Evaluating medical students on radiology clerkships in a filmless environment: Use of an electronic test prepared from PACS and digital teaching collection images

Rationale and Objectives. The competency of medical students in radiology c lerkships is traditionally evaluated with film images, projected slides of photographed films, or printed reproductions of films. As radiology departm ents switch to filmless imaging, it seemed appropriate to determine the fea sibility of an electronic evaluation prepared directly from digital images. Materials and Methods. The image-based portion of a multiple-choice final e xamination was prepared as a PowerPoint presentation that included images d ownloaded from the departmental picture archiving and communication system (PACS) or digital teaching collections. The images were downloaded as bitma p files, imported to Adobe Photoshop for image editing, converted to tagged image file format, and finally imported to PowerPoint, where they were com bined with text to create 50 questions. A liquid crystal diode projector di splayed the questions, with a timer set to advance them automatically. Results. The examination was easy and inexpensive to prepare (no photograph y costs). In an initial survey of 25 students, 17 (71%) of 24 students rate d the resolution of images as excellent and five (21%) as good. No student gave an image a poor rating. Students preferred that images cover at least 40%-50% of the slides, and most approved of a blue background. An original allowance of 30 seconds per slide was reported to be too fast; the interval was increased to 45 seconds. Conclusion. An electronic final examination for medical students, prepared with images downloaded from PACS or digital teaching collections. is feasib le, easy to prepare, and cost-effective, and it provides an excellent displ ay of test images.