there? Does it matter to me if "first responders" know ACLS, BLS or how to put in IVs? How is this related to my clinical practice?

 

[FoughtFyr]

I don't understand the EMS questions. Why are they on there? Does it matter to me if "first responders" know ACLS, BLS or how to put in IVs? How is this related to my clinical practice?

Umm, if you are taking radio calls (a common EM task) you should probably know what skills the providers have...

Just a thought!

- H

 

[bulgethetwine]

Umm, if you are taking radio calls (a common EM task) you should probably know what skills the providers have...

Just a thought!

- H

Well, in theory, I take FF's point. But in reality, I agree with General for two points. First, even armed with that theoretical question, it seems to me that the skillset possessed by the first responder on the other end of the radio call varies from county to county, transport service to transport service, and maybe even individual by individual within the company. And second, I just don't think it passes the "bread and butter" test that most of the questions should be held to.

Yes, I know that a certain percentage of the questions have to be discriminators so that we don't all just score 100%, but I'd like to see them be more clinical minutiae as opposed to this stuff. If they are gonna test transport medicine/EMT type questions as discriminators, they could do a better job than the one referred to in the example. But overall, out of 225 questions, I thought this year's exam was pretty relevant, if not over dramatic.