title: Evaluating medical students on radiology clerkships in a filmless environment: use of an electronic test prepared from PACS and digital teaching collection images.
abstract: OBJECTIVE
  The competency of medical students in radiology clerkships is traditionally evaluated with film images, projected slides of photographed films, or printed reproductions of films. As radiology departments switch to filmless imaging, it seemed appropriate to determine the feasibility of an electronic evaluation prepared directly from digital images.
  
  
  METHODS
  The image-based portion of a multiple-choice final examination was prepared as a PowerPoint presentation that included images downloaded from the departmental picture archiving and communication system (PACS) or digital teaching collections. The images were downloaded as bitmap files, imported to Adobe Photoshop for image editing, converted to tagged image file format, and finally imported to PowerPoint, where they were combined with text to create 50 questions. A liquid crystal diode projector displayed the questions, with a timer set to advance them automatically.
  
  
  RESULTS
  The examination was easy and inexpensive to prepare (no photography costs). In an initial survey of 25 students, 17 (71%) of 24 students rated 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.
  
  
  CONCLUSIONS
  An electronic final examination for medical students, prepared with images downloaded from PACS or digital teaching collections, is feasible, easy to prepare, and cost-effective, and it provides an excellent display of test images.
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston 02114, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Mullins
authors.forename: M
authors.initials: M
authors.lastname: Will
authors.forename: A
authors.initials: A
authors.lastname: Mehta
authors.forename: R A
authors.initials: RA
authors.lastname: Novelline
mesh_terms: D002982:Clinical Clerkship / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D011871:Radiology / Q000193:education*; D014741:Video Recording